The purpose of this study was to investigate the relationships among Type A behavior, need to control, perceptions of loss of control and coronary artery disease in a cross sectional design with a clinical sample. The study was a first step in investigation of the mechanistic interaction model of Type A behavior. This model, which has been the predominant approach to Type A behavior and coronary artery disease, postulates that the overt Type A behaviors are a characteristic style of responding to certain stimuli (eg., challenges, demands, threats to control). The behaviors, in turn are associated with enhanced cardiovascular reactivity which results in neuroendocrine changes and percipitates coronary artery disease. The study tested whether these variables, Type A behavior, need to control or perceptions of loss of control, individually or as a set were significantly related to the severity of coronary artery disease.

The sample was 80 white males between the ages of 30 and 70 who were admitted to a large university hospital for cardiac catheterization. Subjects completed the Jenkins Activity Survey, the Desirability of Control Scale, and the Schedule of Recent Life Events, which was modified to ascertain perceptions of control over past events. Subjects were interviewed using the Structured Interview. Data was analyzed using multiple regression equation to control for confounding standard risk factors.

Results demonstrated a relationship between need to control and the Type A behavior pattern, but failed to find a relationship between Type A behavior pattern, need to control, or perceptions of loss of control and clinical coronary artery disease. Implications for reevaluating the Type A construct and the assessment procedures for identifying Type A behavior, controlling behavior and clinical coronary artery disease are discussed, as well as the limitations of cross-sectional angiographic studies.