Date of Award

1986

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

Abstract

There is substantial evidence to indicate that the Type A Behavior Pattern is associated with an increased risk of coronary heart disease. Recent research has shown that Type As, as compared to Type Bs, demonstrate enhanced biochemical and cardiovascular responses to stressful situations. These findings have led researchers to postulate that physiological reactivity may be one of the mechanisms through which Type A behavior confers coronary risk. The present study was designed to investigate physiological and psychological reactivity in Type A and Type B cardiac patients exposed to a cardiac catheterization. The effects of drugs (i.e., none versus beta-blockers and calcium channel blockers) on the response to stress was systematically evaluated. Dependent measures, adrenocorticotropic hormone (ACTH), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), state anxiety (STAI-state), and Total Mood Disturbance (TMD), were obtained prior to cardiac catheterization (day 1) and 24 hours later (day 2). A 2 x 2 x 2 (Behavior Type x Drug Group x Day) analysis of variance with repeated measures on day revealed significant main effects of day for ACTH, SBP, and state anxiety. A significant main effect for drug group and a significant Behavior Type x Drug interaction was revealed for ACTH. A significant Behavior Type x Day interaction was found for SBP. An additional analysis investigating the responses of extreme Type A and Type B subjects revealed significant main effects of day for HR and State Anxiety. The results of the present study failed to support previous research demonstrating that Type A subjects, as compared to Type B subjects, exhibit exaggerated responsivity to stress. Possible reasons for this failure to find significant A-B differences are explored. The major contribution of the present study was the finding, consistent with previous research, that the target medications were associated with substantially reduced responsivity to stress (as measured by ACTH) in Type A cardiac patients to levels consistent with the response of Type B cardiac patients. The clinical and research implications arising from this finding are discussed. Continued systematic evaluation of the effects of medications on reactivity is strongly recommended.

Pages

148

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