Why Do We Call Some People 'Type A'?

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iStock

We all have at least a few Type A people in our lives, and we might have even butted heads with one or two of them. The highly competitive, angry, impatient, perfectionist sort of person who strives to be the best at everything is a familiar type, whether you consider them models of success or workaholics with tunnel vision.

"I tell my students, they call it Type A, not Type B, for a reason," Susan Whitbourne, a psychologist based at the University of Massachusetts Amherst, tells Mental Floss. "You want to be Type A-plus, if you're Type A."

The phrase Type A wasn't just born out of the ether: It was created as a way to identify people with certain patterns of behavior prevalent among those with coronary heart disease. In the 1950s, a pair of American cardiologists, Meyer Friedman and Ray Rosenman, were sharing an office in San Francisco when an upholsterer repairing their waiting-room furniture made an odd remark. He was surprised by the wear pattern on their chairs, he said, in which only the front edges of the seats were worn, rather than the back. Patients were literally waiting on the edges of their seats for their name to be called—rather than reclining comfortably toward the back.

At first the pair were too busy to take much note of the upholsterer's comments. But in the mid-1950s, they began looking at the literature around coronary heart disease and wondering if something other than diet (then painted as the most significant culprit) might be playing a part. In a 1956 study of San Francisco Junior League members, they found that diet and smoking didn't seem like adequate explanations for the different rates of heart disease they were seeing in women and men, since husbands and wives tended to share the same food and smoking habits. Female hormones were dismissed as a factor, since black women were suffering just as much heart disease as their husbands. They discussed the issue with the president of the Junior League, who responded, "If you really want to know what is going to give our husbands heart attacks, I'll tell you … It's stress."

That's when Friedman and Rosenman remembered the upholsterer's remarks, and began researching the link between stressed-out, achievement-driven behavior and heart disease. In 1959, they identified a type of behavior pattern they called Type A—highly competitive, very concerned with time management, and aggressive—and found that patients with this behavior pattern had seven times the frequency of clinical coronary artery disease compared to other groups.

The pair also created a Type B label, which basically encompassed behaviors and attitudes that weren't defined as Type A. People with Type B behavior were easy-going and enjoyed lower levels of stress, and while they may have been just as ambitious and driven, they seemed more secure and steady. The pair wrote a popular 1974 book about their research, Type A Behavior and Your Heart, which helped spread their ideas in the general consciousness. And while their initial emphasis was on behavior patterns, not entire personalities, the public quickly began referring to Type A and Type B personality types.

Over the next few years researchers began accepting that there could be a link between Type A behaviors, especially hostility, and lethal heart failure. The picture of the fuming man with high blood pressure who succumbs to a rage-induced heart-attack isn't just a cliché, Whitbourne says. (In fact, some modern studies have supported the idea of an increased risk of heart attack after a bout of intense anger.)

But as time went on, researchers began to notice quite a few problems in the Type A/Type B paradigm. In part this was because our understanding of coronary heart disease improved, and doctors and physiologists began to better understand how diet, physical activity, genetics, and the environment relate to blood pressure and cholesterol. As the decades went on, it became apparent that aggressive personality alone was severely limited in its ability to predict heart disease.

Outside the implications for human health, psychologists also began to critique the Type A/Type B system of personality labeling as reductionist, arguing that it lumped together many different traits and folded them under one of two extremely large umbrellas. Many psychologists now feel that human behavior is too complex and intricate to be described in such a binary way: People might be driven and organized, but not necessarily hostile and prone to angry outbursts. People might also be irritable or impatient, but perhaps rarely cross the threshold into hostility.

"It's not that we don't believe in it anymore," Penn State University psychologist John Johnson tells Mental Floss. "It's just that it's run its course. Type A does have a lot of components, but those are components that can be better explained in other ways in personality psychology."

One prominent newer system for describing personality and behavior is the Five Factor Model, developed in 1961 but not reaching academic prominence until the 1980s. The Five Factor Model assesses personality through five domains: openness, conscientiousness, neuroticism, extraversion, and agreeableness. Johnson likens its impact in personality psychology to the Periodic Table of Elements for chemistry.

Many Type A traits, Johnson says, are probably better described under the Five Factor Model. For example, striving for achievement, a big part of Type A personality behavior, would easily fall under high conscientiousness. Type As might also score high on extraversion, but low on agreeableness, since they're less attuned to see others as collaborators.

But although many psychologists feel the Type A and B model has outlived its usefulness, they say it has an important legacy in modern psychology. "The study of Type A and related personality traits really revolutionized behavioral medicine and behavioral health," Whitbourne says. "There are many psychologists that look at behavior and health hand-in-hand," and much of this work has a foundation in what Type A pioneered, according to Whitbourne.

So if many psychologists (not to mention cardiologists) feel the framework is outdated, why do we still call people Type A? According to Johnson, one of the biggest reasons probably has to do with how easy it is to recognize. "We all know people who are very driven and single-minded about achieving something, but they don't treat other people very well," he says. "It's a familiar thing to most of us."

Looking to Downsize? You Can Buy a 5-Room DIY Cabin on Amazon for Less Than $33,000

Five rooms of one's own.
Five rooms of one's own.
Allwood/Amazon

If you’ve already mastered DIY houses for birds and dogs, maybe it’s time you built one for yourself.

As Simplemost reports, there are a number of house kits that you can order on Amazon, and the Allwood Avalon Cabin Kit is one of the quaintest—and, at $32,990, most affordable—options. The 540-square-foot structure has enough space for a kitchen, a bathroom, a bedroom, and a sitting room—and there’s an additional 218-square-foot loft with the potential to be the coziest reading nook of all time.

You can opt for three larger rooms if you're willing to skip the kitchen and bathroom.Allwood/Amazon

The construction process might not be a great idea for someone who’s never picked up a hammer, but you don’t need an architectural degree to tackle it. Step-by-step instructions and all materials are included, so it’s a little like a high-level IKEA project. According to the Amazon listing, it takes two adults about a week to complete. Since the Nordic wood walls are reinforced with steel rods, the house can withstand winds up to 120 mph, and you can pay an extra $1000 to upgrade from double-glass windows and doors to triple-glass for added fortification.

Sadly, the cool ceiling lamp is not included.Allwood/Amazon

Though everything you need for the shell of the house comes in the kit, you will need to purchase whatever goes inside it: toilet, shower, sink, stove, insulation, and all other furnishings. You can also customize the blueprint to fit your own plans for the space; maybe, for example, you’re going to use the house as a small event venue, and you’d rather have two or three large, airy rooms and no kitchen or bedroom.

Intrigued? Find out more here.

[h/t Simplemost]

This article contains affiliate links to products selected by our editors. Mental Floss may receive a commission for purchases made through these links.

Bad Blood: The Hidden Horror of the Tuskegee Syphilis Study

A doctor draws blood from one of the study’s subjects.
A doctor draws blood from one of the study’s subjects.

In September of 1932, Public Health Service officials visited Tuskegee, Alabama, where they recruited 600 Black men to receive treatment for “bad blood.” The men didn’t realize they had become unwitting participants in one of the most controversial medical studies in recent times.

Of the study’s participants, 399 of the men were suffering from the advanced stages of syphilis, which at that time was incurable, while the other 201 served as controls. Under the guise of offering medical treatment, the Public Health Service set out to study the effects of untreated syphilis in Black men. Doctors enticed the poor, mostly illiterate Macon County residents to take part in return for free medical examinations, rides to the clinic, and hot meals on examination days. For the participants, many of whom had never even visited a doctor, the offer seemed too good to refuse.

A Secretive Study

Nurse Eunice Rivers interacts with a few members of the study.National Archives/Center for Disease Control // Public Domain

Deception was integral to the Tuskegee Syphilis Study. The men did not know they were actually participating in an experiment, and were kept in the dark about the true nature of their diagnosis. They were also unaware they weren’t receiving treatment at all: The drugs they were administered were either inadequate or completely ineffective. At one point, they were even given diagnostic spinal taps, a painful and often complex procedure the doctors referred to as a “special treatment.”

Though the study was originally meant to last for six months, the Public Health Service decided to continue it when the participating doctors deemed that only autopsies could determine the damage the disease caused. In other words, the doctors would keep tabs on the men until they died.

To ensure nothing would interfere with the experiment, doctors in Macon County were given a list of the subjects and instructed to refer them to the Public Health Service if they sought medical treatment. The Public Health Service even hired Eunice Rivers, a Black nurse, to maintain contact with the men and ensure their continued participation. All the while, the experiment's subjects were left to degenerate—when untreated, syphilis can cause bone deformations, heart disease, blindness, and deafness.

A medical breakthrough came in 1947, when penicillin became the standard treatment for syphilis. Despite this, the doctors involved in the Tuskegee study opted not to treat the men so they could continue to monitor the disease's natural progression. As historian Dr. Crystal Sanders tells Mental Floss in an email, “By withholding treatment, doctors subjected these men, their spouses, and their offspring to serious health problems and death.”

The End of the Experiment

None of the medical professionals involved in the decades-long study admitted to any wrongdoing.National Archives/Center for Disease Control // Public Domain

The study was not without its critics. When Public Health Service official Peter Buxtun learned about the experiment in 1966, he expressed grave moral concerns to the Centers for Disease Control. After numerous organizations, doctors, and scientists still opposed ending the study, Buxtun took matters into his own hands and leaked information about the experiment to Associated Press journalist Jean Heller.

On July 26, 1972, The New York Times ran a front page story exposing the study. Public outrage immediately ensued, but by then the damage was done. At least seven of the men had died from syphilis, while more than 150 had died from heart failure, a condition commonly linked to the infection. Forty spouses had also contracted syphilis, and 19 children were born with the condition. Some of the infected women, who believed the study was legitimate medical care, were turned away when they attempted to enroll. 

Once the study became public knowledge, the Department of Health, Education, and Welfare promptly ruled that the 40-year-long experiment come to an immediate end. Yet despite the national outcry, none of the medical professionals involved in the study were prosecuted. “They maintained that they had done nothing wrong,” Sanders explains. “Some even went so far as to assert that the Black male subjects would never have been treated anyway given their financial circumstances, so their study did not harm them.”

With the experiment finally over, the government appointed Dr. Vernal G. Cave to lead a team of Black doctors to investigate. He found that while the experiment was being carried out, at least 16 articles about it had been published in various medical journals. So why had it taken so long to bring the study to an end?

“The subjects were Black and poor and did not warrant much attention from the powers that be,” Sanders says. “Additionally, very few people with the political and social capital to ask questions would have been suspicious of a study underwritten by the federal government and carried out by medical practitioners who had the respect of the local white society.”

A Public Reckoning

In 1973, the National Association for the Advancement of Colored People (NAACP) filed a class action lawsuit on behalf of the study's participants and their families, and the following year a $10 million out-of-court settlement was reached. The U.S. government also agreed to provide free medical treatment to the study’s surviving participants, as well as their family members who became infected during the experiment.

The story of the Tuskegee Syphilis Study was brought to the screen 14 years later in the made-for-TV movie Miss Evers’ Boys. When the study’s participants saw the film, they were disappointed by its portrayal of the series of events. It suggested the men had received treatment for their condition, and shifted the blame from the federal government to a fictitious Black doctor and a Black nurse. As a response to the film, the participants enlisted the help of attorney Fred Gray to make sure the nation understood the truth behind the study.

In March 1997, Gray wrote a letter to president Bill Clinton requesting the victims receive a formal apology. Two months later, and more than 50 years after the experiment began, Clinton delivered his apology in a speech at the White House. By that time, only eight of the men were still alive.

“The United States government did something that was wrong — deeply, profoundly, morally wrong,” Clinton said. “What was done cannot be undone. But we can end the silence. We can stop turning our heads away. We can look at you in the eye and finally say on behalf of the American people, what the United States government did was shameful, and I am sorry.”

Though the last survivor of the study died in 2004, the experiment has had a lasting effect on the African-American community. A 2016 study found that after the Tuskegee study was exposed, the life expectancy of Black men decreased by 1.5 years, with a marked decrease in patient-physician interactions [PDF]. “There is a long history of poor Black people seeking preventative care and getting anything but that,” Sanders says. “I wholeheartedly believe that there is a connection between present-day African American distrust of the medical field and the Tuskegee Syphilis Experiment.”