Unit Eighteen Type-A Personality and Heart Disease If you're a classic "Type A" personality -- hard-driving, impatient, competitive, intense, easily irritated – you are far more likely than a calm, laid-back "Type B" to suffer a heart attack, right?
Wrong, says a Massachusetts General Hospital psychiatrist who has studied more than 200 heart patients awaiting disgnostic tests and found virtually no correlation between classic Type A personalities and subsequent heart disease.
What does appear to be a predictor of serious heart trouble, says Dr. Joel E.Dimsdale, director of the MGH Stress Physiology Laboratory, is a chronic inability to deal constructively with anger and hostility.
He is now doing a study on anger and heart disease. The original insight that people could be classified into Type A and Type B personalities and that Type A's were more heart-attack prone grew out of research at the framingham Heart Study laboratories in the late 1970s.
Since the early studies, the A-B issue has been getting weaker. A large prospective study last year showed the A-B behavior distinction was not associated with coronary artery disease. Now researchers are thinking in terms of "anger in " vs. "anger out" as the latest area of concern.
Behavioral epidemiologist Elaine Eaker at the National Heart, Lung and Blood Institute in Bethesda, one of the nation's foremost scholars of correlations between behavior and heart disease, agrees in principle.
Since holding anger inside may lead to heart trouble and since acting it out by having temper tantrums is highly antisocial, Faker says researchers now advocate maturely "discussing" anger – either with the person who makes you angry or with a friend -- as the most constructive method of dealing with explosive feelings.
Since the early Type A studies, researchers have been attempting to fine-tune the ways in which they can identify a person as Type A or Type B, not an easy task since people often deny or are actually unaware of some facets of their personalities and hence cannot be asked point-blank if they are angry or impatient by nature.
Dimsdale used both pencil-and-paper questionnaires and a "semistructured" interview technique to identify Type A personalities among heart patients. In the interview, he explained, "you ask questions slowly and sometimes even in a stammer and then see how rapidly the person will finish the sentence for you." People who rush to answer are usually highly impatient and impatience has long been considered a major component of Type A behavior.
Yet, no matter whether he used the self-report questionnaires or the more subtle interview technique, people identified as Type A's did not fare worse than the others.