Type A and Type B personality theory describes two contrasting personality types that could
either raise or lower, respectively, one's chances of developing coronary heart disease.
There is considerable controversy about the role of these personality types in coronary
heart disease and the role of tobacco industry funding of early research in this area.
History Type A personality behavior was first described
as a potential risk factor for heart disease in the 1950s by cardiologists Meyer Friedman
and Ray Rosenman.
After an eight-and-a-half-year-long study of healthy men between the ages of 35 and
59, Friedman and Rosenman estimated that Type A behavior doubles the risk of coronary heart
disease in otherwise healthy individuals.
The individuals enrolled in this study were followed well beyond the original time frame
of the study.
Subsequent analysis indicated that although Type A personality is associated with the
incidence of coronary heart disease, it does not seem to be a risk factor for mortality.
This research had a significant effect on the development of the health psychology field,
in which psychologists look at how an individual's mental state affects his or her physical health.
The types Type A
The theory describes "Type A" individuals as ambitious, rigidly organized, highly status-conscious,
sensitive, impatient, take on more than they can handle, want other people to get to the
point, anxious, proactive, and concerned with time management.
People with Type A personalities are often high-achieving "workaholics" who multi-task,
push themselves with deadlines, and hate both delays and ambivalence.
In his 1996 book, Type A Behavior: Its Diagnosis and Treatment, Friedman suggests that Type
A behavior is expressed in three major symptoms: free-floating hostility, which can be triggered
by even minor incidents; time urgency and impatience, which causes irritation and exasperation
usually described as being "short-fused"; and a competitive drive, which causes stress
and an achievement-driven mentality.
The first of these symptoms is believed to be covert and therefore less observable, while
the other two are more overt.
Type B The theory describes "Type B" individuals
as a contrast to those with Type A personalities.
People with Type B personality by definition generally live at a lower stress level and
typically work steadily, enjoying achievement but not becoming stressed when they do not
achieve.
When faced with competition, they do not lose their minds and either enjoy the game or back
down.
They may be creative and enjoy exploring ideas and concepts.
They are often reflective.
Criticism Limitations of the original study comprise
the inclusion of only middle-aged men and the lack of information regarding the diets
of those subjects.
While the latter could serve as a confounding variable, the former calls into question whether
the findings can be generalized to the remaining male population or to the female population
as a whole.
Friedman et al. conducted a randomized controlled trial on 862 male and female post myocardial
infarction patients, ruling out diet and other confounds.
Subjects in the control group received group cardiac counseling, and subjects in the treatment
group received cardiac counseling plus Type-A counseling.
The recurrence rate was 28% in the control group and 13% in the treatment group, a strong
and statistically significant finding.
Funding by Big Tobacco Companies Furtherly discrediting the so-called Type
A Behavior Pattern, a study from 2012 – based on searching the Legacy Tobacco Documents
Library – suggests the phenomenon of initially promising results followed by negative findings
to be partly explained by the tobacco industry’s involvement in TABP research to undermine
the scientific evidence on smoking and health.
The industry’s interest in TABP lasted at least four decades until the late 1990s, involving
substantial funding to key researchers encouraged to prove smoking to simply correlate with
a personality type prone to coronary heart disease and cancer.
Hence, until the early 1980s, the industry’s strategy consisted of suggesting the risks
of smoking to be caused by psychological characteristics of individual smokers rather than tobacco
products by deeming the causes of cancer to be multifactorial with stress as a key contributing
factor.
Philip Morris and RJ Reynolds helped generate substantial evidence to support these claims
by funding workshops and research aiming to educate about and alter TABP to reduce risks
of CHD and cancer.
Moreover, Philip Morris primarily funded the Meyer Friedman Institute, e.g. conducting
the “crown-jewel” trial on the effectiveness of reducing TABP whose expected findings could
discredit studies associating smoking with CHD and cancer but failing to control for
Type A behaviour.
In 1994, Friedman wrote to the US Occupational Safety and Health Administration criticising
restrictions on indoor smoking to reduce CHD, claiming the evidence remained unreliable
since it did not account for the significant confounder of Type A behaviour, notwithstanding
the fact that by then, TABP had proven to be significant in only three of twelve studies.
Though apparently unpaid for, this letter was approved by and blind-copied to Philip
Morris, and Friedman claimed to receive funding largely from the National Heart, Lung and
Blood Institute.
When TABP finally became untenable, Philip Morris supported research on its hostility
component, allowing Vice President Jetson Lincoln to explain passive smoking lethality
by the stress exerted on a non-smoking spouse through media claiming the smoking spouse
to be slowly killing themselves.
When examining the most recent review on TABP and CHD in this light, the close relationship
to the tobacco industry becomes evident: of thirteen etiologic studies in the review,
only four reported positive findings, three of which had a direct or indirect link to
the industry.
Also on the whole most TABP studies had no relationship to the tobacco lobby but the
majority of those with positive findings did.
Furthermore, TABP was used as a litigation defence, similar to psychosocial stress.
Hence, Petticrew et al. proved the tobacco industry to have substantially helped generate
the scientific controversy on TABP, contributing to the enduring popularity and prejudice for
Type A personality even though it has been scientifically disproven.
Other issues Some scholars argue that Type A behavior is
not a good predictor of coronary heart disease.
According to research by Redford Williams of Duke University, the hostility component
of Type A personality is the only significant risk factor.
Thus, it is a high level of expressed anger and hostility, not the other elements of Type
A behavior, that constitutes the problem.
Other studies A study was performed that tested the effect
of psychosocial variables, in particular personality and stress, as risk factors for cancer and
coronary heart disease.
In this study, four personality types were recorded.
Type 1 personality is cancer prone, Type 2 is CHD prone, Type 3 is alternating between
behaviors characteristic of Types 1 and 2, and Type 4 is a healthy, autonomous type hypothesized
to survive best.
The data suggests that the Type 1 probands die mainly from cancer, type 2 from CHD, whereas
Type 3 and especially Type 4 probands show a much lower death rate.
Two additional types of personalities were measured, Type 5 and Type 6.
Type 5 is a rational anti-emotional type, which shows characteristics common to Type
1 and Type 2.
Type 6 personality shows psychopathic tendencies and is prone to drug addiction and AIDS.
While most studies attempt to show the correlation between personality types and coronary heart
disease, studies have suggested that mental attitudes constitute an important prognostic
factor for cancer.
As a method of treatment for cancer-prone patients, behavior therapy is used The patient
is taught to express his/her emotions more freely, in a socially acceptable manner, to
become autonomous and be able to stand up for his/her rights.
Behavior therapy would also teach them how to cope with stress-producing situations more
successfully.
The effectiveness of therapy in preventing death in cancer and CHD is evident.
The statistical data associated with higher death rates is impressive.
Other measures of therapy have been attempted, such as group therapy.
The effects were not as dramatic as behavior therapy, but still showed improvement in preventing
death among cancer and CHD patients.
From the study above, several conclusions have been made.
A relationship between personality and cancer exists, along with a relationship between
personality and coronary heart disease.
Personality type acts as a risk factor for diseases and interacts synergistically with
other risk factors, such as smoking and heredity.
It has been statistically proven that behavior therapy can significantly reduce the likelihood
of cancer or coronary heart disease mortality.
On the contrary, psychoanalysis can increase the likelihood of cancer and coronary heart
disease mortality drastically.
Studies suggest that both body and mental disease arise from each other.
Mental disorders arise from physical causes, and likewise, physical disorders arise from
mental causes.
While Type A personality did not show a strong direct relationship between its attributes
and the cause of coronary heart disease, other types of personalities have shown strong influences
on both cancer-prone patients and those prone to coronary heart disease.
Role of magnesium in cardiovascular health Maintaining healthy magnesium levels in the
body plays a strong role in protecting the cardiovascular health of an individual.
An analysis of the literature suggests the possible role of Mg deficiency in the susceptibility
to cardiovascular diseases, observed among subjects displaying a type A behavior pattern.
Experimental data which support this hypothesis are reviewed.
Type A subjects are more sensitive to stress and produce more catecholamines than type
B subjects.
This, in turn, seems to induce an intracellular Mg loss.
In the long run, type A individuals would develop a state of Mg deficiency, which may
promote a greater sensitivity to stress and, ultimately, lead to the development of cardiovascular
problems.
See also Type D personality
Alpha References