Stress, reactivity, and Type A behavior: Current status and future directions

This paper critically evaluates three areas of research concerning cardiovascular and neuroendocrine reactivity and Type A behavior: the nature and consistency of Type A associations with physiologic reactivity, the role of situational and biological factors in producing such differences, and the relationship between laboratory measures of reactivity and responses to everyday stresses. It is concluded that among males, but perhaps not females, there is a moderately consistent relationship between reactivity and Type A or component behaviors. Laboratory studies suggest that structured interview-defined Type A behavior is associated with increased sympatho-adrenomedullary reactivity to stress under conditions of effortful coping and/or anger. However, studies have painted an inconsistent picture of Type A/B differences in physiologic responses under real-life conditions. Despite numerous studies, the mechanisms linking Type A behaviors to coronary disease are still not well understood. Future research should broaden the array of physiologic parameters studied to those most relevant to account for Type A/B differences in coronary risk. Other areas requiring further attention include the role of naturalistic stressors in eliciting hyperreactivity, the frequency with which such reactivity occurs, and the relationship between component Type A behaviors and reactivity among various demographic groups. Future studies in this area should be conducted with an awareness of the variables that have been empirically linked to coronary disease.