Type A/B differences in coping with acute myocardial infarction: further considerations

To further investigate the link between Type A/B behavior pattern and duration of in-hospital stay after AMI, we had nurses observe and rate patients daily as regards mood, self-initiative, and signs of Type A behavior (time urgency, preoccupation with work, competitiveness). We found Type As to be more alert, more active, friendlier, more competitive, more emotionally withdrawn, and more concerned about return to work than Type Bs while hospitalized. Type A patients also displayed more self-initiative in their daily hospital care, which in turn was inversely related to duration of in-hospital recovery time, i.e., patients who showed greater self-initiative were discharged sooner. Type A/B differences in coping with AMI emerged soon after admission to the CCU. Type A patients quickly began to "take charge" of their illness situation, which they no doubt perceived as a challenge to be overcome. While this may initially suggest a more favorable prognosis for Type As, in the long-run it may explain their differential CHD morbidity and mortality, i.e., Type As are more prone toward recurrent and fatal AMI. As such, therapeutic intervention(s) should be initiated early and designed to accommodate Type As' use of denial and need for environmental control. Preliminary suggestions along these lines are included.