Effect of Level of Challenge on Pressor and Heart Rate Responses in Type A and B Subjects¹

Abstract

The present study examined the relationship between the Type A coronaryprone behavior pattern and the magnitude of cardiovascular response induced by varying levels of environmental challenge. In a 2 × 2 experimental design, Type A and B (noncoronary‐prone) subjects (n= 80) were randomly assigned to either high or low challenge instructional conditions for both the cold pressor (CP) and a choice reaction time task (RT). Overall, across both tasks, Type A subjects responded with greater systolic blood pressure (SBP) and heart rate (HR) elevation than Type B subjects. While these differences between the Types tended to be larger in the high challenge condition, some differences were also observed under low challenge. Component analyses of the Pattern revealed that high hostile/competitive Type A's responded to both low and high challenge instructions in the CP and RT tasks with physiologic elevations comparable to that displayed by globally defined Type A's receiving high challenge instructions. The present findings tentatively suggest that (a) high hostile/competitive Type A's respond to even mild challenge with enhanced physiologic response; (b) globally defined A's tend to evidence the physiologic elevations when specifically challenged; and (c) Type B's show much smaller physiologic reactions to such challenges. Consistent with previous research, comparison of Type A assessment techniques revealed that the Rosenman diagnostic interview was a better predictor of physiologic response than other questionnaire methods. Two hypotheses are advanced and future research recommended regarding possible relationships between environment, behavior, physiology, and disease.

Type A Behaviour, Attention, and the Report of Subjective Arousal

“…This finding was consistent with those of previous research [4][5][6][7][8][9][10][11], This increased level of physiological arousal in type As relative to type Bs was at variance with the data pertaining to selfreported physical symptoms and state anxi ety. Viewed in the context of their greater HR and SBP change, the lower anxiety and physical symptom report, and particularly the lower heart-racing report by type As, sup ports previous findings of their tendency to underreport physical and emotional symp toms [6][7][8][11][12][13].…”

“…The type A behaviour pattern (TABP) [1], which is characterized by the well-defined attributes of excessive competitive drive, hostility, aggressiveness and a sense of time urgency [2], has been shown to relate to cor onary heart disease (CHD) in both prospec tive studies and retrospective ones [3], The mechanisms by which the TABP is linked with CHD arc as yet incompletely under stood but central to the argument is the gen eral hypothesis that at least some situations, particularly those perceived by the individ ual as threatening and competitive, have the capacity to challenge those with the TABP in such a way as to cause exaggerated physio logical activation [4][5][6][7][8][9][10][11]. The risk for CHD implied by such physiological responses has been argued to be exacerbated by type As' tendency to fail to recognize or at least re port these symptoms of physical distress [ 12,13], thus making As less likely to seek medi cal attention or to take other forms of reme dial action.…”

Type A Behavior and Coronary Artery Bypass Surgery: Intraoperative Blood Pressure and Perioperative Complications

“…Moreover, even after disease is manifest, A-B differences in cardiovascular reactivity can still be observed (17,18), suggesting that these mechanisms remain active and may possibly influence the course of the disease and subsequent clinical outcomes.…”

Investigation of the Laterality of Hostility, Cardiovascular Regulation, and Auditory Recognition

“…This requires participants to place their hand in cold water yielding heightened arousal and cardiovascular reactivity (e.g., Glass, McKinney, Hofschire, & Fedorko, 1990). Further, it has been shown that high-hostile individuals evidence greater cardiovascular reactivity (BP and HR) to the cold pressor task than low-hostile individuals (Dembroski, MacDougall, Herd, & Shields, 1979). More recently, Demaree and Harrison (1997) suggested that because stressful cardiovascular measures may tap right cerebrum activity, the effects of stress and arousal on hostile individuals may best be accounted for by right cerebrum reactivity.…”