Psychologic treatment significantly reduced Type A behavior pattern scores (ES 0.61; 95% CI +/- 0.20; p<0.001) and reduced 3-year combined mortality and myocardial infarction by roughly 50%.
Meta-Analysis (n=18)
Effect estimate: ES 0.61 (95% CI +/- 0.20)
p-value: p=< 0.001
The Type A behavior pattern (TABP) is a recognized risk factor for coronary heart disease (CHD), and yet treatments aimed at its modification are not in widespread use. We reviewed the literature of controlled studies (N = 18) of the psychologic treatment of the TABP and of CHD with the statistical method of "meta-analysis." The results of each study were converted to a standardized "Effect Size" (ES). The mean ES for TABP measures was 0.61 +/- 0.20 (95% confidence interval) (p less than 0.001), indicating that after treatment subjects across all studies reduced their TABP scores by half a standard deviation. The combined significance probability (pc) across studies for reduction in 3-year combined mortality and myocardial infarction was pc less than 0.0001, corresponding to a reduction in coronary events of roughly 50% after psychologic treatment. This finding must be approached with caution because it is based on only two studies. The analysis suggested that a combination of treatment techniques is most effective in reducing TABP and CHD recurrences. The literature was critiqued, and limitations of the findings are discussed. We conclude that psychologic intervention to reduce TABP may improve clinical outcome of CHD and that this deserves further study and preliminary clinical application.
Nunes et al. (Sun,) conducted a meta-analysis in Type A behavior pattern and coronary heart disease (n=18). Psychologic treatment vs. Control was evaluated on Type A behavior pattern (TABP) measures (ES 0.61, 95% CI +/- 0.20, p=< 0.001). Psychologic treatment significantly reduced Type A behavior pattern scores (ES 0.61; 95% CI +/- 0.20; p<0.001) and reduced 3-year combined mortality and myocardial infarction by roughly 50%.