We used three methods to investigate the internal structure of the DS14 items using data collected in representative samples from the Dutch general population (N = 3,181). The methods were exploratory factor analysis, confirmatory factor analysis, and Mokken scale analysis.
Exploratory factor analysis suggested a two-factor structure without evidence of the low-level factors, and the other two methods showed evidence of a three-level structure including the low-level factors.
A two-factor model with correlated errors for items defining low-level traits adequately describes the data. The results support the three-level hierarchical model as a conceptual model for Type D personality, and support the interpretation of DS14 scores on item subsets representing medium-level traits and low-level traits.