A prospective study of the relationship between personality and coronary heart disease

Abstract

As part of a prospective epidemiological study of coronary heart disease, the Minnesota Multiphasic Personality Inventory (MMPI) and the Sixteen Personality Factor Questionnaire (16PF) were used to obtain measures of personality from 1990 men who were 40–55 years of age and free of clinical coronary disease at the beginning of the study 4 1 2 years ago. With respect to the MMPI, data are presented for 48 men who have subsequently developed only the symptoms of angina pectoris, 37 men who have had myocardial infarctions, and 1771 men who have remained free of clinical coronary heart disease. For the 16PF, the number of cases in the angina, infarct, and non-coronary groups is 31, 18, and 1773, respectively. In all cases, the data on personality were obtained prior to the appearance of clinical coronary heart disease. Statistical analyses of these data indicate that the men who subsequently developed angina pectoris, in comparison to the subjects with myocardial infarction, scored significantly higher on the HsK and Hy scales of the MMPI and lower on Factor C of the 16PF. It was also found that the total coronary group (cases of angina plus cases of infarct) had significantly higher mean scores on Factors L and Q 2 than the men in the non-coronary group. These findings suggest that the men in the angina group, as compared to the men with myocardial infarction, were characterized before the clinical appearance of coronary heart disease by the following attributes: (1) a tendency to complain about somatic symptoms of all sorts and to be worried about the state of their health even in the absence of objective findings; (2) greater lability in cardiovascular functioning; and (3) greater emotional lability and suggestibility. With respect to the observed psychometric differences between the total coronary and non-coronary groups, it is inferred that the men who later developed coronary heart disease, as compared to those who did not, tended to be: (1) more independent in their social relationships; (2) more suspicious about the motives of other people; and (3) to have greater feelings of inner tension. It is emphasized that these results should not be taken as descriptions of ‘coronaryprone’ or ‘angina-prone’ personalities because these data do not by themselves demonstrate the existence of an etiological relationship between personality and coronary heart disease. This evidence supports the general hypothesis that patterns of behavior are significant in the epidemiology of coronary heart disease in man.