Type A behavior and elevated physiological and neuroendocrine responses to cognitive tasks

The effect of recent life events stress, life assets, and temperament pattern on cardiovascular risk factors for Akron City police officers

Police officers, as a group, experience many occupational demands with physiological and psychological effects that could be harmful to their health. A primary objective of this study was to analyze specific behavioral and physiological risk factors that could lead to hypertension and accelerated coronary artery disease. Three hundred thirty-one male Akron City police officers participated in the study. A group of volunteer males (n = 48) who worked in city clerical jobs were used as controls. Questionnaires were administered in order to measure such behavioral variables as recent life change, life assets, and temperament pattern. Blood chemistry and physiological variables were also measured. The police officers had higher diastolic blood pressure (DBP), norepinephrine (NE) levels, and recent life change unit (LCU) scores than the control group. Increased hostility and depression scores were associated with higher DBP and recent LCU scores and lower life asset unit (LAU) scores. Individuals with higher "dominant" scores and moderate to high recent LCU scores had higher cardiovascular risk factors than those with moderate to high recent LCU scores who were ranked as "subordinate." Rotating shift workers had abnormally elevated NE levels, which, if not controlled, may lead to higher cardiovascular risk. Behavioral intervention programs have been introduced with the goals of reducing stress, increasing life assets, and teaching relaxation techniques.

Psychophysiological reactivity in type A and B women during a rapid information processing task

Type A and Type B women assessed by a newly developed German questionnaire 'need for control' (NC) were compared with respect to time-pressured information processing performance and to simultaneously recorded psychophysiological reactivity. The task was computer controlled, monetarily reinforced and subject paced. The physiological measurements included the cardiovascular parameters, ECG and finger plethysmographic amplitudes and the noncardiovascular parameters, EMG (frontal muscle), skin conductance reactivity, and respiration. NC-Type A and Type B women did not differ in performance, but the Type As showed stronger vasoconstrictive responses to the task than did the Type Bs. Other physiological intergroup differences were not seen. In addition, the Type As scored significantly higher in nervousness and irritability and marginally higher in depression, reactive aggressivity and neuroticism than did the Type Bs. This particular pattern of NC-Type A/B differences is discussed with regard to relevant differences observed by other studies between SI and JAS Type As and Bs.

Reduction of physiological, behavioral, and self-report responses in type A behavior: a preliminary report

Recent reports indicate that Type A Behavior may be reducible by behavioral and other psychotherapeutic methods. To date, however, there has been virtually no demonstration of reduction of the actual, observed behavior. Furthermore, the physiologic hyperresponsiveness that seems to characterize many Type A individuals when under stress, has received relatively little therapeutic attention. This preliminary, uncontrolled report describes a cognitive-behavioral group intervention program, before and after which patients underwent assessment on physiologic, behavioral, and self-report assessments. These included heart rate and blood pressure responsiveness under stressful conditions, trained observer ratings of Type A Behavior, and a variety of subjective measures of Type A Behavior and psychological distress and symptoms. Results showed limited improvement on most behavioral and self-report indices. Relatively greater reduction of Type A Behavior was associated with higher pre-treatment levels of Type A Behavior, with the absence of coronary artery disease and with male gender.

Cardiovascular responses in type A children during a cognitive challenge

The few studies which have examined stress-induced cardiovascular reactivity among Type A children have had equivocal results. In the present study, 41 extreme Type A and 46 extreme Type B children were monitored for heart rate and blood pressure during a challenging cognitive task under clear or ambiguous performance standards. Significant heart-rate and blood-pressure responses were observed, but no effects could be attributed to the behavior pattern or performance standards. Type A's were more self-involved, generally attributing their performance to effort. Under ambiguous performance standards, they perceived themselves more negatively and attributed performance to luck and task difficulty. These results do not support the exaggerated cardiovascular response hypothesis but do suggest that Type A children look toward external cues in the evaluation of both themselves and their performance, particularly when the external standards for performance are ambiguous.

Hypothalamic control of GH secretion: pathophysiology and clinical implications

GH is secreted episodically. Its pattern is regulated by the interplay of a releasing and a release-inhibiting hormone of hypothalamic origin. Modulation occurs by metabolic factors (glucose, free fatty acids, ketone bodies, amino acids). Altered GH secretion has been observed in states of metabolic derangement such as diabetes mellitus, malnutrition and obesity. Further modulation occurs by extrahypothalamic CNS structures. In man--but not in animals, including subhuman primates--sleep has an important effect on GH secretion. A defective GH secretory pattern has been found to occur in several states of sleep disturbance, such as sleep deprivation, narcolepsy, severe psychosocial derangement, the apallic syndrome. Other CNS influences on GH secretion are related to stress, emotional changes and psychiatric disturbances. The exact mechanisms by which most of these influences are relayed to the GH secretory apparatus of the hypothalamus remain yet to be investigated.

Alteration of type A behavior and reduction in cardiac recurrences in postmyocardial infarction patients

Eight hundred sixty-two postmyocardial infarction patients volunteered to be randomly selected and enrolled into: (1) a control section of 270 patients, who received group cardiologic counseling; and (2) an experimental section of 592 patients, who received group type A behavior counseling in addition to group cardiologic counseling. Reduction in type A behavior at the end of 3 years was observed in 43.8% of the 592 participants, who initially were enrolled to receive group cardiologic and type A behavioral counseling. This degree of behavioral reduction was significantly greater than that observed in participants who initially were enrolled to receive only group cardiologic counseling. The 3-year cumulative cardiac recurrence rate was 7.2% in participants who initially were enrolled to receive group cardiologic and type A behavioral counseling. This was significantly less (p less than 0.005) than that (13%) observed in participants who initially were enrolled to receive only cardiologic counseling. This difference in recurrence rates was due to a lesser incidence of nonfatal infarctions in the patients who had been enrolled in the section receiving type A behavioral as well as cardiologic counseling. These data suggest that type A behavior can be altered in a sizable fraction of postinfarction patients and that such alteration is associated with a significantly reduced rate of nonfatal myocardial infarctions.

Relationship between cortisol and cholesterol in men with coronary artery disease and type A behavior

To further understand the hormonal mechanisms linking behavior pattern and coronary artery disease (CAD), we investigated the relationship between 0930-hour plasma cortisol and cholesterol in relatively young males who had undergone coronary angiography and in a subgroup of individuals who had undergone the structured interview for classification of behavior pattern. A statistically significant association (p less than 0.05) was found between cortisol and cholesterol for individuals who had either minimal CAD (20% to 49% narrowing) or significant CAD (greater than or equal to 50% narrowing), but not for subjects without CAD. An association between cortisol and cholesterol was also found to be significant for the subgroup of individuals with Type A-1 behavior pattern, but not for those with Type A-2, X, or B behavior patterns. The findings suggest that hormonal mechanisms involving cortisol and cholesterol metabolism may be operative in individuals with CAD as well as in individuals with Type A-1 behavior.

Psychophysiology of type A behavior pattern: a critical analysis

Based on an analysis of 45 studies recently reported in the literature and data from a psychophysiological investigation, the hypothesized physiological mechanisms underlying Type A behavior and the methods used to determine Type A behavior (e.g., Structured Interview, SI, and the Jenkins Activity Survey, JAS) are tested. After determining behavior type with both the SI and JAS, subjects (N = 58 physical-education students) participated in a laboratory/field experiment with two replications consisting of the following conditions: (1) rest, (2) mental arithmetic, (3) reaction time test, (4) preparing and giving a speech, (5) Cold Pressor Test, (6) bicycle ergometric exercise, and (7) 1000 m run. Blood pressure, heart rate, stroke volume, cardiac output, ventricular ejection time, pulse volume amplitude, pulse transit time, pulse wave velocity, electrodermal activity, respiratory volume, oxygen uptake, and uric catecholamine levels were measured. Results of the analysis of the literature indicate that, with the exception of change scores on systolic blood pressure, mean differences on the physiological measures exhibited by Type A and B men are primarily not significant. The Structured Interview shows only a modest inter-rater reliability. The Jenkins Activity Survey demonstrates relatively low stability upon retest and fails to show sufficient internal consistency. Correlations between these measures are low. No consistent differences on physiological measures could be found in our subjects based on behavior type (according to SI or JAS criteria), although the challenging conditions were selected to elicit Type A behavior. Four our data, differences between Types A and B were also not found for systolic blood pressure, regardless of which behavioral assessment method was employed.

Stress, cortisol, interferon and "stress" diseases. I. Cortisol as the cause of "stress" diseases

An attempt is made to define a biochemical formula for stress, as an overproduction of cortisol +/- impaired interferon response. The behavior Type A individual under stress, would exhibit elevated levels of cortisol with normal interferon response, whereas the Type C individual, would exhibit elevated levels of cortisol and impaired interferon responses. Evidence is presented that elevated levels of cortisol manufactured chronically under the affect of stress, and regardless of the type of individual affected, are a cause or the cause of chronic diseases, and not the result of same. This evidence would show that: Elevated levels of cortisol precede certain diseases, and do not follow them, when cortisol is checked out for this purpose in pre-disease conditions. When elevations of cortisol levels are induced through long-term corticosteroids therapy, in patients suffering of diseases requiring this type of treatment, conditions mimicking chronic diseases, would appear. When corticosteroids therapy would be discontinued, the "chronic diseases" mentioned above would disappear. When pharmaceuticals with potential cortisol antagonistic capabilities, were used in diseases totally unrelated, but having in common, elevated levels of cortisol, alleviation of symptoms and/or diseases would occur.

Exercise and heart disease. Epidemiology of the "exercise hypothesis"

The "exercise hypothesis" states that exercise protects against coronary heart disease. Reviewed herein is the epidemiologic evidence for and against the "exercise hypothesis." The weight of evidence supports the view that exercisers have a lower risk of coronary disease, but that vigorous exercise cannot always prevent progression of coronary atherosclerosis and does increase the risk of sudden death in persons with advanced coronary atherosclerosis. It is concluded that the "exercise hypothesis" is plausible, even likely, but still unproved.

Social stress and atherosclerosis in normocholesterolemic monkeys

Socially stressed adult male cynomolgus monkeys (Macaca fascicularis) fed a low fat, low cholesterol diet developed more extensive coronary artery atherosclerosis than unstressed controls. Groups did not differ in serum lipids, blood pressure, serum glucose, or ponderosity. These results suggest that psychosocial factors may influence atherogenesis in the absence of elevated serum lipids. Psychosocial factors thus may help explain the presence of coronary artery disease (occasionally severe) in people with low or normal serum lipids and normal values for the other "traditional" risk factors.