Can you survive your personality?

When getting a “C” is better than an “A”

Posted Sep 07, 2010

RiskYou've undoubtedly heard the term "Type A" personality to refer to someone who is hard-driving, competitive, and impatient. What you might not realize is that the "A" in Type A doesn't really stand for anything in particular. Though, if you are a true "Type A," you might think it's good to be called anything with an A in it. It certainly seems better than "Type A minus."

The story behind the term's discovery is revealing in and of itself. Back in the late 1960s, cardiologists Meyer Friedman and Ray Rosenman noticed that the chairs in their waiting room showed uneven patterns of wear. All of them were fraying at the edges of the seats and armrests. It dawned on the good doctors (actually their receptionist) that perhaps their patients seeking treatment for heart disease were anything but "patient," and instead were literally on edge as they waited their turn in the examining room. Eventually, this astute observation led them to initiate a series of landmark investigations which related the now well-known Type A behaviors to higher risk of cardiovascular disease. They actually slapped the label Type A onto this behavior pattern for lack of something better to call it. Then they naturally called the "not Type A's" what else? Type B.

Possibly, if you follow psychological research, the "correlation does not equal causation" alarm is ringing in your head. Impatience, competitiveness, and other symptoms of a hard-driving person might cause heart disease, but perhaps people with heart disease express these tendencies because something's wrong with their body's systems. It's also possible that a third factor (say, smoking) causes both these qualities to be related. However, a series of investigations carried out by Duke University researchers over many years is showing that something causal is operating after all, and learning about their results can literally save your life.

It's the personality trait of hostility that seems to be at the root of the Type A's problems. Duke researchers began to add hostility to the Type A mix after findings emerged from their follow-up studies of Baby Boomers first tested in college. The young people who scored high in hostility were most likely to have health problems in their midlife years. From this, the researchers concluded that hostility was the toxic factor in the Type A behavior pattern (Barefoot et al., 1983).

Angry womanBeing high in a personality trait is one thing, but it's not just the angry feelings that cause health problems. It's the behaviors related to hostility that seem to be the real culprits. In subsequent studies, Duke researchers observed that high hostility in young adulthood is related to a variety of coronary risk factors which in turn are related to poorer health habits such as smoking, drinking, overeating and a sedentary lifestyle (Siegler et al., 1992; Siegler et al., 2003).

By now you Type B's might be breathing a sigh of relief. Well, you're not quite off the hook yet. You need to take into account several other important personality-health behavior links that researchers have uncovered in recent years, again using long-term data. One of these factors is the personality trait of Conscientiousness (also called "C"). If you are high on C, you're likely to attend to details, be punctual, and not procrastinate. Sounds like a good set of qualities to have if you're examining the personality-health connection and, in fact, this is what researchers have found.

One study headed by Friedman and others (1995) showed that "high C" kids eventually ended up living longer, most likely because they took better care of themselves. High C is related, for example, to lower body mass index (BMI) in women (Pulkki-Raback et al., 2005).

Neuroticism (N) is another personality trait known to relate to high risk health behaviors. If you are high in N, you are generally anxious, worried, and likely to focus on the negative aspects of situations. In terms of health, high N adults are more likely to smoke, take drugs, and have problems with alcoholism.

The next personality trait is Agreeableness, an indication of how easy going and calm you are. Here's where our laid back and content Type B's might have an edge. As Duke researcher Ilene Siegler and her colleagues are finding (Siegler & Davey, in press), people high in agreeableness seem to be more likely to engage in vigorous exercise than their grumpy peers.

It might sound, then, like your personality seals your fate when it comes to your health and longevity if you're a Type A person, high in Neuroticism, and low on Conscientiousness. Fortunately, the news is not so bleak. First and foremost, your personality can change throughout your life. For many years, a brand of psychologists studying personality traits over time were convinced that personality was immutable after the age of 30. Then they upped the estimate to 50 years, and now these same researchers are talking about continued personality growth through the later years of adulthood as well (Terracciano et al., 2005). So, though you might have been a Low C child or even young adult, you stand a good chance of developing better health habits as you get older-of course, if you survive all the dangerous behaviors that you might have engaged in as a Low C young person.

Stress managementEarly in the Type A research, investigators began to wonder if they could directly intervene to stop the tide of hostility, impatience, and competitive mentality that threatens the life of the most extreme cases. The sorts of interventions they used were a bit novel at the time and tended more toward the behavioral than the psychoanalytic. Rather than investigate which deeply held repressed motives may cause the spiral of self-destructiveness in the Type A person, these investigators threw their subjects into situations known to provoke even mildly Type A people into a fit of heightened blood pressure and intervened right there on the spot.

Long lines at the bank, grocery store, or airline counter are known to throw Type A's into a tizzy. Forcing the Type A's into these situations while getting them to relax or meditate at the same time seemed to flip the switch from Type A fury to Type B "chillin'." As a sidenote, Friedman lived to be 90 but his colleague Rosenman died in his mid-50s after suffering heart disease for 10 years. It was after his colleague's death that Friedman decided to try to reduce stress in his own life, and clearly it worked.

Surprisingly, there has been little research on treatment for Type A personalities. Perhaps not surprisingly, however, there have been precipitous increases in prescription medication use for hypertension, high cholesterol, and other cardiac disease risk factors. It's perhaps easier (and takes less time) for Type A's to pop a pill for their heart condition rather than take the time to deal with these preventable behavioral factors.

To sum up, if you had your choice of personality traits, you'd want the opposite of the grades you'd want to receive in school. It's the one case where C is far better than A. If you think you're an incurable Type A, though, take "heart" in the fact that you can change.

Follow me on Twitter @swhitbo for daily updates on psychology, health, and aging. Feel free to join my Facebook group, "Fulfillment at Any Age," to discuss today's blog, or to ask further questions about this posting. 

Copyright Susan Krauss Whitbourne, Ph.D. 2010


Barefoot, J. C., Dahlstrom, W. G., & Williams, R. B., Jr. (1983). Hostility, CHD incidence, and total mortality: a 25-year follow-up study of 255 physicians. Psychosomatic Medicine, 45, 59-63.
Friedman, H. S., Tucker, J. S., Schwartz, J. E., Martin, L. R., Tomlinson-Keasey, C., Wingard, D. L., et al. (1995). Childhood conscientiousness and longevity: Health behaviors and cause of death. Journal of Personality and Social Psychology, 68, 696-703

Pulkki-Raback, L., Elovainio, M., Kivimaki, M., Raitakari, O. T., & Keltikangas-Jarvinen, L. (2005). Temperament in childhood predicts body mass in adulthood: The Cardiovascular Risk in Young Finns Study. Health Psychology, 24, 307-315.
Siegler, I. C., Peterson, B. L., Barefoot, J. C., & Williams, R. B. (1992). Hostility during late adolescence predicts coronary risk factors at mid-life. AmericanJournal of Epidemiology, 136, 146-154.
Siegler, I. C., Costa, P. T., Brummett, B. H., Helms, M. J., Barefoot, J. C., Williams, R. B., et al. (2003). Patterns of change in hostility from college to midlife in the UNC Alumni Heart Study predict high-risk status. Psychosomatic Medicine, 65, 738-745.
Siegler, I.C., & Davey, A. (in press). Behavioral Stability and Change in Health Across the Adult Life Cycle. To appear in S.K. Whitbourne & M.J. Sliwinski (Eds.). Adult development and aging. London: Wiley-Blackwell.
Terracciano, A., McCrae, R. R., Brant, L. J., & Costa, P. T. J. (2005). Hierarchical linear modeling analyses of the NEO-PI-R Scales in the Baltimore Longitudinal Study of Aging. Psychology and Aging, 20, 493-506.