Is Type A Research Bullshit?

You probably have heard that law school is full of Type A personalities.

As a current law student, I have come across classmates who proudly profess to me that they are “Type A.” For those of you who are not familiar with a Type A personality, the general consensus is that Type A individuals are ambitious, goal-oriented, and competitive.

I never bothered to figure out where the term Type A came from. Sherry was the one who learned that the term was coined as early as the 1950s by, SURPRISE SURPRISE, a pair of cardiologists. After a brief moment of bewilderment, out of sheer curiosity, I read up on Drs. Meyer Friedman and Ray Rosenman and the invention of the Type A “behavior” (as the doctors liked to call it).

The Story You Can Tell at a Dinner Party

The inception of observing the Type A behavior happened in the cardiologists’ waiting room. A particular secretary noticed similar patterns of behavior among a certain set of patients. Dr. Ray Rosenman himself described the anecdote once in an interview and it goes something like this:

“A discerning secretary in our office practice told us that in contrast to our other patients, those with coronary disease were rarely late for appointments and preferred to sit in hard-upholstered chairs rather than softer ones or sofas. These chairs also had to be reupholstered far more often than others because the front edges quickly became worn out. They looked at their watches frequently and acted impatient when they had to wait, usually sat on the edges of waiting room chairs and tended to leap up when called to be examined.”

In short, the two cardiologists listened to their secretary’s anecdote and decided to further study this certain subset of coronary disease patients. In 1959, the two published their results in JAMA (or the Journal of American Medical Association). In the publication, the doctors laid out their findings–the primary one being an association between “overt behavior pattern A” to coronary diseases (such as heart attacks). In fact, the cardiologists found that being Type A more than doubled one’s risk of coronary heart disease.

An individual expressing overt behavior pattern A has:

  1. An intense, sustained drive to achieve self-selected but usually poorly defined goals
  2. Profound inclination and eagerness to compete
  3. Persistent desire for recognition and advancement
  4. Continuous involvement in multiple and diverse functions constantly subject to time restrictions (deadlines)
  5. Habitual propensity to accelerate the rate of execution of many physical and mental functions
  6. Extraordinary mental and physical alertness

The two cardiologists went on to publish a book titled Type A Behavior and Your Heart. This book was a hit (it was on the NY Times bestseller list in 1975) and evolved Type A from a medical terminology to a mainstream term.

DISCLAIMER: If you simply want to flaunt your new insight about the origins of Type A, you can stop reading now!

The Darker Side of the Story

Drs. Friedman and Rosenman’s studies coincided with a time period in which Big Tobacco supported medical research with the primary purpose of rebutting claims that smoking killed people. Big Tobacco looked for research that would provide alternative explanations between smoking and various diseases. And they found such an explanation with Type A and coronary artery disease.

A relationship was formed between Big Tobacco companies and the two doctors, starting from the early 1960s, lasting until the early 2000s. While the initial publication was done without Big Tobacco money, Big Tobacco money and influence, however, would manifest throughout the years in various ways. Big Tobacco heavily promoted the cardiologists’ findings in press releases, popular media, and legislative briefings. The tobacco companies also funded much of Dr. Friedman’s latter research. In fact, Big Tobacco contributed close to $11 million dollars for Dr. Friedman’s project of studying the reduction of coronary disease by adjusting a patient’s Type A behaviors.

The involvement of Big Tobacco does not necessarily make all findings between heart disease and Type A dubious. For those who want to delve into this further, take a look at The Invention of the ‘Type A’ Personality or Type A behavior pattern and coronary heart disease: Philip Morris’s “crown jewel”.

Final Thoughts

  1. Association does not equate correlation or even causation in a scientific study.
  2. Perhaps… lawyers should not smoke. On top of being Type A.

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