The Coronary Personality: A Critique

An examination of the experimental literature lent little support to the concept of a "coronary personality. " The lack of consistent findings was attributed, at least in part, to the action and complex interaction of variables such as age, sex, and socioeconomic status. PSYCHOLOGICAL FACTORS have been im-plicated in the pathogenesis of coronary artery disease (CAD) in several different ways. It has been suggested by some in-vestigators that emotional stress can pre-cipitate a myocardial infarction in indi-viduals who already have the necessary structural impairment.14'B2 Others have argued that emotional stress, operating in a general, nonspecific fashion, has etiological significance with respect to CAD—i.e., that individuals who eventu-ally develop symptoms of structural heart damage have lived for a greater part of their lives under exceptionally stressful conditions and these circum-stances have causally contributed to their development of CAD.43'44 A third way in which, it is asserted, psychological factors are associated with CAD is on the basis of personality—i.e., certain types of people, described in terms of either overt personality traits or conscious and unconscious dynami