After 3 decades of intensive research, there is still confusion about the nature and reliability of relations between psychological factors and coronary heart disease (CHD). A meta-analysis, or quantitative review, was performed to integrate and organize the results of studies that investigated certain personality variables in relation to CHD. The personality variables included were anger, hostility, aggression, depression, extroversion, anxiety, Type A, and the major components of Type A. The meta-analytic framework helps focus attention on issues needing clarification. The results indicate that modest but reliable associations exist between some of the personality variables and CHD. The strongest associations were found for Type A and, surprisingly, for depression, but anger/hostility/ aggression and anxiety also related reliably to CHD. The Structured Interview diagnosis of Type A was shown to be clearly superior to the Jenkins Activity Survey as a predictor of CHD. The Type A-CHD relation was smaller in prospective than in cross-sectional studies and smaller in recent than in less recent studies. This review also revealed that information about the interrelations of personality predictors of CHD is sorely needed. The picture of coronary-proneness revealed by this review is not one of a hurried, impatient workaholic but instead is one of a person with one or more negative emotions. We suggest that the concept of the coronary-prone personality and its associated research be broadened to encompass psychological attributes in addition to those associated with Type A behavior and narrowed to eliminate those components that the accumulated evidence shows to be unimportant.Understanding the relation between psychological factors and heart disease has proved to be a difficult task, hampered by the weaknesses of vague constructs and correlational research designs. After nearly a century of speculation and 3 decades of intensive research, the nature of the relation between psychological factors and coronary heart disease (CHD) is still unclear.Yet because CHD is such a serious problem, accounting for about a third of all deaths in the United States, most would agree that the issue deserves continued investigation and review.Most of the research conducted in search of a coronary-prone personality-a style of behaving and coping that leads to coronary artery damage-has focused on the Type A behavior pattern (TABP), a collection of behaviors that seems predictive of clinically apparent CHD (Cooper, Detre, & Weiss, 1981; Dembroski, Weiss, Shields, Haynes, & Feinleib, 1978). As described by its discoverers, the TABP refers broadly to the behavior pattern of any person who is involved in an aggressive and incessant struggle to achieve more and more in less and less time (e.g., M. Friedman & Rosenman, 1974;Rosenman, 1978). The major elements of the behavior pattern are competitive achievement striving, a sense of time urgency and impatience, aggressiveness, and easily aroused hostility. One major question of this review is whe...

This article examines the notion that personality plays a causal role in the development of disease. In particular, this article develops the heuristic strategy of simultaneously comparing several emotional aspects of personality and several diseases, with close attention to the strength of the links between personality and disease. The published literature on personality correlates of five diseases with so-called "psychosomatic" components-asthma, arthritis, ulcers, headaches, and coronary heart disease--is reviewed and discussed, with a focus on construct validity. The statistical technique of meta-analysis is used to provide an easily viewed comparative summary. The results point to the probable existence of a generic "disease-prone" personality that involves depression, an-ger~hostility, anxiety, and possibly other aspects of personality. However, except in the case of coronary heart disease, the evidence is weak. Nevertheless, there is sufficient evidence to argue for a key role for psychological research on the prevention and treatment of disease. Specific directions for future research are described.June

The fitness and health of military personnel is important for operational readiness and effectiveness. This point is the basis for program's such as the Navy's Health and Physical Readiness Program. The effectiveness of those programs depends on an adequate understanding of the antecedents and consequences of the behaviors the programs attempt to modify. The present study examined personality as an antecedent of differences in health behaviors.A sample of U.S. Navy recruits (n = 103) and a sample of U.S. Marine Corps personnel (n = 76) completed standardized questionnaires to describe their personality and their habitual health behavior patterns. The personality measures included scales for neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness, based on a growing consensus among personality researchers that these dimensions comprehensively cover the major personality domains. The health behavior measures included scales for wellness behaviors, accident prevention, substance-use risk taking, and traffic risk taking developed in prior Naval Health Research Center studies. Correlation and regression analyses were performed separately in each sample to estimate the relationships between personality and health behaviors. The results were pooled to produce overall estimates of the magnitude of associations and their statistical significance.The most important personality correlates of health behaviors were conscientiousness and agreeableness. In the multiple regression analyses, conscientiousness was related to engaging in more frequent wellness behaviors and accident control behaviors and less frequent traffic risk taking behaviors. Agreeableness was related to less traffic risk taking and substance use risk taking. In addition, openness to experience was the strongest single predictor of substance use risk taking and was related to higher risk taking. Extraversion was related to more frequent wellness behaviors. In combination, the personality variables accounted for 9% to 25% of the variance in the health behavior variables.Personality variables merit more attention than they have received in health behavior research. Knowledge of the personality composition of the target population for a program such as the Navy's Health and Physical Readiness Program can be used in two ways to enhance the impact of these programs. One way is by identifying general behavioral trends that must be overcome for a program to be effective. A second way is by providing a basis for selecting the -2-most suitable types of intervention programs for the target population. For example, simply providing information about the need for good health behaviors and the appropriate methods for incorporating those behaviors into one's life style may be sufficient when dealing with people who are high on conscientiousness. For people who are low on conscientiousness, programs which rely more on involvement with peers may be appropriate, particularly among those who are agreeable and presumably more responsive to that ...

Research studies have identified heightened psychiatric problems among veterans of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). However, these studies have not compared incidence rates of psychiatric disorders across robust cohorts, nor have they documented psychiatric problems prior to combat exposure. The authors' objectives in this study were to determine incidence rates of diagnosed mental disorders in a cohort of Marines deployed to combat during OIF or OEF in 2001-2005 and to compare these with mental disorder rates in two historical and two contemporary military control groups. After exclusion of persons who had been deployed to a combat zone with a preexisting psychiatric diagnosis, the cumulative rate of post-OIF/-OEF mental disorders was 6.4%. All psychiatric conditions except post-traumatic stress disorder occurred at a lower rate in combat-deployed personnel than in personnel who were not deployed to a combat zone. The findings suggest that psychiatric disorders in Marines are diagnosed most frequently during the initial months of recruit training rather than after combat deployment. The disproportionate loss of psychologically unfit personnel early in training creates a "healthy warrior effect," because only those persons who have proven their resilience during training remain eligible for combat.

The fitness and health of military personnel is important for operational readiness and effectiveness. This point is the basis for program's such as the Navy's Health and Physical Readiness Program. The effectiveness of those programs depends on an adequate understanding of the antecedents and consequences of the behaviors the programs attempt to modify. The present study examined personality as an antecedent of differences in health behaviors.A sample of U.S. Navy recruits (n = 103) and a sample of U.S. Marine Corps personnel (n = 76) completed standardized questionnaires to describe their personality and their habitual health behavior patterns. The personality measures included scales for neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness, based on a growing consensus among personality researchers that these dimensions comprehensively cover the major personality domains. The health behavior measures included scales for wellness behaviors, accident prevention, substance-use risk taking, and traffic risk taking developed in prior Naval Health Research Center studies. Correlation and regression analyses were performed separately in each sample to estimate the relationships between personality and health behaviors. The results were pooled to produce overall estimates of the magnitude of associations and their statistical significance.The most important personality correlates of health behaviors were conscientiousness and agreeableness. In the multiple regression analyses, conscientiousness was related to engaging in more frequent wellness behaviors and accident control behaviors and less frequent traffic risk taking behaviors. Agreeableness was related to less traffic risk taking and substance use risk taking. In addition, openness to experience was the strongest single predictor of substance use risk taking and was related to higher risk taking. Extraversion was related to more frequent wellness behaviors. In combination, the personality variables accounted for 9% to 25% of the variance in the health behavior variables.Personality variables merit more attention than they have received in health behavior research. Knowledge of the personality composition of the target population for a program such as the Navy's Health and Physical Readiness Program can be used in two ways to enhance the impact of these programs. One way is by identifying general behavioral trends that must be overcome for a program to be effective. A second way is by providing a basis for selecting the -2-most suitable types of intervention programs for the target population. For example, simply providing information about the need for good health behaviors and the appropriate methods for incorporating those behaviors into one's life style may be sufficient when dealing with people who are high on conscientiousness. For people who are low on conscientiousness, programs which rely more on involvement with peers may be appropriate, particularly among those who are agreeable and presumably more responsive to that ...