M.A. / This research has been undertaken against the background of Coronary Heart Disease (CHD) as being one of the major causes of death in South Africa. An indepth literature study made it evident that, despite intervention programs that have been successful in reducing the CHD rate, it still remains a number one killer. This could possibly be attributed to CHD prevention programs that historically have focused on biologically related lifestyle factors, and neglected a very important adjuvant risk factor for CHD, namely Type A behaviour. The aim of this dissertation was to study the viability of changing Type A behaviour in childhood through group sport participation in view of the fact that the Type A behaviour pattern (TABP) already present in childhood, has to date not been addressed as a primary preventative possibility. Group sport was chosen as an intervention by nature of it being co-operative, socially supportive and successful in the improvement of a number of relevant factors. Sport has also been demonstrated to be an appropriate outlet for aggressive impulses apparent in Type A behaviour. Twenty subjects participated in the intervention program that took place over a period of eight weeks. A second group of ten Type A subjects served as a no-treatment control group. The intervention was carried out at a primary school in Johannesburg. The results of the study revealed that Type A behaviour (TAB) was not reduced, save for the impatience component, by participation in group sport. Aggressive potential and anxiety in the Type A child, were also not reduced. It is concluded that the intervention of group sport in the reduction of TAB was not successful, and that future studies should investigate an intervention that is successful for the reduction of the TABP in childhood.

Fifty percent of the diagnosed cases of coronary heart disease in the United States are of unknown etiology. This study proposed that five personality traits— achievement, dominance, aggression, succorance and Critical Parent—differentiate individuals with coronary heart disease manifestations. The ultimate goal of this research was to formulate a predictive profile of at-risk individuals of developing coronary heart disease. Cardiac rehabilitation units' participants from across the United States were recruited as subjects. Randomly selected cardiac rehabilitation units were sent an initial letter inquiring whether their staff would be willing to participate in the study by administering the instruments to their participants. Eight units from each of the 50 states were contacted. A total of fourteen units agreed to participate. One hundred sixty-nine subjects completed the Demographic Data Questionnaire and the Adjective Check List. Five scale scores, representing the five personality differentials, were analyzed. Comparison of the male subject population (n=135) and the male normative population (n=198) revealed no significant differences in terms of the five traits. Comparison of diagnostic subgroups of the subject population also revealed no significant differences. It was concluded that the subject population did not differ significantly from the normative population in terms of the five traits assess by the instrument used. The goal of a predictive profile was not realized due to this lack of findings. / Master of Science / incomplete_metadata

D.Litt. et Phil. / Endometriosis is among the most common gynaecological maladies affecting women's reproductive health and is also known to be associated with infertility. The pathogenesis of endometriosis is however not well understood. Altered immunity has been indicated in the pathophysiology of this puzzling disease. Over the last decade or more the research evidence suggesting that stress might play a role in the pathogenesis of various illnesses has grown significantly. According to certain tenets of psychoneuroimmunology, behaviour and cognitive therapy, by changing an individual's reaction to stress and increasing the ability to cope with stress, thereby altering immune function, may have an effect on the proliferation of a specific illness, in the case of this study, endometriosis. Various behaviour patterns used by individuals to deal with personal and environmental stressors, have been identified. The incessant struggle to overcome real and imagined obstacles imposed by events, time and the actions of other people typifies the Type A behaviour pattern. The aims of this study were to detemine, whether there were, in a randomly chosen group of patients with endometriosis, persons with high indices of Type A behaviour; to determine whether the modification of Type A behaviour in these patients had a positive effect on their biopsychosocial functioning and finally, whether the modification of Type A behaviour had a positive effect on these patients' endometriosis-related infertility. Endometriosis patients being treated at an infertility clinic were invited to participate in the study. Forty-two subjects were recruited. A psychometric test battery was administered to all the participants. Based on the results of the Videotaped Structured Interview, the subjects were equally divided into three groups: a low index Type A group, a high index Type A group and a middle group. Experimental groups 1 and 2 received counseling aimed at reducing Type A behaviour, using the revised version of the SARCPP, which was originally used with coronary heart disease patients. The test battery was again administered after the intervention. It was found that a subset of endometriosis patients did show higher indices of Type A behaviour. Furthermore an intervention that was found to be successful in reducing the Type A behaviour intensity and frequency in subjects with coronary heart disease was also found to be similarly successful in a subset of women with endometriosis. The most significant finding was the increase in pregnancies among the group of subjects who had been exposed to the treatment. Type A behaviour modification was indeed found to be effective in the treatment of infertility in couples where the female experienced endometriosis-related infertility.

M.A. / It is a well-known fact that South Africans of all races are a high risk population for the development of coronary heart disease and hypertension . More recent statistics indicate that cardiovascular disease caused 12 % of deaths amongst black South Africans in 1994 (Webster, 1996). Risk factors for CHI) can be grouped into four domains : Biomedical (e.g. hypertension, family history), behavioural (e.g. substance intake), sociodemographic (e.g. socio - economic status) and personality (e.g. Type A Behaviour). While there is a general agreement on many of the risk factors for CHIC, there are many more which are still being debated such as the influence of offspring parental heart disease and hypertension and coronary - prone behaviour. In a developing country, such as South Africa, with its heterogeneous population, it seemed that cardiovascular diseases are assuming epidemiological proportions among both White and Black South Africans, and thus appears necessary to establish whether Black patients with cardiovascular disease exhibits the TABP, closely related with diseases of the cardiovascular system among Whites. Els (1987) noted that stress associated with lifestyle changes in Black urbanisation in South Africa, not only showed psychological markers of CHD, but also physiological markers, such as substance intake. A cohort of 67 Black South African university students (38 male & 29 female), with a mean age of 23 was selected. The experimental groups being children of parents with hypertension and heart disease and the controls being children of normotensive parents and without a history of heart disease. A battery of tests were used to measure TAB, depression, hostility, anger and substance consumption. Results indicated that the experimental groups showed a significantly higher index of Type A Behaviour (p < 0, 01) than the controls and there was a significant correlation in terms of Parental hypertension and parental heart disease with coronary - prone behaviour (anger, hostility and depression) as well as substance consumption.

M.A. (Psychology) / The health context of South Africa is on the one hand unique in comparison to the rest of the world. On the other hand does it also. show characteristics of both Third World and First World disease patterns. There is a substantial component of the South African health sector that is negatively affected. This can possibly be ascribed to previous health policies. South Africa has unique characteristics concerning the chronic degenerative aspects of the First World disease pattern. White South Africans have the same cardiovascular disease patterns as the rest of the world with the exception that the South African disease patterns has a much larger incidence and degree of seriousness that the rest of the world. Research in the area of the chronic degenerative nature of heart disease and vascular disease is of great importance. It becomes necessary to address degenerative disease and also lifestyle diseases not only medically but also in terms of an individual's lifestyle. The management of an individual's lifestyle will not only have preventive consequences in the South African context, but it can also be utilised in the treat~ent of cardiovascular disease. Research undertaken at the Clinic and Centre for Behavioral Medicine at the Rand Afrikaans University found that the management or treatment of the Type A behavior pattern for the prevention of recurrent cardiovascular diseases were particularly effective. It therefore seems that technology developed elsewhere proves to be effective for the South African context. According to Johnston (1992) two types of risk factors contribute to the development of cardiovascular disease. The first constitute of classical risk factors which include aspects of blood pressure and cholesterol. The second risk factor includes psychological aspects and in particular the Type A behavior pattern and its components. Johnson and Broman (1987) indicate that the components of anger and hostility of the Type A behavior pattern constitute the most important behavioral factor of Type A coronary-prone behavior and cardiovascular disease. Research also indicate that the component of hostility presents a significant predictor of cardiovascular disease (Helmers et al., 1993) . The role of aggression and its components in the Type A behavior pattern was investigated in this study. An attempt was made to establish whether there is a simultaneous reduction in aggression, its components and the Type A behavior pattern and whether certain components of aggression were more important that others. A group of 39 heart patients were investigated on the following indexes: psychological, cardiological and biochemical in order to establish heart disease risk factors in a biopsychosocial context. A modified Type A treatment progranme was administered to this group over a period of twelve weeks at a local heart rehabilitation centre. A second group of 19 patients served as a no-treatment waitinglist control group, but simultaneously underwent an aerobic exercise and cardiovascular counselling programne. The results of this study indicated that cynical hostility was probably the major risk factor of all the components of aggression in the Type A behavior pattern. The second most important component of aggression in the Type A behavior pattern is the expression of anger in general. The latter also corresponds with results found in research on this subj ect. Ov-ert or specific expression of anger .nd the control of anger also contribute to the psychosocial causation of Type A behavior pattern in cardiovascular disease. Comparisons of the experimental and control groups after the intervention showed statistically significant differences of anger expression in general, specific anger expression, inhibition of anger, control of anger, and hostility. It was concluded that significant differences for the diverse components of aggression have been found due to the experimental intervention programme.

D.Litt. et Phil. (Psychology) / It has long been known that South Africans are a high risk population for the development of coronary heart disease. Cardiovascular diseases accounted for 8,7% of all deaths in this country in 1988. Despite this distressing situation, rehabilitation facilities for people who have suffered a myocardial infarction or heart attack are relatively scarce. The facilities that exist tend to focus on the biomedical aspects of cardiac rehabilitation such as exercise and diet, and tend to neglect the psychosocial factors. A review of the literature shows, however, that psychosocial factors, and in particular the Type A coronary-prone behaviour pattern are significantly related not only to the development of coronary heart disease, but also to the probability of sUffering and surviving a heart attack. In addition, Type A.behaviour has been shown to be predictive of the risk of a second infarction after an initial attack. For this reason, the proven technology of a treatment programme developed under the auspices of the Recurrent Coronary Prevention Project (Powell & Thoresen, 1986) was applied in an attempt to adapt the programme for the" South African context. The study was aimed at establishing whether the RCPP programme could successfully be employed in this country, and whether the duration could be shortened so as to be more economically viable given the limited economic resources that characterise health care in South Africa. The modified programme was administered to a group of 13 post-myocardial patients at a local cardiac rehabilitation centre. A second group of 11 patients at the same centre served as a no-treatment waiting list control group, but simultaneously underwent an aerobic exercise and cardiovascular counselling programme. Results of the study indicate that 'the modified programme is highly successful in modifying Type A behaviour and its components in South African sUbjects. Comparisons of the experimental and control groups after the intervention showed statistically significant differences on the majority of measures. It was therefore concluded that the modified programme can be used fruitfully in the local context, but it was cautioned that the present sample needs to be followed up over time to ensure that the treatment gains are maintained.

本研究之目的在了解兩人合作時，團隊成員與夥伴之A/B類行為、能力差異知覺對於團隊工作表現、合作滿意及情緒的影響。本研究採實驗室實驗法，以131名大學女生為實驗對象，兩人一組，所需完成之作業為一電腦判斷任務。 本研究的結果乃根據2（個體之行為組型：A/B）X 2（夥伴之行為組型：A/B）X 2（能力差異知覺：佳/差）三因子變異數分析而來。在團隊工作表現方面，「個體之A/B類行為」的主要效果顯示，A類行為者的團隊工作表現，與B類行為者並沒有差異。「個體之A/B類行為」與「能力差異知覺」的交互作用顯示能力差異知覺對B類行為者的影響較A類行為者大；在被告知其能力較差時，B類行為者的團隊工作表現較A類行為者佳，而在被告知其能力較佳時，其團隊工作表現則較A類行為者差。另外，「個體之A/B類行為」、「夥伴之A/B類行為」及「能力差異知覺」的三因子交互作用達顯著，A類行為者在「知覺能力較差」且「夥伴為A類行為者」時，團隊工作表現最差。 在合作滿意方面，「個體之A/B類行為」的主要效果顯示，兩者的合作滿意度沒有差異；而「夥伴之A/B行為」的主要效果達顯著，表示不論本身為A類或B類行為者，與A類行為者合作的滿意度較低於與B類行為者合作。 在情緒部分，「個體之A/B類行為」的主要效果顯示A類行為者的情緒較B類行為者為負向，較容易焦慮；此外，「個體之A/B類行為」、「夥伴之A/B類行為」與「能力差異知覺」的三因子交互作用達顯著，當A類行為者被告知能力較差時，A類行為者與A類夥伴合作時，其情緒最為負向。 本研究最後針對所有的研究結果作整合性的討論，並依實驗所得的結果，提出可能的貢獻、限制、對未來研究的建議及工商實務上的應用。

D.Litt. et Phil. / This research investigated the effectiveness of the treatment programme used by the South African Recurrent Coronary Prevention Project (SARCPP) in reducing the risk of not only recurrent heart disease, but also of original occurrence of heart disease. Heart disease can often be attributed to lifestyle factors such as obesity, high fat content diets and smoking (Friedman & Ulmer, 1995 and Richards & Baker, 1988). Another lifestyle risk factor of heart disease is Type A behaviour, as first discovered by Rosenman and Friedman (1959). Type A behaviour is made up of various components, such as hostility, time urgency and insecurity. The SARCPP has effectively reduced Type A behaviour in past studies (Venter, 1993; Viljoen, 1993; MacLennan, 1994 and Webster, 1994) and it has been found that reducing Type A behaviour through this programme increases high density lipoproteins and decreases total triglycerides, thus decreasing physiological risk factors of heart disease (Wolff, Thoresen, Viljoen, & Venter, 1994). The SARCPP thus far had only been used with Type A persons who had already suffered a form of heart disease, such as myocardial infarction and angina pectoris (here called "unhealthy" Type As). Other interventions have been used to decrease Type A behaviour in subjects who had not yet suffered heart disease (or "healthy" Type As). A leading researcher in this field is Ethel Roskies (1979-1990). Due to ineffective measurement and ineffective treatment programmes, her attempts were not successful, though. This research study applied the treatment used in the SARCPP to both "healthy" and "unhealthy" Type As and it was found that it was as successful in reducing Type A behaviour in both the "healthy" subjects as in the "unhealthy" subjects. Not only was global Type A behaviour as measured by the Videotaped Structured Interview decreased in the treatment groups, but so were the components of Hostility, Time Urgency and Insecurity (although Insecurity was not decreased in the "unhealthy" subjects). The tendency by the subjects to repress angry feelings was reduced in both "unhealthy" and "healthy" subjects, as was cynical hostility in the "healthy" subjects. It was found that the "unhealthy" subjects had significantly more State and Trait anxiety before the treatment took place than the "healthy" subjects and that the treatment reduced that anxiety in the "unhealthy" subjects significantly. Depression was decreased in both "healthy" and "unhealthy" subjects. Thus, the treatment programme of the SARCPP was effective in reducing coronary-prone behavioural factors and can be used as both prevention in recurrence and prevention in original occurrence of heart disease.

Text in English / Regular exercise has significant physical and psychological health benefits yet, paradoxically, may also have harmful effects. The purpose of this study was to investigate the physical and psychological health risks of distance running, a popular participation sport in South Africa. Structural equation modelling was employed to examine the personality and motivational antecedents of running addiction and its influence, in turn, on self-reported overuse injuries and upper respiratory tract infections in 220 athletic club members. The predictors and physical health effects of customary training load were also assessed. It was found that perfectionistic concerns, Type A behaviour pattern, and task goal orientation had a direct, positive impact on running addiction, which predicted higher running injury scores. In contrast, training workload (Volume × Intensity) was inversely related to injury risk. Neither running addiction nor any training load variables influenced infectious illness susceptibility. The findings of this study indicate that maladaptive perfectionism, Type A behaviour, and achievement goal orientation may be risk factors for running addiction, which may, in turn, contribute to increased injury incidence in South African distance runners. Conversely, heavier training loads may be protective against injury occurrences in this population. The results of this research may help to enhance current understanding of the possible health hazards of distance running. This knowledge may have practical implications for the health and well-being of runners of diverse levels of ability and experience. / Psychology / D.Litt. et Phil. (Psychology)