Friedman and Rosenman concluded that type A behaviour significantly increased the risk of coronary heat disease.
One advantage of the Western Collaborative Study lies in it being longitudinal. It tracked men who were originally healthy and developed CHD during the study rather than using retrospective data (such as questionnaires and interviews) which is less reliable as it depends on human memory, which can get distorted over time.
Another strength of the study is sample size. Using 3500 men meant that a significant number went on to develop CHD (over 250), which helps to provide a more representative set of results. However, the sample can also be criticised for being narrow. All the participants were middle-aged men from California. It is important to cautious about generalising from this sample, as it doesn’t represent women or people from other cultures. This sample may have been more prone to CHD, perhaps though living in a more stressful culture or having a specific diet. This point also raises the question of lifestyle factors.
Although some life-style factors such as diet and smoking were controlled in the study, not all were. For example, Kobasa has demonstrated that hardy personalities who show high level of commitment, challenge and control are resistant to stress. It is quite possible that many type A personalities also have these qualities and could be described as hardy. This variable wasn’t controlled.
Furthermore, the finding is a correlation and cannot prove a cause and effect relationship between type A personality and stress. The majority of men in the study, many of whom would be classed as type A, did not develop CHD. Also some ‘type B’ participants did develop CHD, so it is important to acknowledge that there are many potential causes and the relationship between personality and stress related disorders should not be over-simplified.
Later studies have found that it is hostility rather than a wider range of type A behaviours that is a better predictor of heart disease (Barefoot et al. 1989). It is also worth noting that type A and type B perhaps better describe a way of behaving rather than personality itself. Many psychologists disagree on what personality actually is.