To the hundreds of Hopkins medical students between 1947 and 1964 who gamely agreed to be poked, prodded, analyzed, and forever followed as part of Caroline Bedell Thomas's Precursors Study, taking the Rorschach test must have been something of a relief.

But their responses to the ink blots they saw have, in some cases, proved ominous. Those who described the ink blots using "morbid" words (like drowning or monster) later developed coronaries, hypertension, and malignancies at much higher rates. And those who later committed suicide had used cancer-related descriptive words 14 times more often than their still-healthy counterparts.

Considered the longest continuous study of its kind in the country, the Precursors of Essential Hypertension and Coronary Artery Disease (as it was originally known) has yielded important findings during its half-century-plus lifespan: that high cholesterol in young adulthood often leads to heart disease in later life, for instance, and the link between high levels of coffee consumption and future heart attacks.

But it is the link between personality and subsequent illness that most intrigued study founder Thomas (MD '30), professor emeritus of medicine, who died in 1997. Could "unconscious dreads and morbid fears, which, in some individuals, are ever-present stresses, [undermine] the biological guardians of general resistance?" she wondered, in a 1985 paper on the Rorschach findings.

The data continue to come in, as Hopkins researchers led by study director Michael Klag work to identify the danger signals that could provide an early tip-off to future disease.