Generalizability and durability of treatment effects in an intervention program for coronary-prone (type A) managers

Abstract

To test the reliability and durability of positive treatment effects obtained in a type A intervention project for healthy managers, the analysis was extended to data available from a third treatment group (a special behavior therapy group for participants eliminated from the main sample because of manifestations of clinical CHD) and to measures obtained 6 months following the end of treatment. Immediately after treatment all three groups showed a similar pattern of improvement, although the two behavior therapy groups did show a greater decrease in serum cholesterol levels. Six months after treatment the sample as a whole showed good maintenance of treatment effects, but the differences between groups had become somewhat sharper, with the special behavior therapy group faring best, the regular behavior therapy group intermediate, and the psychotherapy group worst. The logical consistency of these findings increases our confidence in the initial treatment results, as well as permitting cautious optimism concerning the possibility of developing effective intervention programs for coronary-type (type A) behavior.

Behavioral Interventions and Compliance to Treatment Regimes

“…It is encourag ing that several studies utilized Applied Analysis of Behavior to expedite the intervention process or recognized that the demands of the behav ior change process should be recognized and dealt with (e.g. giving up Type A behavior may be very anxiety provoking) (41,42,47). Some re searchers not only recognized the demand characteristics of the interven tion, but attempted to control for their contaminating effect on out come (44,46).…”

Effects of two self-control procedures on modifying type a behavior

“…Although behavioral approaches with self-control components seem to be most effective, the best method for intervention has not been identified. Roskies (1979) indicated that it was important to distinguish key pathogenic elements in the TABP. The hard-driving/competitive factor and the speed/impatience factor showed the highest association with CHD among the Type A dimensions (Matthews, Glass, Rosenman, & Bortner, 1977).…”

Can the Type A Behavior Pattern be Altered after Myocardial Infarction? A Second Year Report from the Recurrent Coronary Prevention Project

“…Few Type A intervention studies have been conducted (2)(3)(4)(5)(6)(7). Those Received for publication May 20, 1983; revision received February 21, 1984. done used the same general approach.…”

“…Those Received for publication May 20, 1983; revision received February 21, 1984. done used the same general approach. Following the hypothesis that the pathway leading from behavior to CHD is the chronic sympathetic nervous system arousal accompanying chronic Type A hyperreactivity (1), targets of treatment were to reduce the frequency, intensity, and duration of physiologic (2)(3)(4)(5)(6)(7), cognitive (4)(5)(6)(7), and/or behavioral (2,6) hyperreactivity. The most common research design evaluated the effectiveness with which a variety of therapeutic approaches [e.g., physical relaxation (2)(3)(4)(5)(6), cognitive self-instruction (7), insight (4,5), group support (6)] reduced Type A hyperreactivity in small groups of subjects (from 14 to 42) over short periods of time (from 5 to 14 hr).…”

“…Following the hypothesis that the pathway leading from behavior to CHD is the chronic sympathetic nervous system arousal accompanying chronic Type A hyperreactivity (1), targets of treatment were to reduce the frequency, intensity, and duration of physiologic (2)(3)(4)(5)(6)(7), cognitive (4)(5)(6)(7), and/or behavioral (2,6) hyperreactivity. The most common research design evaluated the effectiveness with which a variety of therapeutic approaches [e.g., physical relaxation (2)(3)(4)(5)(6), cognitive self-instruction (7), insight (4,5), group support (6)] reduced Type A hyperreactivity in small groups of subjects (from 14 to 42) over short periods of time (from 5 to 14 hr). Reductions in the type A behavior pattern (TABP) were assessed using Type A questionnaires [e.g., the Jenkins Activity Survey (3)(4)(5)(6), the Framingham Type A Behavior Scale (6), the Bortner Type A Rating Scale (7), Type A components questionnaires (e.g., the Novaco Anger Scale (6), the Thurstone Adjective Checklist (6)], and measures of psychologic distress [e.g., the State-Trait Anxiety Inventory (3,5)].…”