Type A behavior pattern is not a predictor of premature mortality

Abstract

Background: Type A personality was introduced in the 1950s and was defined as an action-emotion complex characterized by excessive competitive drive, intense striving for achievement, easily provoked hostility, aggressiveness, impatience, and exaggerated sense of time urgency. Despite many positive findings earlier, almost 50 years of studies have not yielded conclusive results regarding Type A as a risk factor for negative health outcomes and early death. This may partly be due to methodological weaknesses such as small and selected samples, short follow-up times, and varying ways to assess Type A across studies.

Purpose: We 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.

Method: The study sample were the participants of the Kuopio Ischemic Heart Disease Risk Factor Study, (KIHD), which includes a randomly selected representative sample of Eastern Finnish men, aged 42-60 years at baseline in the 1980s. They were followed up until the end of 2011 through linkage with the National Death Registry. Four self-administered scales, Bortner Short Rating Scale, Framingham Type A Behavior Pattern Scale, Jenkins Activity Survey, and Finnish Type A Scale, were used for Type A assessment at the start of follow-up.

Results: Type A measures were inconsistently associated with cardiovascular mortality, and most associations were non-significant. Some scales suggested slightly decreased, rather than increased, risk of CVD death during the follow-up. Associations with non-cardiovascular deaths were even weaker.

Conclusion: Our findings further suggest that there is no evidence to support the Type A as a risk factor for CVD and non-CVD mortality.