Type D personality and acceptance of illness in people with inflammatory bowel diseases. Mediating role of self-esteem


  • Olga Graf Polska Akademia Nauk
  • Beata A. Urbańska Polska Akademia Nauk
  • Patrycja Uram Polska Akademia Nauk

Słowa kluczowe:

self-esteem, acceptance of illness, type D personality



Type D personality is analyzed more and more frequently in the context of various chronic illnesses, including bowel diseases. Acceptance of illness is affected by many factors that facilitate adaptation to the difficulties and limitations and support the healing process. One of those factors may be self-esteem.

Participants and procedure

One hundred fifty-nine individuals, aged 18 to 65, participated in the study. 67% (n  =  107) stated that they have ulcerative colitis (UC), and the remaining 33% (n  =  52) reported suffering from Crohn’s disease (CD). The following measurement tools were used: Rosenberg Self-Esteem Scale (SES), Acceptance of Illness Scale (AIS), and Personality Type D Scale (D14).


The conducted analyses revealed significant correlations between all studied elements. Self-esteem was proven to be a full mediator in relations between one of the dimensions of type D personality, negative affectivity, as well as between both dimensions of type D personality (negative affectivity and social inhibition) and acceptance of illness in individuals with bowel diseases. However, mediation analysis did not confirm that self-esteem is a mediator between social inhibition and acceptance of illness.


The results show that self-esteem is, for an individual, an essential resource in coping with an illness and adjusting to it. Therefore, providing patient support in the scope of reinforcing self-esteem may prove to be one of the key elements affecting illness acceptance.


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Basińska, M., & Andruszkiewicz, A. (2016). Cechy osobowości typu D a funkcjonowanie w chorobie pacjentów z chorobami przewlekłymi [Type D personality traits and disease functioning in patients with chronic diseases]. Polskie Forum Psychologiczne, 22, 221–237.

Bisschop, M. I., Kriegsman, D. M. W., Beekman, A. T. F., & Deeg, D. J. H. (2004). Chronic diseases and depression: The modifying role of psychosocial resources. Social Science & Medicine, 59, 721–733. https://doi.org/10.1016/j.socscimed.2003.11.038.

Byron, C., Cornally, N., Burton, A., & Savage, E. (2020). Challenges of living with and managing inflammatory bowel disease: a meta‐synthesis of patients’ experiences. Journal of Clinical Nursing, 29, 305–319. https://doi.org/10.1111/jocn.15080.

Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159. https://doi.org/10.1037/0033- 2909.112.1.155.

Cybulski, M., Cybulski, L., Krajewska-Kulak, E., & Cwalina, U. (2017). Illness acceptance, pain perception and expectations for physicians of the elderly in Poland. BMC Geriatrics, 17, 46. https://doi. org/10.1186/s12877-017-0441-4.

Denollet, J. (1998). Personality and coronary heart disease: The Type-D Scale-16 (DS16). Annals of Behavioral Medicine, 20, 209–215. https://doi.org/10.1007/ BF02884962.

Denollet, J. (2005). DS14: Standard assessment of negative affectivity, social inhibition, and type D personality. Psychosomatic Medicine, 67, 89–97. https:// doi.org/10.1097/01.psy.0000149256.81953.49.

Fakhoury, M., Al-Salami, H., Negrulj, R., & Mooranian, A. (2014). Inflammatory bowel disease: Clinical aspects and treatments. Journal of Inflammation Research, 7, 113–120. https://doi.org/10.2147/JIR.S65979.

Felton, B. J., Revenson, T. A., & Hinrichsen, G. A. (1984). Stress and coping in the explanation of psychological adjustment among chronically ill adults. Social Science & Medicine, 18, 889–898. https://doi.org/10.1016/0277-9536(84)90158-8.

Goodhand, J. R., Wahed, M., Mawdsley, J. E., Farmer, A. D., Aziz, Q., & Rampton, D. S. (2012). Mood disorders in inflammatory bowel disease: Relation to diagnosis, disease activity, perceived stress, and other factors. Inflammatory Bowel Diseases, 18, 2301–2309. https://doi.org/10.1002/ibd.22916.

Goodhand, J., & Rampton, D. (2008). Psychological stress and coping in IBD. Gut, 57, 1345–1347. https://doi.org/10.1136/gut.2008.154229.

Greenley, R. N., Hommel, K. A., Nebel, J., Raboin, T., Li, S. H., Simpson, P., & Mackner, L. (2010). A meta-analytic review of the psychosocial adjustment of youth with inflammatory bowel disease. Journal of Pediatric Psychology, 35, 857–869. https:// doi.org/10.1093/jpepsy/jsp120.

Hayes, A. F. (2012). PROCESS: a versatile computational tool for observed variable mediation, moderation, and conditional process modeling. Retrieved from http://www.afhayes.com/ public/process2012.pdf.

Hogg, M. A., & Vaughan, G. M. (2011). Self and identity. In G. M. Vaughan & M. A. Hogg (Eds.), Social psychology (Vol. 6, pp. 111–146). NY Pearson Prentice Hall.

Huis in ’t Veld, E. M. J., Vingerhoets, A. J. J. M., & Denollet, J. (2011). Attachment style and self-esteem: The mediating role of type D personality. Personality and Individual Differences, 50, 1099–1103. https://doi.org/10.1016/j.paid.2011.01.034.

Janke, K. H., Klump, B., Gregor, M., Meisner, C., & Haeuser, W. (2005). Determinants of life satisfaction in inflammatory bowel disease. Inflammatory Bowel Diseases, 11, 272–286. https://doi. org/10.1097/01.MIB.0000160809.38611.f7.

Juczyński, Z. (2012). Narzędzia pomiaru w promocji i psychologii zdrowia [Measurement tools in health promotion and psychology]. Pracownia Testów Psychologicznych PTP.

Juczyński, Z., & Ogińska-Bulik, N. (2012). Narzędzia pomiaru stresu i radzenia sobie ze stresem [Measurement tools in stress and coping tools]. Pracownia Testów Psychologicznych PTP.

Juth, V., Smyth, J. M., & Santuzzi, A. M. (2008). How do you feel? Self-esteem predicts affect, stress, social interaction, and symptom severity during daily life in patients with chronic illness. Journal of Health Psychology, 13, 884–894. https://doi. org/10.1177/1359105308095062.

Kiebles, J. L., Doerfler, B., & Keefer, L. (2010). Preliminary evidence supporting a framework of psychological adjustment to inflammatory bowel disease. Inflammatory Bowel Diseases, 16, 1685–1695. https://doi.org/10.1002/ibd.21215.

Krajewski, W., Mazur, M., Poterek, A., Pastuszak, A., Halska, U., Tukiendorf, A., Rymaszewska, J., & Zdrojowy, R. (2018). Assessment of pain management, acceptance of illness, and adjustment to life with cancer in patients with nonmuscle invasive bladder cancer. BioMed Research International, 2018, 7598632. https://doi.org/10.1155/2018/ 7598632.

Larsson, K., Lööf, L., & Nordin, K. (2017). Stress, coping and support needs of patients with ulcerative colitis or Crohn’s disease: a qualitative descriptive study. Journal of Clinical Nursing, 26, 648–657. https://doi.org/10.1111/jocn.13581.

Łaguna, M., Lachowicz-Tabaczek, K., & Dzwonkowska, I. (2007). Skala samooceny SES Morrisa Rosenberga – polska adaptacja metody [Rosenberg Self-Esteem Scale: Polish adaptation of the scale] Psychologia Społeczna, 2, 164–176.

Maunder, R. G., & Levenstein, S. (2008). The role of stress in the development and clinical course of inflammatory bowel disease: Epidemiological evidence. Current Molecular Medicine, 8, 247–252. https://doi.org/10.2174/156652408784533832.

Mawdsley, J. E., & Rampton, D. S. (2006). The role of psychological stress in inflammatory bowel disease. Neuroimmunomodulation, 13, 327–336. https://doi.org/10.1159/000104861.

McDermott, E., Mullen, G., Moloney, J., Keegan, D., Byrne, K., Doherty, G. A., Cullen, G., Malone, K., & Mulcahy, H. E. (2015). Body image dissatisfaction: Clinical features, and psychosocial disability in inflammatory bowel disease. Inflammatory Bowel Diseases, 21, 353–360. https://doi.org/10.1097/ MIB.0000000000000287.

Moreno-Jiménez, B., López Blanco, B., RodríguezMuñoz, A., & Garrosa Hernández, E. (2007). The influence of personality factors on health-related quality of life of patients with inflammatory bowel disease. Journal of Psychosomatic Research, 62, 39– 46. https://doi.org/10.1016/j.jpsychores.2006.07.026.

Morys, J. M., Kaczówka, A., & Jeżewska, M. (2016). Assessment of selected psychological factors in patients with inflammatory bowel disease. Gastroenterology Review, 1, 47–53. https://doi.org/10.5114/ pg.2015.52560.

Moss-Morris, R. (2013). Adjusting to chronic illness: Time for a unified theory. British Journal of Health Psychology, 18, 681–686. https://doi.org/10.1111/ bjhp.12072.

Ogińska-Bulik, N. (2009). Osobowość typu D – teoria i badania [Type D personality – theory and research]. WSHE.

Ogińska-Bulik, N., Juczyński, Z., & Denollet, J. (2012). DS14 – skala do pomiaru typu D [DS14 – scale for measurement type D]. In Z. Juczyński & N. Ogińska-Bulik (Eds.), Narzędzia pomiaru stresu i radzenia sobie ze stresem [Measurement tools in stress and coping tools] (pp. 71–85). Pracownia Testów Psychologicznych PTP.

Opheim, R., Moum, B., Grimstad, B. T., Jahnsen, J., Prytz Berset, I., Hovde, Ø., Huppertz-Hauss, G., Bernklev, T., & Jelsness-Jørgensen, L. P. (2020). Self-esteem in patients with inflammatory bowel disease. Quality of Life Research, 29, 1839–1846. https://doi.org/10.1007/s11136-020-02467-9.

Pellissier, S., Dantzer, C., Canini, F., Mathieu, N., & Bonaz, B. (2010). Psychological adjustment and autonomic disturbances in inflammatory bowel diseases and irritable bowel syndrome. Psychoneuroendocrinology, 35, 653–662. https://doi.org/ 10.1016/j.psyneuen.2009.10.004.

Polak, E. J., O’Callaghan, F., & Oaten, M. (2020). Perceptions of IBD within patient and community samples: a systematic review. Psychology & Health, 35, 425–448. https://doi.org/10.1080/088 70446.2019.1662014.

Rampton, D. (2009). Does stress influence inflammatory bowel disease? The clinical data. Digestive Diseases, 27, 76–79. https://doi.org/10.1159/000268124.

Rosenberg, M. (1965). Society and the adolescent selfimage. Princeton University Press.

Sajadinejad, M. S., Molavi, H., Asgari, K., Kalantari, M., & Adibi, P. (2012). Personality dimensions and type D personality in female patients with ulcerative colitis. Journal of Research in Medical Sciences, 17, 898–904.

Sgambato, D., Miranda, A., Ranaldo, R., Federico, A., & Romano, M. (2017). The role of stress in inflammatory bowel diseases. Current Pharmaceutical Design, 23, 3997–4002. https://doi.org/10.2174/138 1612823666170228123357.

Taft, T. H., Keefer, L., Artz, C., Bratten, J., & Jones, M. P. (2011). Perceptions of illness stigma in patients with inflammatory bowel disease and irritable bowel syndrome. Quality of Life Research, 20, 1391– 1399. https://doi.org/10.1007/s11136-011-9883-x.

Taft, T. H., Keefer, L., Leonhard, C., & NealonWoods, M. (2009). Impact of perceived stigma on inflammatory bowel disease patient outcomes. Inflammatory Bowel Diseases, 15, 1224–1232. https:// doi.org/10.1002/ibd.20864.

Telford, K., Kralik, D., & Koch, T. (2006). Acceptance and denial: Implications for people adapting to chronic illness – literature review. Journal of Advanced Nursing, 55, 457–464. https://doi.org/10.1111/j.1365- 2648.2006.03942.x.

Triantafillidis, J. K., Merikas, E., & Gikas, A. (2013). Psychological factors and stress in inflammatory bowel disease. Expert Review of Gastroenterology & Hepatology, 7, 225–238. https://doi.org/10.1586/ egh.13.4.

Watson, D., & Pennebaker, J. W. (1989). Health complaints, stress, and distress: Exploring the central role of negative affectivity. Psychological Review, 96, 234–254. https://doi.org/10.1037/0033-295x.96.2.234.



Jak cytować

Graf, O., Urbańska, B. A., & Uram, P. (2021). Type D personality and acceptance of illness in people with inflammatory bowel diseases. Mediating role of self-esteem. Current Issues in Personality Psychology, 9(3), 205–214. Pobrano z https://czasopisma.bg.ug.edu.pl/index.php/CIiPP/article/view/6049