ABSTRACT
Since the conclusion that Type A behavior pattern is a risk factor for coronary heart disease was reached at the Amelia Island Conference (Review Panel on Coronary-Prone Behavior, 1981), several negative studies have raised questions about the robustness of the Type A hypothesis. In prospective studies of healthy individuals with multiple risk factors (Shekelle, Hulley et al., 1985) and survivors of a myocardial infarction (Case, Heller, Case, & Moss, 1985; Shekelle, Gale, & Norusis, 1985), both structured interview (SI) and questionnaire (JAS) measures of Type A behavior failed to predict subsequent coronary events. Following the publication of three studies, in the mid-1970s, in which Type A was found to correlate significantly with severity of coronary atherosclerosis (CAD) in patients undergoing coronary angiography, there have been ten studies of the relationship of Type A to CAD (Bass & Wade, 1982; Dimsdale et al., 1978, 1979; Kornitzer et al., 1982; Krantz, Sanmarco, Selvester, & Matthews, 1979; Krantz et al., 1981; Pearson, 1983; Scherwitz et al., 1983; Williams et al., 1980; Young, Barboriak, Anderson, & Hoffman, 1980)—only one of these studies (Williams et al., 1980) reported unequivocal evidence of a Type A-CAD association. Case et al. (1985) concluded that these negative results “… raise serious questions about the effect of Type A behavior on the whole spectrum of coronary disease” (p. 740).
