Type A behaviour in patients with chest pain: test-retest reliability and psychometric correlates of Bortner scale

Ninety-nine patients with chest pain and a presumptive diagnosis of coronary heart disease were assessed within 24 hr of angiography using a standardised psychiatric interview, personality inventory and Bortner Type A questionnaire. Ninety-six of the 99 patients completed the Bortner scale 4 months later, when test-retest reliabilities were 0.84 for both the 65 men and 31 women. There were significant correlations between Bortner score and measures of both psychiatric morbidity and neuroticism in men; and those items on the Bortner scale denoting speed and impatience were most highly correlated with neuroticism. None of these associations were noted in women. Men with normal or near-normal coronary arteries had higher measures of extraversion, neuroticism and Type A score than those with important occlusions, suggesting an association between insignificant coronary artery disease, "complaint behaviour" and raised Type A score. The findings question the unitary nature of Type A behaviour, and suggest an important association between the behaviour pattern and the personality dimension of neuroticism in men.