The Type A disease association may be obscured by the failure of epidemiological studies to take into account the person by situation nature of the Type A construct. Past research suggests that it is not coping with demand that is stressful for Type As, but rather the perception that the job or life event is less than completely controllable that leads to distress. To further explore this issue, Type A behavior, life change, psychological impairment, and symptom reports were measured on two occasions 6 months apart in 183 male public school principals. Subjects, categorized as Type A or Type B by the Jenkins Activity Survey, completed questionnaires that assessed the experience and appraisal of life change and psychological and physical impairment. The results indicated that events which Type As perceived as moderately controllable, particularly those also perceived as negative, were associated prospectively with psychological distress and physical symptoms. Type Bs reported greater physical and psychological symptomatology if 6 months prior they had reported elevated levels of life change that they appraised as negative and uncontrollable. The results provide a field analog of laboratory demonstrations of the challenge induced stressful response style of the Type A. (Author/NB)