August 19, 1974

Behavior and Stress

Author Affiliations

Buffalo, NY

JAMA. 1974;229(8):1045. doi:10.1001/jama.1974.03230460013007

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To the Editor.—  The juxtaposition of the letters entitled "Type A or B Behavior?" and "Psychiatric Disorders and Criminality" (228:1369, 1974) prompts me to comment on the statistics that were included.We know that type A behavior does have a significant effect on morbidity and mortality, particularly in relation to cardiovascular disease. Our group has determined that this is also behavior which is effected by the overuse of alcohol and secondarily by certain demographic characteristics related to family life. Divorce, for example, is higher in a type A individual who has the additional problem of alcohol excess. Our very select sample is management for executive persons who have come to psychiatric referral. The interesting thing is that the statistics compiled by Drs. Paull and Malek parallel our own, except that their population is of a lower socioeconomic level. The significant factor seems to be that even in an upper-class managerial