251-
JAPANESE TYPE A BEHAVIOR PATTERN IS ASSOCIATED WITH "TYPUS MELANCHOLICUS": A STUDY FROM THE SOCIOCULTURAL VIEWPOINT
FUKUNISHI, MASAKI HATTORI, HIROTAKA HATTORI, YASUHIRO IMAI, YUKO MIYAKE, MASAHIRO MIGUCHI & KAZUYA YOSHIMATSU
ISAO
SUMMARY An examination of the relationship between Type A behavior pattern (TABP) and "Typus Melancholicus" (TM) in 212 coronary heart disease (CHD) patients in Japan revealed that: CHD patients with TABP were significantly more likely to have a depression-prone personality, what Tellenbach calls "Typus Melancholicus"; this tendency was observed not only in CHD patients but also among healthy Type A subjects; and TM is positively correlated with Type A. The results of our studies from a comparative sociocultural viewpoint indicate that TM may be involved in Japanese traits self- sacrificing and obsessional TABP, suggesting the possibility that driving, are related to Type A behavior in a variety of different cultural contexts.
INTRODUCTION
Type A behavior pattern (TABP) (Jenkins ccl. 1967; Jenkins et al. 1974), manifested by competitiveness, excessive drive and an enhanced sense of time urgency, has been associated with an increased risk of coronary heart disease (CHD) (R.osenanan et al. 1975; Rosenman et al, 1976). TABP studies in the United States have drawn attention to hostility and anger as the TABP components most strongly correlated with CHD (Williams et al. 1980; Dembroski et ccl. 1985; Siegman et al. 1987). On the other hand, TABP has also been shown to exist in one Eastern country, namely Japan (Hayano et al. 1989). Since TABP may be influenced by various environmental and sociocultural factors, psychosocial considerations including these factors should be included in any study of TABP. Since in Japan hostility and anger are not so obvious as in the United States, some questions arise. Is the Japanese TABP the same as the Western one? If there are differences in TABP between Japan and Western countries, what are they? The present study examines the relationship between TM and TABP in Japan in 212 CHD patients and discusses this relationship from a comparative sociocultural standpoint.
Downloaded from isp.sagepub.com at Univ of Illinois at Chicago Library on May 3, 2015
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SUBJECTS AND METHODS The subjects were 212 male CHD patients at Meijo Hospital in Nagoya city in Japan. The mean age ± standard deviation was 50.9 ±10.0 (37-73) years. Ninety four healthy subjects not suffering from any somatic disorder were randomly selected from the general population as controls and matched for age and sex. Any CHD patient who could not adequately complete the psychological tests because of metabolic or organic brain damage, serious somatic complications, or physiological memory disturbance due to aging was excluded from the study. Two psychological tests, the Jenkins Activity Survey (JAS) Form C and DepressionRelated Personality Trait Scale (DRP) were administered to both subjects and controls. As shown in the Appendix, the DRP was developed by Yoshimatsu eat al. (1989) to evaluate the depression-related personality or &dquo;Typus Mclancholicus&dquo; as Tellenbach calls it (1961), in Japan. The questionnaire has a high construct validity and reliability (Miguchi et al. 1990). Previous reports (Yoshimatsu et al, 1989; Miguchi et c~l. 1990), assume that TM is present when the total score is in excess of 55 points (out of 76). The Zung’s Self-Rating Depression Scale (SDS) was also administered to 69 CHD patients who had been under observation for over three years, to evaluate the severity of the depressive symptoms. The results thus obtained were statistically analyzed by the Student t-test, the X2 test and the Pearson’s correlation coefficient.
RESULTS
Table I shows the prevalence of Type A and TM amongst CHD patients and in the controls. Type A was significantly commoner in CHD patients than in the controls (~~ 5.97, p < 0.01 ), as was TM (x2 3.92, p < 0.05). TM was also significantly commoner in CHD patients with Type A than in those with non-Type A (X2= 13.42, p
JAPANESE TYPE A BEHAVIOR PATTERN IS ASSOCIATED WITH "TYPUS MELANCHOLICUS": A STUDY FROM THE SOCIOCULTURAL VIEWPOINT
FUKUNISHI, MASAKI HATTORI, HIROTAKA HATTORI, YASUHIRO IMAI, YUKO MIYAKE, MASAHIRO MIGUCHI & KAZUYA YOSHIMATSU
ISAO
SUMMARY An examination of the relationship between Type A behavior pattern (TABP) and "Typus Melancholicus" (TM) in 212 coronary heart disease (CHD) patients in Japan revealed that: CHD patients with TABP were significantly more likely to have a depression-prone personality, what Tellenbach calls "Typus Melancholicus"; this tendency was observed not only in CHD patients but also among healthy Type A subjects; and TM is positively correlated with Type A. The results of our studies from a comparative sociocultural viewpoint indicate that TM may be involved in Japanese traits self- sacrificing and obsessional TABP, suggesting the possibility that driving, are related to Type A behavior in a variety of different cultural contexts.
INTRODUCTION
Type A behavior pattern (TABP) (Jenkins ccl. 1967; Jenkins et al. 1974), manifested by competitiveness, excessive drive and an enhanced sense of time urgency, has been associated with an increased risk of coronary heart disease (CHD) (R.osenanan et al. 1975; Rosenman et al, 1976). TABP studies in the United States have drawn attention to hostility and anger as the TABP components most strongly correlated with CHD (Williams et al. 1980; Dembroski et ccl. 1985; Siegman et al. 1987). On the other hand, TABP has also been shown to exist in one Eastern country, namely Japan (Hayano et al. 1989). Since TABP may be influenced by various environmental and sociocultural factors, psychosocial considerations including these factors should be included in any study of TABP. Since in Japan hostility and anger are not so obvious as in the United States, some questions arise. Is the Japanese TABP the same as the Western one? If there are differences in TABP between Japan and Western countries, what are they? The present study examines the relationship between TM and TABP in Japan in 212 CHD patients and discusses this relationship from a comparative sociocultural standpoint.
Downloaded from isp.sagepub.com at Univ of Illinois at Chicago Library on May 3, 2015
252
SUBJECTS AND METHODS The subjects were 212 male CHD patients at Meijo Hospital in Nagoya city in Japan. The mean age ± standard deviation was 50.9 ±10.0 (37-73) years. Ninety four healthy subjects not suffering from any somatic disorder were randomly selected from the general population as controls and matched for age and sex. Any CHD patient who could not adequately complete the psychological tests because of metabolic or organic brain damage, serious somatic complications, or physiological memory disturbance due to aging was excluded from the study. Two psychological tests, the Jenkins Activity Survey (JAS) Form C and DepressionRelated Personality Trait Scale (DRP) were administered to both subjects and controls. As shown in the Appendix, the DRP was developed by Yoshimatsu eat al. (1989) to evaluate the depression-related personality or &dquo;Typus Mclancholicus&dquo; as Tellenbach calls it (1961), in Japan. The questionnaire has a high construct validity and reliability (Miguchi et al. 1990). Previous reports (Yoshimatsu et al, 1989; Miguchi et c~l. 1990), assume that TM is present when the total score is in excess of 55 points (out of 76). The Zung’s Self-Rating Depression Scale (SDS) was also administered to 69 CHD patients who had been under observation for over three years, to evaluate the severity of the depressive symptoms. The results thus obtained were statistically analyzed by the Student t-test, the X2 test and the Pearson’s correlation coefficient.
RESULTS
Table I shows the prevalence of Type A and TM amongst CHD patients and in the controls. Type A was significantly commoner in CHD patients than in the controls (~~ 5.97, p < 0.01 ), as was TM (x2 3.92, p < 0.05). TM was also significantly commoner in CHD patients with Type A than in those with non-Type A (X2= 13.42, p
