In this article we will look at one particular personality type and see what the consequences are in terms of vulnerability to stress-related diseases. Though the picture is grim for such people, there is definite good news—the proverbial silver lining to the dark cloud. Such personality traits are not permanent and you can make an active effort to change, which reduces your vulnerability.
It is not usually difficult to spot people with this particular personality type. It is even easier to meet them in the higher rungs of the competitive corporate world. They are immensely competitive, aggressive, under time pressure, impatient and hostile. These are the traits that have been rewarded in the corporate world and they have reached high positions. I was reminded of this when standing in line at a bank ATM. There was a very small queue of three people and the well-dressed executive in front of me was getting upset.
In the few minutes that it took for his turn to come, he was tapping his foot, muttering under his breath about slow people who should not use ATMs and must have looked at his watch at least 10 times. No, he was not impatient because he had to rush to a hospital to save a life! For such people it does not matter how important or trivial their work is. They are concerned about doing things on time and with the greatest possible speed.
The fascinating story of how this personality type came to be identified as the one that ran the greatest risk of contracting diseases, begins in the 1950s. Two successful cardiologists Friedman and Rosenman were facing an unexpected problem in their office. The chairs in their waiting room were being worn out quickly and had to be reupholstered every few months. Being busy cardiologists, they could not be bothered by such a small problem but the chairs continued to show immense wear and tear.
No doubt there were frequent clashes between their office manager and the upholsterer about the quality of work. One day, a new upholsterer took a look at the chairs and made a simple observation—what is wrong with your patients? People don’t wear out chairs in this way. It was not difficult to see what he meant. Only the front section and the arms of the chairs were worn out. It was as if all the patients were sitting on the edge of their chair and plucking at the arms of the chair.
Of course, nobody paid the slightest attention to what the upholsterer was saying. If Dr Fried-man and Rosenman listened to him it made no impact on them. It was four or five years later and the formal research conducted by Dr Friedman and Dr Rosenman began to show the role of personality in cardiovascular disease that everyone was suddenly reminded about the upholsterer and his observation about the wear pattern. Interesting postscript—to this day, no one seems to remember the name of the upholsterer!
So, what was this fascinating study conducted by Friedman and Rosenman? They observed that many of their coronary patients exhibited some common personality traits— immensely competitive, over-achieving, impatient, under time pressure and hostile. Later they named this personality as Type A. Their initial observation was met with a lot of scepticism but their next study was well accepted.
In that prospective study they started out with healthy individuals and examined whether having a Type A personality increased the risk of coronary disease. Surprisingly, they discovered that Type A personality was a huge risk factor for coronary disease; the risk was almost equal to that presented by other factors like smoking or high cholesterol levels.
This was accepted by the medical community and was given a lot of publicity by the popular press at that time. Several carefully conducted studies after that failed to establish such a link! It seemed as if being Type A was not a risk factor after all. To make matters worse for Dr Friedman and Dr Rosenman, other studies showed that having Type A personality actually helped in recovering from coronary disease and indicated better chances of survival.
Recent analysis of the original data and other studies have identified the characteristic from Type A personality which is the main risk factor. It turns out to be hostility. The same results were found in a large prospective study of doctors conducted over a period of 25 years. It discovered that a high degree of hostility predicted a greater chance of coronary disease. Newer studies with a number of different groups of people, have confirmed the same basic finding—hostility predicts a high degree risk of coronary disease, atherosclerosis and higher risk of death from these diseases.
Some notable scientists disagree with this view, the chief among them being Dr Friedman. They argue that the core of hostility is a sense of being under time pressure and the basis for that is rampant insecurity. Their work suggests that a persistent sense of insecurity is, in fact, a better predictor of coronary disease.
Therefore, what is the latest research on this subject? A huge prospective study started in 1985 in the US tracked people for 15 years. The aim was to uncover the risk of cardiovascular diseases associated with these Type A traits viz.— time urgency, impatience, hostility and achievement striving competitiveness. The results published in 2003 confirm previous studies that both hostility and time urgency are associated with higher risk of cardiovascular diseases within 15 years.
These results are independent of age, sex, race, alcohol consumption, body weight andphysical activity. This is a remarkable finding and we need to focus on changing these two aspects in our personalities. Another thing to note from this study is that striving for achievement and competitiveness do not have any effect on the risk for heart diseases. So don’t worry if you are highly competitive and are working hard to achieve your goals.