Type A and Type B personality theory

[1] Following the results of further studies and considerable controversy about the role of the tobacco industry funding of early research in this area, some reject, either partially or completely, the link between Type A personality and coronary disease.

[2] Type A personality behavior was first described as a potential risk factor for heart disease in the 1950s by cardiologists Meyer Friedman and Ray Rosenman.

They credit their insight to an upholsterer who called to their attention the peculiar fact that the chairs in their waiting rooms were worn out only on the arms and on the front edge of the seat.

"[5] Subsequent analysis indicated that although Type A personality is associated with the incidence of coronary heart disease, it does not seem to be a risk factor for mortality.

[8] The hypothesis describes Type A individuals as outgoing, ambitious, rigidly organized, highly status-conscious, impatient, anxious, proactive, and concerned with time management.

Depending on the task and the individual's sense of time urgency and control, it can lead to poor results when there are complex decisions to be made.

[15] In his 1996 book, Type A Behavior: Its Diagnosis and Treatment, Friedman suggests that dangerous Type A behavior is expressed through three major symptoms: (1) free-floating hostility, which can be triggered by even minor incidents; (2) time urgency and impatience, which causes irritation and exasperation usually described as being "short-fused"; and (3) a competitive drive, which causes stress and an achievement-driven mentality.

[18] There are two main methods to assessing Type A behavior, the first being the a structured interview (SI) developed by Friedman and Rosenman, and the second being the Jenkins Activity Survey (JAS).

[19] The SI assessment involves an interviewer's measuring a person's emotional, nonverbal, and verbal responses (expressive style).

[27] While Achievement Striving is associated with higher job performance, motivation, and career success, Impatience/Irritability correlates with negative stress responses, interpersonal conflict, and health risks such as coronary heart disease.

This distinction suggests that not all Type A traits are detrimental, and organizations may benefit from fostering achievement-oriented behaviors while mitigating the negative consequences of impatience and irritability.

In contrast, those with high Impatience/Irritability are more likely to perceive stressors as overwhelming, leading to lower job satisfaction, increased burnout, and strained professional relationships.

Organizations that recognize these nuances in personality can develop targeted interventions, such as stress management programs and leadership training, to help employees leverage the positive aspects of Type A behavior while reducing its negative effects.

[27] Friedman et al. (1986)[28] conducted a randomized controlled trial on 862 male and female post-myocardial infarction patients, ruling out (by probabilistic equivalence) diet and other confounds.

[citation needed] Further discrediting the so-called Type A Behavior Pattern (TABP), a study from 2012 – based on searching the Truth Tobacco Industry Documents – suggests the phenomenon of initially promising results followed by negative findings to be partly explained by the tobacco industry's involvement in TABP research to undermine the scientific evidence on smoking and health.

[29] The industry's interest in TABP lasted at least four decades until the late 1990s, involving substantial funding to key researchers encouraged to prove smoking to simply correlate with a personality type prone to coronary heart disease (CHD) and cancer.

[31][32][33] Philip Morris (today Altria) and RJ Reynolds helped generate substantial evidence to support these claims by funding workshops and research aiming to educate about and alter TABP to reduce risks of CHD and cancer.

Moreover, Philip Morris primarily funded the Meyer Friedman Institute, e.g. conducting the "crown-jewel" trial on the effectiveness of reducing TABP whose expected findings could discredit studies associating smoking with CHD and cancer but failing to control for Type A behavior.

Though apparently unpaid for, this letter was approved by and blind-copied to Philip Morris, and Friedman (falsely) claimed to receive funding largely from the National Heart, Lung and Blood Institute.

[39] According to research by Redford Williams of Duke University, the hostility component of Type A personality is the only significant risk factor.

[41] As time continued, more research was conducted which focused on different components of type A behavior such as hostility, depression, and anxiety predicting cardiac disease.

[41] The initial study that pointed to the association of Type A personality and heart attacks had a massive number of questions under consideration.

A study undertaken by the U.S. National Institute of Aging, Sardinian and Italian researchers, as well as bio-statisticians from the University of Michigan, had specifically tested for a direct relationship between coronary heart disease and Type A personalities, and the results had indicated that no such relation exists.

[citation needed] A study (that later was questioned for nonplausible results[42] and considered unsafe publication[43][44]) was performed that tested the effect of psychosocial variables, in particular personality and stress, as risk factors for cancer and coronary heart disease (CHD).

[48] A study conducted by the International Journal of Behavioral Medicine re-examined the association between the Type A concept with cardiovascular (CVD) and non-cardiovascular (non-CVD) mortality by using a long follow-up (on average 20.6 years) of a large population-based sample of elderly males (N = 2,682), by applying multiple Type A measures at baseline, and looking separately at early and later follow-up years.