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.
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.
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.
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.
Booth-Kewley, S., and Friedman, H. (1987). Psychological predictors of heart disease: A quantitative review.Psychol. Bull. 101: 343–359.
Bortner, R. W. (1969). A short rating scale as a potential measure of pattern A behavior.J. Chron. Dis. 22: 87–91.
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.
Bryne, D. G., and Rosenman, R. H. (1986). Type A behavior and the experience of affective discomfort.J. Psychosom. Res. 30: 663–672.
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.
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.
Cassell, J. (1976). The contribution of the social environment to host resistance.Am. J. Epidemiol. 104: 107–123.
Cline, D. W., and Chosey, J. J. (1972). A prospective study of life changes and subsequent health changes.Arch. Gen. Psychiat. 27: 51–53.
Cobb, S. (1976). Social support as a moderator of life stress.Psychosom. Med. 38: 300–314.
Cohen, S., and Wills, T. A. (1985). Stress, social support, and the buffering hypothesis.Psychol. Bull. 98: 310–357.
Cooke, W., and Medley, D. (1954). Proposed hostility and pharasaic-virtue scales for the MMPI.J. Appl. Psychol. 38: 414–418.
Cooper, H. (1982). Scientific guidelines for conducting integrative research reviews.Rev. Educ. Res. 52: 442–449.
Cooper, T., Detre, T., and Weiss, S. M. (Eds.). (1981). Coronary prone behavior and coronary heart disease: A critical review.Circulation 63: 1199–1215.
Costa, P. T., and McCrae, R. R. (1985). Hypochondriasis, neuroticism, and aging: When are the somatic complaints unfounded?Am. Psychol. 40: 19–28.
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.
Dembroski, T. M., and Costa, P. (1987). Coronary-prone behavior: Components of the Type A pattern and hostility.J. Personal. 55: 211–236.
Dembroski, T. M., Weiss, S. M., Shields, J. L., Haynes, S. G., and Feinleib, M. (eds.) (1978).Coronary-Prone Behavior, Springer-Verlag, New York.
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.
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.
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.
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.
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.
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.)
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.
Eysenck, H., and Eysenck, S. B. G. (1968).Eysenck Personality Inventory, Educational and Testing Service, San Diego, Calif.
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.
Friedman, M., and Rosenman, R. H. (1974).Type A Behavior and Your Heart, Fawcett, Greenwich, Conn.
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.
Glass, D. C. (1977).Behavior Patterns, Stress, and Coronary Disease, Erlbaum, Hillsdale, N.J.
Glass, G. V. (1977). Integrating findings: The meta-analysis of research.Rev. Res. Educ. 5: 351–379.
Hart, K. E. (1983). Physical symptom reporting and health among Type A and Type B college males.J. Hum. Stress 9: 17–22.
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.
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.
Hedges, L. V. (1982). Fitting categorical models to effect sizes from a series of experiments.J. Educ. Stat. 7: 119–137.
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.
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.
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.
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.
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.
Kobasa, S. C. (1979). Stressful life events, personality and health: An inquiry into hardiness.J. Personal. Soc. Psychol. 37: 1–11.
Kobasa, S. C., Maddi, S. R., and Zola, M. A. (1983). Type A and hardiness.J. Behav. Med. 6: 41–51.
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.
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.
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.
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.
Lundberg, P. K., and Paludi, M. A. (1981). Type A behavior patterns and the reporting of lifetime symptomatology.Percept. Motor Skills 52: 473–474.
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.
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.
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.
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.
Matthews, K. A. (1982). Psychological perspectives on the Type A behavior pattern.Psychol. Bull. 91: 293–323.
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.
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.
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.
Mechanic, D. (1962). The concept of illness behavior.J. Chron. Dis. 15: 189–194.
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.
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.
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.
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.
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.
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.
Shekelle, R. B., Gale, M., Ostfeld, A. M., and Paul, O. (1983). Hostility, risk of coronary disease, and mortality.Psychosom. Med. 45: 219–228.
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.
Siegel, J. M. (1982). Type A behavior and self-reports of cardiovascular arousal in adolescents.J. Hum. Stress 8: 24–30.
Siegman, A., and Dembroski, T. M. (eds.) (1988).In Search of Coronary-Prone Behavior, Erlbaum, Hillsdale, N.J.
Sklar, L. S., and Anisman, H. (1981). Stress and cancer.Psychol Bull. 89: 369–406.
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.
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.
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.
Stout, C. W., and Bloom, L. J. (1982). Type A behavior and upper respiratory infections.J. Hum. Stress 8: 4–7.
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.
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.
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.
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.
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.
Wallston, B. S., Alagna, S. W., DeVellis, B. M., and DeVellis, R. F. (1983). Social support and physical health.Health Psychol. 2: 367–392.
Watson, D., and Clark, L. A. (1984). Negative affectivity: The disposition to experience aversive emotional states.Psychol. Bull. 96: 465–490.
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.
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.
Woods, P. J., and Burns, J. (1984). Type A behavior and illness in general.J. Behav. Med. 7: 411–416.
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.
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.
Wyler, A. R., Masuda, M., and Holmes, T. H. (1967). Seriousness of illness rating scale.J. Psychosom. Res. 11: 363–374.
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.
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.
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.
Author information
Authors and Affiliations
Rights 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
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00844428