Medical Hypotheses 77 (2011) 294–300

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Medical Hypotheses
journal homepage: www.elsevier.com/locate/mehy

Personality traits of aggression-submissiveness and perfectionism associate

with ABO blood groups through catecholamine activities
Donna K. Hobgood ⇑
University of Tennessee College of Medicine, Chattanooga, TN 37421, United States

a r t i c l e i n f o a b s t r a c t

Article history: Personality trait research has shown associations with many genes, prominently those of the catechol-
Received 2 April 2011 amine metabolism such as dopamine beta hydroxylase (DBH), catechol-O-methyltransferase (COMT),
Accepted 28 April 2011 and monoamine oxidase A (MAOA). Because DBH gene is in linkage disequilibrium with ABO gene, there
is reason to think that other catecholamine genes using the same substrate as DBH may also have asso-
ciations with ABO blood groups, and this paper demonstrates how this may be so. Reasons include sim-
ilarities in hapmap population frequency distributions, similarities in illness risks between ABO blood
groups and DBH activities as well as between ABO blood groups and COMT activities and between
ABO blood groups and MAOA activities. If ABO blood groups can be demonstrated to associate with all
these catecholamine genes, then the catecholamine personality trait research can be applied to ABO
blood groups and tested for confirmation. ABO blood typing is widely available and affords ability to test
this hypothesis and thus confirm the possible joint association of personality traits of aggression-submis-
siveness and perfectionism to catecholamine genes and to ABO blood groups. Clinical applications and
implications are discussed.
Ó 2011 Elsevier Ltd. All rights reserved.

Background
Personality traits have been studied since ancient times with
Aristotle’s humors: sanguine, choleric, phlegmatic, and melan-
cholic, these thought emanating from blood, yellow bile, phlegm,
and black bile imbalances. Philosophers of the middle ages, renais-
sance, enlightenment, and romantic eras moved away from physi-
ologic explanations of human behavior, but modern more
physiologic trait research began nearly 100 years ago with Ey-
senck, Big Five traits [openness to experience, conscientiousness,
extraversion, agreeableness and neuroticism (and psychoticism
added in later work)] being the culmination of work on logical
analysis of descriptors of human behavior. A landmark study by
Cloninger et al. 25 years ago is credited with inspiring much of
present day research on the physiology and genetics of personality
in humans [1], this escalating with the human genome project in
the last 10 years. Though consensus has not been reached, many
genes show reproducible associations with personality traits such
that the current consensus is that personality is heritable on the or-
der of 50% [2,3].
A Mendelian trait showing some research findings with person-
ality traits is the ABO blood grouping. ABO blood typing was dis-
covered by Landsteiner in 1901, but the explanation for the
inheritance pattern for this one of the first if not the first human
⇑ Tel.: +1 423 894 1355; fax: +1 423 899 8066.
E-mail address: donnahmd@gmail.com
Mendelian traits described was not understood fully until 1920s.
The human genome project has brought further detailed under-
standing of the single nucleotide polymorphisms (SNPS) of the
ABO gene locus at chromosome 9q34.
ABO alleles have been studied for personality trait differences
with no consensus of findings. ABO O has been found associated
with higher anger in a study of male patients with myocardial
infarction [4]. ABO A has been found in one study to be associated
with obsessive compulsiveness though this has not been replicated
in other studies [5,6]. Fifty years ago, ABO group B was found to be
associated with toughmindedness (vs. tendermindedness) in a
study of adolescent Italian and Italian–American males though
the statistical validity of the work was questioned [7].
Personality trait research has, however, consistently found cat-
echolamines to be correlated with traits. One trait system dealing
specifically with sympathetic nervous system and catecholamines
is the NPA, narcissism, perfectionism, and aggression-submissive-
ness personality theory. The NPA theory posits that submissiveness
is related to aggression by deficits of the sympathetic nervous sys-
tem (SNS) (i.e. ‘‘fight or flight’’ behaviors and emotions) function
while aggression has high function of SNS. Perfectionism is posited
to be a modulation of functioning of the autonomic nervous system
[8]. And, consistent with this theory, a body of research over the
last 25 years has found congruent catecholamine correlates to
aggression-submissiveness and perfectionism [9–18].
Three of the best studied catecholamine genes are Mendelian
in inheritance pattern: dopamine beta hydroxylase (DBH),

0306-9877/$ - see front matter Ó 2011 Elsevier Ltd. All rights reserved.
doi:10.1016/j.mehy.2011.04.039
 D.K. Hobgood / Medical Hypotheses 77 (2011) 294–300
catechol-O-methyltransferase (COMT), and monoamine oxidase A
(MAOA) [19]. DBH catalyzes the conversion of dopamine to norepi-
nephrine COMT and MAOA catalyze the degradation of neurotrans-
mitters, primarily dopamine and norepinephrine. DBH varies
among individuals as a function of genetics such that one SNP,
rs1611115C, the most frequent allele, is the predominant determi-
nant of high activity DBH while rs1611115T encodes the low activ-
ity variant [20]. The gene for DBH is on chromosome 9q34 and is in
tight linkage disequilibrium with ABO gene [21]. Personality trait
research has found that low activity DBH is associated with impul-
siveness trait while high activity DBH is associated with sensation-
seeking [22,23]. Other traits, such as antisocial and aggression
traits have been studied as to association with DBH with consensus
that impulsiveness mediates most personality trait associations
with DBH. Because DBH determines the dopamine:norepinephrine
ratio and, based on the research regarding dopamine and norepi-
nephrine function in behavior, a reasonable inference is that low
activity DBH would relate to impulsive behaviors while high activ-
ity DBH would relate to persistent behaviors [21,24]. Further, sub-
missiveness trait would be congruent with impulsive behaviors as
opposed to persistent behaviors so that low activity DBH would
associate with submissiveness trait as well as impulsive behaviors.
The semantic analysis of these two traits shows congruence of
impulsive and non-persistent approaches to behavior with submis-
siveness behaviors. That is, submissiveness would subsume a ten-
dency to give up or give in, to ‘‘flight rather than fight’’, such that
submissive behavior is impulsive, not persistent, not steady and
not unrelenting. And the consequences of low DBH (high dopa-
mine:norepinephrine ratio) would be congruent with personality
trait literature whereby the social desirability trait subscale of sub-
missiveness is associated with higher dopamine levels [17,18].
COMT, on chromosome 22, catalyzes the degradation of cate-
cholamines including dopamine and norepinephrine. COMT activ-
ity varies in individuals as a function of genetics. Perhaps the
most studied SNP in the COMT gene, rs4680, features a substitution
of methionine for valine which significantly lowers the activity of
the gene [19]. The Met allele has been found associated with traits
like the Big Five (extraversion, openness to experience, agreeable-
ness, neuroticism, conscientiousness) plus psychoticism, aggres-
sion and all the Cloninger traits: harm avoidance, reward
dependence, persistence, and novelty seeking, with disagreement
in the findings as to whether low activity COMT has a reproducible
association with any of these traits since research findings are at
both extremes. For example, low activity COMT is found to be asso-
ciated with high novelty seeking in some populations and with low
novelty seeking in other populations [25–29]. And research with
conflicts in regard to gene function and enzyme levels’ effects on
phenotypes are not straightforward to resolve. For example, since
novelty seeking is theorized by the Cloninger trait system to be re-
lated to low dopamine neurotransmission, and since low activity
COMT would lower the degradation of dopamine, the low activity
allele should not be theoretically associated with high novelty
seeking. So no consensus exists regarding the personality traits
associated with low activity COMT though high reward depen-
dence and high harm avoidance seem to be found with some reg-
ularity in the COMT personality trait literature [30–33]. However,
since these two Cloninger trait constructs are posited to be related
to low norepinephrine neurotransmission and low serotonin neu-
rotransmission respectively, there is not an intuitive reason for
their lower levels with lower degradation activity of genetically
low COMT. In contrast to these traits, perfectionism trait has been
found to be consistently associated with low activity COMT
[14,9,34].
MAOA degrades catecholamines and varies in individuals as a
function of genetics with low and high variants described. The gene
for MAOA is on the X chromosome. One of the best studied SNPSs
295
for MAOA is rs6323. The low activity variant allele has been found
to be related to aggression in an extensive research literature [11–
13,15–18]. This aggression trait is thought to be related to higher
levels of norepinephrine and its metabolite epinephrine and, in
some studies higher dopamine neurotransmission, this consistent
with lower activity of the degradation enzymatic activity of low
activity MAOA. Additionally, studies have shown that the higher
the catabolism, the lower the synthesis of catecholamines, the
higher the neuroticism and the lower the extraversion and consci-
entiousness traits, three Big Five traits found to be related to MAOA
activity [35]. And high activity variants of MAOA were associated
with persistence trait in Asian females, this perhaps related to a
lower level of catecholamines consequent to the higher level of
degradation enzyme such that increased MAOA effects lower dopa-
minergic neurotransmission and thus higher persistence trait
[36,37], as has been demonstrated in other studies [38–44].
Hypothesis
With these research findings on the traits of aggression-submis-
siveness and perfectionism and the catecholamines, if ABO blood
groups are also associated with catecholamine genes such as COMT
and MAOA as well as with DBH, then all these personality traits
could be associated with ABO blood groups as well. Thus personal-
ity traits of perfectionism and aggression-submissiveness as a par-
simonious construct system for human behavior may be associated
with ABO blood groups as well as with catecholamine genes and
thus afford a particularly robust view of the interface of personality
and health.
Evaluation
Many clinicians have been struck by a possible tendency of per-
sonality and ABO blood group correlation as have we. And there are
theoretic physiologic reasons that would support ABO blood group
stratification of personality traits.
The first reason to think that ABO blood groups have genetic
association with personality traits is that ABO gene is in tight LD
with DBH gene on chromosome 9q34 [21]. Given the extensive
body of research demonstrating catecholamine involvement in
personality and behavior, it is possible that ABO groups would also
demonstrate linkage with personality and behavior.
The second line of evidence lies in examining the distinctly dif-
fering population stratifications of ABO blood groups in various re-
gions of the world [45]. The population frequencies of the ABO
groups are congruent with those of mitochondrial DNA and Y chro-
mosome haplogroups as they reflect deep ancestral patterns of
population migrations into present day populations [46]. Catechol-
amine genes exhibit marked variations in population frequency
distributions also reflecting deep ancestral migration patterns. So,
comparison of tendencies in the frequencies of both the ABO alleles
markers and of the frequencies of the catecholamine gene alleles
could suggest though by no means prove associations of these
alleles.
A third line of evidence for association of ABO blood group al-
leles with catecholamine alleles would be the congruence of health
risks between these groups of alleles. In general ABO groups non-O
are associated with higher health risks than ABO O, and catechol-
amine alleles of DBH, COMT, and MAOA are associated with trends
in health risks stratification. If congruence is noted as to their
respective health risks, then association of ABO alleles with cate-
cholamine alleles is not ruled out.
ABO gene and DBH gene are in tight linkage disequilibrium on
chromosome 9q34 [21]. And hapmap population frequency distri-
butions are similar for ABO blood group B and for low activity of
296 D.K. Hobgood / Medical Hypotheses 77 (2011) 294–300

the major allelic marker contributing to variation in DBH activity,
rs1611115 [47]. And linkage disequilibrium within the ABO locus
is consistent with this. Further, review of the publically available
genomes of two individuals, Craig Venter and James Watson, and
their biographical information is also supportive of this associa-
tion. Both Venter and Watson appear to have both non-B ABO
blood group and high activity DBH [47–51]. Medical risks, includ-
ing hypertension and stroke, of low activity DBH are less than
those of high activity DBH [52–56], and ABO group B appears to
be associated low activity DBH and with lower risks of hyperten-
sion and stroke than ABO group A [57–63].
So low activity DBH may be associated with ABO group B based
on the congruence of population frequency distributions and
health risks, and since DBH and COMT both use dopamine as a sub-
strate, many relationships between these two gene activities
would be expected. An example of such an association is found
in a linkage study showing a site near DBH gene, CACNA1B,
rs936249, demonstrating a significant additive effect on expressiv-
ity of COMT [64] such that the authors of the study commented
that more study should be done on the linkage of DBH and COMT.
Rs936249C would appear to be more prevalent in individuals
with ABO group A and O in that the genomes of the two individu-
als, Venter and Watson, whose genomes are publically available
are consistent with this: Venter has genotypes consistent with
ABO group A and has rs936249C while Watson has genotypes con-
sistent with ABO group O and has rs936249C as well [47].
Rs936249C appears to be associated with increased rather than de-
creased COMT expression since research demonstrates that
rs936249 differentiates fibromyalgia from chronic fatigue syn-
drome [65]: since fibromyalgia is associated with low COMT [66],
if the effect of rs936249C were to be one of increasing COMT
expression, this would be consistent with the genomes and the
medical histories of Venter and Watson, their having no known
history of fibromyalgia or any similar pain syndromes. Although
information from only two individuals’ genomes cannot be used
to prove a hypothesis, it may be suggestive. So this site at chromo-
some 9q34 near the DBH/ABO genes regulates COMT expression
and helps explain how activities of DBH and activities of COMT
could be associated such that ABO groups non-B experience an in-
creased expression of COMT while ABO group B experiences a de-
creased expression of COMT [manuscript under review by Medical
Hypotheses].
And from an inspection of the hapmap population frequency
distributions of DBH rs1611115 and of COMT rs4680 it would ap-
pear that low activity DBH populations tend to be the low COMT
activity populations (Table 1). Noteworthy is the appearance of
hapmap populations with highest frequency of low activity DBH
(MEX, GIH and TSI) to have very low COMT activity as well as very
low DBH activity. Other evaluations of this hypothesis include the
clinical correlations of low activity COMT with ABO blood group B.
Their respective known risks of illness are compatible. Decreased
COMT activity with resultant higher dopamine is associated with
lower risks of hypertension and myocardial infarction as is ABO
blood group B compared to group A [57–63,67–70].
As expected, given ABO group B’s increased risk of pancreatic
cancer, low expression of COMT is associated with pancreatic can-
cer [71–75]. And consistent with ABO group B increased risk of
DVT, low COMT has increased risk of DVT [76–79]. Endometrial
cancer is lower in ABO group B and in decreased COMT [80,81].
And colorectal cancer is lower in ABO group B and in low COMT
[82,83]. Given the role of mutagenesis in cancer, it isn’t surprising
to find that mutagenicity is lower with decreased COMT and that
ABO group B cancer risk is lower compared to group A [84]. Small
cell cancer of the lung is lower in ABO group B, and COMT is higher
in expression in that cancer [85,86]. And gastric cancer and esoph-
ageal cancer are lower in ABO group B and in lower COMT [87–91].
Ovulatory dysfunction is higher in high COMT and ovulation dys-
function is a cause of ovarian cancer which is high in ABO blood
group A [92,93]. Breast cancer has been well studied as to links
with COMT, but no consensus exists regarding COMT activity
though ABO group A has higher risks of breast cancer [94].
Low activity alleles of MAOA may be associated with ABO group
O. The only available study done on association of ABO blood
groups and MAOA activity has shown association of ABO O with
decreased MAO [95]. Further, inspection of the hapmap population
frequency distributions of ABO marker alleles and MAOA alleles
gives some indication of their possible relationship Table 2. Note-
worthy is the tendency for high frequency of low activity MAOA al-
lele rs6323 in populations with lower frequency of ABO A marker
allele rs651007, such as YRI, ASW, and MKK, all populations of re-
cent African ancestry. Also notable is that populations with high
frequency of high activity allele for MAOA are also those with high
frequency of ABO B marker allele rs8176746, such as GIH, CHB, and
JPT, all with Mongolian founder strains. And also consistently with
this theory, ABO O marker rs505922 demonstrates that popula-
tions with a high frequency of this marker tend toward a high fre-
quency of low activity MAOA marker rs6323, such as MKK, YRI,
LWK, and ASW, all populations with recent African ancestry. And
it is noteworthy that MEX, though the highest frequency popula-
tion for ABO O marker rs505922, is the prominent exception in that
MEX has tendencies to medium value to MAOA low activity fre-
quency. MEX, Mexican–Americans in Los Angeles, California, is
an admixture of 60% AmerIndian and 40% European [96]. The foun-
der population of the AmerIndian component is thought to be

Table 1 Table 2
Comparisons of hapmap population frequencies. Comparisons of some ABO group marker alleles with an MAOA allele.

COMT (low) DBH (low) A rs651007 MAOA rs6323:L B rs8176746 O rs505922

MEX .362 .361 TSI .250 GIH .382 GIH .252 JPT .580
GIH .431 .243 JPT .235 CHB .389 CHB .204 GIH .589
TSI .451 .235 CEU .204 CHD .393 JPT .190 CHB.631
ASW .272 .219 CHB .169 JPT .444 YRI .170 TSI .632
MKK .271 .205 CHD .165 MEX .682 LWK .165 CEU.637
CEU .478 .192 LWK .150 TSI .702 CHD .142 ASW.667
CHB .288 .188 GIH .144 CEU .757 MKK .125 LWK.677
JPT .290 .174 YRI. 136 ASW .800 ASW .123 YRI .677
CHD .264 .174 ASW .132 MKK .811 TSI .084 CHD.679
YRI .313 .168 MEX .121 LWK .918 MEX .078 MKK.696
LWK .294 .130 MKK .110 YRI .919 CEU .075 MEX.759

Legion for Hapmap populations: ASW: African ancestry in Southwest USA, CEU:
Utah residents with Northern and Western European ancestry from the CEPH col-
lection, CHB: Han Chinese of Beijing China, CHD: Chinese in Metropolitan Denver,
Colorado, GIH: Gujarati Indians in Houston Texas, JPT: Japanese in Tokyo Japan,
LWK: Luhya in Webuye Kenya, TSI: Tuscan in Italy, YRI: Yoruban in Ibadan Nigeria.
Legion for Hapmap populations: ASW: African ancestry in Southwest USA, CEU:
Utah residents with Northern and Western European ancestry from the CEPH col-
lection, CHB: Han Chinese of Beijing China, CHD: Chinese in Metropolitan Denver,
Colorado, GIH: Gujarati Indians in Houston Texas, JPT: Japanese in Tokyo Japan,
LWK: Luhya in Webuye Kenya, TSI: Tuscan in Italy, YRI: Yoruban in Ibadan Nigeria.
 D.K. Hobgood / Medical Hypotheses 77 (2011) 294–300
Mongolian prior to the Bering Strait crossing of some 10,000 or
more years ago [97,98]. Since the Mongolian population founder
group appears to be more equally distributed as to ABO blood
group frequencies [45], and since the very small band of AmerIn-
dian founders were selected from this genetic pool then migrated
a hemisphere away, it is possible that the MEX hapmap population
demonstrates many founder effects that would not reflect the ABO
blood group associations in other populations. So the MEX hapmap
group would be expected to be an exception to these
generalizations.
Another illustration of the complexity of these patterns and the
need for much more complex methodologies to understand any
possible association of ABO blood group alleles with other alleles
is seen by inspecting the frequencies of CEU and TSI, two popula-
tions with less ABO group B, moderate ABO A and a majority of
ABO O [45] so CEU and TSI are consistently found to be moderately
high in low activity MAOA population frequency, reflecting as they
do almost an equal admixture of high activity populations (ABO
groups A and B) and low activity populations (ABO group O).
Though no conclusions can be drawn as to there being any rela-
tionship between alleles just because they have similar frequencies
in the same populations, there is at least reason to explore this po-
tential relationship further.
So MAOA and ABO alleles show some hint of associations in the
hapmap population frequencies. Further, MAOA activity is associ-
ated with stratification of health risks in populations as are ABO
blood groups. High activity MAOA is associated with higher risks
for illness than is low activity MAOA [99–102]. Consistent with
the forementioned reasons why low activity MAOA appears to be
associated with ABO group O, ABO groups A and B are associated
with higher risks for illness compared with ABO group O [57–
63,70–73,75–77,79,82,84,86,89,90,92,93].
Another approach to the question of whether this hypothesis is
supported by facts is to ask whether research on illnesses’ relation-
ships to personality traits is consistent with the research showing
consistency of ABO blood groups stratification of illnesses and of
catecholamine enzymes of DBH, COMT, and MAOA stratification
of illnesses with the ABO stratification of catecholamine activities.
And this appears to be generally consistent. For example, cardio-
vascular illness has been linked to personality traits such as hostil-
ity and inward vs outward-directed aggression and lack of control
[103,104]. These constructs are similar to submissiveness, linked to
ABO group B with high dopamine: norepinephrine ratio, and they
are similar to non-aggressiveness, linked to ABO group A and low
norepinephrine activity. Conversely, aggression personality trait
is associated with ABO group O so this is consistent with ABO
groups A and B having higher cardiovascular risks than ABO group
O. Cancer diagnosis is associated with worse prognosis in patients
with personality traits of high neuroticism and lower optimism,
traits semantically similar to submissiveness trait [105]. This
would be consistent with ABO groups B’s tendency to higher sub-
missiveness and more cancer related disease burden than group O
though not higher than group A.
Another example is that cardiovascular disease has been found
to have a better prognosis with the personality trait of perfection-
ism [106]. And consistently, ABO group B has higher perfectionism
trait compared with other blood groups and does have more favor-
able cardiovascular outcomes compared with ABO group A though
not more favorable in most populations than ABO group O [57–63].
Discussion
Since personality traits show correlations with catecholamine
genes, if catecholamine genes are correlated with ABO blood
groups, then there would be tendencies of the catecholamine activ-
297
ities’ effects on personality noted with the ABO blood groups.
These tendencies are consistent with our observations of ABO
blood group personality traits.
We have observed in southeast USA in female outpatients that
ABO blood group A correlates with a calm, smooth pleasant demea-
nor. Based on this hypothesis, ABO group A appears to show ten-
dencies to correlations with increased DBH, increased COMT, and
increased MAOA with result of low dopamine and norepinephrine.
Based on consensus in catecholamine personality trait research,
personality trends in ABO A therefore would be non-submissive-
ness, non-perfectionism, and non-aggressiveness. These traits
seem consistent with the calm, smooth and pleasant demeanor
we have observed.
We have observed that patients with ABO group B are preoccu-
pied and reticent in demeanor. Based on this hypothesis, ABO B ap-
pears to have decreased DBH, decreased COMT, and increased
MAOA with resultant higher dopamine and moderate norepineph-
rine. Catecholamine research-supported personality trait trends
would thus be submissiveness, perfectionism, and non-aggressive-
ness and these traits would be congruent with the preoccupied,
reticent demeanor we have observed.
We have observed that patients with ABO group O are firm and
self-confident and commanding. According to this hypothesis, ABO
O has research showing trends toward high DBH, high COMT, and
low MAOA with resultant low dopamine and moderate to high nor-
epinephrine and thus personality trait trends of non-submissive-
ness, non-perfectionism, and aggressiveness. These traits seem
congruent with the firmness, self-confidence and commanding de-
meanor we have observed.
Japan and Korea have long traditions of popular interest in and
use of ABO blood group typing to understand an individual’s per-
sonality. According to Japanese ABO blood group personality the-
ory, there is consensus in the personality of each ABO blood
group: ABO A is described in such terms as quiet, concerned about
the feelings of others, and peaceful. ABO B is described as being
individualistic, unconventional, and unaware of others’ feelings.
ABO O is called a leader, outgoing and strong. ABO AB is noted to
be one who tries to fit in but who feels aloof. Interest in ABO blood
group correlations with personality may have taken hold of the
popular fancy in Japan and Korea because the types are somewhat
more equally prevalent there, i.e., there is more opportunity for
noticing enough of each type to begin to form empiric conclusions.
Though their conclusions regarding personality and ABO type seem
congruent with our observations and conclusions, there is not yet
scientific consensus that ABO blood type does relate to personality
[107,108].
In the future, verification by studying large populations of pa-
tients for correlation of ABO blood groups, diagnoses, and person-
ality traits can be done. If validated by studying large populations,
assessing catecholamine tone by personality and by using ABO
blood group typing would help in understanding of human behav-
ior as well as in advancing efforts to assess patients’ risks for ill-
ness. Assessing personality can be done by using standard
instruments, but, at least for health screening, some preliminary
assessments can be made by experienced clinicians by observation
of patient affect and demeanor. The overtly aggressive patient, for
example, would be easy to categorize, but more subtle findings
may include intense, almost glaring, eye contact and brusque, com-
manding manner. The submissive patient also can be easy to recog-
nize by deferential manner and averted eye gaze, over-
cooperativeness, and shyness. And the perfectionistic patient
may be recognized by repetitive behaviors, obsessiveness, at the
worst, and thoroughness and orderliness, at the best. The non-
aggressive, non-submissive patient would be recognized by a re-
laxed, calm manner with smooth slower speech and a ready, warm,
relaxed smile [8]. When the aggressive patient is recognized in this
298 D.K. Hobgood / Medical Hypotheses 77 (2011) 294–300
way, the clinician can surmise type O blood and elevated norepi-
nephrine and low dopamine. The patient who is both aggressive
and perfectionistic can be surmised to be of type O blood but to
have elevated norepinephrine and moderate dopamine. When
the submissive and perfectionistic patient is recognized, the clini-
cian can guess type B blood group and moderate to low norepi-
nephrine and high dopamine. When the submissive, non-
perfectionistic patient is recognized, the clinician can surmise type
B and moderate dopamine and low norepinephrine. When the non-
aggressive, non-submissive, non-perfectionistic patient is recog-
nized, the clinician can surmise type A blood and low norepineph-
rine and low dopamine. When the non-aggressive, non-submissive,
perfectionistic patient is recognized, the clinician can surmise type
A blood, low norepinephrine and moderate dopamine. ABO blood
typing, if available, can be used to confirm these subjective person-
ality assessments. These patient assessments thus can be used to
surmise the catecholamine status and thus health risks. It is more
intuitive to see how mental health assessment is benefited by
understanding the patient’s catecholamine tone, but many health
issues seem impacted as well. Personality assessment can thus as-
sist in stratifying patients’ health risks. Until whole genomes are
available for all patients, this method of using ABO-guided person-
ality assessment will yield much information about catecholamine
metabolism in each patient.
Conflicts of interest statement
There are no conflicts of interest.
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