Handbook of Psychology and Health: Cardiovascular Disorders and Behavior - Vol. 3

By David S. Krantz; Andrew Baum et al. | Go to book overview

control of CHD. For example, research of this sort might be expected to evolve psychophysiological maneuvers that may transcend the error involved in current behavioral assessment procedures by serving as a more reliable and stronger predictor of CHD. In fact, we have proposed a testable model in this regard ( Dembroski et al., 1979a), in which levels of propensity for physiologic reactivity and differential exposure to various levels of environmental challenge can be used in combination to predict levels of risk for CHD. It is our belief that more research emphasis on the above combinations should be included in paradigms investigating the A-B phenomenon. Two reasons dominate our thinking in this regard. First, there is a clear trend for researchers to find disproportionate numbers of Type As in their samples, which seriously questions the specificity value of Type A (see Chesney et al., 1981; MacDougall et al., 1979), and second, as noted above, there are wide individual differences in physiologic reactivity within both Type As and Type Bs. The major assumption underlying all of this work is that exaggerated physiologic response to everyday life events may hasten the onset of CHD. Therefore, direct study of physiologic reactivity as an individual difference variable in and of itself and the characteristics associated with such a propensity offers a more promising approach to understanding the behaviorphysiologic response-disease relationship than primary focus on the A-B variable. We clearly are not recommending abandonment of the A-B phenomenon. After all, Type A is at least as potent a risk factor for CHD as the traditional risk factors and, indeed, interesting differences may yet be uncovered between Type A and B subjects who are both identified as high physiologic reactors by some standard maneuver. Rather, we are suggesting a better balance between future study of the two individual difference variables of Type A on the one hand and dispositional high physiologic response on the other.


ACKNOWLEDGMENTS

Preparation of this manuscript was supported by research grant HL-22809 awarded to the first two authors by the National Heart, Lung, and Blood Institute of the National Institutes of Health.


REFERENCES

Arlow J. A. "Identification of mechanisms in coronary occlusion". Psychosomatic Medicine, 1945, 7, 195-209.

Benson H., Herd J. A., Morse W. H., & Kelleher R. T. "Behavioral induction of arterial hypertension and its reversal". American Journal of Physiology, 1969, 217,30-34.

Blumenthal J. A., Williams R., Kong Y., Schanberg S. M., & Thompson L. W. "Type A behavior and angiographically documented coronary disease". Circulation, 1978, 58,634-639.

Bortner R. W. "A short rating scale as a potential measure of Pattern A behavior". Journal of Chronic Diseases, 1969, 22,87-91.

Brand R. J. "Coronary-prone behavior as an independent risk factor for coronary heart disease". In T.M. Dembroski

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Handbook of Psychology and Health: Cardiovascular Disorders and Behavior - Vol. 3
Table of contents

Table of contents

  • Title Page iii
  • Table of Contents v
  • Preface ix
  • Handbook of Psychology and Health *
  • 1 - Behavior and Cardiovascular Disease: Issues and Overview 1
  • References 14
  • 2 - Animal Behavior Models of Coronary Heart Disease 19
  • References 50
  • 3 - Perspectives on Coronary-Prone Behavior 57
  • Acknowledgments 77
  • References 77
  • 4 - Attention and Coronary Heart Disease 85
  • Acknowledgments 116
  • References 116
  • 5 - Psychological Factors in Cardiac Arrhythmias and Sudden Death 125
  • Acknowledgments 150
  • References 150
  • 6 - Animal Models of Hypertension 155
  • References 189
  • 7 - Behavioral-Cardiac Interactions in Hypertension 199
  • ACKNOWLDEGMENTS 226
  • References 226
  • 8 - Modification of Coronary-Risk Behavior 231
  • Acknowledgments 270
  • References 270
  • 9 - The Non-Pharmacologic Treatment of Hypertension 277
  • References 291
  • 10 - Recovery and Rehabilitation of Heart Patients: Psychosocial Aspects 295
  • References 328
  • Author Index 335
  • Subject Index 355
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