Type A Behavior, Self-Involvement, and Coronary Atherosclerosis

Abstract

Prior to coronary angiography, 150 men were assessed for Type A behavior using the structured interview and two questionnaire measures. The results show no relationship between Type A behavior and extent of coronary artery disease (CAD). A second finding is that the number of self-references (I, me, my) derived from speech in the structured interview correlated positively with the number of previous myocardial infarctions and the extent of CAD; self-references correlated negatively with time on the treadmill and catheterization ejection fraction. Multiple regression analyses show self-references to remain a significant correlate of extent of disease when controlled for age, blood pressure, cholesterol, and Type A behavior.

Components of Type A, Hostility, and Anger-In: Relationship to Angiographic Findings

“…Of the entire sample, 23 patients (17.6%) were classified as Type B, 26 (19.8%) as Type X, 65 (49.6%) as Type A 2 , and 17 (13.0%) as Type A^ This distribution was generally similar to that observed in previous studies of angiography patients (9)(10)(11)15,16), except that a somewhat larger percentage of patients was observed in the Type X category at the expense of the Type B group. Descriptive data for each of the Type A components and interrater reliability coefficients for the entire sample are presented in Table 2.…”

“…Together, these findings have supported the risk factor status of the TABP for CHD (6). It is important to note, however, that several studies have failed to uncover an association between the TABP and arteriographically documented severity of coronary artery disease (CAD), using either the Jenkins Activity Survey (JAS) (10,11,13) or the Structured Interview (SI) method of assessment (14)(15)(16)(17). Moreover, because some studies have reported a significant association between Si-defined TABP and CHD, but not JAS-defined TABP in the same sample (10,11), it is clear that some aspects of the TABP are probably more important than others in mediating an association between globally defined TABP and CHD endpoints.…”

The Type A Behavior Pattern and Carotid Artery Atherosclerosis

“…The correlation of age and Type A scores (r = 0.44, p < 0.10) in the nondiseased group was significantly different from the correlations in the moderate (Z = 2.04, p< 0.05) and the severe disease (Z = 2.32, p< 0.02) groups (33). Although these analyses are post hoc and necessarily tentative, they do have implications for studies that have failed to find an association between coronaryprone behavior and severity of coronary atherosclerosis (9,10). That is, while these studies found no association between level of disease and A -B scores, one might expect different correlations between Type A scores and age within subjects grouped by level of disease.…”

“…Using coronary angiography as the method to quantify the narrowing of the coronary artery lumen, these studies typically have demonstrated that Type A individuals have a significantly greater likelihood of developing coronary artery disease. Two studies have failed to find a relationship between the coronary-prone behavior pattern and degree of atherosclerosis (9,10), however, these studies differ from the above in important ways such as the criterion for diagnosis of the presence of disease. Thus, while the evidence is inconsistent, it is accurate to say that in some circumstances the coronary-prone behavior pattern increases the risk for CHD by promoting or accelerating atherosclerosis (6)(7)(8).…”

A Brief History of Mind-Body Medicine

“…This approach seeks to demonstrate that mental dysfunction accompanied by persistent psychological distress is a contributing factor to biological dysfunction. There is an extensive literature on this approach (Scherwitz et al, 1983;Rose, 1980;Schnall, Landsbergis, & Baker, 1994), and this research will not be reviewed here. The second perspective aims at directly measuring the subjective and objective results of consciousness-based interventions on measurable mental and biological factors.…”