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. 2025 Aug 5:16:1628451.
doi: 10.3389/fpsyg.2025.1628451. eCollection 2025.

Type D personality and fear of progression among patients with first-ever stroke: the serial mediation role of perceived social support and intolerance of uncertainty

Xiaoping Yang  1 , Lijun Wang  2 , Xiaohui Liu  2 , Miaomiao Chen  2 , Yingjie Zheng  2 , Shailing Ma  2 , Jialin Yuan  2 , Huijuan Wang  2
Affiliations

Type D personality and fear of progression among patients with first-ever stroke: the serial mediation role of perceived social support and intolerance of uncertainty

Xiaoping Yang et al. Front Psychol. .

Abstract

Objective: Fear of progression (FoP) significantly impacts multidimensional health outcomes in stroke patients. Although Type D personality predicts FoP, mechanisms underlying the association between Type D personality and FoP remain poorly understood. This study aimed to investigate the impact of Type D personality on FoP in first-ever stroke patients and the serial mediation role of perceived social support (PSS) and intolerance of uncertainty (IU).

Methods: This cross-sectional study employed convenience sampling to recruit 300 patients with first-ever stroke (228 males and 72 females; mean age 59.52 ± 12.72 years) from two tertiary hospitals in Yinchuan, China. Participants completed the following scales: the General Information Questionnaire, the 14-item Type D scale, the Multidimensional Scale of Perceived Social Support, the Intolerance of Uncertainty Scale-12, and the Fear of Progression Questionnaire-Short Form. SPSS 24.0 was used for Harman's single-factor test, descriptive statistics, Pearson correlation analysis, and regression analysis, with serial mediation role examined using the PROCESS macro v3.5.

Results: Our results showed that: (1) the direct effect of Type D personality on FoP was significant. (2) PSS did not independently mediate the Type D personality-FoP relationship. (3) IU significantly mediated the Type D personality-FoP relationship. (4) PSS and IU demonstrated the significant serial mediation role between Type D personality and FoP.

Conclusion: Type D personality exerted a direct effect on FoP among first-ever stroke patients. The serial mediation model demonstrated that enhancing PSS could reduce IU, thereby alleviating FoP. Interventions targeting PSS enhancement and IU reduction constitute a promising approach to mitigate FoP in these patients, despite Type D traits' inherent stability.

Keywords: fear of progression; intolerance of uncertainty; perceived social support; serial mediation role; stroke; type D personality.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Hypothetical model.
Figure 2
Figure 2
Serial mediation model (***p < 0.001, **p < 0.0.1, and *p < 0.05).
See this image and copyright information in PMC

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