Type A, B, C and D Personalities Compared

What these four labels actually are

Type A, B, C, and D personality sound like one system with four parts, largely because of the shared letters, but they come from three separate research traditions built decades apart, for different purposes, with very different amounts of supporting evidence. Grouping them here is a convenience for anyone comparing the labels, not a claim that they form a single, coherent model.

Type A and Type B come from the earliest and most famous of the four, cardiologist Meyer Friedman and Ray Rosenman's 1959 description of a hard-driving, hostile-prone behavior pattern they observed in heart patients, later popularized in their 1974 book Type A Behavior and Your Heart. Type A and Type B are opposite ends of one measured scale, not two unrelated categories.

Type C arrived later, in 1987, from a different field entirely, psycho-oncology, through psychologist Lydia Temoshok's hypothesis about a cancer-linked personality style. Type D arrived later still, formalized in 2005 by researcher Johan Denollet, and returned the letter system to cardiology with a more rigorously measured construct than either of its predecessors.

It helps to hold these four labels the way a careful reader of health research would: as four separate claims, each with its own evidence trail, rather than as four flavors of one settled truth. Some of that evidence held up well, some held up only in a narrower form than first proposed, and some did not hold up at all. This page walks through each one honestly, in the order Type A, B, C, then D, before comparing what the research actually supports.

How each pattern is defined

Type A and Type B are defined by three measured components: time urgency, the felt pressure of the clock; achievement striving, competitive drive and high standards; and hostility, a quick trigger for irritation and a cynical read on other people. Our Type A Personality Test scores all three together on a 0 to 64 scale, and a result in the upper half produces the Type A pattern described on its own page, while a result in the lower half produces Type B.

Type C is defined more loosely, as a cluster of traits observed in some cancer patients: cooperation to a fault, difficulty expressing anger or other negative emotion, and a tendency to appease and comply rather than assert. It has no standardized scoring scale in wide clinical use, which is one reason it remains a hypothesis rather than a measured construct.

Type D is defined precisely, as the combination of two traits measured by a specific instrument, the DS14: negative affectivity, a general tendency toward worry and gloom, and social inhibition, a reluctance to express that distress to others. A person is classified as Type D only when both traits cross a defined threshold together, not when either trait is high on its own.

Type A: the driven, time-urgent pattern

Type A describes a fast-moving, competitive way of relating to time and other people: clock-watching, multitasking, a need to win even casual competitions, and a short fuse that can tip into open hostility. It is the high band of our Type A Personality Test and the pattern most people mean when they use the phrase in everyday conversation.

The strongest, most consistent finding in decades of follow-up research is that the hostility component specifically, not the whole pattern, carries a modest link to cardiovascular risk, while the achievement-striving component is linked to real accomplishment rather than health cost. The full page on Type A personality covers the history, the strengths, the blind spots, and what actually helps.

Type B: the relaxed, even-paced pattern

Type B sits at the low end of the same scale that produces Type A: a relaxed relationship with time, a lighter approach to competition, and a slow fuse that rarely tips into hostility. It was originally defined by contrast, as the pattern shown by heart patients who did not display the Type A profile Friedman and Rosenman were studying.

The research is kinder to this pattern than the original theory implied it needed to be, since low hostility sits on the favorable side of the one component that meta-analyses consistently link to cardiovascular risk. The full page on Type B personality covers its strengths, its own blind spots around being underestimated, and where it fits at work and in relationships.

Type C: the contested hypothesis

Type C describes a cooperative, unassertive, emotion-suppressing style that psychologist Lydia Temoshok proposed in 1987 as a possible cancer-prone pattern, almost the mirror image of Type A's outward hostility. It has no test on this site and no result key, because no validated instrument reliably measures it.

This is the weakest evidence base of the four patterns on this page. Systematic reviews since, including a 2002 BMJ analysis and a 2004 Clinical Psychology Review, found no consistent evidence connecting coping style or personality to cancer survival, recurrence, or development. The full explainer on Type C personality lays out the history and the evidence honestly, without repeating the cancer claim as fact.

Type D: the distressed personality pattern

Type D combines negative affectivity with social inhibition, holding chronic worry or gloom inside rather than sharing it with other people. Researcher Johan Denollet formalized the construct with the DS14 scale in a 2005 paper, giving it a level of measurement precision that neither Type A's original theory nor Type C ever had at their outset.

It sits in the middle of this page's evidence spectrum: a real, active, self-correcting research literature links it to worse outcomes in people who already have cardiovascular disease, though the size of that link has shrunk under scrutiny in the largest recent studies. The full explainer on Type D personality covers the construct, the debate, and how it differs from its neighbors.

How to find out where you land

Type A and Type B are the two patterns you can actually get a result for. Our free Type A Personality Test scores time urgency, achievement striving, and hostility separately, then gives an overall band from strong Type B lean through strong Type A pattern, along with an optional in-depth report for anyone who wants a more detailed breakdown to bring to a therapist or coach.

Type C and Type D do not have a corresponding Psychology.com test, for different reasons: Type C lacks a validated instrument entirely, and Type D's standard instrument, the DS14, is licensed and not something this site reproduces. Readers curious about the emotional-suppression territory those two labels describe are better served by our Stress Level Test or Mental Health Assessment than by searching for a Type C or Type D score.

A practical way to use all four pages together: take the Type A Personality Test first, since it is the only one with an actual score, then read whichever of the four full pages matches your result and curiosity, Type A, Type B, Type C, or Type D, for the deeper history, evidence, and, where one exists, growth guidance specific to that pattern.

What the research says, across all four

Taken together, these four labels are a useful case study in how personality-and-health science actually progresses: an early, compelling theory, Type A, generates decades of follow-up research that ultimately narrows the claim to a smaller, more defensible piece, hostility, rather than confirming the original broad idea. A related theory in a different field, Type C, generates its own follow-up research that does not confirm the original claim at all. A later, more carefully measured construct, Type D, arrives with better methodology from the start and produces a real, if still debated, research base.

Not a diagnosis, not a fixed personality box, and not a medical risk score you can calculate from a quiz: that is what all four of these labels have in common. Each is a behavior pattern or a hypothesis, best used as a starting point for self-reflection, with different, specific, and honestly reportable levels of evidence behind it, not as a verdict.

Common misconceptions

The most common misconception is that all four letters form one validated system, the way the four-letter types in some other personality frameworks do. They do not; they are four separate research efforts that happen to share a letter-naming convention and a general interest in personality and physical health.

A second common misconception is that a high Type A score, or a Type C or Type D description, functions as a personal health risk calculation. None of these constructs works that way. Even where a real, replicated link exists, as with Type A's hostility component or Type D in cardiac patients, the finding describes a population-level pattern across many people, not a specific prediction about any one individual's health.

A third misconception, especially around Type C, is that a personality description can explain why someone became ill. Systematic review after systematic review has found no support for that specific claim, and treating illness as evidence of a personality flaw is neither accurate nor kind.