Skip to main content
Log in

Type A behavior as a general risk factor for physical disorder

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

A behavior pattern characterized by excessive competitiveness, impatience, hostility, and time urgency, known as Type A, has typically been investigated as a risk factor for coronary heart disease. The present paper evaluates the Type A pattern as a general risk factorfor a wide variety of physical disorders. Research on Type A as a moderator of the effects of life stress on health is also reviewed. When Type A or physical health is measured with objective indicators, Type A does not emerge as a general risk factor for illness, with the following exceptions: Type A's are more likely to have accidents, to die from accidents or violence, and to incur cerebrovascular and peripheral atherosclerosis. In contrast, research relying on self-report measures of Type A and symptomatology find a consistent link between Type A behavior and a variety of minor illness and symptoms. There is little support for the notion that Type A is a potentiator of the effects of life events stress.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Ader, R., and Cohen, N. (1984). Behavior and the immune system. In Gentry, W. D. (ed.)Handbook of Behavioral Medicine, Guilford, New York, pp. 117–173.

    Google Scholar 

  • Barefoot, J. C., Dahlstrom, W. G., and Williams, R. B. (1983). Hostility, CHD incidence, and total mortality: A 25-year follow-up study of 255 physicians.Psychosom. Med. 45: 59–63.

    Google Scholar 

  • Barton, S., Brautigam, M., Fogle, G., Freitas, and Hicks, R. A. (1982). Type A-B behavior and the incidence of allergies in college students.Psychol. Rep. 50: 566.

    Google Scholar 

  • Booth-Kewley, S., and Friedman, H. (1987). Psychological predictors of heart disease: A quantitative review.Psychol. Bull. 101: 343–359.

    Google Scholar 

  • Bortner, R. W. (1969). A short rating scale as a potential measure of pattern A behavior.J. Chron. Dis. 22: 87–91.

    Google Scholar 

  • Burke, R. J., and Weir, T. (1980). The Type A experience: Occupational and life demands, satisfaction and well-being.J. Hum. Stress 6: 28–38.

    Google Scholar 

  • Bryne, D. G., and Rosenman, R. H. (1986). Type A behavior and the experience of affective discomfort.J. Psychosom. Res. 30: 663–672.

    Google Scholar 

  • Carmody, T. P., Hollis, J. F., Matarazzo, J. D., Fey, S. G., and Connor, W. E. (1984). Type A behavior, attentional style, and symptom reporting among adult men and women.Health Psychol. 3: 45–61.

    Google Scholar 

  • Carver, C. S., Coleman, A. E., and Glass, D. C. (1976). The coronary-prone behavior pattern and the suppression of fatigue on a treadmill test.J. Person. Soc. Psychol. 36: 361–366.

    Google Scholar 

  • Cassell, J. (1976). The contribution of the social environment to host resistance.Am. J. Epidemiol. 104: 107–123.

    Google Scholar 

  • Cline, D. W., and Chosey, J. J. (1972). A prospective study of life changes and subsequent health changes.Arch. Gen. Psychiat. 27: 51–53.

    Google Scholar 

  • Cobb, S. (1976). Social support as a moderator of life stress.Psychosom. Med. 38: 300–314.

    Google Scholar 

  • Cohen, S., and Wills, T. A. (1985). Stress, social support, and the buffering hypothesis.Psychol. Bull. 98: 310–357.

    Google Scholar 

  • Cooke, W., and Medley, D. (1954). Proposed hostility and pharasaic-virtue scales for the MMPI.J. Appl. Psychol. 38: 414–418.

    Google Scholar 

  • Cooper, H. (1982). Scientific guidelines for conducting integrative research reviews.Rev. Educ. Res. 52: 442–449.

    Google Scholar 

  • Cooper, T., Detre, T., and Weiss, S. M. (Eds.). (1981). Coronary prone behavior and coronary heart disease: A critical review.Circulation 63: 1199–1215.

    Google Scholar 

  • Costa, P. T., and McCrae, R. R. (1985). Hypochondriasis, neuroticism, and aging: When are the somatic complaints unfounded?Am. Psychol. 40: 19–28.

    Google Scholar 

  • Cottier, C., Adler, R., Vorkauf, H.,et al. (1983). Pressured pattern of Type A behavior in patients with peripheral arteriovascular disease: Controlled retrospective exploratory study.Psychosom. Med. 45: 187–193.

    Google Scholar 

  • Dembroski, T. M., and Costa, P. (1987). Coronary-prone behavior: Components of the Type A pattern and hostility.J. Personal. 55: 211–236.

    Google Scholar 

  • Dembroski, T. M., Weiss, S. M., Shields, J. L., Haynes, S. G., and Feinleib, M. (eds.) (1978).Coronary-Prone Behavior, Springer-Verlag, New York.

    Google Scholar 

  • Dembroski, T. M., MacDougall, J. M., Herd, J. A., and Shields, J. L. (1979). Effects of level of challenge on pressor and heart response in Type A and B subjects.J. Appl. Soc. Psychol. 9: 209–228.

    Google Scholar 

  • Dembroski, T. M., MacDougall, T. M., Slaats, S., Eliot, R. S., and Buell, J. C. (1983). Challenge-induced cardiovascular response as predictor of minor illnesses.J. Hum. Stress 9: 2–5.

    Google Scholar 

  • Dembroski, T. M., MacDougall, J. M., Williams, R. B., Haney, T. L., and Blumenthal, J. A. (1985). Components of Type A, hostility, and anger-in: Relationship to angiographic findings.Psychosom. Med. 47: 219–233.

    Google Scholar 

  • Depue, R. A., and Monroe, S. M. (1986). Conceptualization and measurement of human disorder in life stress research: The problem of chronic disturbance.Psychol Bull. 99: 36–51.

    Google Scholar 

  • Eagleston, J. R., Kirmil-Gray, K., Thoresen, C. E., Wiedenfeld, S. A., Bracke, P., Heft, L., and Arrow, B. (1987). Physical health correlates of Type A behavior in children and adolescents.J. Behav. Med. 9: 341–362.

    Google Scholar 

  • Eaker, E. D., Feinleib, M., and Wolf, P. (1983). Psychosocial factors and the ten-year incidence of cerebrovascular accident in the Framingham Heart Study.Am. Heart Assoc. CVD Epid Newslett. 33: 54 (abstr.)

    Google Scholar 

  • Evans, G. W., Palsane, M. N., and Carrere, S. (1987). Type A behavior and occupational stress: A cross-cultural study of blue-collar workers.J. Personal. Soc. Psychol. 36: 1213–1220.

    Google Scholar 

  • Eysenck, H., and Eysenck, S. B. G. (1968).Eysenck Personality Inventory, Educational and Testing Service, San Diego, Calif.

    Google Scholar 

  • Friedman, M., and Rosenman, R. H. (1959). Association of a specific overt behavior pattern with blood and cardiovascular findings—blood cholesterol level, blood clotting time, incidence of arcus senilis, and clinical coronary artery disease.JAMA 169: 1286–1296.

    Google Scholar 

  • Friedman, M., and Rosenman, R. H. (1974).Type A Behavior and Your Heart, Fawcett, Greenwich, Conn.

    Google Scholar 

  • Gentry, W. D., Jenkins, C. D., Kaplan, B. H., Heyman, A., Breslin, M. S., and Gianturco, D. T. (1979). Type A behavior pattern and ischemic cerebrovascular disease.Heart Lung 8: 113–116.

    Google Scholar 

  • Glass, D. C. (1977).Behavior Patterns, Stress, and Coronary Disease, Erlbaum, Hillsdale, N.J.

    Google Scholar 

  • Glass, G. V. (1977). Integrating findings: The meta-analysis of research.Rev. Res. Educ. 5: 351–379.

    Google Scholar 

  • Hart, K. E. (1983). Physical symptom reporting and health among Type A and Type B college males.J. Hum. Stress 9: 17–22.

    Google Scholar 

  • Haynes, S. G., Levine, S., Scotch, N. A., Feinleib, M., and Kannel, W. B. (1978). The relationship of psychosocial factors to coronary heart disease in the Framingham Study. I. Methods and risk factors.Am. J. Epidemiol. 107: 362–383.

    Google Scholar 

  • Haynes, S. G., Feinleib, M., and Kannel, W. B. (1980). The relationship of psychosocial factors to coronary heart disease in the Framingham Study. III. Eight-year incidence of coronary heart disease.Am. J. Epidemiol. 3: 37–58.

    Google Scholar 

  • Hedges, L. V. (1982). Fitting categorical models to effect sizes from a series of experiments.J. Educ. Stat. 7: 119–137.

    Google Scholar 

  • Hicks, R. A., and Campbell, J. (1983). Type A-B behavior and self-estimates of the frequency of headaches in college students.Psychol. Rep. 52: 912.

    Google Scholar 

  • Howard, J. H., Cunningham, D. A., and Rechnitzer, P. A. (1976). Health patterns associated with Type A behavior: A managerial population.J. Hum. Stress 2: 24–31.

    Google Scholar 

  • Ivancevich, J. M., Matteson, M. T., and Preston, C. (1982). Occupational stress, Type A behavior, and physical well being.Acad. Manage. J. 373–391.

  • Jemmott, J. B., and Locke, S. E. (1984). Psychosocial factors, immunologic mediation, and human susceptibility to infectious diseases: How much do we know?Psychol. Bull. 95: 78–108.

    Google Scholar 

  • Jenkins, C. D., Rosenman, R. H., and Zyzanski, S. J. (1974). Prediction of clinical coronary heart disease by a test for the coronary-prone behavior pattern.N. Engl. J. Med. 290: 1271–1275.

    Google Scholar 

  • Kelly, K. E., and Houston, B. K. (1985). Type A behavior in employed women: Relation to work, marital, and leisure variables, social support, stress, tension, and health.J. Personal. Soc. Psychol. 48: 1067–1079.

    Google Scholar 

  • Kobasa, S. C. (1979). Stressful life events, personality and health: An inquiry into hardiness.J. Personal. Soc. Psychol. 37: 1–11.

    Google Scholar 

  • Kobasa, S. C., Maddi, S. R., and Zola, M. A. (1983). Type A and hardiness.J. Behav. Med. 6: 41–51.

    Google Scholar 

  • Krantz, D. S., and Manuck, S. B. (1984). Acute psychophysiologic reactivity and risk of cardiovascular disease: A review and methodological critique.Psychol. Bull. 96: 435–464.

    Google Scholar 

  • Krantz, D. S., Sanmarco, M. E., Selvester, R. H., and Matthews, K. A. (1979). Psychological correlates of progression of atherosclerosis in men.Psychosom. Med. 41: 467–475.

    Google Scholar 

  • LaRue, A., Bank, L., Jarvik, L., and Hetland, M. (1979). Health in old age: How do physicians' ratings and self-ratings compare?J. Gerontol. 34: 687–691.

    Google Scholar 

  • Linn, B. S., and Linn, M. W. (1980). Objective and self-assessed health in the old and very old.Soc. Sci. Med. 14: 311–315.

    Google Scholar 

  • Lundberg, P. K., and Paludi, M. A. (1981). Type A behavior patterns and the reporting of lifetime symptomatology.Percept. Motor Skills 52: 473–474.

    Google Scholar 

  • Lundberg, U. (1980). Type A behavior and its relation to personality variables in Swedish male and female university students.Scand. J. Psychol. 21: 133–138.

    Google Scholar 

  • MacDougall, J. M., Dembroski, T. M., Dimsdale, J. E., and Hackett, T. (1985). Components of Type A, hostility, and anger-in: Further relationships to angiographic findings.Health Psychol. 4: 137–152.

    Google Scholar 

  • Maddox, G. L., and Douglas, E. B. (1973). Self-assessment of health: A longitudinal study of elderly subjects.J. Health Soc. Behav. 14: 87–93.

    Google Scholar 

  • Matteson, M. T., and Ivancevich, J. M. (1982). Type A and B behavior patterns and self-reported health symptoms and stress: Examining individual and organizational fit.J. Occup. Med. 24: 585–589.

    Google Scholar 

  • Matthews, K. A. (1982). Psychological perspectives on the Type A behavior pattern.Psychol. Bull. 91: 293–323.

    Google Scholar 

  • Matthews, K. A., and Angulo, J. (1980). Measurement of Type A behavior pattern in children: Assessment of children's competitiveness, impatience-anger, and aggression.Child Dev. 51: 466–475.

    Google Scholar 

  • Matthews, K. A., and Haynes, S. G. (1986). Type A behavior pattern and coronary disease risk. Update and critical evaluation.Am. J. Epidemiol. 123: 923–960.

    Google Scholar 

  • Mayes, B. T., Sime, W. E., and Ganster, D. C. (1984). Convergent validity of Type A behavior pattern scales and their ability to predict physiological responsiveness in a sample of female public employees.J. Behav. Med. 7: 83–108.

    Google Scholar 

  • Mechanic, D. (1962). The concept of illness behavior.J. Chron. Dis. 15: 189–194.

    Google Scholar 

  • Rhodewalt, F., Hays, R. B., Chemer, M. M., and Wysocki, J. (1984). Type A behavior, perceived stress, and illness: A person-situation analysis.Personal. Soc. Psychol. Bull. 10: 149–159.

    Google Scholar 

  • Rosenman, R. H. (1978). The interview method of assessment of the coronary-prone behavior pattern. In Dembroski, T. M., Weiss, S. M., Shields, J. L., Haynes, S. G., and Feinleib, M. (eds.),Coronary-Prone Behavior, Springer-Verlag, New York, pp. 55–70.

    Google Scholar 

  • Rosenman, R. H., Friedman, M., Straus, R., Wurm, M., Kositchek, R., Hahn, N., and Werthesson, N. T. (1964). A predictive study of coronary heart disease: The Western Collaborative Group Study.JAMA 189: 15–22.

    Google Scholar 

  • Rosenman, R. H., Brand, R. J., Jenkins, C. D., Friedman, M., Straus, R., and Wurm, M. (1975). Coronary heart disease in the Western Collaborative Group Study: Final followup experience of 8 1/2 years.JAMA 233: 872–877.

    Google Scholar 

  • Sales, S. M. (1969). Differences among individuals in affective, behavioral, biochemical and psychological responses to work load (Doctoral dissertation, University of Michigan).Dissert. Abstr. Int. No. 60-18098.

  • Schlegal, R. P., Wellwood, J. K., Copps, B. E., Gruchow, W. H., and Sharatt, M. T. (1980). The relationship between perceived challenge and daily symptom reporting in Type A vs. Type B postinfarct subjects.J. Behav. Med. 3: 191–204.

    Google Scholar 

  • Schmied, L. A., and Lawler, K. A. (1986). Hardiness, Type A behavior, and the stressillness relation in working women.J. Personal. Soc. Psychol. 51: 1218–1223.

    Google Scholar 

  • Shekelle, R. B., Gale, M., Ostfeld, A. M., and Paul, O. (1983). Hostility, risk of coronary disease, and mortality.Psychosom. Med. 45: 219–228.

    Google Scholar 

  • Shekelle, R. B., Hulley, S. B., Neaton, J.,et al. (1985). The MRFIT behavior pattern study. II. Type A behavior pattern and incidence of coronary heart disease.Am. J. Epidemiol. 122: 559–570.

    Google Scholar 

  • Siegel, J. M. (1982). Type A behavior and self-reports of cardiovascular arousal in adolescents.J. Hum. Stress 8: 24–30.

    Google Scholar 

  • Siegman, A., and Dembroski, T. M. (eds.) (1988).In Search of Coronary-Prone Behavior, Erlbaum, Hillsdale, N.J.

    Google Scholar 

  • Sklar, L. S., and Anisman, H. (1981). Stress and cancer.Psychol Bull. 89: 369–406.

    Google Scholar 

  • Smith, T. W., and Sanders, J. B. (1986). Type A behavior, marriage, and the heart: Person by situation interactions and the risk of coronary disease.Behav. Med. Abstr. 7: 59–67.

    Google Scholar 

  • Somes, G. W., Garrity, T., and Marx, M. (1981). The relationship of coronary-prone behavior pattern to the health of college students at varying levels of recent life change.J. Psychosom. Res. 25: 565–572.

    Google Scholar 

  • Stevens, J. H., Turner, C. W., Rhodewalt, F., and Talbot, S. (1984). The Type A behavior pattern and carotid artery atherosclerosis.Psychosom. Med. 17: 105–113.

    Google Scholar 

  • Stout, C. W., and Bloom, L. J. (1982). Type A behavior and upper respiratory infections.J. Hum. Stress 8: 4–7.

    Google Scholar 

  • Strube, M. J., Berry, J. M., Goza, B. K., and Fennimore, D. (1985). Type A behavior, age, and psychological well-being.J. Personal. Soc. Psychol. 49: 203–218.

    Google Scholar 

  • Suls, J. (1982). Social support, interpersonal relations, and health: Benefits and liabilities. In Sanders, G. S., and Suls, J.Social Psychology of Health and Illness, Erlbaum, Hillsdale, N.J., pp. 255–277.

    Google Scholar 

  • Suls, J., and Sanders, G. S. (1988). Why do some behavioral styles place people at coronary risk? In Siegman, A., and Dembroski, R. M. (eds.),In Search of Coronary-Prone Behavior, Erlbaum, Hillsdale, N.J.

    Google Scholar 

  • Suls, J., Becker, M., and Mullen, B. (1981). Coronary-prone behvavior, social insecurity and stress among college age adults.J. Hum. Stress 7: 27–34.

    Google Scholar 

  • Thoits, P. A. (1982). Conceptual, methodological, and theoretical problems in studying social support as a buffer against life stress.J. Health. Soc. Behav. 23: 145–159.

    Google Scholar 

  • Wallston, B. S., Alagna, S. W., DeVellis, B. M., and DeVellis, R. F. (1983). Social support and physical health.Health Psychol. 2: 367–392.

    Google Scholar 

  • Watson, D., and Clark, L. A. (1984). Negative affectivity: The disposition to experience aversive emotional states.Psychol. Bull. 96: 465–490.

    Google Scholar 

  • Weidner, G., and Matthews, K. A. (1978). Reported physical symptoms elicited by unpredictable events and the Type A coronary-prone behavior pattern.J. Personal. Soc. Psychol. 36: 1213–1220.

    Google Scholar 

  • Wolinsky, F. D., Coe, R. M., Miller, D. K., and Prendergast, J. M. (1984). Measurement of the global and functional dimensions of health status in the elderly.J. Gerontol. 39: 88–92.

    Google Scholar 

  • Woods, P. J., and Burns, J. (1984). Type A behavior and illness in general.J. Behav. Med. 7: 411–416.

    Google Scholar 

  • Woods, P. J., Morgan, B. T., Day, B. W., Jefferson, T., and Harris, C. (1984). Findings on a relationship between Type A behavior and headaches.J. Behav. Med. 7: 277–286.

    Google Scholar 

  • Wright, R., Contrada, R., and Glass, D. C. (1986). Psychophysiological correlates of Type A behavior. In Katkin, E. S., and Manuck, S. B. (eds.),Advances in Behavioral Medicine, Vol. 2, JAI Press, Greenwich, Conn., pp. 39–88.

    Google Scholar 

  • Wyler, A. R., Masuda, M., and Holmes, T. H. (1967). Seriousness of illness rating scale.J. Psychosom. Res. 11: 363–374.

    Google Scholar 

  • Zeldow, P. B., Clark, D., and Daughterty, S. R. (1985). Masculinity, femininity, Type A behavior, and psychosocial adjustment in medical students.J. Personal. Soc. Psychol. 48: 481–492.

    Google Scholar 

  • Zyzanski, S. J. (1978). Coronary-prone behavior pattern and coronary heart disease: Epidemiological evidence. In Dembroski, T. M., Weiss, S. M., Shields, J. L., Haynes, S. G., and Feinleib, M. (eds.),Coronary-Prone Behavior, Springer-Verlag, New York, pp. 25–41.

    Google Scholar 

  • Zyzanski, S. J., Wrzesniewski, K., and Jenkins, D. C. (1979). Cross-cultural validation of the coronary-prone behavior pattern.Soc. Sci. Med. 13A: 405–412.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Suls, J., Sanders, G.S. Type A behavior as a general risk factor for physical disorder. J Behav Med 11, 201–226 (1988). https://doi.org/10.1007/BF00844428

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00844428

Key words

Navigation