Personality and cardiovascular disease: Overview

Abstract

This chapter provides an overview of major attempts to relate personality in the form of stable traits to the development and progression of coronary heart disease (CHD). Among the first attempts to relate personality to CHD was the Type A behavior pattern, a complex of emotion and action tendencies including aggressive competitiveness, free-floating hostility, and time urgency. Although evidence supported the relationship of the Type A pattern to CHD, questions arose concerning the aspects of the Type A pattern that were the active ingredients. Analysis of components of the Type A pattern suggested hostility as the primary active ingredient. This has led to a large number of studies of the relationship of hostility and anger to CHD, mostly with positive results. In addition to this work, there is also a body of literature suggesting that a combination of negative affectivity and social inhibition, a pattern known as the Type D (distressed) personality, is associated with heightened CHD risk. Although some studies have supported this idea, a number of studies have obtained negative findings, and there are concerns about the way in which the Type D personality is conceptualized and measured. Recently, an integrative review has suggested that the personality trait of interpersonal sensitivity, a concern with negative social evaluation, is associated with CHD. This review concludes by considering possible mechanisms by which personality traits are associated with CHD.