Psychological and physiological responses of individuals displaying type A behaviour

Earlier findings on the relationship between the coronary-prone behaviour pattern Type A and coronary heart disease (CHD) are briefly reviewed, with particular reference to the underlying pathophysiological mechanisms linking the two. Results obtained during the playing of competitive games with or without harassment from the opponent suggest that competition alone does not distinguish between Type A and Type B individuals. The Type A pattern appears to be associated with exaggerated cardiovascular responses only as the result of hostile interactions. The primary need to study the Type A pattern as psychological construct is emphasized. Analysis of structured interview responses suggests that hostility and competitive drive are the two components of the pattern associated with cardiovascular disease. A model is proposed in which Type A subjects, faced with threats of their control, exhibit first hyper-responsive and then hypo-responsive efforts to regain it, and experimental evidence in support of this model is presented. However, such hyper-responsive reactions might be linked more closely to coping and defence mechanisms than they are to Type A. It is proposed that the Type A pattern be regarded as an aspect of the person-situation interaction and that efforts be made to establish those classes of environmental stimuli likely to elicit it.