Aims: The main objective of this research was to determine if Type D personality predicts distress in Heart failure (HF) patients. The study also sought to examine whether there is a relationship between Type D personality, coping and psychological distress in this cardiac patient group. Method: A cross-sectional, quantitative design was used. 72 (58 %) with HF between September 2005 and March 2006 completed questionnaires in the outpatient clinic of a cardiology department. The DS14 questionnaire was used to measure Type D personality (predictor variable), the Hospital Anxiety and Depression Scale (HADS) measured psychological distress (outcome variable) and the Brief COPE inventory was the measure of coping used (mediator variable) of this HF patient sample. Main analyses: An ANOVA test investigated whether Type D predicted distress. The mediational regression model (National Institute for Clincial Excellence, 1986) was used to analyse the relationships between the three variables. Results: Type D significantly predicted depression (p