Skip to main content
SpringerLink
Log in

Biobehavioral research on coronary heart disease: Where is the person?

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

This study examined the thesis that patients with coronary heart disease (CHD) comprise discrete personality subtypes and that identification of these subtypes may benefit biobehavioral research on CHD. Measures of Negative Affectivity, Social Inhibition, and Self-Deception were used to generate a personality taxonomy through cluster analysis in a sample of 405 men with CHD. This empirical taxonomy served as a basis for the development of a conceptual model which delineates hardy, distressed, inhibited,and repressivesubtypes. Coronary proneness may differ across these subtypes to the extent that potential behavioral correlates of CHD were associated with subtype membership. Distressed individuals (characterized by elevated levels of Type A behavior, anger, hostility, and life stress) and inhibited individuals (characterized by the nonexpression of anger) may be particularly coronary prone. It is concluded that research should focus on the interaction of global traits that may define subtypes of patients with CHD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Ahern, D. K., Gorkin, L., Anderson, J. L., Tierney, C., Hallstrom, A., Ewart, C., Capone, R. J., Schron, E., Kornfeld, D., Herd, J. A., Richardson, D. W., and Follick, M. J. (1990). Biobehavioral variables and mortality or cardiac arrest in the Cardiac Arrhythmia Pilot Study (CAPS).Am. J. Cardiol. 66: 59–62.

    Google Scholar 

  • Alden, L. E., and Wallace, S. T. (1991). Social standards and social withdrawal.Cognit. Ther. Res. 15: 85–100.

    Google Scholar 

  • Allport, G. W. (1937).Personality: A Psychological Interpretation, Henry Holt, New York. Cited by Funder, D. C. (1991). Global traits: A neo-Allportian approach to personality.Psychol. Sci. 2: 31–39.

    Google Scholar 

  • Allred, K. D., and Smith, T. W. (1989). The hardy personality: Cognitive and physiological responses to evaluative threat.J. Pers. Soc. Psychol. 56: 257–266.

    Google Scholar 

  • Antonovsky, A. (1990). Personality and health: Testing the sense of coherence model. In Friedman, H. S. (ed.),Personality and Disease, Wiley, New York, pp. 155–177.

    Google Scholar 

  • Appels, A. (1985).Jenkins Activity Survey, Swets & Zeitlinger, Lisse, The Netherlands.

    Google Scholar 

  • Arrindell, W. A., and Ettema, J. H. (1986).SCL90 Handleiding bij een Multidimensionele Psychopathologie-Indicator (SCL90. Manual for a Multi-Dimensional Psychopathology-Indicator), Swets & Zeitlinger, Lisse, The Netherlands.

    Google Scholar 

  • Barefoot, J. C., Dahlstrom, W. G., and Williams, R. B. (1983). Hostility, CHD incidence and total mortality: A 25-year follow-up study of 255 physicians.Psychosom. Med. 45: 59–63.

    Google Scholar 

  • Barefoot, J. C., Peterson, B. L., Harrell, F. E., Hlatky, M. A., Pryor, D. B., Haney, T. L., Blumenthal, J. A., Siegler, I. C., and Williams, R. B. (1989). Type A behavior and survival: A follow-up study of 1467 patients with coronary artery disease.Am. J. Cardiol. 64: 427–432.

    Google Scholar 

  • Ben-Porath, Y. S., Hostetler, K., Butcher, J. N., and Graham, J. R. (1989). New subscales for the MMPI-2 social introversion (Si) scale.Psychol. Assess. J. Consult. Clin. Psychol. 1: 169–174.

    Google Scholar 

  • Blashfield, R. K. (1976). Mixture model tests of cluster analysis: Accuracy of four agglomerative hierarchical methods.Psychol. Bull. 83: 377–388.

    Google Scholar 

  • Blumenthal, J. A., Burg, M. M., Barefoot, J., Williams, R. B., Haney, T., and Zimet, G. (1987). Social support, Type A behavior, and coronary artery disease.Psychosom. Med. 49: 331–340.

    Google Scholar 

  • Booth-Kewley, S., and Friedman, H. S. (1987). Psychological predictors of heart disease: A quantitative review.Psychol. Bull. 101: 343–362.

    Google Scholar 

  • Carmelli, D., Rosenman, R. H., and Swan, G. E. (1988). The Cook and Medley Ho scale: A heritability analysis in adult male twins.Psychosom. Med. 50: 165–174.

    Google Scholar 

  • Carney, R. M., Rich, M. W., Freedland, K. E., Saini, J., TeVelde, A., Simeone, C., and Clark, K. (1988). Major depressive disorder predicts cardiac events in patients with coronary artery disease.Psychosom. Med. 50: 627–633.

    Google Scholar 

  • Carney, R. M., Freedland, K. E., and Jaffe, A. S. (1990). Insomnia and depression prior to myocardial infarction.Psychosom. Med. 52: 603–609.

    Google Scholar 

  • Case, R. B., Heller, S. S., Case, N. B., and Moss, A. J. (1985). Multicenter Post-Infarction Research Group. Type A behavior and survival after acute myocardial infarction.N. Engl. J. Med. 312: 737–741.

    Google Scholar 

  • Cheek, J. M., and Buss, A. H. (1981). Shyness and sociability.J. Pers. Soc. Psychol. 41: 330–339.

    Google Scholar 

  • Clark, L. A., and Watson, D. (1991). Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications.J. Abnorm. Psychol. 100: 316–336.

    Google Scholar 

  • Cook, W. W., and Medley, D. M. (1954). Proposed hostility and pharisaic-virtue scales for the MMPI.J. Appl. Psychol. 38: 414–418.

    Google Scholar 

  • Costa, P. T., and McCrae, R. R. (1987). Neuroticism, somatic complaints, and disease: Is the bark worse than the bite?J. Personal. 55: 299–316.

    Google Scholar 

  • Crisp, A. H., Queenan, M., and D'Souza, M. F. (1984). Myocardial infarction and the emotional climate.Lancet 1: 616–619.

    Google Scholar 

  • Crowne, D. P., and Marlowe, D. (1960). A new scale of social desirability independent of psychopathology.J. Consult. Psychol. 24: 349–354.

    Google Scholar 

  • Dembroski, T. M., MacDougall, J. M., Williams, R. B., Haney, T. L., and Blumenthal, J. A. (1985). Components of Type A, hostility, and anger-in: Relationship to angiographic findings.Psychosom. Med. 47: 219–233.

    Google Scholar 

  • Dembroski, T. M., MacDougall, J. M., Costa, P. T., and Grandits, G. A. (1989). Components of hostility as predictors of sudden death and myocardial infarction in the Multiple Risk Factor Intervention Trial.Psychosom. Med. 51: 514–522.

    Google Scholar 

  • Denollet, J. (1991). Negative affectivity and repressive coping: Pervasive influence on self-reported mood, health, and coronary-prone behavior.Psychosom. Med. 53: 538–556.

    Google Scholar 

  • Denollet, J., and De Potter, B. (1992). Coping subtypes for men with coronary heart disease: Relationship to well-being, stress, and Type A behavior.Psychol. Med. 22: 667–684.

    Google Scholar 

  • Digman, J. M., and Inouye, J. (1986). Further specification of the five robust factors of personality.J. Pers. Soc. Psychol. 50: 116–123.

    Google Scholar 

  • Dimsdale, J. E. (1988). A perspective on Type A behavior and coronary disease.N. Engl. J. Med. 318: 110–112.

    Google Scholar 

  • Emmons, R. A. (1992). The repressive personality and social support. In Friedman, H. S.(ed.),Hostility, Coping, & Health, American Psychological Association, Washington, DC, pp. 141–150.

    Google Scholar 

  • Erdman, R. A., Duivenvoorden, H. J., Verhage, F., Kazemier, M., and Hugenholtz, P. G. (1986). Predictability of beneficial effects in cardiac rehabilitation: A randomized clinical trial of psychosocial variables.J. Cardiopulm. Rehab. 6: 206–213.

    Google Scholar 

  • Esterling, B. A., Antoni, M. H., Kumar, M., and Schneiderman, N. (1990). Emotional repression, stress disclosure responses, and Epstein-Barr viral capsid antigen titers.Psychosom. Med. 52: 397–410.

    Google Scholar 

  • Evans, R. G. (1982). Clinical relevance of the Marlowe-Crowne scale: A review and recommendations.J. Pers. Assess. 46: 415–425.

    Google Scholar 

  • Eysenck, H. J. (1990). Genetic and environmental contributions to individual differences: The three major dimensions of personality.J. Personal. 58: 245–261.

    Google Scholar 

  • Eysenck, H. J. (1991). Dimensions of personality: 16, 5, or 3?—Criteria for a taxonomic paradigm.Person. Indiv. Diff. 12: 773–790.

    Google Scholar 

  • Folkman, S., and Lazarus, R. S. (1985). If it changes, it must be a process: A study of emotion and coping during three stages of a college examination.J. Pers. Soc. Psychol. 48: 150–170.

    Google Scholar 

  • Frasure-Smith, N. (1991). In-hospital symptoms of psychological stress as predictors of long-term outcome after acute myocardial infarction in men.Am. J. Cardiol. 67: 121–127.

    Google Scholar 

  • Friedman, H. S. (1990). Where is the disease-prone personality? Conclusion and future directions. In Friedman, H. S. (ed.),Personality and Disease, Wiley, New York, pp. 283–292.

    Google Scholar 

  • Friedman, H. S. (1991).The Self-Healing Personality: Why Some People Achieve Health and Others Succumb to Illness, Henry Holt, New York.

    Google Scholar 

  • Friedman, H. S. (1992). Understanding hostility, coping, and health. In Friedman, H. S. (ed.),Hostility, Coping, & Health, American Psychological Association, Washington, DC, pp. 3–9.

    Google Scholar 

  • Friedman, H. S., and Booth-Kewley, S. (1987a). The “disease-prone personality”: A meta-analytic view of the construct.Am. Psychol. 42: 539–555.

    Google Scholar 

  • Friedman, H. S., and Booth-Kewley, S. (1987b). Personality, Type A behavior, and coronary heart disease: The role of emotional expression.J. Pers. Soc. Psychol. 53: 783–792.

    Google Scholar 

  • Friedman, H. S., and Booth-Kewley, S. (1988). Validity of the Type A construct: A reprise.Psychol. Bull. 104: 381–384.

    Google Scholar 

  • Friedman, H. S., and DiMatteo, M. R. (1989).Health Psychology, Prentice Hall, Englewood Cliffs, NJ, pp. 192–219.

    Google Scholar 

  • Friedman, M., and Powell, L. H. (1984). The diagnosis and quantitative assessment of Type A behavior: Introduction and description of the Videotaped Structured Interview.Integrat. Psychiat. July–Aug.: 123–129.

    Google Scholar 

  • Gangestad, S., and Snyder, M. (1985). “To carve nature at its joints”: On the existence of discrete classes in personality.Psychol. Rev. 92: 317–349.

    Google Scholar 

  • Gleick, J. (1987).Chaos: Making a New Science, Penguin Books, New York.

    Google Scholar 

  • Grignani, G., Soffiantino, F., Zuchella, M., Pacchiarini, L., Tacconi, F., Bonomi, E., Psatoris, A., Sbaffi, A., Fratino, P., and Tavazzi, L. (1991). Platelet activation by emotional stress in patients with coronary artery disease.Circulation 83 (Suppl. II): II-128–II-136.

    Google Scholar 

  • Gross, J. (1989). Emotional expression in cancer onset and progression.Soc. Sci. Med. 12: 1239–1248.

    Google Scholar 

  • Gur, R. C., and Sackheim, H. A. (1979). Self-deception: A concept in search of a phenomenon.J. Pers. Soc. Psychol. 37: 147–169.

    Google Scholar 

  • Haynes, S. G., Feinleib, M., and Kannel, W. B. (1980). The relationship of psychosocial factors to coronary heart disease in the Framingham Study. III. Eight-year incidence of coronary heart disease.Am. J. Epidemiol. 111: 37–58.

    Google Scholar 

  • Hearn, M. D., Murray, D. M., and Luepker, R. V. (1989). Hostility, coronary heart disease, and total mortality: A 33-year follow-up study of university students.J. Behav. Med. 12: 105–121.

    Google Scholar 

  • Hecker, M. H., Chesney, M. A., Black, G. W., and Frautschi, N. (1988). Coronary-prone behaviors in the Western Collaborative Group Study.Psychosom. Med. 50: 153–164.

    Google Scholar 

  • Jamner, L. D., Schwartz, G. E., and Leigh, H. (1988). The relationship between repressive and defensive coping and monocyte, eosinophile, and serum glucose levels: Support for the opioid peptide hypothesis of repression.Psychosom. Med. 50: 567–575.

    Google Scholar 

  • Jamner, L. D., Shapiro, D., Goldstein, I. B., and Hug, R. (1991). Ambulatory blood pressure and heart rate in paramedics: Effects of cynical hostility and defensiveness.Psychosom. Med. 53: 393–406.

    Google Scholar 

  • Jenkins, C. D., Zyzanski, S. J., and Rosenman, R. H. (1976). Risk of new myocardial infarction in middle-aged men with manifest coronary heart disease.Circulation 53: 342–347.

    Google Scholar 

  • Jensen, M. R. (1987). Psychobiological factors predicting the course of breast cancer.J. Personal. 55: 317–342.

    Google Scholar 

  • Julius, M., Harburg, E., Cottington, E. M., and Johnson, E. H. (1986). Anger-coping types, blood pressure, and all-cause mortality: A follow-up in Tecumseh, Michigan (1971–1983).Am. J. Epidemiol. 124: 220–233.

    Google Scholar 

  • Kagan, J., Reznick, J. S., and Snidman, N. (1988). Biological bases of childhood shyness.Science 240: 167–171.

    Google Scholar 

  • King, A. C., Taylor, C. B., Albright, C. A., and Haskell, W. L. (1990). The relationship between repressive and defensive coping styles and blood pressure responses in healthy, middle-aged men and women.J. Psychosom. Res. 34: 461–471.

    Google Scholar 

  • Kobasa, S. C. (1979). Stressful life events, personality, and health: An inquiry into hardiness.J. Pers. Soc. Psychol. 37: 1–11.

    Google Scholar 

  • Kornitzer, M., Kittel, F., De Backer, G., and Dramaix, M. (1981). The Belgian Heart Disease Prevention Project: Type “A” behavior pattern and the prevalence of coronary heart disease.Psychosom. Med. 433: 133–145.

    Google Scholar 

  • Krantz, D. S., and Durel, L. A. (1983). Psychobiological substrates of the Type A behavior pattern.Health Psychol. 2: 393–411.

    Google Scholar 

  • Krantz, D. S., and Hedges, S. M. (1987). Some cautions for research on personality and health.J. Personal. 55: 351–357.

    Google Scholar 

  • Krantz, D. S., Contrada, R. J., Hill, D. R., and Friedler, E. (1988). Environmental stress and biobehavioral antecedents of coronary heart disease.J. Consult. Clin. Psychol. 56: 333–341.

    Google Scholar 

  • Krantz, D. S., Helmers, K. F., Bairey, C. N., Nebel, L. E., Hedges, S. M., and Rozanski, A. (1991). Cardiovascular reactivity and mental stress-induced myocardial ischemia in patients with coronary artery disease.Psychosom. Med. 53: 1–12.

    Google Scholar 

  • Kune, G. A., Kune, S., Watson, L. F., and Bahnson, C. B. (1991). Personality as a risk factor in large bowel cancer: Data from the Melbourne Colorectal Cancer Study.Psychol. Med. 21: 29–41.

    Google Scholar 

  • Ladwig, K. H., Kieser, M., König, J., Breithardt, G., and Borggrefe, M. (1991). Affective disorders and survival after acute myocardial infarction. Results from the Post-Infarction Late Potential Study.Eur. Heart J. 12: 959–964.

    Google Scholar 

  • Lane, R. D., Merikangas, K. R., Schwartz, G. E., Huang, S. S., and Prusoff, B. A. (1990). Inverse relationship between defensiveness and lifetime prevalence of psychiatric disorder.Am. J. Psychiat. 147: 573–578.

    Google Scholar 

  • Lazarus, R. S. (1990). Stress, coping, and illness. In Friedman, H. S. (ed.),Personality and Disease, Wiley, New York, pp. 97–120.

    Google Scholar 

  • Leon, G. R., Finn, S. E., Murray, D., and Bailey, J. M. (1988). Inability to predict cardiovascular disease from hostility scores or MMPI items related to Type A behavior.J. Consult. Clin. Psychol. 56: 597–600.

    Google Scholar 

  • Lorr, M., and Suziedelis, A. (1982). A cluster analytic approach to MMPI profile types.Multivar. Behav. Res. 17: 287–299.

    Google Scholar 

  • MacDougall, J. M. Dembroski, T. M., Dimsdale, J. E., and Hackett, T. P. (1985). Components of Type A, hostility and anger-in: Further relationships to angiographic findings.Health Psychol. 4: 137–152.

    Google Scholar 

  • Matthews, K. A. (1988). Coronary heart disease and Type A behaviors: Update on and alternative to the Booth-Kewley and Friedman (1987) quantitative review.Psychol. Bull. 104: 373–380.

    Google Scholar 

  • Matthews, K. A., Rosenman, R. H., Dembroski, T. M., Harris, E. L., and MacDougall, J. M. (1984). Familial resemblance in components of the Type A behavior pattern: A reanalysis of the California Type A twin study.Psychosom Med. 46: 512–522.

    Google Scholar 

  • McCrae, R. R., and Costa, P. T. (1983). Social desirability scales: More substance than style.J. Consult. Clin. Psychol. 51: 882–888.

    Google Scholar 

  • McCrae, R. R., and Costa, P. T. (1986). Personality, coping, and coping effectiveness in an adult sample.J. Personal. 54: 385–405.

    Google Scholar 

  • McCrae, R. R., and Costa, P. T. (1987). Validation of the five factor model of personality across instruments and observers.J. Pers. Soc. Psychol. 52: 81–90.

    Google Scholar 

  • McCranie, E. W., Watkins, L. O., Brandsma, J. M., and Sisson, B. D. (1986). Hostility, coronary heart disease (CHD) incidence, and total mortality: Lack of association in a 25-year follow-up study of 478 physicians.J. Behav. Med. 9: 119–125.

    Google Scholar 

  • Millon, T., Green, C., and Meagher, R. (1982).Millon Behavioral Health Inventory. Manual, 3rd ed., National Computer Systems, Minneapolis.

    Google Scholar 

  • Murphy, J. M., Monson, R. R., Olivier, D. C., Sobol, A. M., and Leighton, A. H. (1987). Affective disorders and mortality. A general population study.Arch. Gen. Psychiat. 44: 473–480.

    Google Scholar 

  • Nobuyoshi, M., Tanaka, M., Nosaka, H., Kimura, T., Yokoi, H., Hamasaki, N., Kim, K., Shindo, T., and Kimura, K. (1991). Progression of coronary atherosclerosis: Is coronary spasm related to progression?J. Am. Coll. Cardiol. 18: 904–910.

    Google Scholar 

  • Ouellette Kobasa, S. C. (1990). Lessons from history: How to find the person in health psychology. In Friedman, H. S. (ed.),Personality and Disease, Wiley, New York, pp. 14–37.

    Google Scholar 

  • Paulhus, D. L., and Levitt, K. (1987). Desirable responding triggered by affect: Automatic egotism?J. Pers. Soc. Psychol. 52: 245–259.

    Google Scholar 

  • Pennebaker, J. W. (1992). Inhibition as the linchpin of health. In Friedman, H. S. (ed.),Hostility, Coping, & Health, American Psychological Association, Washington, DC, pp. 127–139.

    Google Scholar 

  • Pennebaker, J. W., and Susman, J. R. (1988). Disclosure of traumas and psychosomatic processes.Soc. Sci. Med. 26: 327–332.

    Google Scholar 

  • Pennebaker, J. W., Colder, M., and Sharp, L. K. (1990). Accelerating the coping process.J. Pers. Soc. Psychol. 58: 528–537.

    Google Scholar 

  • Ragland, D. R., and Brand, R. J. (1988). Type A behavior and mortality from coronary heart disease.N. Engl. J. Med. 318: 65–69.

    Google Scholar 

  • Revenson, T. A. (1990). All other things are not equal: An ecological approach to personality and disease. In Friedman, H. S. (ed.),Personality and Disease, Wiley, New York, pp. 65–94.

    Google Scholar 

  • Rosengren, A., Tibblin, G., and Wilhelmsen, L. (1991). Self-perceived psychological stress and incidence of coronary artery disease in middle-aged men.Am. J. Cardiol. 68: 1171–1175.

    Google Scholar 

  • Rosenman, R. H., Brand, R. J., Jenkins, C. D., Friedman, M., Straus, R., and Wurm, M. (1975). Coronary heart disease in the Western Collaborative Group Study. Final follow-up experience of 8 1/2 years.JAMA 233: 872–877.

    Google Scholar 

  • Ruberman, W., Weinblatt, E., Goldberg, J. D., and Chaudhary, B. S. (1984). Psychosocial influences on mortality after myocardial infarction.N. Engl. J. Med. 311: 552–559.

    Google Scholar 

  • Schwartz, G. E. (1983). Disregulation theory and disease: Applications to the repression/cerebral disconnection/cardiovascular disorder hypothesis.Int. Rev. Appl. Psychol. 32: 95–118.

    Google Scholar 

  • Shekelle, R. B., Gale, M., and Norusis, M. (1985a). Type A score (Jenkins Activity Survey) and risk of recurrent coronary heart disease in the Aspirin Myocardial Infarction Study.Am. J. Cardiol. 56: 221–225.

    Google Scholar 

  • Shekelle, R. B., Hulley, S. B., Neaton, J. D., Billings, J. H., Borhani, N. O., Gerace, T. A., Jacobs, D. R., Lasser, N. L., Mittlemark, M. B., and Stamler, J. (1985b). The MRFIT behavior pattern study II. Type A behavior and incidence of coronary heart disease.Am. J. Epidemiol. 122: 559–570.

    Google Scholar 

  • Smith, T. W., and Christensen, A. J. (1992). Hostility, health, and social contexts. In Friedman, H. S. (ed.),Hostility, Coping, & Health, American Psychological Association, Washington, DC, pp. 33–48.

    Google Scholar 

  • Smith, T. W., and Frohm, K. D. (1985). What's so unhealthy about hostility? Construct validity and psychosocial correlates of the Cook and Medley Ho scale.Health Psychol. 4: 503–520.

    Google Scholar 

  • Somervell, P. D., Kaplan, B. H., Heiss, G., Tyroler, H. A., Kleinbaum, D. G., and Obrist, P. A. (1989). Psychologic distress as a predictor of mortality.Am. J. Epidemiol. 130: 1013–1023.

    Google Scholar 

  • Stone, S. V., and Costa, P. T. (1990). Disease-prone personality or distress-prone personality? The role of neuroticism in coronary heart disease. In Friedman, H. S. (ed.),Personality and Disease, Wiley, New York, pp. 178–200.

    Google Scholar 

  • Suls, J., and Rittenhouse, J. D. (1990). Models of linkages between personality and disease. In Friedman, H. S. (ed.),Personality and Disease, Wiley, New York, pp. 38–64.

    Google Scholar 

  • Tellegen, A. (1985). Structures of mood and personality and their relevance to assessing anxiety, with an emphasis on self-report. In Tuma, A. H., and Maser, J. (eds.),Anxiety and the Anxiety Disorders, Erlbaum, Hillsdale, NJ, pp. 681–706.

    Google Scholar 

  • Tellegen, A., Lykken, D. T., Bouchard, T. J., Willcox, K. J., Segal, N. L., and Rich, S. (1988). Personality similarity in twins reared apart and together.J. Pers. Soc. Psychol. 54: 1031–1039.

    Google Scholar 

  • Temoshok, L. (1990). On attempting to articulate the biopsychosocial model: Psychological-psychophysiological homeostasis. In Friedman, H. S. (ed.),Personality and Disease, Wiley, New York, pp. 203–225.

    Google Scholar 

  • Thaulow, E., Erikssen, J., Sandvik, L., Stormorken, H., and Cohn, P. F. (1991). Blood platelet count and function are related to total and cardiovascular death in apparently healthy men.Circulation 84: 613–617.

    Google Scholar 

  • Turk, D. C., and Rudy, T. E. (1990). The robustness of an empirically derived taxonomy of chronic pain patients.Pain 43: 27–35.

    Google Scholar 

  • Van Der Ploeg, H. M., Defarres, P. B., and Spielberger, C. D. (1980).ZBV. Een Nederlandstaligee Bewerking van de Spielberger State-Trait Anxiety Inventory (ZBV. A Dutch-Language Adaptation of the Spielberger State-Trait Anxiety Inventory), Swets & Zeitlinger, Lisse, The Netherlands.

    Google Scholar 

  • Van Der Ploeg, H. M., Defares, P. B., and Spielberger, C. D. (1982).ZAV. Een Nederlandstalige Bewerking van de Spielberger State-Trait Anger Scale (ZAV. A Dutch-Language Adaptation of the Spielberger State-Trait Anger Scale), Swets & Zeitlinger, Lisse, The Netherlands.

    Google Scholar 

  • Watson, D., and Pennebaker, J. W. (1989). Health complaints, stress and distress: Exploring the central role of negative affectivity.Psychol. Rev. 96: 234–254.

    Google Scholar 

  • Weinberger, D. A., and Schwartz, G. E. (1990). Distress and restraint as superordinate dimensions of self-reported adjustment: A typological perspective.J. Personal. 58: 381–417.

    Google Scholar 

  • Wiebe, D. J. (1991). Hardiness and stress moderation: A test of proposed mechanisms.J. Pers. Soc. Psychol. 60: 89–99.

    Google Scholar 

  • Williams, J. K., Vita, J. A., Manuck, S. B., Selwyn, A. P., and Kaplan, J. R. (1991). Psychosocial factors impair vascular responses of coronary arteries.Circulation 84: 2146–2153.

    Google Scholar 

  • Williams, R. B. (1987). Psychological factors in coronary artery disease: Epidemiologic evidence.Circulation 76 (Suppl. I): I-117–I-123.

    Google Scholar 

  • Yeung, A. C., Vekshtein, V. I., Krantz, D. S., Vita, J. A., Ryan, T. J., Ganz, P., and Selwyn, A. P. (1991). The effect of atherosclerosis on the vasomotor response of coronary arteries to mental stress.N. Engl. J. Med. 325: 1551–1556.

    Google Scholar 

  • Zonderman, A. B., Costa, P. T., and McCrae, R. R. (1989). Depression as a risk factor for cancer morbidity and mortality in a nationally representative sample.JAMA 262: 1191–1195.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center of Cardiac Rehabilitation, University Hospital of Antwerp, Antwerp, Belgium

    Johan Denollet

Authors
  1. Johan Denollet
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

This research was supported by a grant of from National Fund for Scientific Research, Brussels, Belgium.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Denollet, J. Biobehavioral research on coronary heart disease: Where is the person?. J Behav Med 16, 115–141 (1993). https://doi.org/10.1007/BF00844889

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00844889

Key words

Search

Navigation