Type A behavior, family history of hypertension, and cardiovascular responsivity among black women

The purpose of this study was to determine the effects of Type A behavior and family history of hypertension on cardiovascular reactivity to mental stress in a group of employed black women. Measures of heart rate and of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were taken at rest, during a mental arithmetic task, and during the Type A Structured Interview (SI). Results indicated that the Type A behavior pattern was associated with SBP and DBP hyperresponsivity during the SI but not during mental arithmetic. Additionally, certain speech components of the Type A pattern, as well as features of the potential-for-hostility component, were also related to cardiovascular responses during the SI. Family history of hypertension did not influence the cardiovascular parameters either alone or in combination with Type A behavior. The results suggest that many of the cardiovascular response characteristics of the Type A pattern that have been observed in predominantly white samples also hold true for blacks. Replication of these findings with other subgroups of blacks, such as young females and middle-aged males, will help document the generality of these findings within the black population.     

Type D personality and cardiovascular reactivity to an ecologically valid multitasking stressor

Previous research investigating the influence of Type D personality on cardiovascular reactivity to stress in healthy young adults is somewhat mixed. The present study sought to investigate this question using an ecologically valid laboratory stressor. Beat-to-beat blood pressure and heart rate were measured in 77 healthy young adults during exposure to multitasking stress. Mood and background stress were both associated with Type D personality when Type D was conceptualised as a dimensional construct, with less robust findings observed using the traditional dichotomous typological approach. However, the continuous Type D construct added limited predictive value of the self-report measures above that of its constituent components, negative affectivity (NA) and social inhibition (SI). Further, an inverse relationship between the continuous Type D construct and blood pressure reactivity to multitasking stress was observed. In summary, our findings suggest that Type D personality is predictive of blunted cardiovascular reactivity to stress in healthy individuals when Type D is considered as a dimensional construct and the independent influence of NA and SI is controlled for. Further, our findings suggest that Type D does not predict additional variance in mood and background stress above that of NA and SI when these constituent factors are considered independently.     

Component analysis of the type A coronary-prone behavior pattern in male and female college students

Two studies investigated the psychological dimensions encompassed by the Rosenman Structured Interview (SI) method of assessing the Type A behavior pattern. In Study 1, female students completed the SI and Jenkins Activity Survey (JAS). Factor analysis of the verbal stylistic and answer content components of the SI yielded a 5-factor solution, with one factor--Clinical Rating--accounting for most nonerror variance in Type A ratings. The remaining factors were derived from answer content and correlated more substantially with JAS Type A ratings than with SI Type A ratings. In Study 2, male and female college students completed the SI and JAS and a battery of questionnaires that tap trait dimensions implied by the conceptual definition of Type A. For both males and females, SI ratings of Type A could almost be completely predicted by scores on the Clinical Rating factor. For both sexes, content dimensions of the SI related to other measures of Type A and to Type A-consistent traits, whereas the Clinical Rating factor was only modestly associated with such traits. Moreover, sex differences were observed in the trait constellations composing SI and JAS definitions of Type A. These results suggest that a discrepancy exists between conceptual and operational definitions of the Type A pattern.     

The nomological validity of the Type A personality among employed adults

The nomological validity of the Type A behavior pattern was explored. The Structured Interview (SI) and a battery of personality trait, physical health, and strain measures were administered to an occupationally diverse sample of 568 workers. Ss were also monitored for physiological reactivity and recovery (blood pressure, heart rate, skin temperature, and electrodermal response) to the SI and a subsequent Stroop Color-Word Conflict Task. A confirmatory factor analysis demonstrated that SI scores can be factored into three distinct dimensions. There was considerable overlap in the patterns of personality traits that characterized the Type A components, but only a Hostility dimension was significantly related to physiological reactivity and recovery. The results have implications for distinguishing coronary-proneness from the more traditional Type A conceptualization.     

Type A behavior pattern, parental history of hypertension, and cardiovascular reactivity in college males

Two risk factors for cardiovascular disorders, parental history of hypertension and the Type A behavior pattern, were investigated concurrently with respect to cardiovascular reactivity to challenging situations. Sixty-four college males were given both the Structured Interview (SI) and Jenkins Activity Survey (JAS) for the Type A behavior pattern and a family health questionnaire to determine parental history of hypertension. The students were monitored for blood pressure (BP), heart rate (HR), and pulse transit time (PTT) response to four tasks: cold pressor, isometric handgrip exercise, a reading comprehension task, and backwards digit span. Type As based on SI classification had significantly higher HR levels across all tasks than did Type Bs, as well as higher diastolic BP levels in the cold pressor task. No main effects for Type A-B using JAS classification were found. Positive parental history students had higher HR and shorter PTT levels across all the tasks. Type A and parental history did interact in a limited way on some tasks, but the interactions were also dependent on the Type A classification used.     

Type a behavior,irritability, and cardiovascular response

Previous research suggests that high levels of hostility may augment the cardiovascular reactivity and risk of coronary heart disease (CHD) associated with Type A behavior. In contrast, other research indicates that the tendency to deny or suppress anger is associated with enhanced cardiovascular reactivity and risk of CHD. To delineate further the combined role of anger processes and Type A behavior in CHD risk, this study examined the interactive effects of Type A behavior and self-reported irritability on cardiovascular response to a challenging mental task. Type A and Type B college students were further classified as either high or low in self-reported irritability. Type A subjects who were low in self-reported irritability evidenced greater cardiovascular reactivity (i.e., systolic blood pressure and pulse rate) than did Type B subjects low in irritability. However, Type A subjects who were high in irritability tended to demonstrate less cardiovascular response than Type B subjects high in irritability. Further, Type A's low in self-reported irritability evidenced greater cardiovascular response than high-irritability Type A's. It is suggested that reduced reporting of irritability by Type A's may reflect suppression or denial, and further that this reduced reporting is associated with enhanced cardiovascular responsivity.     

Type A behavior, personality hardiness, and cardiovascular responses to stress

Type A behavior and hardiness were examined as predictors of cardiovascular responses to stress in 68 male undergraduates. Systolic and diastolic blood pressure (SBP and DBP) and heart rate were monitored while subjects performed a difficult mirror-tracing task. Type A assessments based on the Structured Interview, but not those based on the Jenkins Activity Survey, were associated with significantly enhanced SBP and DBP elevations. Hardiness was associated with significantly reduced DBP responsiveness. In addition, a significant interaction indicated that the Type B-high hardiness group showed the least DBP reactivity. A near-significant interaction (p = .06) suggested that Type B-high hardiness subjects also reported the least anger. Further exploration of the data indicated that the challenge component of hardiness accounted for its relationship to DBP reactivity. These results have implications both for the psychophysiologic study of Type A behavior and for understanding the health-promoting effects of hardiness.     

Type D personality and cardiac output in response to stress

Type D personality is predictive of adverse clinical outcome and psychological distress in cardiac patients. However, the mechanisms by which Type D affects health are largely unknown. This study (1) investigated the relationship between Type D and cardiovascular reactivity to experimentally induced stress and (2) tested the influence of Type D on subjective feelings of stress. Eighty four healthy young adults (50% males, mean (SD) age 22 (6.84) years), completed measures of Type D personality, stress arousal and a stress-inducing procedure involving a taxing mental arithmetic task. Cardiovascular measures were recorded throughout the experiment. Mixed measures ANOVA showed a significant main effect of Type D and a significant group by time effect of Type D on cardiac output in male participants. Type D males exhibit significantly higher cardiac output during the stressor phase compared to non-Type D males. However, there was no relationship between Type D and cardiovascular reactivity in females. In addition, Type D individuals exhibited significantly higher feelings of subjective stress compared to non-Type D's. These findings provide new evidence on Type D and suggest that Type D may affect health through increased cardiac output and higher subjective feelings of stress following acute stress.     

Familial similarity in Type A behaviour and physiological measurements as related to sex

Thirty-one families with pre-school children were examined with regard to Type A behaviour and cardiovascular and neuroendocrine measurements. Type A scores (MYTH) of the children from the ages of three to six were positively correlated with independent Type A measurements (Jenkins Activity Survey, Bortner Type A scale) of the parents (significant for fathers but not for mothers). The children's resting systolic blood pressures were significantly correlated with maternal and paternal values, while no significant familial aggregation was found for diastolic blood pressure, heart rate, catecholamine or cortisol excretion. The children's systolic and diastolic blood pressures and adrenaline excretion were significantly correlated between ages three and six. The results are consistent with the assumption that genetic as well as environmental factors contribute to the development of Type A behaviour. No significant association was found between Type A scores and physiological measurements during routine activities in the children or the adults.     

Decomposing coronary-prone behavior: Dimensions of type a behavior in the Videotaped Structured Interview

This study examined the factorial structure of data generated in the Videotaped Structured Interview for assessment of Type A behavior. Based on the literature, it was argued that there are at least three distinct concepts of Type A behavior, focused on competitiveness and pressured drive, speech characteristics, and hostility, respectively. These three concepts were clearly represented among the factors from factor analyses based on data from 282 subjects. Three factors represented speech and psychomotor characteristics, where the first reflected interactions between subject and interviewer (e.g., response latency, interruptions), the second tempo of speech (accelerating, dysrhythmic and rapid speech), and the third oral gestures (e.g., expiratory sighs). Hostility was reflected in two factors, one defined by emotional intensity (e.g., anger when recalling paat event) and the other hostility expressed towards the interviewer. Pressured drive dominated a content factor reflecting self-awareness of Type A behavior. Finally, there was one factor related to psychomotor tension. Through further factor and item analyses, it was possible to combine these factors into three homogeneous and moderately intercorrelated subscales of Type A behavior reflecting Hostility, Speech Characteristics, and Self-Awareness of Type A behavior. These scales showed good interrater agreement and stability over two years. The Self-Awareness Scale was highly correlated with self-report measures of Type A behavior. The Hostility Scale, on the other hand, was moderately related to measures of Type A behavior, anger and hostility, but was unrelated to anxiety. The Speech Characteristic Scale, finally, was virtually unrelated to psychometric measures.     

A note on measurement issues in type A research: let's not throw out the baby with the bath water

It has been suggested that researchers rely exclusively on the structured interview (SI) to assess Type A behavior instead of using objective self-report measures, because the SI is the only prospectively validated instrument currently available. This article considers the costs and benefits of relying solely on the SI to measure Type A behavior. Although using only the SI would assure that researchers measure, in a relatively unobtrusive fashion, actual Type A behaviors known to be predictive of heart disease, it would dramatically increase research costs, impede longitudinal studies of changes in Type A behavior, reduce the validity of statistical conclusions, restrict the convergent and discriminant validity of the Type A construct, and ultimately inhibit our ability to improve accuracy in predicting heart disease. A set of recommendations is proposed for improving the quality of measurement in Type A research.     

A Note on Measurement Issues in Type A Research: Let's Not Throw Out the Baby With the Bath Water

It has been suggested that researchers rely exclusively on the structured interview (SI) to assess Type A behavior instead of using objective self-report measures, because the SI is the only prospectively validated instrument currently available. This article considers the costs and benefits of relying solely on the SI to measure Type A behavior. Although using only the SI would assure that researchers measure, in a relatively unobtrusive fashion, actual Type A behaviors known to be predictive of heart disease, it would dramatically increase research costs, impede longitudinal studies of changes in Type A behavior, reduce the validity of statistical conclusions, restrict the convergent and discriminant validity of the Type A construct, and ultimately inhibit our ability to improve accuracy in predicting heart disease. A set of recommendations is proposed for improving the quality of measurement in Type A research.     

The type A behavior pattern and immune reactivity to brief stress: change of volume of secretory immunoglobulin A in saliva

This article presents findings of a laboratory experiment on the association of the Type A behavior pattern with reactivity of secretory immune functioning to brief stress. 38 female undergraduate students classified as Type A (n = 19) or as Type B (n = 19) on the basis of their scores on the Kwansei Gakuin Type A scale performed a continuous arithmetic task in a situation in which they were exposed to aversive loud noise. Secretory immunoglobulin A (s-IgA) in saliva and autonomic measures (heart rate and frequency of eyeblink) were evaluated before and after the manipulation of stress. The volume of s-IgA at baseline was significantly higher for the Type A group than for the Type B group, suggesting that the former relative to the latter might be chronically higher in mucosal immune functioning. Also, the volume of s-IgA significantly increased after exposure to a brief stress for the Type B group but did not change for the Type A group, a finding which might indicate that the Type A group may have less immune reactivity to a brief stress.     

The Montreal Type A Intervention Project: major findings

This article reports a comparison of three short-term treatments (aerobic exercise, cognitive-behavioral stress management, and weight training) in modifying behavioral and cardiovascular reactivity to laboratory psychosocial stressors in healthy Type A men. One hundred seven men completed the treatments and evaluations, 33 in the aerobic exercise group, and 37 each in the cognitive-behavioral stress management and weight-training groups. The stress management group showed significantly greater changes in behavioral reactivity (reductions of 13% to 23% below initial values) than the two physical exercise groups, which did not differ significantly from each other. For physiological reactivity, changes attributable to intervention were trivial for all three treatment groups. The positive finding of reduced behavioral reactivity as a result of the stress management intervention is of potential clinical significance and warrants further exploration. The lack of meaningful reductions in physiological reactivity also requires further exploration in that it raises questions concerning the ability of behavioral treatments in general to modify physiological reactivity, the ability of existing measures to assess accurately changes that are produced and, most fundamental of all, the relevance of physiological reactivity as an outcome measure for treatment efforts with Type As.     

Individual Differences in Risk Taking1

Risk taking behavior in civilian and military settings often results in unnecessary loss of life and equipment. The present research investigates the contribution of three cognitive styles (Type A., Cognitive Complexity, and GIAL) to risky behavior under varying task load conditions. The research is further concerned with uncovering possible relationships between these cognitive styles and physiological arousal (cardiovascular response) as interactive sources of risky actions. A variety of diverse and combined effects of styles on the propensity to take risks was obtained. These relationships were not generally reflected in arousal levels. In addition, the present findings support the conclusions of Streufert et al. (1983) who suggested that risk taking is primarily an effect of cognitive error. In the absence of an arousal based “thrill” finding, specific “educational” programs, based on a person's stylistic characteristics, may be possible to reduce the propensity for risky actions.     

A psychometric investigation of the content of the structured interview

The responses of 92 British males to the questions of the Structured Interview (SI) were content analysed. The consistency of the content in measuring a single concept was investigated by means of item and factor analyses. A simple, unweighted sum of the content ratings was then compared with the scores achieved on the three prospectively validated Type A measures—the Jenkins Activity Survey, the Framingham Scale and the SI. The results from the analyses suggest that the content of the SI has many similarities with the questionnaire assessments of Type A behaviour and is a poor predictor of SI assessment. It is argued that the added dimension of style of response that is considered in the SI is the reason for different assessments being made by the SI and the questionnaire measures of Type A behaviour. The implications for the measurement of Type A behaviour are discussed.     

Women's Cognitive,Affective, and Physiological Reactions to a Male Coworker's Sexist Behavior1

Empirical research has documented the attitudinal and behavioral consequences of sexual harassment, but has not examined the physiological consequences. In the present study, we monitored women's autonomic physiological activity while they performed a word‐association task with a male confederate who was either harassing, egalitarian, or submissive. Subsequently, we examined the women's cognitive, affective, and physiological reactions as they prepared and delivered a speech to the same confederate. Results indicate that harassment led to greater cardiovascular reactivity during the word‐association task and to greater cognitive, negative affective, and cardiovascular reactions during the subsequent speech compared with other conditions. Subgroups of harassed women who confronted their coworker, or who blamed themselves for his behavior, also exhibited greater cardiovascular reactivity during both tasks compared to women who did not use these coping responses. We integrate our laboratory results with those obtained in field settings.     

The framingham Type A Scale: Cardiovascular and cognitive-behavioral responses to interpersonal challenge

Most of the primary measures of Type A behavior have been found to be associated with physiological reactivity to stressors, as well as coronary heart disease (CHD). While it does predict CHD, the Framingham Type A Scale (FTAS) has not been conclusively linked to physiological reactivity. Similarly, in contrast to other Type A measures, little is known concerning the cognitive behaviors associated with the FTAS in stressful situations. The present study was conducted to evaluate the cardiovascular and cognitive-behavioral responses to interpersonal challenge of Type A versus Type B subjects, as classified by the FTAS. Type A's evidenced increased systolic blood pressure (SBP) reactivity and a greater degree of negatively toned cognitive activity than did Type B's. The SBP findings are consistent with those obtained with other measures of Type A behavior, and with the hypothesis that neuroendocrine reactivity mediates the link between the behavior pattern and CHD. The somewhat unique cognitive-behavior findings, however, may reflect important psychological differences among the various Type A measures.Portions of this paper were presented at the meeting of the Society of Behavioral Medicine, Philadelphia, 1984.     

Stress and Distress as a Function of Jenkins Activity Survey-Defined Type A Behavior and Control Over the Work Environment

Although laboratory studies have demonstrated that situational factors which are particularly threatening to Type A individuals induce both Type A behaviors and cardiovascular reactivity, field studies have failed to demonstrate consistent differences between Types A and B in response to stress. Rhodewalt, Hays, Chemers, and Wysocki (1984) argued that this inconsistency is caused by the failure to take into account the individual's perception of the situation. They demonstrated that Type A individuals who perceived high levels of job stress reported more psychological and physical health problems than Type As under low stress or Type Bs under high or low stress. This study attempted to replicate this earlier finding, as well as identify factors in the situation which lead Type A individuals to perceive their job as stressful. Three hundred thirty-six male school principals (categorized as Type A or Type B by the Jenkins Activity Survey [JAS]) completed questionnaires assessing their degree of control in their work environment, perceived job stress, and physical and psychological well-being. A path mediation analysis indicated that Type A individuals reported more job stress under lower levels of perceived control, and that higher job-stress levels subsequently lead to greater incidence of physical and psychological symptoms, especially for Type As.     

Chronic stress as a factor in physiologic reactivity to challenge

This study examined the hypothesis that chronic stress contributes to heightened cardiovascular reactivity. Chronic stress was operationalized as crowding stress associated with commercial-residential mixes in high-density neighborhoods. Seventeen residents of crowded neighborhoods and 24 residents of uncrowded neighborhoods worked on a challenging task while blood pressure and heart rate were measured. Self-report and biochemical measures indicated that the two groups differed in level of chronic stress. Results also indicated that chronic stress contributes to cardiovascular reactivity. Crowded residents showed greater increases in systolic and diastolic blood pressure and heart rate and took longer to return to baseline than did uncrowded residents. The few differences found between Type A and Type B residents were found only in the low-stress group.