Significant differences in perceptions on cause of disease between Type Ds and non-Type Ds were found for psychological distress (16.2 vs. 10.9%; p<0.01), randomness (1.7 vs. 5.3%; p<0.01) and unknown (18.8 vs. 24.4%; p<0.01). Multivariate analyses showed that Type D was negatively associated with 'coherence' and positively with 'consequences', 'timeline', 'identity', 'concern', and 'emotional representation'. CONCLUSIONS: These results elucidate the associations between personality and illness perceptions, demonstrating their close interrelatedness. Our study may be helpful in further developing theoretical models regarding giving meaning to illness and the illness perceptions that the illness elicits. Future studies should investigate whether interventions can positively impact illness perceptions of Type D cancer patients.