Many stress-related psychological factors have been studied as potential risk factors for heart disease. One is the Type A Behavioral Pattern (TABP), which refers to a set of behaviors such as competitiveness, striving for achievement, impatience/time urgency, hostility/anger, and animated speech. Type B refers to a more relaxed pattern of behavior with a relative lack of Type A characteristics. The attributes that define Type A are believed to be caused by stressful or difficult situations.
Research shows that Type A and Type B represent extremes of a continuum of variation in people’s behavior rather than discrete categories of people. It has also been shown that the individual components of Type A behavior do not necessarily come together. People can be competitive without having a lively speech style, without being impatient or hostile.
Anger and Hostility as Primary Type A Attributes
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Most importantly, anger and hostility appear to be associated with heart disease risk. It is also important to note that while “hostility” can include aggressive behavior, in this context it includes a range of attitudes such as sarcasm and distrust.
These attitudes can provoke anger, increase stress levels, negatively affect social relationships, and reduce the availability of social support to deal with stress.
depression, anxiety, and other emotion-related features
Although anger and hostility continue to receive research attention, investigations of emotion-related factors that may drive heart disease have recently focused on other traits. It has been identified as a potentially important predictor of heart disease, both at the symptom level and in the form of major depressive disorder. This appears to be true in both healthy individuals and heart disease patients and may be associated with heart disease relapses.
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Another emotional quality that has been highlighted in cardiovascular research is anxiety. Similar to depression, anxiety has been studied as a potential aspect of individual variability and in terms of clinical conditions such as post-traumatic stress disorder. References to individual differences in irritability, anger, sadness, and anxiety in relation to anxiety and neurosis are associated with health outcomes, including heart disease.
Optimism in nature, a generalized expectation of positive outcomes, has also been implicated as a possible protective factor against heart disease. However, recent research complicates this situation. Optimism and pessimism are not necessarily opposites, and high optimism does not necessarily mean low pessimism. There are some indications that high levels of pessimism may be a more important predictor of adverse health effects than low levels of optimism.
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what this means
One important implication of this study is that the behaviors that define Type A behavioral patterns are a matter of degree and do not form categories of people, so we should think of ourselves as ‘Type A’ or ‘Type B’. It means that it is not. The other is anger and hostility to the extent that they exhibit any of the behaviors associated with the Type A concept.
But we need to think beyond the concept of Type A when assessing how our personality relates to heart health. Associated is a tendency to experience depressed moods and anxiety, as well as pessimism, which may be associated with these attributes. Underlying factors and health effects should also be kept in mind. There is encouraging evidence to suggest that effective stress management is cardioprotective.
Finally, while emotions and stress almost certainly play a role in cardiovascular disease, heart health reflects multiple potentially modifiable factors. Major cardiac risk factors include smoking, blood cholesterol levels, resting blood pressure, diabetes, and other metabolic factors. Changing these variables is, in part, a matter of lifestyle change aspects that many of us must contemplate and implement throughout the year, not just as New Year’s resolutions.