Interviewer style, type A behavior, and cardiovascular response

The present study assessed whether Type A ratings obtained through different styles of administering the structured interview (SI) differed in their relation to cardiovascular reactivity and questionnaire measures of Type A. Seventy-four male subjects were administered the SI in either a fast, interruptive style or a slower, less disruptive style. Subjects' blood pressure and pulse rate responses to a mirror-tracing and a memory-for-digits task were measured, and subjects also completed the Framingham Type A Scale (FTAS) and the Jenkins Activity Survey (JAS). Increases in diastolic blood pressure in response to the tasks and scores from the FTAS were positively related to Type A ratings obtained from slower interviews; they tended to be negatively related to Type A ratings obtained from fast, interruptive interviews. These results support the notion that style of administering the SI may influence prediction by Type A ratings of cardiovascular end-points, including CHD.     

Marital relationships and Type A-B Behavior assessed using the structured interview,Jenkins Activity Survey,and Framingham Type A Scale

Associations between spouses' Type A/Type B Behavior and marital distress, communication, and desired relationship changes were investigated in a sample of 42 healthy Caucasian couples aged 39 to 60 years. Consistency of relationships between marital distress and behavior type (BT) across different BT measurement techniques was also evaluated. BT was measured using the Structured Interview (SI), the Jenkins Activity Survey (JAS), and the Framingham Type A Scale (FTAS). Type A behavior in women was associated with increased marital distress and communication difficulties, as reported by both men and women. Participants also desired greater relationship changes when women were Type A. Findings varied greatly across BT measures. The strongest effect occurred for the FTAS, followed by the JAS. No significant effects were found for SI-assessed BT. Results reflect the multifaceted nature of the Type A construct and may reflect gender role differences within marital relationships.This research was supported by a grant from the National Heart, Lung and Blood Institute (HL34642; M. Morell, Principal Investigator; M. Sullaway, Coprincipal Investigator), with supplemental funding from University Research Grants and Biomedical Research Support Grants (RR07009) awarded to the second author by the University of California, Los Angeles.     

Identification of a coronary-prone profile for business managers: comparison of three approaches to Type A assessment

This study compares three approaches to Type A assessment for identifying a coronary-prone profile for business managers. The Survey of Work Styles (SWS), a profile measure of the Type A behavior pattern, was compared with the Structured Interview (SI), a categorical measure, and with the Jenkins Activity Survey (JAS) and Framingham Type A Scale, both continuous measures. The blood pressure, heart rate, and cardiac effort of 163 middle-aged male business managers (107 of whom were classified as Type A by the SI) were assessed during the SI. Neither the classification by the SI of the subjects into Type A and non-Type A groups nor Type A1, A2, X, B3, and B4 revealed differences in physiological arousal. Similarly, no relationship was found between physiological variables and Type A behavior that was assessed on a continuum by the JAS or Framingham Type A Scale. When business managers were classified by the SWS according to their pattern of Type A components, however, the results showed that men high on Anger but low on Competitiveness and Job Dissatisfaction had significantly higher levels of systolic blood pressure during the SI. The importance of recognizing individual differences in the expression of Type A behavior when assessing coronary-prone physiological reactivity is discussed.     

Behavioral and content components of the structured interview assessment of the Type A behavior pattern in women

The purpose of this study was to analyze relationships among (1) the global assessment of the Type A behavior pattern determined by the Structured Interview (SI), (2) the Type A score of the Jenkins Activity Survey (JAS), and (3) ratings of individual behaviors and content items in the SI. These relationships were analyzed in a sample of 88 white suburban women. The individual behaviors rated were four speech characteristics and motor pace. The correlation between SI global assessment of behavior pattern and JAS Type A score was only 0.27. SI global assessment was strongly correlated with ratings of individual behaviors such as speech speed, speech emphasis, and rapid motor pace. There was little or no correlation between these behaviors and the JAS Type A scores. For items reflecting the content of the interview responses, correlations with JAS Type A scores were generally stronger than correlations with SI global assessment. The findings for this sample of women are quite similar to results from previous studies of men. Thus, the characteristics that influence SI global assessment appear to be similar for women and men.     

Convergent validity of Type A behavior pattern scales and their ability to predict physiological responsiveness in a sample of female public employees

The purpose of this study was to assess the construct validity of the structured interview (SI), Jenkins Activity Survey (JAS), Thurstone Activity Scale, and Bortner Type A Scale in a sample of female employees from a government service agency. Criteria for validity assessment were physiological reactance to a mental stressor, psychological strains experienced at work, physical symptoms associated with work, and urinary catecholamine production at work. A continuous Type A SI scale demonstrated better convergent and construct validity than did the SI category scores. All of the SI Type A scales were reliable. Among the questionnaire measures only the Thurstone Activity Scale was reliable and showed the strongest construct validity. The SI measures of Type A tended to correlate with physiological responsiveness (changes in heart rate, skin temperature, and skin conductance), while the questionnaire measures correlated with self-reports of job strains (satisfaction, irritation, depression, physical symptoms), thus indicating the operation of measurement artifacts in validity assessment. No significant correlations were obtained between Type A and catecholamines. Comparison of correlation analysis with subgroup analysis revealed the former to be a more powerful test of the relationships that may exist between Type A behavior pattern and relevant criteria.This research was supported by the University of Nebraska—Lincoln Research Council and NIH Biomedical Research Support Grant RR-07055.The authors wish to express their appreciation to Susan Haeker who conducted and scored Type A Structured Interviews that were essential to the completion of this project. The help of Jerry Lemonds and Mary Boschult who provided support and assistance in date collection is also gratefully acknowledged.     

Type A behaviour, borderline hyperventilation and psychological, psychosomatic and neuroendocrine responses to mental task load

Psychological, psychosomatic and neuroendocrine (in blood) responses to mental task load were investigated in relation to Type A behaviour and borderline hyperventilation. For this purpose 32 apparently healthy, male volunteers were classified on the basis of their scores on the Jenkins Activity Survey (JAS) and on a questionnaire assessing hyperventilation related symptoms (HRS). The subjects performed a memory search task in which a monetary bonus could be won or lost. At rest higher HRS scores were related to increased acute psychosomatic symptom scores and higher JAS scores to higher prolactin levels. Task performance caused an increase of state anxiety, acute psychosomatic symptoms, adrenaline and cortisol, whereas prolactin decreased. Higher JAS scores were related to greater cortisol responses and higher HRS scores to smaller adrenaline responses.     

Principal Dimensions of the Framingham Type A Scale: Differential Relationships to Cardiovascular Reactivity and Anxiety

Abstract

The present investigation sought to identify the principal dimensions of the Framingham Type A scale (FTAS) and then to examine their physiological and psychological correlates. A factor analysis of the FTAS items, which was cross-validated, revealed two factors. Items concerning achievement and competitive-striving loaded primarily on the first factor. Scores on a subscale composed of these items (labeled Competitive Drive) were related to systolic blood pressure reactivity during an interpersonal task but were unrelated to anxiety. FTAS items concerning impatient, time urgent, and domineering propensities loaded primarily on the second factor. Scores on a subscale composed of these items (labeled Speed and Impatience) were not related to cardiovascular reactivity during the task but were related to anxiety. Results are discussed in terms of the psychological heterogeneity of the Type A behavior pattern and possible differences between dimensions of the overall Type A pattern and their association with different manifestations of coronary heart disease.     

Type A and social support

This investigation tested Matthews's hypothesis, which proposed that reduced social support may be one of the mediators of susceptibility to coronary disease in Type A individuals. In addition, sex differences were hypothesized to be an important aspect of the findings. Subjects were 72 women and 57 men undergraduate students who completed the Jenkins Activity Survey (JAS) and the Sarason Social Support Questionnaire. For women, both the Type A and Speed and Impatience subscales of the JAS were negatively related to satisfaction with social support. For men, however, Type A scores on JAS were positively correlated with satisfaction with social support. The implications of these findings, particularly with regard to the importance of separate analyses by sex, are discussed.     

The relationship between sex-role orientation and the type A behavior pattern: a test of the main effect hypothesis

Examined the relationship between sex-role orientation and the Type A behavior pattern. Eighty undergraduates were classified as high or low on masculinity and femininity on the basis of Bem Sex Role Inventory (BSRI) formed on student Jenkins Activity Survey (JAS) scores for pooled Ss, for males, and for females; each yielded a main effect for masculinity. JAS scores were correlated positively with BSRI Masculinity scores and not correlated with BSRI Femininity scores across pooled Ss, across males, and across females. These results are discussed in terms of their research and treatment implications.     

Type A behavior and its association with cardiovascular disease prevalence in Blacks and Whites: The Minnesota heart survey

Population-based surveys were conducted in 1985 and 1986 to measure the prevalence of coronary heart disease (CHD) history and risk factors in Black and White adults. Type A behavior was measured by the Jenkins Activity Survey (JAS). JAS scores were associated with age (negatively), education (positively), and sex (men>women) but were largely unrelated to CHD risk factors. Blacks had significantly lower age- and education-adjusted Type A and component scores than Whites, more so formen than women. Univariate analysis indicated that a history of angina and/or heart attack was positively associated with the Type A score in both Blacks and Whites. Following adjustment for known cardiovascular risk factors, Type A score remained positively and significantly associated with CHD prevalence. These findings are consistent with other cross-sectional studies and suggest that Type A behavior, as measured by the JAS, may increase the risk of CHD in both Blacks and Whites. Follow-up of these cohorts may help to clarify the complex relationship of Type A behavior to the risk of CHD.Supported by a National Heart, Lung and Blood Institute Grant (RO1-23727).     

Psychological correlates of gastric and duodenal ulcer disease

Psychological correlates of gastric and duodenal ulcer disease were assessed in a group of somewhat older patients with ulcer disease identified by endoscopy. Associations between both ulcer types and symptom measures (anxiety and depression) seemed only to reflect severity or chronicity of gastrointestinal symptoms or the impending endoscopy procedure. Associations with 'trait' psychological indices may be of causal significance. Duodenal ulcer patients had higher 'introversion' and 'psychoticism' scores (on the EPQ) than controls, while gastric ulcer patients had higher psychoticism scores and 'trait anxiety' scores. These findings could not be attributed to confounding variables. When the two ulcer groups were compared, the gastric ulcer group had significantly higher neuroticism, psychoticism and hostility scores which were not attributable to confounding variables. The higher depression scores in gastric ulcer patients, however, simply reflected the greater chronicity of their physical symptoms. The groups did not differ significantly on measures of trait anxiety, tension, introversion or Type A behaviour.     

A moratorium on research using the Jenkins Activity Survey for type A behavior?

This article presents a brief review of literature which indicates that it may be premature to abandon the use of the Jenkins Activity Survey (JAS) for assessing Type A behavior. In particular, the literature suggests that the time urgency/irritability subcomponent of the JAS may represent a nonspecific susceptibility factor for general ill health. Moreover, studies demonstrate that the time urgency/irritability facet of the JAS is associated with a negative health-risk profile which consists of the presence of vulnerability factors and the absence of protective factors. Finally, results of this brief review are consistent with previous research with paper and pencil measures of Type A behavior showing that subcomponent measures are superior to global measures. © 1997 John Wiley & Sons, Inc. J Clin Psychol 53: 905–907, 1997     

Assessing adaptive and maladaptive coping in the early phase of acute myocardial infarction

We assessed retrospectively symptom management behaviors among 45 patients with acute myocardial infarction (AMI). Cluster analysis was conducted on data from the Structured Interview (SI), in order to group patients according to the global TABP, Anger-In, Potential for Hostility, and a newly derived measure of Behavioral Compensation for Stress (BEH-COMP). Two groups were identified. MALADAPT SI-copers (N = 24) had higher scores on Anger-In and Hostility and lower scores on BEH-COMP in comparison to the ADAPT SI-copers (N = 21), while no difference was observed on TABP. The SI groups were next compared on AMI symptom management behaviors. A hierarchical discriminant analysis found that the MALADAPT group reported greater distraction from AMI symptoms, were relief-seeking behavior, and greater perceived vulnerability to reinfarction. AMI coping behaviors correlated meaningfully with delay in seeking medical assistance. Further research is warranted, given the potential for using the ADAPT/MALADAPT SI-profiles to predict adjustment to AMI.     

Physical Symptom Reporting and Health Perception among Type a and b College Males

Abstract

This investigation studied the relationship of Type A behavior to physical symptom reporting and self-appraised health status. The student version of the Jenkins Activity Survey was administered to thirty male college seniors during a high-stress period of the semester. Results showed that Type A's reported relatively fewer physical symptoms and perceived themselves as being more healthy than Type B's. Type A individuals also rated themselves as healthier than their peers, whereas Type B individuals rated themselves as being less healthy than their peers. In addition, symptom reporting and health perception were negatively correlated in the Type B subsample; however, this relationship was not evident in the Type A subsample. In the discussion, it was suggested that the attentional style of Type A's may contribute to lower levels of symptom reporting and faulty appraisals of health status. The notion of an attributional bias whereby Type A's define internal somatovisceral states differently than Type B's was also discussed. Finally, the results were discussed in terms of their implications for understanding the mechanisms through which Type A behaviors might translate into increased coronary heart disease (CHD) risk.     

Do Type A men drink more frequently than Type B men? Findings in the Multiple Risk Factor Intervention Trial (MRFIT)

The association between the Type A behavior pattern and self-reported alcohol intake was studied among men at high risk for coronary disease in the Multiple Risk Factor Intervention Trial. Two assessments of behavior pattern, the Structured Behavior Pattern Interview (SBPI) and the Jenkins Activity Survey (JAS), and two measures of alcohol intake were examined. Type A's consumed more alcohol (up to 30% more) than Type B's. Type A's drank more frequently than Type B's rather than more alcohol per occasion. This association was consistent for both SBPI and JAS assessments of behavior pattern and was independent of age, income, smoking, and marital status. Increased drinking frequency appears to be a concomitant of the Type A behavior pattern.This work was supported by National Heart, Lung and Blood Institute Contracts 72-2971 and HV22976, National Research Service Awards HL07036 (Dr. Folsom) and HL07023 (Dr. Buehler), and Research Career Development Award HL00287 (Dr. Jacobs).     

Type A behaviour differentiates bipolar II from unipolar depressed patients

BACKGROUND: A relation between the type A behaviour pattern (TABP) and coronary heart disease has been found in many studies and the existence of a psychiatric coronary-prone mood profile has been suggested. TABP consist of fairly stable character traits such as time urgency, impatience, irritability and competitiveness, which in patients with affective disorders could be bipolar traits. The aim of this study was to compare TABP in depressed unipolar and bipolar II patients, and explore the relation between TABP, affective temperaments and migraine headaches, another disorder associated with bipolar II disorder. METHODS: The Jenkins Activity Survey (JAS) (Form C), a self-report multiple-choice questionnaire designed to measure TABP, was given to 99 patients diagnosed with a DSM-IV major affective disorder. Affective temperaments were diagnosed according to Akiskal's criteria and migraine diagnosed according to the criteria of the International Headache Society. The JAS was scored in the traditional manner, yielding scores for TABP and three factorially independent components, speed and impatiens (factor S), job involvement (factor J) and hard-driving and competitive (factor H). RESULTS: 65 patients diagnosed with a unipolar (n = 42) or bipolar II (n = 23) disorder had valid scores on the JAS. Patients with bipolar II diagnosis had significantly higher JAS scores than the unipolar patients (Wilks' lambda = 0.851, F = 2.62, df = 4, 60, p < 0.05). Type A behaviour differed (total JAS score: mean square 509.3, df = 1, F = 9.4, p < 0.005), mainly due to a divergence in factor S (mean square 465.5, df = 1, F = 6.0, p < 0.02). Higher JAS scores were significantly associated with having a cyclothymic temperament (Wilks' lambda = 0.728, F = 4.30, df = 4, p = 0.005) and lower JAS scores with having a depressive temperament (Wilks' lambda = 0.747, F = 3.13, df = 4, p = 0.026). TABP was not associated with migraine. LIMITATIONS: Non-blind, cross-sectional assessment of affective disorders and migraine headaches and questionnaire-based type A behaviour assessment. CONCLUSIONS: These results indicate that a well-established questionnaire designed to recognize the type A behaviour pattern, distinguishes depressed unipolar from depressed bipolar II patients as well.     

Relationships among locus of control, self-concept, and anxiety.

Sixty male alcoholic inpatients were administered the Locus of Control scale (IE), the Activity Preference Questionnaire (APQ), the Manifest Anxiety scale (MAS), and the Tennessee Self Concept scale (TSCS). Ss defined as having an external locus of control appeared significantly more anxious than internal Ss on the MAS; however, no differences were found between groups on the APQ or TSCS scales. The self-report (MAS) and nonobtrusive (APQ) measures of anxiety were not correlated significantly. A differential pattern of correlations was found between the MAS and APQ and TCSC subscale scores. The obtained correlations support the contention that the MAS may measure more accurately a dimension of neuroticism and/or negative self-concept rather than anxiety. Further research appears necessary to investigate the internal consistency and dimensionality of the MAS.     

Psychophysiological reactivity and speech behavior during the Structured Type A Interview and a self-disclosure monologue

Speech characteristics and the simultaneously recorded psychophysiological reactivity were compared between two tape-recorded speech tests, the Structured Type A Interview (SI) and a standardized 'self-disclosure' monologue (SD) as a non-social speech test. The SD started with a 5-min mental preparation interval followed by 3 subsequent self-reports each lasting 1.5 min. The 26 students used as subjects showed in all cardiovascular parameters (interbeat interval, pulse transit time to the earlobe, finger plethysmographic amplitudes and blood pressure) strong and similar reactivity to both tests. The individual rankings of physiological reactivity turned out to be remarkably constant over all experimental periods, but this reactivity was neither correlated with the Type A scores nor with sex. Modest correlations between the SI and SD test were obtained for word rate, expiratory sighs, and silent latent pauses. Thereby, some speech variables tended to be affected by the Type A behavior, and, to a somewhat stronger extent, by sex. The desirability of a non-social speech test for assessing Type A behavior is discussed.