Cardiovascular Diseases Clinical Trial
To test the physiological and psychosocial correlates of Type A behavior.
BACKGROUND:
The Type A behavior pattern as described by Friedman and Rosenman is characterized by
extremes of competitiveness, easily aroused hostility, a sense of urgency and aggression. In
1981 the Review Panel of Coronary Prone Behavior and Coronary Heart Disease concluded that
the Type A behavior pattern was associated with an increased risk for coronary heart
disease. Studies have challenged the independent predictive value of the behavior pattern
with respect to coronary heart disease. There was a need to develop physiological
measurements related to coronary-prone behavior and to reexamine the stability of the
psychological assessment. It was hypothesized that Type A behavior or some component such as
hostility might be associated with a state of chronic, generalized sympathetic-adrenal
arousal. Preliminary research was conducted on interpersonal dynamic correlates of Type A
behavior among married couples. Research was needed on whether certain types of marriages,
according to the Type A/B classification of the two spouses, are more pathogenic than
others. Additional research is also needed on which components of the global Type A pattern
were of primary importance as risk factors for coronary disease, and which components were
enduring, which were transient, and which were situationally related.
In 1982, a household survey on Type A behavior was initiated. Measures included the Jenkins
Activity Survey, the Framingham Type A Questionnaire, hostility scales, and other behavioral
tests. Information was also collected on demographic variables, social support, marital
satisfaction, life events, social values, and job and family stress. After the household
survey was completed, the respondents were contacted by the Type A interviewers and the
Structured Interviews conducted. A total of 1,114 Type A interviews were completed yielding
902 primary respondents and 239 spouses.
DESIGN NARRATIVE:
The concurrent relationship of the Structured Interview (SI) global and component Type A
behavior measures were tested to levels of chronic and acute sympathetic nervous system
activity, as assessed by platelet and plasma catecholamines, heart rate, blood pressure, and
pupil size. The correlations among heart rate, pupil size, blood pressure, and the plasma
and platelet catecholamine measures were determined as were the relationships with reported
global health, chronic disease, and functional disability levels. The five-year
predictability was tested of reported global health, chronic disease, and functional
disability from measures of global and component Type A behavior.
Tests were made of the differences in the chronic and acute sympathetic-adrenal responses,
as assessed by platelet and plasma catecholamines, pupil size, heart rate, and blood
pressure, among married couples having different combinations of Structured Interview global
and component Type A classifications. The five year marital stability and health of these
couples were followed. A comparison was made of one week test-retest reliability with the
five year stability of the Structured Interview global and component Type A measures.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
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