The Ketterer Stress Symptom Frequency checklist: anger and the severity of coronary artery disease.

Recent research suggests that the most potent feature of the Type A behavior pattern for prospectively predicting cardiac disease is aggravation, irritation, anger, and impatience (AIAI). The present study examines psychometric properties of a new AIAI measure and its relationship to the severity of coronary artery disease (CAD). Subjects included 61 males undergoing coronary angiography. Comparisons were made of mean psychometric scores across groupings, defined by number of vessels occluded. These comparisons showed that the normal or subclinically occluded coronary angiographic group had high levels of depression and anxiety. Higher levels of AIAI were observed in patients with multivessel CAD compared to those with single vessel disease. Because of their psychological abnormality, the normal and subclinically occluded angiographic patients are an inappropriate control group for AIAI studies intended to address the etiology of CAD. Nonetheless, evaluation of these patients for the presence of depressive and anxiety disorders frequently has clinical importance.