Development of a brief self-report measure of the type A (coronary prone) behavior pattern

Involvement of psychosocial factors in the association of obesity with periodontitis

The present case-control study of 79 subjects (19-69 yr) was designed to assess the relationship of several psychological determinants to periodontal disease and obesity. Periodontal clinical examinations were performed, and the subjects were asked to complete a set of questionnaires measuring Type A personality, anxiety, depression, dental anxiety, hopelessness, emotional intelligence, stress, self-esteem, optimism and satisfaction with life. In a bivariate analysis, overweight individuals presented higher levels of smoking exposure, anxiety and depression and lower levels of optimism and satisfaction with life. They were mainly females, with a higher number of sites and teeth with probing depth (PD) >6 mm and clinical attachment level (CAL) >5 mm. Patients with a mean PD exceeding 3 mm and a bleeding on probing index of >25% presented higher values of dental anxiety and lower levels of self-esteem. Multiple linear regression analyses revealed that dental anxiety was positively associated with the number of teeth with a PD of >6 mm and with reasons for visiting a dentist, while satisfaction with life was associated with flossing frequency. We conclude that there is an association between several psychological determinants, periodontitis, and body mass index.

Type A behavior and work situation: Associations with burnout and work engagement

The aim of the present study was to investigate Type A behavior as well as perceived work situation, and associations with burnout and work engagement. The associations in focus were investigated through hierarchical regressions in a sample (N= 329) of Swedish Information Communication Technology consultants. The findings indicated that both work situation and Type A behavior was correlated with work engagement and burnout; however, no interactions between Type A behavior and work situation were elicited. The main conclusion was that the achievement striving aspect of Type A behavior appears as "non-toxic" and is related only to work engagement. However, the irritability/impatience aspect appears to be responsible for burnout complaints among Type A individuals, possibly through negative effects of the mood itself than through perceived stress at work.

The Work Addiction Risk Test: development of a tentative measure of workaholism

The development and analyses of the psychometric characteristics of a tentative self-report measure of work addiction are reported. A total of 363 college students completed a battery of tests including the Work Addiction Risk Test. Internal consistency of the scores was .88. Also, these scores were compared with those on the Type A Self-rating Scale and the Jenkins Activity Survey, which give self-reports of Type A behavior and the State-Trait Anxiety Inventory. That scores on the work addiction risk test were reliable and showed concurrent validity supported psychometric utility for research and clinical practice.

Job hassles and cardiovascular reaction patterns among urban bus drivers

Forty-six bus drivers took pan in a longitudinal field study of cardiovascular reactions to urban driving. "Job hassles" were recorded by observers using a standardized list of stress-related events in traffic and on the bus. Measures of blood pressure, heart rate, and ratings of perceived mental strain were obtained after each route segment. Intraindividual correlations between psychophysiological recordings and job hassles were calculated and submitted to cluster analysis. Two reaction patterns were identified, 1 characterized by consistently, although modestly, positive associations between the frequency of job hassles and psychophysiological reactions, the other characterized by a low association between the frequency of hassles and indicators or psychophysiological arousal. The former group displayed significantly higher blood pressure and mental strain ratings in the unwinding phase after work than did the latter group of workers. The results are discussed in terms of rate or "unwinding" after exposure to stressful conditions.

Concurrent validity of the Work Addiction Risk Test as a measure of workaholism

The Work Addiction Risk Test was administered, with a measure of anxiety and two measures of Type A behavior, to 363 undergraduates at a major southern institution to test for concurrent validity. Correlations of scores on the Work Addiction Risk Test with other scores support the scale as a valid measure of workaholism.

Family history of hypertension influences neurobehavioral function in hypertensive patients

This study examined the influence of family history of hypertension on neurobehavioral performance. Sixty-two hypertensive men and women who reported a family history of hypertension (+FH) were compared with 28 hypertensive individuals without a family history (-FH) and 32 normotensive control subjects. A neurocognitive test battery that included tests of information processing, verbal memory, and figural memory was administered individually to each patient. Results showed that +FH, compared with -FH and normotensive control subjects, was associated with poorer performance on three tests of attention and short-term memory (Sternberg reaction time, Trails B, and Digit Span). There were no differences between the groups on tests of either verbal or figural memory. Other variables, including gender, ethnicity, age, years of education, blood pressure, state anxiety, depression, and Type A behavior did not account for these results. In addition, +FH hypertensive subjects reported greater levels of state anxiety and depression compared with -FH hypertensive subjects and normotensive control subjects. The findings suggest a genetic link to impaired cognitive abilities, as observed among hypertensive patients relative to their normotensive counterparts.

A measurement model for the Type A Self-Rating Inventory

Compared to other questionnaire measures of Type A behavior, the Type A Self-Rating Inventory (TASRI) possesses particularly strong face validity. This study sought to develop a formal measurement model for the TASRI using a sample of 352 male and 479 female undergraduate psychology students. Assessed via structural equation modeling, an oblique two-factor (Hard-Driving, Extroverted) model explained over 90% of the common variance in responses to a subset of 13 of the original 28 TASRI items for men, women, and the pooled data. As hypothesized, relative to women, men had a greater mean score on the Hard-Driving factor and a lower mean score on the Extroverted factor. However, the magnitude of these gender differences is small. When reconceptualized in the context of work on the Big Five factor model, the Hard-Driving and Extroverted factors were found to reflect related elements of positive sociability and negative power, respectively.

Serum lipids, neuroendocrine and cardiovascular responses to stress in healthy Type A men

This study examined the relationship between serum lipid activity in healthy Type A men and cardiovascular and neuroendocrine responses to a behavioral stressor, mental arithmetic. Assessment of blood lipids included measures of total cholesterol (TC), low density lipoprotein cholesterol (LDLC), high density lipoprotein cholesterol (HDLC), and serum triglycerides. Cardiovascular (blood pressure and heart rate) and neuroendocrine (epinephrine, norepinephrine and cortisol) responses were recorded before (rest), during (stress) and after (recovery) the mental arithmetic test. Diastolic blood pressure, mean arterial pressure and, to a lesser extent, systolic blood pressure levels at rest, during stress, and at recovery correlated positively with TC levels. In addition, both diastolic and mean arterial pressure were positively correlated with the ratio of TC to HDLC and with triglycerides during stress and recovery. Heart rate did not correlate with any lipid measure. Cardiovascular stress-reactivity calculated as change from rest to stress did not correlate significantly with any lipid measure. Plasma norepinephrine during stress correlated positively with triglycerides; a similar trend was observed for the TC/HDLC ratio. Plasma cortisol at rest and during stress correlated positively with the TC/HDLC ratio and serum triglycerides, and negatively with HDLC. Plasma norepinephrine reactivity calculated as change from rest to stress correlated negatively with HDLC and positively with triglycerides. In addition, cortisol reactivity was positively correlated with triglycerides. It is suggested that the mechanisms mediating Type A behavior and coronary heart disease may include increased cardiovascular and neuroendocrine responses as well as unfavorable lipid profiles.

Social interaction, cardiovascular activation and the Type A behavior pattern

The purpose of the study was to explore the relationship between social interaction and cardiovascular activity during a conflict-inducing communication task in Type A and B subjects. One of the subjects, the leader, was instructed to lead the other subject, the follower, through defined routes on a city map merely by help of instructions. The subjects were facing each other on each side of a screen which allowed eye contact but shielded the maps from view. 40 male students (mean age 24 years) exhibiting Type A or Type B behavior according to the Videotaped Structured Interview participated in the study. The results demonstrated large cardiovascular increases during task performance, particularly for leaders, in systolic blood pressure and heart rate. There were no main effects of Type A vs. Type B, but dyads composed of two Type As showed larger increase in diastolic blood pressure during the conflict phase of the task compared to dyads composed of Type Bs.

Neuroendocrine responses of type A individuals to exercise

Ten Type A and 10 Type B individuals exercised for 20 minutes on a bicycle ergometer at 40%, 60%, and 80% of maximal capacity to determine if differences in neuroendocrine reactivity exist. Pre-exercise plasma concentrations of beta-endorphin and epinephrine were similar for Type As and Type Bs. Pre-exercise plasma levels of norepinephrine tended to be higher for the Type As (p less than 0.07). Post-exercise plasma epinephrine concentrations were similar for As and Bs for all trials. The 40% and 60% trials resulted in no differences in post-exercise norepinephrine and beta-endorphin levels for the Type As and Bs. Conversely, the 80% trials resulted in significantly greater norepinephrine and beta-endorphin concentrations for the Type As (p less than 0.05). Plasma serotonin levels at rest and during exercise were always lower for the Type As (p less than 0.05). These results suggest that our Type As had a greater neuroendocrine response to high-intensity exercise than our Type Bs. The greater reactivity and analgesia may allow the Type A person to suppress feelings of fatigue, thus enduring higher levels of exertion for longer periods of time.

A note on measurement issues in type A research: let's not throw out the baby with the bath water

It has been suggested that researchers rely exclusively on the structured interview (SI) to assess Type A behavior instead of using objective self-report measures, because the SI is the only prospectively validated instrument currently available. This article considers the costs and benefits of relying solely on the SI to measure Type A behavior. Although using only the SI would assure that researchers measure, in a relatively unobtrusive fashion, actual Type A behaviors known to be predictive of heart disease, it would dramatically increase research costs, impede longitudinal studies of changes in Type A behavior, reduce the validity of statistical conclusions, restrict the convergent and discriminant validity of the Type A construct, and ultimately inhibit our ability to improve accuracy in predicting heart disease. A set of recommendations is proposed for improving the quality of measurement in Type A research.

Disease based spectrum bias in referred samples and the relationship between type A behavior and coronary artery disease

Using referred samples to study predictors of disease produces statistical problems that reduce the likelihood of obtaining statistically significant results even when a substantial relationship is present between a risk factor and a disease. The present paper refers to these problems as disease based spectrum (DBS) bias. DBS bias is present when subjects are directed into or excluded from the study sample according to their disease status. For example, healthy individuals are excluded from and diseased individuals are directed into referred samples. Therefore, DBS bias is present in referred samples. Examples from the literature on Type A behavior and coronary artery disease (CAD) are presented to illustrate how DBS bias reduces statistical associations. The results of the current research indicate DBS bias has reduced the association between Type A behavior and CAD in a number of studies reported in recent years. In addition, the present article discusses techniques for assessing and controlling for DBS bias.

Physical and psychological correlates of severe heart disease in men

Seventy eight men were assessed one month before coronary artery bypass graft surgery using standardized measures of psychiatric morbidity and personality as well as a measure of emotional expression (the CECS). All patients had at least one coronary vessel occluded by 75% or more of its diameter, and functional capacity was assessed by calculating the exercise treadmill time (in seconds) for each patient. Most of the variance in exercise treadmill time was accounted for by the following variables: young age, short duration of symptoms, and less severe angina. Only one of five men was designated a psychiatric 'case'. The only psychological measure significantly associated with atherosclerosis was expression of fear (on the CECS). A measure of Type A behaviour (Bortner score) was related to exercise treadmill time, but not to any of the angiographic or clinical indices of coronary heart disease (CHD). Like other measures of Type A behaviour, the Bortner scale is psychometrically impure and has doubtful validity. More valid behavioural variables (such as those measured by the CECS) require further investigation. Future studies on the relation between psychological factors and the extent of CHD should take account of not only sex differences but also patients without significant CHD: high rates of psychiatric morbidity in such patients confound the relation between psychological trait measures and atherosclerosis.

Convergent validity of self-reported type A behavior pattern of patients with coronary artery disease

A number of instruments has been proposed purporting to measure the Type A Behavior Pattern and evidence suggests little agreement among the measures. In this paper data are presented on the convergent validity of three self-report measures, the Jenkins Activity Survey, Form C; the Adjective Check List, Type A Behavior Scale; and the Coronary-prone Behavior Attitudes scale. A consecutive series of 33 outpatients affected by angina pectoris from a cardiologic department were subjects. Treatment with beta-blockers led to exclusion of eight subjects so that final sample was of 25, whose mean age was 60.24 yr. Most were female (76%, n = 19) and blue collar workers (72%, n = 18). A significant correlation was shown between the scores of Jenkins Activity Survey and the other scales, except for Type A elements related to hard-driving attitudes and job situation. No correlation was found between scores on the Adjective Check List scale and on the Coronary-prone Behavior Attitudes scale. The data are discussed in the light of the complexity of Type A Behavior Pattern, supporting the hypothesis of the multidimensional nature of this phenomenon and in terms of sociodemographic characteristics of the group.