Abbott A V, Peters R K, Vogel M E
Department of Family Medicine, University of Southern California School of Medicine, Los Angeles 90033.
Psychosom Med. 1988 Mar-Apr;50(2):123-38. doi: 10.1097/00006842-198803000-00003.
To examine the temporal stability of the Type A behavior pattern (TABP) after a cardiac event, both a Videotaped Clinical Interview (VCI) (formerly known as the Videotaped Structured Interview) and the Jenkins Activity Survey (JAS) were administered to 81 male and 19 female patients three times during the first year after hospitalization for an initial myocardial infarction, coronary artery bypass graft, or both. There was no intervention other than the usual treatment provided by the medical care system. The test-retest reliability coefficients were moderately high for all measures of TABP. The JAS provided the most reliable scores in both sexes. The Hard Driving and Competitive component of the JAS decreased significantly throughout the year in both men (p less than 0.001) and women (p less than 0.01), but in men all three overall indices of TABP and their components (other than Hard Driving and Competitive) decreased spontaneously between 1 and 3 months, and then increased again by 1 year to nearly the original levels. In women, there were no consistent changes over time among the indices other than that for the Hard Driving and Competitive component of the JAS. Intercorrelations among the indices demonstrate the failure of the JAS to assess the Hostility component of the TABP and the possibility that the Speed and Impatience subscale of the JAS measures different things in men and women. The newest method of scoring the VCI appeared to provide the best index for measuring TABP in male coronary patients, while the original scoring was more reliable for women.
为了研究心脏事件后A型行为模式(TABP)的时间稳定性,对81名男性和19名女性患者在因首次心肌梗死、冠状动脉搭桥手术或两者住院后的第一年进行了三次录像临床访谈(VCI,前身为录像结构化访谈)和詹金斯活动调查表(JAS)。除了医疗系统提供的常规治疗外,没有进行其他干预。TABP所有测量指标的重测信度系数都处于中等偏高水平。JAS在男女两性中都提供了最可靠的分数。JAS中“拼命工作和竞争”分量表在男性(p<0.001)和女性(p<0.01)中全年均显著下降,但在男性中,TABP的所有三个总体指标及其分量表(除“拼命工作和竞争”外)在1至3个月间自发下降,然后到1年时又回升至接近初始水平。在女性中,除JAS的“拼命工作和竞争”分量表外,其他指标随时间没有一致的变化。各指标之间的相互关系表明,JAS未能评估TABP的“敌意”分量表,且JAS的“速度和不耐烦”子量表在男性和女性中测量的可能是不同的内容。VCI的最新计分方法似乎为测量男性冠心病患者的TABP提供了最佳指标,而原始计分方法对女性更可靠。