Walter I. Wardwell

Behavioral variables and myocardial infarction in the southeastern Connecticut heart study

The potential etiologic role of sociological and psychological variables defined as stressful in the production of myocardial infarction (MI) was studied in 114 surviving hospitalized MI subjects, 114 subjects free of cardiovascular disease but hospitalized for a different serious illness, and 145 ‘normal’ subjects. All were white males aged 35–64 who were interviewed in their homes, the sick groups during convalescence. Hypotheses based on previous research relating to the following variables were not supported: situational stress, Symes cultural mobility, religious affiliation, commitment to social norms, feminine psychosexual identification, anxiety, alienation and psychopathological tendencies. However, MIs scored higher than both the other sick and normal subjects on an original scale designed to measure Rosenman and Friedmans Behavior Pattern A and on a scale of somatization, i.e. the tendency to translate conflict and affect into bodily symptoms. The principal conclusion is that what counts in the production of MI may not be the amount of situational or intrapsychic stress a person is subjected to but the way he copes with it—is defensive style.

SOCIAL AND PSYCHOLOGICAL FACTORS IN CORONARY HEART DISEASE.

Sociological and personality factors in the etiology of coronary heart disease were investigated by comparing all the surviving cases of myocardial infarction occurring in one year in white males aged 35-64 with an equal-sized age-matched series of seriously ill persons residing in the same county. Urban middle-class Protestants of Northwestern European stock were found to be the most vulnerable to the disease. Several personality and social characteristics were also found to be closely associated with coronary heart disease.

Socio-environmental antecedents to coronary heart disease in 87 white males.

Abstract Men of middle-class Protestant background have the highest ratios of “observed” to “expected” cases of coronary heart disease even when other sociological and selected “physiological” variables (hypertension, obesity, smoking, and diet) are controlled for. “Preference for planning vacations hour by hour” and “inability to relax after a hard day” in the coronary patients are interpreted as supporting evidence that personality characteristics associated with Protestant and middle-class values may be important in the etiology of this puzzling disease.