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More Than One Culprit at Work

Redford B. Williams, MD; John C. Barefoot, PhD; Neil Schneiderman, PhD

JAMA. 2003;290:2190-2192.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Solid scientific evidence supporting the adverse effects of stress on health began to emerge nearly 30 years ago with the report by Rosenman et al¹ showing that men with type A behavior (time urgency, hostility, achievement striving) were twice as likely as their counterparts with type B behavior (lacking type A characteristics) to develop coronary heart disease (CHD) over an 8- year period.¹ Failure to replicate this finding in another large-scale prospective study² raised questions about the validity of type A behavior as a CHD risk factor. However, subsequent research makes a strong case that of the 3 components of the global type A behavior pattern, hostility is the one most reliably associated with increased CHD risk.^3-5

In this issue of THE JOURNAL, the article by Yan et al⁶ provides credible evidence that not only hostility, but another type . . . [Full Text of this Article]

Author Affiliations: Departments of Psychiatry and Behavioral Sciences (Drs Williams and Barefoot), Medicine (Dr Williams), and Psychology (Dr Williams), and the Behavioral Medicine Research Center (Dr Williams), Duke University Medical Center (Drs Williams and Barefoot), Durham, NC; and Departments of Psychology, Medicine, and Psychiatry, and the Behavioral Medicine Research Center, University of Miami, Miami, Fla (Dr Schneiderman).

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