Type A behavior pattern: Bortner scale vs. Japanese-original questionnaires.

Background: Type A behavior pattern (TABP) has been regarded as a putative risk factor for coronary heart disease and recent studies from our group suggest that TABP individuals, identified via the Bortner scale whose validity had been confirmed by structured interviews, may have a greater tendency towards hyperthymic temperament, shorter sleep time and shorter snooze time. Since the Bortner scale was developed in USA and may reflect western culture, it is necessary to reconfirm our findings using a Japanese questionnaire such as Coronary-prone Type Scale for Japanese (CTS) and Kwansei Gakuin's daily life questionnaire (KG questionnaire).

Methods: Fifty healthy subjects were assessed for TABP using the Bortner scale, as well as the CTS and KG questionnaires. Hyperthymic temperament was assessed via the Japanese standardized version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-auto questionnaire (TEMPS-A), while sleep time and snooze time were measured by actigraphy.

Results: Both CTS and KG questionnaire scores were significantly and positively associated with the Bortner scale scores. Although CTS and KG scores were significantly and positively associated with hyperthymic temperament scores, none were associated with sleep time or snooze time.

Limitations: The number of subjects was relatively small.

Conclusions: The findings suggest that Japanese questionnaires such as CTS and KG questionnaires are valid as measures of TABP. Moreover, the association between TABP and hyperthymic temperament was reconfirmed by both CTS and KG questionnaires, whereas the association between TABP and sleep pattern was not. As such, the present findings provide supportive evidence about the usefulness of CTS and KG questionnaires.