This critique seems to reflect the bias of its authors and advisers, but cannot be considered as too constructive. The study of psychosocial factors in the pathogenesis of coronary heart disease is fraught with methodologic difficulties that have variously led to confusion. A significant amount of the confusion has been introduced in publications written all too frequently by those who are inadequately informed or experienced in the issues they so readily criticize.
In this instance Horwitz and Horwitz have selected a handful of publications dealing with type A behavior pattern and its relationship to coronary heart disease, but they either have ignored or are inadequately familiar with literally hundreds of other publications on the subject that have emerged in the past two decades from a remarkably large number of investigators in many countries. A well-considered critique should be based on complete, if not personal, familiarity with the subject. I am
Rosenman RH. Response. Arch Intern Med. 1986;146(7):1433. doi:10.1001/archinte.1986.00360190225033