Type A Personality: What the Research Actually Says

"I'm so Type A." People say it about their colour-coded calendars, their inability to sit through a slow lunch, the way they reread an email six times before sending it. It has become a personality in shorthand: driven, organised, a bit intense.

The phrase did not come from psychology. It came from cardiology, from two doctors trying to explain why some of their patients had heart attacks and others didn't. Their idea was famous, influential, and in its original form largely wrong. One piece of it held up. And what most people mean when they call themselves Type A today is something the original theory never looked at.

Where "Type A" came from

In the 1950s, Meyer Friedman and Ray Rosenman were cardiologists in San Francisco. In 1959 they published a study in JAMA comparing three groups of men. Group A was 83 men chosen because they showed "an intense, sustained drive for achievement" and were continually involved in competition and deadlines, at work and outside it. Group B was 83 men chosen for the opposite pattern. Group C was 46 unemployed blind men, selected as a contrast group living with chronic insecurity and anxiety.

The headline finding: clinical coronary artery disease was seven times more frequent in Group A than in Group B or Group C. The authors concluded that the behaviour pattern itself was a large part of the difference.

It was a striking result from a small study. The men were picked out by the researchers for their behaviour, and the study compared them as they were at one point in time rather than following them forward. So Friedman and Rosenman set up something much bigger.

The Western Collaborative Group Study began in 1960 with 3,524 men employed by 11 California companies, both blue- and white-collar. Type A behaviour was rated with a structured interview, and the men were followed for years. At the 8.5-year follow-up the result looked solid: Type A behaviour was associated with coronary heart disease independently of the usual risk factors such as smoking, blood pressure and cholesterol, and it carried roughly a 2:1 risk.

In 1974 the pair published a popular book, Type A Behavior and Your Heart, and the phrase escaped into everyday language. By then "Type A" meant something everyone could picture: the man eating lunch at his desk, finishing your sentences, honking at the light the instant it turns green.

Then it stopped replicating

The same study that made Type A famous is the one that undid it. When researchers followed the Western Collaborative Group men for 22 years, 214 had died of coronary heart disease. Blood pressure, cholesterol, smoking and age strongly predicted who. Type A behaviour did not: it showed no association with 22-year coronary mortality (a standardised relative hazard of 0.98, essentially even).

A second paper from the same cohort, in the New England Journal of Medicine in 1988, looked at the men who had already had a coronary event and survived the first 24 hours. Among them, Type A men had a lower rate of later coronary death than Type B men: 19.1 versus 31.7 per 1,000 person-years. The authors called the finding surprising and said it needed confirmation, but it was hard to square with Type A being the dangerous one.

Other large studies found the same nothing. In 2001, a meta-analysis by Michael Myrtek pooled the prospective studies (the kind that measure behaviour first and wait to see who gets ill). Across 74,326 participants, the association between Type A and coronary heart disease was effectively zero (r = 0.003) and not statistically significant.

There is an uncomfortable footnote. In 2012, researchers who analysed tobacco industry documents reported in the American Journal of Public Health that the industry had been a major funder of Type A research. According to their paper, Philip Morris provided nearly $11 million to the Meyer Friedman Institute up to 1997, and called a trial of counselling to reduce Type A behaviour its "crown jewel". The authors found that selected results were used to counter concerns about tobacco and health, and argue that industry involvement helps explain why early promising findings gave way to negative ones. That is their interpretation, but the funding itself is documented.

The part that held up: hostility

When the overall pattern stopped predicting anything, researchers asked a sharper question. Type A was a bundle: ambition, speed, impatience, competitiveness and a readiness to get angry. Was one ingredient doing the work?

The ingredient that kept showing up was hostility: cynical mistrust of other people, frequent anger, and antagonistic ways of dealing with them. A 1996 meta-analysis in Psychological Bulletin by Miller and colleagues combined 45 studies and concluded that hostility is an independent risk factor for coronary heart disease. The effects were modest (correlations of roughly 0.08 to 0.18, depending on how hostility was measured), but they were there in a way the global Type A pattern was not.

A 2009 meta-analysis by Chida and Steptoe in the Journal of the American College of Cardiology pooled 25 studies of initially healthy people and 19 studies of people who already had heart disease. Anger and hostility were associated with more coronary events in the first group and a poorer outlook in the second. The authors noted signs of publication bias, though not enough to erase the result.

Not everyone is convinced. Myrtek's 2001 meta-analysis found the hostility link statistically significant but so small that he judged it of no practical use for prediction. The 2012 tobacco-documents paper is sceptical of the hostility work too. The fair reading is that hostility is the one piece of the original idea with consistent, if modest, support, and the hurry and the ambition are not.

That is a finding about large groups of people, not something you can read off any one person. What it does do is change what Type A is about. In this research the drive did not predict anything. The anger, modestly, did.

Type A vs Type B, plainly

Here is the difference, as the original research drew it and as people use it now.

	Type A	Type B
Original definition (1959)	An intense, sustained drive to achieve; constant competition and deadlines	The opposite pattern. Not defined on its own terms
Everyday meaning now	Driven, organised, impatient, competitive, hard on themselves	Relaxed, patient, unhurried, easygoing
How it was measured	Mostly a structured interview rating behaviour, later questionnaires. A category, not a scale
What survived	The hostility component, with modest support. The overall A/B split as a heart-disease predictor did not

Two things are worth knowing about the split itself. First, Type B was never a personality. It was a comparison group, the absence of Type A, and the relaxed, patient version of it is mostly a later invention. Second, sorting people into two boxes is not how personality science works now. Traits like conscientiousness or neuroticism are measured on a continuum, and most people sit somewhere in the middle of most of them. (If you want the longer version of that argument, it is the same one we make about the MBTI's four letters.)

So treat Type A and Type B as a piece of history and a handy bit of slang. Both are fine as long as nobody mistakes them for a measurement.

What people usually mean by "I'm so Type A"

Listen to how people actually use the phrase, and it is rarely about hostility or eating lunch fast. It is usually something more like this:

• Your standards are high, and you mostly like that about yourself.
• The more something matters, the harder it is to start, and then it gets done in a rush the night before.
• You find the flaw in your work before anyone else can, and a small mistake replays for days.
• Praise lands as a misunderstanding. The success was luck, or timing, or other people, and next time you will be found out.
• Rest has to be earned, so you rarely stop, and time off does not fill the tank back up.

Notice the second point. Putting things off is close to the opposite of the textbook Type A, and yet a lot of people who call themselves Type A will recognise it at once. That is the clue that the label is covering something the 1950s theory never measured. (If putting things off is the part you recognise most, we have written about it twice: why people procrastinate, which is rarely about time management, and why high achievers put off the things they care about most.)

Research on perfectionism draws the line that makes sense of this. It separates two things that usually get lumped together:

• High standards (researchers call these perfectionistic strivings): setting the bar high, caring about quality, pushing yourself.
• The fear of falling short (perfectionistic concerns): fear of mistakes, doubt about finished work, worry about other people's judgement, the sense that your worth rides on how well you do.

The two behave very differently. A 2016 meta-analysis by Hill and Curran pooled 43 studies with almost 10,000 participants. High standards had small negative or non-significant relationships with burnout. The fear of falling short had medium-to-large positive relationships with it. A 2017 meta-analysis by Sirois, Molnar and Hirsch found the same split for procrastination: the concerns side went with more putting things off (r = 0.23), the strivings side with less (r = -0.22).

In other words, the bar is not what wears people down or makes them freeze. The fear riding on the bar is. And the feeling of being a fraud fits the same picture. Psychologists Pauline Clance and Suzanne Imes described it in 1978, from their clinical work with high-achieving women, as an inner sense of "intellectual phoniness" that success did nothing to dislodge.

Put those together and you get a familiar shape: a high bar, a fear attached to it, putting off the things that matter most, a last-minute sprint, success that does not count, and a tank that never quite refills. For some people those pieces move together as one pattern. For others it is mostly one of them, and the rest is noise. You cannot tell which from a label.

That is the question The Achiever's Pattern is built to answer. It looks at putting things off, perfectionism, feeling like a fraud and running on empty, tests whether they move together for you rather than assuming they do, and separates your high standards from the fear riding on them. If the four are not one pattern for you, it says so.

So should you stop calling yourself Type A?

No need. It is a useful bit of shorthand, and there is no harm in it as long as it stays shorthand. Just know what it leaves out.

Two people can both say "I'm so Type A" and mean opposite things. One loves the bar and is energised by it. The other is afraid of it, puts things off because of it, and is quietly exhausted. The label is the same. What is driving it is not, and that is the part worth knowing about yourself.

Frequently Asked Questions

What is a Type A personality?

Type A is a behaviour pattern described by two San Francisco cardiologists, Meyer Friedman and Ray Rosenman, in 1959: an intense, sustained drive to achieve, constant competition and deadlines, impatience and time pressure. It was proposed as a risk factor for heart disease, not as a personality type in the modern sense. Today people mostly use it to mean driven, organised and hard on themselves.

What is the difference between Type A and Type B?

Type A describes competitive, hurried, achievement-driven behaviour. Type B was never defined on its own terms: in the original 1959 study it was simply men showing the opposite pattern. In everyday use, Type B has come to mean relaxed, patient and unhurried. Personality science now measures traits on a continuum rather than sorting people into two boxes.

Is Type A personality real?

The behaviours are real and recognisable, but the original theory did not hold up. Early studies linked Type A to heart disease, then later follow-ups and a 2001 meta-analysis of prospective studies found no meaningful association for the overall pattern. The hostility component held up better, with small but consistent associations in meta-analyses.

Is Type A the same as perfectionism?

No. Type A was about pace, competition and hostility. Perfectionism research splits into two parts: high standards (perfectionistic strivings) and the fear of falling short (perfectionistic concerns). The concerns side, not the high standards, is what meta-analyses link to burnout and procrastination. Many people who call themselves Type A are describing that second side.

Sources & References

1. Friedman, M., & Rosenman, R. H. (1959). Association of specific overt behavior pattern with blood and cardiovascular findings: blood cholesterol level, blood clotting time, incidence of arcus senilis, and clinical coronary artery disease. JAMA, 169(12), 1286-1296. doi:10.1001/jama.1959.03000290012005
2. Rosenman, R. H., Brand, R. J., Jenkins, D., Friedman, M., Straus, R., & Wurm, M. (1975). Coronary heart disease in the Western Collaborative Group Study: final follow-up experience of 8 1/2 years. JAMA, 233(8), 872-877. PMID 1173896
3. National Heart, Lung, and Blood Institute. Western Collaborative Group Study (WCGS): 25-year follow-up of cardiovascular disease morbidity and mortality. ClinicalTrials.gov NCT00005174
4. Friedman, M., & Rosenman, R. H. (1974). Type A Behavior and Your Heart. Knopf.
5. Ragland, D. R., & Brand, R. J. (1988). Coronary heart disease mortality in the Western Collaborative Group Study: follow-up experience of 22 years. American Journal of Epidemiology, 127(3), 462-475. PMID 3341353
6. Ragland, D. R., & Brand, R. J. (1988). Type A behavior and mortality from coronary heart disease. New England Journal of Medicine, 318(2), 65-69. doi:10.1056/NEJM198801143180201
7. Myrtek, M. (2001). Meta-analyses of prospective studies on coronary heart disease, type A personality, and hostility. International Journal of Cardiology, 79(2-3), 245-251. doi:10.1016/s0167-5273(01)00441-7
8. Petticrew, M. P., Lee, K., & McKee, M. (2012). Type A behavior pattern and coronary heart disease: Philip Morris's "crown jewel." American Journal of Public Health, 102(11), 2018-2025. PMC3477961
9. Miller, T. Q., Smith, T. W., Turner, C. W., Guijarro, M. L., & Hallet, A. J. (1996). A meta-analytic review of research on hostility and physical health. Psychological Bulletin, 119(2), 322-348. doi:10.1037/0033-2909.119.2.322
10. Chida, Y., & Steptoe, A. (2009). The association of anger and hostility with future coronary heart disease: a meta-analytic review of prospective evidence. Journal of the American College of Cardiology, 53(11), 936-946. doi:10.1016/j.jacc.2008.11.044
11. Hill, A. P., & Curran, T. (2016). Multidimensional perfectionism and burnout: a meta-analysis. Personality and Social Psychology Review, 20(3), 269-288. doi:10.1177/1088868315596286
12. Sirois, F. M., Molnar, D. S., & Hirsch, J. K. (2017). A meta-analytic and conceptual update on the associations between procrastination and multidimensional perfectionism. European Journal of Personality, 31(2), 137-159. doi:10.1002/per.2098
13. Clance, P. R., & Imes, S. A. (1978). The imposter phenomenon in high achieving women: dynamics and therapeutic intervention. Psychotherapy: Theory, Research & Practice, 15(3), 241-247. doi:10.1037/h0086006