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February 10, 1989

Distrust, Rage May Be 'Toxic Core' That Puts 'Type A' Person at Risk

JAMA. 1989;261(6):813. doi:10.1001/jama.1989.03420060013002

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IT'S NOT talking fast, feeling pressed for time, and putting in long hours that will kill you. It's being suspicious of and hostile toward your fellow humans that will do you in. So finds Duke University Medical Center's Redford B. Williams, Jr, MD, professor of psychiatry at the Durham, NC, campus.

Speaking at the annual American Heart Association science writers' forum in Monterey, Calif, he said this distrustful attitude, rather than the sense of time urgency, is the "toxic core" of the renowned Type A personality. The latter, a set of traits originally described by cardiologists Meyer Friedman, MD, and Ray Rosenman, MD (JAMA. 1959;169:1286-1296 and 1984;252:1385-1393), had been thought to increase the risk of coronary heart disease and death until, in the early 1980s, several studies cast doubt on its value as a predictor of risk.

For example, the Western Collaborative Study Group reported that Type A persons survived