The assessment of type a behaviour: A critique

Abstract

The validity of type A behaviour (TAB) as a precursor to heart disease is now increasingly subject to debate. This review examines some issues in the assessment of TAB that may have confused rather than clarified such debate. The status and interrelations between four widely used measures of TAB (Jenkins Activity Survey, Framingham Type A Scale, Bortner Rating Scale, and Structured Interview) are described, and a number of problems in their use discussed, including: differing conceptualisations of TAB, drifting criteria of assessment, failure to obtain accurate self-report of TAB, and difficulties associated with the measurement of TAB in populations other than male non-manual workers. Future research should attempt to obviate such difficulties, while elucidating pathogenic behaviours and attitudes, and how these interact with other variables to increase the risk of heart disease. Finally, the value of a state measure of TAB is discussed.