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PubMedDate not supplied

[The hostility complex and myocardial infarct].

Several studies have associated the hostility complex (part of type A personality) to the development of coronary atherosclerosis. The complex is composed by aggressive behavior, frequent rage outbursts, intolerance to waiting lines and sense of urgency. To investigate the occurrence of this behavioral trait, 50 post-myocardial infarction men were compared against 50 normal male subjects of the same age. In all of them sphygmomanometric blood pressure was obtained, total blood cholesterol was measured and hostility was quantified by means of the Cook and Medley's questionnaire and an arbitrary ad hoc scale. Diastolic blood pressure was significatively higher in post-infarction patients (82 +/- 10 vs 77 +/- 9, p < 0.001), as well as the cholesterol level (231 +/- 55 vs 197 +/- 43, p < 0.001). Also, hostility score was higher in the post-infarcted men (16 +/- 4 vs 13 +/- 5, p < 0.001). The hostility score showed correlation with the occurrence of myocardial infarction (p < 0.02). These results establish that post-myocardial infarction patients express more hostility than control subjects. It was not possible to establish the true nature of the relationship among hostility and diastolic blood pressure, total cholesterol and the occurrence of coronary events. Nevertheless, this study confirms that the hostility complex is frequently present in atherosclerotic patients.

Adult↗

PubMed2006

Intrauterine insemination versus timed intercourse for cervical hostility in subfertile couples.

The postcoital test has poor diagnostic and prognostic characteristics. Nevertheless, some physicians believe it can identify scanty or abnormal mucus that might impair fertility. One way to avoid "hostile" cervical mucus is intrauterine insemination. With this technique, the physician injects sperm directly into the uterine cavity through a small catheter passed through the cervix; the theory is to bypass the "hostile" cervical mucus. Although most gynecologic societies do not endorse use of intrauterine insemination for hostile cervical mucus, some physicians consider it an effective treatment for women with infertility thought the result of cervical mucus problems. The aim of this review was to determine the effectiveness of intrauterine insemination with or without ovarian stimulation in women with cervical hostility who failed to conceive.We searched Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library Issue 2, 2005, MEDLINE (1966 to June 2005), EMBASE (1980 to June 2005), POPLINE (to June 2005), and LILACS (to June 2005). In addition, we contacted experts and searched the reference list of relevant articles and book chapters. We included randomized and quasirandomized, controlled trials comparing intrauterine insemination with intercourse timed at the presumed fertile period. Participants were women with cervical hostility who failed to conceive for at least 1 year. We assessed the titles and abstracts of 386 publications and 2 reviewers independently abstracted data on methods and results from 5 studies identified for inclusion. The main outcome is pregnancy rate per couple. We did not pool the outcomes of the included 5 studies in a meta-analysis resulting from the methodological quality of the trials and variations in the patient characteristics and interventions. Narrative summaries of the outcomes are provided. Each study was too small for a clinically relevant conclusion. None of the studies provided information on important outcomes such as spontaneous abortion, multiple pregnancies, and ovarian hyperstimulation syndrome. There is no evidence from the published studies that intrauterine insemination is an effective treatment for cervical hostility. Given the poor diagnostic and prognostic properties of the postcoital test and the observation that the test has no benefit on pregnancy rates, intrauterine insemination (with or without ovarian stimulation) is unlikely to be a useful treatment for putative problems identified by postcoital testing. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completion of this article, the reader should be able to recall that there is a lack of adequate studies that support that intrauterine insemination (IUI) is an effective treatment of cervical hostility, explain that the postcoital test has poor diagnostic and prognostic properties, and state that the use of both tests has no benefit on pregnancy rates. EDITOR'S NOTE: Although many assisted reproductive technology (ART) programs no longer perform postcoital tests, many perform intrauterine insemination (IUI), often with gonadotropins or clomiphene citrate, in their subfertile patients. Therefore, this review article will be of value to our readers who treat subfertile patients with IUI, whether or not they perform postcoital tests. For additional explanations of the statistical tests employed in this review, see D. Grimes, KF Schulz, Obstetrical and Gynecologic Survey, 57; Supplement 3: S35, September 2002; and D. Grimes, KF Schulz, Obstetrical and Gynecologic Survey, Supplement 2, S53-S69, September 2005.-RBJ.

Cervix Mucus↗

PubMedDate not supplied

Outcomes of endovascular AAA repair in patients with hostile neck anatomy using adjunctive balloon-expandable stents.

Hostile neck anatomy remains the predominant reason that patients are denied endovascular aneurysm repair (EVAR). We reviewed our experience of EVAR with use of prophylactic adjunctive proximal balloon-expandable stents in patients with hostile neck anatomy and adjunctive proximal balloon-expandable stents in patients with type I endoleaks. Of 140 patients who underwent EVAR between 2000 and 2004, we reviewed data for 19 patients in whom we used proximal balloon-expandable stents. By high-resolution computed tomography scan or angiography, hostile neck anatomy was classified as length <15 mm, neck diameters > or =26 mm, circumferential thrombus at the proximal neck, angulated neck > or =60 degrees, and neck bulge or reverse taper necks. Patients were considered to have hostile anatomy if they met 1 or more of the above-cited criteria. All patients underwent AAA repair with commercially available endograft systems, Zenith (Cook, Bloomington, IN) and AneuRx (Medtronic/AVE, Minneapolis, MN). Balloon-expandable stents utilized included Cordis-Palmaz stents (17/19) and eV3 Max stents (2/19). Stents were deployed in the proximal graft with transrenal extension. AneuRx (18/19) and Zenith (1/19) endografts were used in all of the patients. Of the 19 patients, 15 had prophylactic stent placement for known hostile neck anatomy and 4 patients had stent placement for type I endoleak. Assisted primary technical success was achieved in all patients. Three patients had maldeployment of the endograft or proximal stent requiring additional endovascular interventions at the time of surgery. No endografts were deployed too low requiring stent placement. Procedure-related complications occurred in 2 of 19 patients. These included 1 operative death secondary to pneumonia and 1 patient who developed progressive renal failure. Short-term clinical success was achieved in 17 of 19 patients. Two patients required secondary interventions, 1 due to device migration with secondary conversion to open repair, and an endoleak, which, on angiogram, was a large type II endoleak successfully treated with coiling of the inferior mesenteric artery. One patient was observed to have a type II endoleak with no associated aneurysm enlargement. Short-term results suggest the use of prophylactic adjunctive balloon-expandable stents may decrease the incidence of secondary interventions related to hostile neck anatomy when used as an adjunctive measure with EVAR. Based on our experience, we feel EVAR may be offered to an expanded patient population with hostile neck anatomy with use of prophylactic balloon-expandable stents.

Aged↗

PubMed2005

Hostility and violence of acute psychiatric inpatients.

OBJECTIVE: The aim of the present study was to find out the extent of hostility and violence and the factors that are associated with such hostility and violence in a psychiatric intensive care unit. METHODS: Retrospective analysis of data prospectively collected in a 6-year period. RESULTS: No hostility was observed in 56.1%, hostility in 40.9%, and violence in 3.0% of the admitted cases. Seclusion was never used. Six cases (2.5 per thousand) required physical restraint. Risk factors associated with violence were younger age, suicidal risk, and diagnosis of schizophrenia. Risk factors associated with hostile and violent behavior were younger age at the onset of the disorder, being single, having no children, lower GAF scores, higher BPRS hostility, SAPS, and CGI scores, lower BPRS anxiety-depression score, higher doses of psychoactive drugs, more frequent use of neuroleptics, diagnosis of mania, personality disorder, substance and alcohol related disorders, no diagnosis of depression. CONCLUSION: The study confirms the low rate of violence among Italian psychiatric in-patients, the major relevance of clinical rather than socio-demographic factors in respect of aggressive behavior, the possibility of a no seclusion-no physical restraint policy, not associated either with higher rates of hostility or violence or with more severe drug side effects.

Journal Article↗

PubMed2005

Hostile marital interactions, proinflammatory cytokine production, and wound healing.

CONTEXT: A growing epidemiological literature has suggested that marital discord is a risk factor for morbidity and mortality. In addition, depression and stress are associated with enhanced production of proinflammatory cytokines that influence a spectrum of conditions associated with aging. OBJECTIVE: To assess how hostile marital behaviors modulate wound healing, as well as local and systemic proinflammatory cytokine production. DESIGN AND SETTING: Couples were admitted twice to a hospital research unit for 24 hours in a crossover trial. Wound healing was assessed daily following research unit discharge. PARTICIPANTS: Volunteer sample of 42 healthy married couples, aged 22 to 77 years (mean [SD], 37.04 [13.05]), married a mean (SD) of 12.55 (11.01) years. INTERVENTIONS: During the first research unit admission, couples had a structured social support interaction, and during the second admission, they discussed a marital disagreement. MAIN OUTCOME MEASURES: Couples' interpersonal behavior, wound healing, and local and systemic changes in proinflammatory cytokine production were assessed during each research unit admission. RESULTS: Couples' blister wounds healed more slowly and local cytokine production (IL-6, tumor necrosis factor alpha, and IL-1beta) was lower at wound sites following marital conflicts than after social support interactions. Couples who demonstrated consistently higher levels of hostile behaviors across both their interactions healed at 60% of the rate of low-hostile couples. High-hostile couples also produced relatively larger increases in plasma IL-6 and tumor necrosis factor alpha values the morning after a conflict than after a social support interaction compared with low-hostile couples. CONCLUSIONS: These data provide further mechanistic evidence of the sensitivity of wound healing to everyday stressors. Moreover, more frequent and amplified increases in proinflammatory cytokine levels could accelerate a range of age-related diseases. Thus, these data also provide a window on the pathways through which hostile or abrasive relationships affect physiological functioning and health.

Adult↗

PubMed1979

Rorschach hostility content and its relation to anxiety, neuroticism and P-E-N measures.

Assessed the relationships between Rorschach hostility scores and anxiety, neuroticism, overt/covert hostility, intelligence, and Eysenck's Personality Questionnaire. The sample consisted of 200 (100 male, 100 female) Indian undergraduates aged 15 to 20 years. There were some indications that high hostility scores on the Rorschach tended to be worldly wise, covertly hostile, independent, stubborn, and poor fakers. A factor analysis of the intercorrelations showed six interpretable factors: Anxiety, Neuroticism, Body measures. Hostility, Psychoticism and Tender-minded, respectively. Further, it was concluded that Eysenck's Psychoticism is factorially a complex measure and that projective and direct verbal measures of hostility seem to be measuring dissimilar constructs. A few hypotheses for independent verification were proposed.

Adolescent↗

PubMed1993

Heritability of hostility-related emotions, attitudes, and behaviors.

Hostility-related variables have been categorized as to kinds of emotions, attitudes, and behaviors. Relatively few studies have explored whether genetic factors contribute to individual differences in these variables. Moreover, the majority of this research has involved male subjects. The present study utilized the twin method to evaluate the influence of genetic factors on hostility-related emotions, namely, trait anger and irritability, hostility-related attitudes, namely cynical hostility and suspiciousness, and hostility-related behaviors, namely, physical, verbal, and indirect aggression in adult women. Responses on the measure of trait anger showed evidence of significant heritability. However, evidence for a genetic component to responses on the irritability scale was less clear. There was no support for the notion of a genetic component to the measure of suspiciousness, and the evidence of a genetic contribution for cynical hostility was not significant. It was expected that due to environmental influences for women, only certain forms of aggression would show genetic variance, namely, verbal and indirect as opposed to physical forms. The results were generally congruent with these expectations.

Adult↗

PubMed1996

Gender differences in the relation between interview-derived hostility scores and resting blood pressure.

We examined the correlations between Structured Interview (SI)-derived hostility scores and resting blood pressure (BP) to see if they would be the same or different for healthy men and women. Standard risk factor information and resting BP measures were obtained from 193 undergraduates (109 men, 84 women), who underwent the SI. Subjects were rated for Potential for Hostility, Hostile Style, Intensity and Content, and completed Antagonism and Neuroticism scales. As expected, SI hostility scores were related to higher resting SBP in men, however; in women, they were related to lower resting SBP and Neuroticism. Regression analyses controlling for standard CHD risk factors indicated that SI-derived hostility predicted resting SBP and hypertensive status in both men and women, though in opposite directions. Thus, SI-derived hostility may assess a different construct in women than in men.

Arousal↗

PubMed1996

Interpersonal and self-reported hostility among combat veterans with and without posttraumatic stress disorder.

The present study investigated self-reported and interpersonal hostility in 70 Vietnam combat veterans with and without posttraumatic stress disorder (PTSD) and 60 comparison community volunteer subjects. Veterans were 50 help-seeking, male Vietnam combat veterans with PTSD and 20 non-help-seeking male combat veterans without PTSD. Vietnam veterans with PTSD not only reported more hostility than non-PTSD veterans and healthy community volunteers, but also reacted behaviorally with more hostility during an interpersonal interaction. Compared to veterans without PTSD, veterans with PTSD reported significantly higher levels of hostility and demonstrated significantly greater non-verbal expressions of hostility during an interpersonal task. These results suggest that the level of hostility in PTSD combat veterans may be high as compared to comparison groups. The implications of these results and possible research directions are presented.

Case-Control Studies↗

PubMed2006

Hostility, anger, and marital adjustment: concurrent and prospective associations with psychosocial vulnerability.

Hostility may contribute to risk for disease through psychosocial vulnerability, including the erosion of the quality of close relationships. This study examined hostility, anger, concurrent ratings of the relationship, and change in marital adjustment over 18 months in 122 married couples. Wives' and husbands' hostility and anger were related to concurrent ratings of marital adjustment and conflict. In prospective analyses, wives' but not husbands' hostility and anger were related to change in marital adjustment. In hierarchical regression and SEM models wives' anger was a unique predictor of both wives' and husbands' change in marital adjustment. The association between wives' anger and change in husbands' marital satisfaction was mediated by husbands' ratings of conflict in the marriage. These results support the role of hostility and anger in the development of psychosocial vulnerability, but also suggest an asymmetry in the effects of wives' and husbands' trait anger and hostility on marital adjustment.

Adult↗

PubMed1994

Hostility in asymptomatic men with angiographically confirmed coronary artery disease.

The association of hostility and coronary artery disease was evaluated in a case-control study of aircrew members who had been referred for coronary angiography on the basis of noninvasive tests or risk factor status. The asymptomatic status of the sample and the structured nature of the referral process minimize the methodologic problems normally associated with studies of patients undergoing angiography. Cases (n = 24) had some angiographic evidence of coronary artery disease, whereas controls (n = 25) were found to have no evidence of occlusion. An interaction was observed between smoking history and a measurement of hostility based on observations of the respondent's behavior during a standard interview. Among nonsmokers, cases had higher hostility scores than did controls (p = 0.004). This association was not present among smokers. Self-reported hostility did not discriminate cases from controls. These findings support the notion that hostility plays a role in the pathogenesis of coronary atherosclerosis and point to the potential importance of interactions between hostility and other risk factors.

Adult↗

PubMed1992

Relation of hostility to medication adherence, symptom complaints, and blood pressure reduction in a clinical field trial of antihypertensive medication.

The impact of hostility was examined in relation to the conduct and results of a clinical field trial. Data were derived from a multi-center randomized double-blind study of the comparative effects of antihypertensive therapy (captopril, methyldopa and propranolol) on the quality of life of 620 hypertensive men. Hostility levels were higher in subjects reporting skipping medication dosages compared to those reporting they always complied with the medication schedule. Reporting of symptoms often associated with antihypertensive drug regimens was positively related to hostility scores throughout the study, even during the blinded placebo period. Persons with high hostility scores showed the greatest decline in blood pressure independent of type of antihypertensive medication. However, there was some limited evidence that hostility levels were significantly reduced by one antihypertensive medication. Overall, the present findings suggest that double-blind pharmacologic clinical trials may benefit from using reliable measures of hostility as covariates in the evaluation of symptom reports and amount of blood pressure reduction.

Adult↗

PubMed1994

Hostility and myocardial infarction in men.

This case-control study examines the association of hostility (as measured by the Cook-Medley Hostility Scale) with myocardial infarction in adult males from The Netherlands. Subjects included patients with first myocardial infarction (MI; N = 81), who were compared with a neighbourhood control (NC) group (N = 168). Cases had somewhat higher scores on the Cook-Medley Hostility Scale, although the differences between cases and controls were not statistically significant. Multivariate analysis revealed the presence of an interaction between hostility and age, suggesting that the association of hostility with MI is age-dependent. The results indicate that hostility only constitutes a risk indicator for first MI in men who are younger than 50 yr of age.

Adult↗

PubMed1991

Hostility and its association with behaviorally induced and somatic coronary risk indicators in Finnish adolescents and young adults.

The association of hostility to behaviorally induced (i.e. smoking behavior, alcohol consumption and physical activity) and somatic coronary risk indicators (i.e. LDL- and HDL-cholesterol, systolic and diastolic blood pressure and obesity) was studied in a randomly selected representative sample of healthy adolescents and young adults (n = 1609). The question was whether the association, previously found between hostility and CHD incidence could be confirmed between hostility and CHD risk level in healthy young subjects. Results indicate that hostility is unrelated to somatic coronary risk factors, while an association with behaviorally induced risk factors was found. This association was, however, mediated by gender: current and heavy smoking, and physical inactivity were reported more commonly by hostile women, while frequent drinking by hostile men. These findings were replicated in a 3-year follow-up.

Adolescent↗

PubMed1996

Anger management style, hostility and spouse responses: gender differences in predictors of adjustment among chronic pain patients.

This study examined whether relationships between anger management style (anger suppression; anger expression) and adjustment variables for patients with chronic pain depend on patient hostility, and/or depend on a patient's gender. A 'spouse response model' was also evaluated to test whether patient expression of hostile anger is linked to infrequent positive and frequent negative responses from spouses, and hence to poor adjustment. The sample of 127 married chronic pain patients was assessed prior to entry into a multidisciplinary pain treatment program. Hierarchical multiple regressions revealed significant 'Anger Expression x Hostility x Gender' interactions for pain severity, activity interference and activity level: High Anger Expressor/Low Hostile women reported the lowest pain and highest activity; Low Anger Expressor/High Hostile men reported the highest pain and highest interference. Among men, support was also found for a spouse response model: pain severity and activity interference for High Anger Expressors was partly accounted for by negative spouse responses. Results suggest that discriminations among patients may be made based on anger management style in interaction with level of hostile attitude and the patient's gender, and that these distinctions may have implications for understanding mechanisms of pain and disability, and for designing appropriate treatment.

Adaptation, Psychological↗

PubMedDate not supplied

Aggression and hostility in substance abusers: the relationship to abuse patterns, coping style, and relapse triggers.

A cohort of 3,367 substance abusers seeking treatment were administered measures of aggression and hostility including the Buss-Durkee Hostility Inventory and the NEO Personality Inventory Hostility Scale. Polysubstance abusers scored significantly higher on all measures of hostility and aggression, regardless of whether they abused cocaine or not. Subjects scoring higher on aggression and hostility utilized escape-avoidance, distancing, and confrontational coping styles more regularly. Subjects scoring higher on measures of aggression and hostility reported more situations that triggered their use of substances and less confidence that they could resist using when faced with such situations in the future. This was especially true for situations involving unpleasant internal states, situations involving rejection, and situations involving conflict with family and friends. The implications of these findings for clinical assessment and treatment planning are discussed.

Adaptation, Psychological↗

PubMed2005

Combined effect of the metabolic syndrome and hostility on the incidence of myocardial infarction (the Normative Aging Study).

A growing body of evidence suggests that the metabolic syndrome and hostility are independent risk factors for the development of coronary heart disease. However, few studies have examined the combined effect of the metabolic syndrome and hostility on the incidence of myocardial infarction (MI). We examined prospectively the relation among the metabolic syndrome, hostility, and the incidence of MI in healthy, older men (mean +/- SD 59.7 +/- 7.2 years) who participated in the Normative Aging Study. Seven hundred fifty-four men who were diagnosed as not having coronary heart disease and diabetes mellitus were included in the present study. Men were assigned to 1 of 4 risk-factor groups based on the presence or absence of the metabolic syndrome and low or high hostility. Hierarchical logistic regression was used to assess the multivariate risk of developing a MI. The incidence of MI was 11.3% (n = 85) over an average follow-up period of 13.8 years. After adjusting for potential covariates, risk-factor group significantly predicted the incidence of MI (odds ratio 1.59, 95% confidence interval 1.29 to 1.96, p <0.0001). The effect was strongest among patients who had the metabolic syndrome and high levels of hostility, with this subgroup showing a fourfold increase in the odds of developing a MI (odds ratio 4.21, 95% confidence interval 2.21 to 8.04, p = 0.0001). In conclusion, it appears that hostility may provide additional prognostic information to the assessment of coronary heart disease risk in patients with the metabolic syndrome and should routinely be evaluated as part of a comprehensive risk factor assessment.

Age Distribution↗

PubMed2006

Hostility and pain are related to inflammation in older adults.

Chronically elevated systemic inflammation has a dramatic impact on health for older individuals. As stress-related responses, both hostility and pain perception may contribute to inflammation which in turn may maintain negative emotion and pain over time. We used structural equation modeling to examine the degree to which trait hostility and pain were uniquely associated with C-reactive protein (CRP) and serum IL-6 levels over a 6-year span in a sample of older adults. The sample included 113 present or former caregivers of a spouse with dementia and 101 non-caregivers. After accounting for depression, health behaviours, and other risk factors, which were also assessed longitudinally, pain and, to a lesser extent, hostility were uniquely associated with plasma levels of CRP but not IL-6. When examined separately, the association between pain and CRP was significant only for caregivers, while the association between hostility and CRP was comparable for the two groups. These findings suggest that hostility may play a role in a cycle of inflammation among older adults, and that pain may be particularly problematic for those under chronic stress. Our results also shed light on inflammation as a mechanism underlying the effects of hostility on cardiovascular disease morbidity and mortality.

Age Factors↗