Almost two decades ago, Drs. Meyer Friedman and Ray Rosenman de veloped the concept of the Type A coronary-prone behavior pattern and pioneered research in the area. Since then, much effort has been devoted to investigating both medical and psychosocial implications of this phenomenon by an impressive array of biomedical and behavioral scientists. On the basis of the National Heart, Lung, and Blood Institute's (NHLBI) recent Congressional mandate concerning disease prevention and control, the Division of Heart and Vascular Diseases undertook an intensive review of the existing literature in this area. The review underscored that the very nature of the concept of coronary-prone behavior requires examination by researchers from a variety of disciplines. Publication of findings in both the medical and behavioral literature, however, has created difficulties in gaining a truly com prehensive understanding of the total effort in this area. It became obvious that there was no coherent integration of information regarding the strength of the association between behaviors and disease processes (or outcomes), how be havioral factors associated with coronary heart disease were measured, the possible physiological mechanisms mediating the relationship between be havior and disease, whether intervention could be effective, and what forms of intervention appeared most promising. In short, a clear need existed to or ganize this information in a more coherent fashion so that it could be subjected to critical review by members of both the medical and behavioral scientific communities.

Cardiovascular disease continues to be the number ioral medicine" was developed and shaped into the one source of morbidity and mortality in our coun­ following definition: try. Despite a 35% reduction since 1964, these Behavioral medicine is the interdisciplinary field con­ diseases, particularly coronary heart disease cerned with the development and integration of behav­ (CHD), claim nearly 1,000,000 lives each year in ioral and biomedical science knowledge and techniques the United States (Havlik & Feinleib, 1979). relevant to the understanding of health and illness and The Framingham study, among others, has iden­ the application of this knowledge and these techniques to prevention, diagnosis, treatment and rehabilitation. tified three major risk factors implicated in the de­ (Schwartz & Weiss, 1978) velopment of CHD: smoking, elevated serum cho­ lesterol, and high blood pressure (Castelli et at., This concept of "biobehavioral" collaboration 1986). Given that these factors account for less challenged scientists and clinicians of many disci­ than 50% of the variance associated with CHD plines to consider how they might more effectively (Jenkins, 1976), it has become obvious that addi­ develop diagnostic, treatment, and prevention tional risk factors must be identified if further pro­ strategies by merging their perspectives to address gress is to be made in disease prevention and simultaneously, among others, behavioral, psy­ control.

Increasing attention has been paid to the links between psychological, social and behavioral factors and the onset of coronary heart disease. This work assesses the present state of knowledge concerning Type A behaviour - the most common and extensively researched behaviour pattern.

Despite medical technological advances, the major killers with which we must currently contend have remained essentially the same for the past few decades. Stroke, cancer, and heart disease together account for the vast majority of deaths in the United States. In addition, due to improved medical care, many Americans who would previously have died now survive these disorders, necessitating that they receive appropriate rehabilitation efforts. One result of our own medical advances is that we must now accept the high costs associated with providing quality care to individuals who develop one of these problems, and we must avail ourselves to assist of afflicted individuals. families Despite the relative stability of causes of death and disability, the health-care field is currently experiencing tremendous pressures, both from professionals with in the field, who desire more and better technology than is currently available, and from the public and other payers of health care (e.g., insurance companies), who seek an end to increasing health-care costs. These pressures, along with an increased emphasis on providing evidence of cost-effectiveness and quality assurance, are substantially changing the way that health-care professionals perform their jobs.

Provides a comprehensive overview of epidemiologic, experimental, and clinical data evidencing the emergence of cardiac psychology as a specialty. It offers a thorough and up-to-date review of the scientific research supporting the relationship between cardiac disease and psychological condition, practical suggestions for developing a clinical practice and directions for future research in this new field of "cardiac psychology". The first part provides an overview of the psychological risk factors for cardiac disease. Emphasis is placed on physiological basis of mind-heart link, depression and anxiety, personality and relational aspects, and on advanced statistical tools for the study of personalities at risk. The second part offers a systematic overview of literature on psychological treatments in cardiac rehabilitation.

The original and creative analyses presented in this work represent a new understanding of the exciting field of personality and disease. Contributors offer current research findings and their experienced opinions on the relationship that exists between personality and disease in a clear, comprehensive fashion. Among the topics covered are models of linkages between personality and disease, stress and illness, individual differences and health--gender, coping and stress. Personality and social factors or and how they affect the outcome of cancer, are also discussed. The exploration and examination of the issues presented here are extremely valuable and will have a major impact on future research and practice.

Fundamental and challenging questions about the origin and sustenance of Type A behaviour - such as whether environmental or genetic factors play a role in its development, and whether Type A parents raise Type A children - are explored in this volume. Leading scholars also present current research on such topics as whether gender affects the development of Type A behaviour, and methods of developing and evaluating programmes aimed at altering such behaviour.

Meyer Friedman, the physician who first identified Type A behavior (TAB), here offers a full description of the most effective way to correctly diagnose it. This guidebook offers a step-by-step description of his revolutionary method that has proven successful in treating thousands of TAB sufferers, in many cases, alleviating it completely. A truly unique resource, Type A Behavior features drawings and photographs illustrating the psychomotor signs of TAB. A special appendix lists a series of quotations found especially useful for changing some of the false belief systems held by TAB subjects.

Clinical trials have demonstrated that psychosocial intervention with patients who have coronary heart disease (CHD) may reduce morbidity and help patients achieve better quality of life. "Heart and Mind: The Practice of Cardiac Psychology" explores these findings and how they can be applied to improve the prognosis for patients with CHD. This [is a] sourcebook for a career in cardiac psychology [intended for] psychologists, psychiatrists, cardiologists, internists, exercise physiologists, cardiac nurses, and other specialists as well as by social workers and primary care physicians.

This handbook brings together the full weight of contemporary evidence bearing on what is now commonly termed “psycho-cardiology”. It focuses on the role of psycho-social factors in the genesis and clinical management of cardiovascular disease (CVD). The book constitutes a critically reviewed compendium of current knowledge in the area, coupled with guides to evidence-based best practice in the field of psycho-cardiology. The following categories are covered: Social/demographic risk for CVD, Personality and CVD risk, Stress and CVD risk, Psychopathology (particularly affective disorders) and CVD risk, The psychological management of those with clinical CVD, Psychology in the prevention of CVD. The book integrates the evidence into a compelling argument that clinicians, researchers and those in public health will discount the role of psychological factors in regard to CVD at their own peril. And importantly for clinicians charged with the care of patients with CVD, the book poses the argument that failure to recognize the links between psychological factors and CVD may well be at the considerable peril of those patients under their care.