Type A Behavior

According to a 1950s theory, humankind exhibits two main, contrasting personality types, known as Type A and Type B. Typically, a person of Type A behavior (TAB) is presented as aggressive, hostile, seeking perfection, highly driven, competitive, impatient and with a strong urge to maintain control. In contrast, Type B behavior is characterized by the absence of such characteristics; usually Type B personalities demonstrate moderate ambition, ease, self-control and cooperation.

In the 1950s two cardiologists, Meyer Friedman and R.H. Rosenman, noticed that most of their patients with heart attacks shared certain traits, such as sense of time urgency and obsession with their work. They also noticed physical manifestations of this type of personality - frequent fidgeting or grimacing, foot tapping, fast eating, dominating conversations. Cardiologists noted that TAB personalities are up to twice more prone to heart problems, due to a higher release of stress hormones. According to different studies, as much as 75 percent of urban male population exhibits TAB characteristics of various degrees, whereas only 25 percent of working women show any of these traits. There are indications that TAB is gradually acquired over time, perhaps with accumulation of stress, exhaustion or boredom.

Friedman identifies two psychological and six physical signs that determine TAB. The psychological ones are presence of impatience and anxiety about future events and the physical signs include excessive sweat on the forehead and upper lip, teeth grinding, indentation of the tongue (due to frequent pressing to the upper teeth), tic-lid reaction of the upper eyelid, tic-like reaction of the corners of the mouth, and brown coloring of the skin of the lower eyelid.

It is now an established fact that the traditional risk factors for coronary heart disease (CHD), such as smoking, high blood pressure, obesity and family history apply to about a half of all the cases. Therefore, there should be other factors that determine the proneness to such conditions. The search for these factors is what led Friedman and Rosenman to their theory. They developed a structured interview to evaluate TAB and carried out a survey of more than 3,000 men, aged between 39 and 59, who were interviewed and monitored for eight years. The results confirmed that individuals without TAB were twice less likely to develop CHD.

Further studies imply that TAB personalities are also more likely to be unhappy in their personal life. Because of their preoccupation about work and ambition, they are more likely to spend less time with their families and thus may feel isolated and irritated. Moreover, their strive for perfection makes them underrate the quality of their relationships and define them as unsatisfactory. All these facts can in their turn lead to a higher level of stress and increased likelihood of CHD.

Friedman himself argued that the only potentially dangerous Type A characteristics are hostility and anger and not all Type A components can lead to coronary heart disease. Anger and hostility are the most reliable predictors of CHD. Hostility has been defined as the tendency to react to unpleasant or unexpected situations with frustration, irritation and disgust. Anger is the inability to express negative emotions directly toward the recipient, thus bottling them up inside. Research in the 21st century shows that other components of the Type A Behavior are no more indicative of a possible CHD development than their absence.

However, there has been extensive criticism on the direct TAB-CHD relation. First, as the subjects of the study were all middle-aged men, there was no variety of demographic profiles to prove the findings universal. In other words, the results may be accurate but statistically they can be applied only to other groups of middle-aged men. Since then, a number of new surveys have been carried out but results have been inconclusive. Another problem is the difficulty in measuring risk factors and the variety of methods employed in analysis.

Other critics point to the fact that the human body is an extremely complex structure and emotions and behavior are very closely connected. Therefore, it is possible that various influences, including mood and emotions, may influence behavioral patterns and affect the relationship between personality and health.

Type A Behavior: Selected full-text books and articles

In Search of Coronary-Prone Behavior: Beyond Type A By Aron W. Siegman; Theodore M. Dembroski Lawrence Erlbaum Associates, 1989
Persons, Situations, and Emotions: An Ecological Approach By Hermann Brandstätter; Andrzej Eliasz Oxford University Press, 2001
Librarian's tip: Chap. 3 "Temperament, Type A, and Motives: A Time Sampling Study"
Anger, Hostility, and the Heart By Aron Wolfe Siegman; Timothy W. Smith Lawrence Erlbaum Associates, 1994
Librarian's tip: Chap. 1 "From Type A to Hostility to Anger: Reflections on the History of Coronary-Prone Behavior"
Stress and Coping across Development By Tiffany M. Field; Philip M. McCabe; Neil Schneiderman Lawrence Erlbaum Associates, 1988
Librarian's tip: Includes discussion of type A behavior in multiple chapters
Child Health Psychology By Barbara G. Melamed; Karen A. Matthews; Donald K. Routh; Brian Stabler; Neil Schneiderman Lawrence Erlbaum Associates, 1988
Librarian's tip: Chap. 7 "Type A Behavior in Children: Demographic, Behavioral, and Physiological Correlates"
The Acute Affective Response of Type A Behaviour Pattern Individuals to Competitive and Noncompetitive Exercise By Masters, Kevin S; LaCaille, Rick A; Shearer, David S Canadian Journal of Behavioural Science, Vol. 35, No. 1, January 2003
Peer-reviewed publications on Questia are publications containing articles which were subject to evaluation for accuracy and substance by professional peers of the article's author(s).
Application of Self-Control Procedures to Modifying Type A Behavior By Nakano, Keiko The Psychological Record, Vol. 46, No. 4, Fall 1996
Peer-reviewed publications on Questia are publications containing articles which were subject to evaluation for accuracy and substance by professional peers of the article's author(s).
The Deadly Emotions: The Role of Anger, Hostility, and Aggression in Health and Emotional Well-Being By Ernest H. Johnson Praeger, 1990
Librarian's tip: "Lethal Type A Behavior, Coronary Heart Disease, and the AHA! Syndrome" begins on p. 74
Women, Stress, and Heart Disease By Margaret Chesney; Nanette K. Wenger; Kristina Orth-Gomér Lawrence Erlbaum Associates, 1998
Librarian's tip: Chap. 3 "Psychosocial Risk Factor Profile in Women with Coronary Heart Disease"
Handbook of Health Psychology By Andrew Baum; Tracey A. Revenson; Jerome E. Singer Lawrence Erlbaum Associates, 2001
Librarian's tip: Discussion of Type A behavior begins on p. 61
Stress and Disease Processes By Neil Schneiderman; Philip McCabe; Andrew Baum Lawrence Erlbaum Associates, 1992
Librarian's tip: Chap. 10 "Interactive Models of Reactivity: The Relationship between Hostility and Potentially Pathogenic Physiological Responses to Social Stressors"
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