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Psychologic treatment for the type A behavior pattern and for coronary heart disease: a meta-analysis of the
Insights
Psychological interventions effectively reduce Type A Behavior Pattern (TABP) scores, a risk factor for coronary heart disease (CHD). This meta-analysis suggests potential for significant reductions in CHD events with such treatments.
Area of Science:
- Behavioral Medicine
- Cardiology
- Psychology
Background:
- Type A Behavior Pattern (TABP) is a known risk factor for coronary heart disease (CHD).
- Psychological treatments for TABP are not widely implemented despite their potential benefits.
Purpose of the Study:
- To systematically review and meta-analyze controlled studies on the psychological treatment of TABP.
- To assess the impact of these interventions on TABP modification and CHD outcomes.
Main Methods:
- A meta-analysis was conducted on 18 controlled studies examining psychological treatments for TABP and CHD.
- Effect Sizes (ES) were calculated for TABP measures and combined significance probabilities (pc) for CHD events.
Main Results:
- Psychological interventions resulted in a significant reduction in TABP scores, with a mean ES of 0.61.
- A trend towards a significant reduction in 3-year CHD events (mortality and myocardial infarction) was observed (pc < 0.0001), though based on limited studies.
- Combined treatment techniques appeared most effective for reducing both TABP and CHD recurrences.
Conclusions:
- Psychological interventions show promise in reducing TABP and potentially improving clinical outcomes in CHD patients.
- Further research and preliminary clinical application of these interventions are warranted.
Abstract:
The Type A behavior pattern (TABP) is a recognized risk factor for coronary heart disease (CHD), and yet treatments aimed at its modification are not in widespread use. We reviewed the literature of controlled studies (N = 18) of the psychologic treatment of the TABP and of CHD with the statistical method of "meta-analysis." The results of each study were converted to a standardized "Effect Size" (ES). The mean ES for TABP measures was 0.61 +/- 0.20 (95% confidence interval) (p less than 0.001), indicating that after treatment subjects across all studies reduced their TABP scores by half a standard deviation. The combined significance probability (pc) across studies for reduction in 3-year combined mortality and myocardial infarction was pc less than 0.0001, corresponding to a reduction in coronary events of roughly 50% after psychologic treatment. This finding must be approached with caution because it is based on only two studies. The analysis suggested that a combination of treatment techniques is most effective in reducing TABP and CHD recurrences. The literature was critiqued, and limitations of the findings are discussed. We conclude that psychologic intervention to reduce TABP may improve clinical outcome of CHD and that this deserves further study and preliminary clinical application.