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PubMed1997

Lack of relations of hostility, negative affect, and high-risk behavior with low plasma lipid levels in the Coronary Artery Risk Development in Young Adults Study.

BACKGROUND: Previous studies have suggested that low plasma cholesterol levels or cholesterol lowering may increase the risk of suicide and violent death. Increased aggression, risk-taking behavior, or depression has been associated with low cholesterol levels in some studies. METHODS: A total of 4240 subjects of the Coronary Artery Risk Development in Young Adults study, aged 23 to 35 years, were included in the study. Analyses were stratified by race (black or white) and sex. Persons in the lowest 10% of plasma total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride levels were compared with the other participants in each race/sex group, using standardized measures of hostility, anger suppression, depressive symptoms, and anxiety. The relations between 5-year change in hostility and 5-year change in lipid levels also were examined. The relations between lipid levels and high-risk behavior (e.g., violent arguments or having a gun at home) were examined in a subset of subjects. All analyses were adjusted for relevant covariates. RESULTS: In cross-sectional analyses, low total cholesterol levels were not related to any of the psychological measures in any race/sex group. Among black women only, low low-density lipoprotein cholesterol was related to greater anxiety, and low triglycerides were related to lower anger suppression (P < or = .002). Among white men only, increases in hostility during the 5-year follow-up were related to increases in triglycerides (P < .01), but changes in hostility were unrelated to changes in cholesterol levels. Among a subset of 371 subjects with initially elevated total cholesterol (> or = 5.17 mmol/L [> or = 200 mg/dL]) and a non-medicated decrease of 0.52 mmol/L (> or = 20 mg/dL) or more during 5 years, hostility decreased in a univariate analysis (P < .001). High-risk behaviors also were not associated with low lipid levels. CONCLUSION: The results do not support a consistent relation between hostility, negative affect, or high-risk behaviors with low lipid levels or lipid-lowering among young adults.

Adolescent↗

PubMed2005

Intra-uterine insemination versus timed intercourse for cervical hostility in subfertile couples.

BACKGROUND: 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 gynaecological societies do not endorse use of intrauterine insemination for hostile cervical mucus, some physicians consider it an effective treatment for women with infertility thought due to cervical mucus problems. OBJECTIVES: 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. SEARCH STRATEGY: 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. SELECTION CRITERIA: We included randomized and quasi-randomized 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 one year. DATA COLLECTION AND ANALYSIS: We assessed the titles and abstracts of 386 publications and two reviewers independently abstracted data on methods and results from five studies identified for inclusion. The main outcome is pregnancy rate per couple. MAIN RESULTS: We did not pool the outcomes of the included five studies in a meta-analysis due to 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. AUTHORS' CONCLUSIONS: 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.

Biomarkers↗

PubMed1996

The psychobiology of hostility: possible endogenous opioid mechanisms.

This study examined the role of endogenous opioids in the relation between hostility and cardiovascular stress responsiveness. Forty-six men completed the Cook-Medley Hostility Scale and experienced a laboratory pain stressor once under opioid blockade and once under placebo. Hostility scores were significantly related to the magnitude of change in cardiovascular reactivity/recovery resulting from opioid blockade. Low scorers on the Cynicism subscale displayed increases in heart rate (HR) reactivity under blockade relative to placebo, with reactivity decreases noted in high scorers. Low Hostile Affect scores were similarly associated with impaired diastolic blood pressure recovery under opioid blockade. HR recovery results were somewhat different, with high scorers on Aggressive Responding and the total Cook-Medley displaying improved HR recovery under opioid blockade, with no change noted in low scorers. These data provide preliminary support for the hypothesis that low hostile individuals rely on endogenous opioids for buffering cardiovascular stress responsiveness, but high hostiles do not.

Journal Article↗

PubMed1997

Hostility, testosterone, and vascular reactivity to stress: effects of sex.

This study investigated the association of personality with cardiovascular stress reactivity (CVR) in men and women. Also, the degree to which testosterone and estradiol reactivity were related to personality and CVR measures was examined. Twenty-six men and 44 women completed the Cook-Medley Hostility Scale, the Beck Depression Inventory, and the Spielberger Trait Anxiety Inventory before speech, Stroop, and math stress. Testosterone (men) and estradiol (subset of women) were sampled once after an initial rest period and again after the last stressor. Cardiovascular reactivity, including cardiac output and total peripheral resistance (TPR), was assessed during stressors. For men, testosterone increased significantly with stress, and testosterone reactivity to stressors was significantly correlated with hostility. However, stepwise multiple regression revealed that hostility was the only independent predictor of CVR to speech, math, and Stroop stress in men, accounting for 13%-32% of the variance in TPR. Baseline systolic blood pressure explained 22% of the variance in TPR reactivity to speech preparation. No evidence was obtained to suggest that hostility, depressive mood, or anxiety predicted CVR in women, and estradiol did not show stress-sensitive effects. These data provide evidence that increased vascular reactivity may be one mechanism linking hostility to increased cardiovascular mortality in men and support the notion that hostility may have different implications for CVR in women.

Journal Article↗

PubMed2000

Reducing adolescents' aggressive and hostile behaviors: randomized trial effects of a brief family intervention 4 years past baseline.

OBJECTIVE: To examine the long-term effects of a brief family intervention on aggressive and hostile behaviors of adolescents in the general population. DESIGN: Randomized trial including 22 public schools assigned to the Iowa Strengthening Families Program or a control condition. Analyses supported sample representativeness and failed to show differential attrition effects 4 years after baseline. INTERVENTION: Seven-session intervention for parents and their sixth-grade children. MEASURES: The multi-informant, multimethod measures included independent observer ratings of adolescent aggressive and hostile behaviors in adolescent-parent interactions, family-member report of aggressive and hostile behaviors in those interactions, and adolescent self-report of aggressive and destructive conduct across settings. Data were collected during the 6th (preintervention and postintervention), 7th, 8th, and 10th grades. RESULTS: All measures showed a generally positive trend in intervention-control group differences over time. During 10th grade, significant intervention-control differences were found for adolescent self-report of aggressive and destructive conduct (P =. 01), with relative reduction rates ranging from 31.7% to 77.0%. Significant differences were shown for observer-rated aggressive and hostile behaviors in adolescent-parent interactions (P =.01); differences in family member reports of those behaviors were not significant. Supplemental analyses of both interactional behavior measures, specific to parent sex, indicated significant experimental group differences in interactions with mothers (P =.04 for both measures) but not with fathers. CONCLUSIONS: Brief family competency-training interventions designed for general populations can reduce aggressive and hostile behaviors in adolescents' interactions with parents and adolescent aggressive behaviors outside of the home setting. Thus, this type of intervention has important public health implications. Arch Pediatr Adolesc Med. 2000;154:1248-1257.

Adolescent↗

PubMed2000

Association of hostility with coronary artery calcification in young adults: the CARDIA study. Coronary Artery Risk Development in Young Adults.

CONTEXT: Psychosocial factors, including personality and character traits, may play a role in the development and expression of coronary artery disease. OBJECTIVE: To evaluate whether hostility, a previously reported predictor of clinical coronary artery disease, is associated with coronary calcification, which is a marker of subclinical atherosclerosis. DESIGN: Prospective cohort study. SETTING AND PARTICIPANTS: Volunteer subsample from Chicago, Ill, and Oakland, Calif, consisting of 374 white and black men and women, aged 18 to 30 years at baseline, who participated in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Cook-Medley hostility assessment data were collected at baseline from 1985 to 1986 and at year 5 examinations from 1990 to 1992. After the 10-year examinations in the 1995-1996 year, electron-beam computed tomographic scans were performed. MAIN OUTCOME MEASURES: Presence of any detectable coronary artery calcification (coronary calcium score >0), and coronary artery calcium scores of 20 or higher. RESULTS: In logistic regression analysis adjusting for age, sex, race, and field center comparing those with hostility scores above and below the median of the distribution of the present sample, the odds ratio of having any coronary calcification was 2.57 (95% confidence interval, 1.31-5.22), and the odds ratio of having a calcium score of 20 or higher was 9.56 (95% confidence interval, 2.29-65.9) for calcium scores of 20 or higher. The associations with any coronary artery calcification persisted after adjusting for demographic, lifestyle, and physiological variables. Results using a cynical distrust subscale were somewhat weaker than for those using the global hostility score. Power was inadequate to perform sex- or race-specific analyses. CONCLUSION: These results suggest that a high hostility level may predispose young adults to coronary artery calcification. JAMA. 2000;283:2546-2551

Adult↗

PubMed1977

Feelings of hostility and personal control as related to depression.

The relationships among depression, hostility, and locus of control were investigated in 58 clinic outpatients. Depth of depression was correlated positively with both covert hostility and external control, while external control correlated with covert hostility. Analysis of subscales on the hostility inventory indicated that overt forms of hostility were unrelated to depression, while the subscales of guilt, resentment, irritability, and suspicion were related positively (r = .50, p less than .005). Partial correlations suggested that the relationship between depression and external control may depend on the presence of resentment and irritability and that a combination of these covert factors with external control commonly is found in depression.

Adjustment Disorders↗

PubMed1995

Hostility and erosion of marital quality during early marriage.

We examined the association between hostility and longitudinal changes in marital quality in a sample of 53 newlywed couples who were in their first marriages and were without children. Spouses' reports of marital quality were assessed initially at an average of 5 months into marriage and, thereafter, at three follow-up points approximately 1, 2, and 3 years subsequent to the date of marriage. Individual growth models were computed to assess the rate of change of marital quality. Hostility among husbands was significantly associated with linear decreases in their own, and their wives', reports of marital quality, even after controlling for the passage of time and the correlated variable of neuroticism. Results are consistent with the psychosocial vulnerability model of hostility and illness (Smith, Health Psychol. 11: 139-150, 1992), which posits that associations between hostility and heightened risk for morbidity and mortality are partially mediated by poor-quality relationships that develop as a consequence of the abrasive interpersonal properties of hostility.

Adult↗

PubMed2005

Mediation and modification of the association between hopelessness, hostility, and progression of carotid atherosclerosis.

Hopelessness and hostility are linked to progression of carotid atherosclerosis (PCA). The purpose of this study was to replicate such relations and to evaluate the role of biological pathways involving hyperactivation of the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenocortical (HPA) axis. PCA was evaluated by 4-year change in three ultrasound measures of intima-media thickness (IMT) in 1027 men aged 42-60 years at baseline. Effect modification and mediation of relationships between psychosocial factors and PCA were examined for the measures systolic blood pressure (SBP), fibrinogen, and waist-to-hip ratio (WHR), levels of which are indicative of activity along these pathways. Hopelessness and hostility were associated with PCA. Fibrinogen mediated to a moderate extent the association between hopelessness and PCA. SBP significantly modified the relation between hostility and PCA in participants of moderate hostility. The above biological pathways are implicated in the mechanisms connecting hopelessness, hostility, and PCA.

Adult↗

PubMed1987

The relationship between cynical hostility and blood pressure reactivity.

It is hypothesized that high levels of hostility stimulate blood pressure hyperresponsivity to challenge. Seventy-six normotensive adults completed the MMPI hostility subscale, and blood pressure reactivity to, and recovery from, cold pressor and mental arithmetic stressors were measured on two occasions. Only one of twenty Pearson correlations between Cook-Medley hostility and blood pressure reactivity was significant. Analyses of variance revealed that blood pressure reactivity was influenced by sex and family history of cardiovascular disease, but neither factor interacted with hostility. There was no evidence from the present study that cynical hostility as measured by the Cook-Medley was associated with blood pressure reactivity.

Adult↗

PubMed2006

The longitudinal effects of social support and hostility on depressive tendencies.

This 14-year longitudinal study examined the independent association between perceived social support and the 5-year progression of depressive tendencies while taking into account the potential effects of childhood/adolescent anger and later hostility. From the on-going population based study of "Cardiovascular Risk in Young Finns", 553 male and 860 female participants responded to a revised version of Beck's Depression Inventory in 1992 and 1997. Hostility and perceived social support were assessed by self-rated questionnaires in 1992. Childhood/adolescent anger was assessed by parent-reports in 1983. Our results showed that higher levels of perceived social support were associated with the decrease of depressive tendencies after 5 years and lower levels of depressive tendencies prospectively and after 5 years. This association persisted after adjusting for childhood/adolescent anger and later hostility. In addition, hostility was strongly related to the 5-year increase of depressive tendencies and higher levels of depressive tendencies. Social support may therefore be a long-term protective factor from depression irrespective of personality characteristics, such as hostility and anger.

Adolescent↗

PubMed1998

Hostility, social support, and coronary heart disease in the National Heart, Lung, and Blood Institute Family Heart Study.

This cross-sectional study investigated the association of hostility and social support to coronary heart disease (CHD) in 2 groups of men and women: those with a familial predisposition for CHD (high-risk sample) and a randomly selected group. The hypothesis was that hostility and low social support would be associated with CHD, and would have a greater effect in the high-risk group. The random sample contained 2,447 individuals (47.1% male) from 576 families, and the high-risk sample consisted of 2,300 people (45.5% male) from 542 families. Odds ratios (OR) and their 95% confidence intervals were calculated using generalized estimating equations (GEE) for logistic regression. Family was specified as the clustering variable, and robust SEEs were obtained to account for dependence of the data within families. After controlling for age, education, body mass index, exercise, smoking history, drinking history, and drinking >5 drinks a day, hostility was associated with a history of coronary bypass surgery or coronary angioplasty in high-risk men (OR 1.21) and a history of myocardial infarction in high-risk women (OR 1.39). High-risk women with high social support had reduced odds of a previous myocardial infarction (OR 0.76), whereas women with high network adequacy in the random sample had reduced risk of myocardial infarction (OR 0.41) and angina (OR 0.49). A ratio of high hostility to low social support was associated with past myocardial infarction in high-risk women (OR 2.47) and a history of angina (OR 2.02) in the random sample men. These results suggest that high hostility and low social support are associated with some manifestations of CHD after controlling for adverse health behaviors.

Adult↗

PubMedDate not supplied

Substance abuse patterns and their association with psychopathology and type of hostility in male patients with borderline and antisocial personality disorder.

The aim of this study was to investigate the prevalence of substance use disorder in young adult patients with borderline personality disorder (BPD) and antisocial personality disorder (APD) and to ascertain the specific substances each of these groups choose to abuse. An additional aim was to assess whether alcohol and drug abuse in the patients related to their psychopathology and hostility. The study subjects were 41 hospitalized patients with BPD and 44 hospitalized patients with APD. The diagnoses of personality disorders and substance use disorders were made using DSM-III criteria. Psychopathology patterns were assessed using the Brief Psychiatric Rating Scale, Hamilton Depression Rating Scale, and State-Trait Anxiety Inventory. Hostility was assessed using the Hostility and Direction of Hostility Questionnaire. Abuse of one or more substances was reported by 76% of BPD patients and 95% of APD patients. There was no difference between the two groups in terms of alcohol abuse, but certain substances (such as benzodiazepines, anticholinergics, cannabis, and opioids) were abused more than twice as often by APD patients versus BPD patients. APD patients were more likely than BPD patients to be multiusers. In BPD patients, the number of substances abused showed a negative association with depression, while in APD patients it was positively related to state anxiety. In both patient groups, there was no correlation of the number of abused substances with the degree of extroverted or introverted hostility.

Adjustment Disorders↗

PubMed2000

Heart period and QT variability, hostility, and type-A behavior in normal controls and patients with panic disorder.

OBJECTIVES: Excess cardiovascular morbidity has been reported in association with phobic anxiety as well as in association with hostility and type-A behavior. The aim of this study was to investigate the relationship between the measures of hostility and type-A behavior, and heart period (HP) and QT variability in normal controls and patients with panic disorder. METHODS: Data were obtained from Holter ECG records for HP and heart rate (HR) and QT variability measures were obtained from 5 min laboratory ECG records in normal controls (n=21) and patients with panic disorder (n=27). RESULTS: Patients with panic disorder were significantly more hostile, and had significantly higher scores on Jenkins Activity Survey (JAS) speed and impatience subscale (S scale). Hostility did not correlate with either HP variability or QT variability. Higher type-A scores were associated with higher low frequency (LF) and high frequency (HF) powers of HP variability and standing QT variability was associated inversely with type-A and S scores of the JAS in patients with panic disorder. CONCLUSIONS: Our results do not support the hypothesis that higher hostility and higher type-A scores are associated with decreased cardiac vagal function.

Adult↗

PubMed1996

Are abnormal gastrofiberscopic findings related to hostility with poor social support or to negative responses to stress?

Recent studies have highlighted physiological effects of emotional stress presumably leading to gastrointestinal disease. This study examined the effects of stress (hostility) and coping (social support and negative responses to stress) on asymptomatic gastric diseases. We investigated whether gastrofiberscopic findings were related to stress and coping in 269 volunteers without gastrointestinal complaints. These subjects were taking part in primary health care assessments. Analysis of variance found that volunteers with abnormal gastrofibercopic findings (i.e., erosions and/or ulceration) demonstrated significantly higher hostility and lower social support scores than those without abnormal findings. Analysis of covariance found that abnormal gastrofiberscopic findings remained significantly related to hostility scores after controlling for hostility's correlations with social support and negative responses to stress. The results suggest that hostility, along with poor social support or negative responses to stress, is associated with asymptomatic gastric disease.

Adult↗

PubMed2000

Plasma homocysteine concentrations are positively associated with hostility and anger.

Homocysteine is a sulphur amino acid that is positively associated with risk of vascular disease. Very few behavioral or psychological factors have been studied in relationship to homocysteine levels, despite the fact that several psychological factors have also been linked with risk for cardiovascular disease. One psychological attribute showing a strong association with risk is hostility, which is prospectively predictive of future cardiovascular disease endpoints. Another related psychological factor is anger expression; coronary heart disease risk is associated with both heightened expression and inhibition of anger. The purpose of this study was to test the relationship of hostility and anger expression with homocysteine concentrations in a sample of healthy, middle-aged men and women. Participants completed the Cook-Medley hostility questionnaire, the Speilberger Anger Expression questionnaire, and had blood taken for the assessment of plasma homocysteine concentrations. Results indicated positive and significant associations between hostility and homocysteine levels for all participants, and positive and significant correlations between anger-in and homocysteine levels for men only. These data are among the first to test the relationship between homocysteine and psychological risk factors for cardiovascular diseases, and suggest one potential mechanism for the increased cardiovascular risk associated with hostility and anger expression.

Anger↗

PubMed1999

Anger, hostility, and visceral adipose tissue in healthy postmenopausal women.

Central obesity is an important risk factor for chronic disease. Its etiology remains unclear. We examined whether anger and hostility, ie, psychological attributes that influence cardiovascular morbidity and mortality, prospectively predict central visceral obesity across 13 years. Visceral adipose tissue (VAT) was determined by x-ray computed tomography (CT) at the L4-L5 disc space in a population-based sample of 157 postmenopausal Healthy Women Study participants. Standardized tests were completed to measure separately trait anger (anger frequency and intensity), style of anger expression (holding anger in and expressing it outwardly), and hostile (mistrustful) attitudes. The higher the VAT score, the higher the trait anger and anger-out scores measured 13 years earlier (Ps < .04) and the higher the concurrent hostile attitudes score (P < .02). Moreover, the higher the VAT score, the greater the increase in trait anger over the study period (P < .03). Trait anger and hostility predicted VAT independent of fasting insulin levels, although both predicted an increase in fasting insulin over time. Women were categorized into three groups according to the distribution of the average percent increase in trait anger and in weight across the study period, respectively. The mean VAT scores increased with the likelihood of being in the highest tertile of increasing trait anger (means: 129.1, 131.1, and 155.8, P < .048) and in the highest tertile of increasing weight (means: 122.4, 131.1, and 162.2, P < .003). The association between a high trait anger score and VAT remained significant, controlling for weight gain. We conclude that hostile attributes, fasting insulin, and weight gain in midlife may contribute to the development of VAT in healthy Caucasian women.

Adipose Tissue↗

PubMed1989

Psychological correlates of two measures of coronary-prone hostility.

The psychological correlates of the Cook and Medley Hostility (Ho) Scale and independent behavioral ratings of hostility were compared in a sample of adult, middle-aged male participants from the National Heart, Lung and Blood Institute Twin Study. Although the Ho Scale and behavioral ratings of hostility purport to measure the same construct, the underlying correlational pattern for each was quite different. Scores on the Ho Scale were associated positively with anxiety, neuroticism, and the tendency to "fake good"; behavioral hostility was related to measures of dominance, vigor, and self-confidence. Some correlates, such as the hard-driving and speed and impatience subscales from the Jenkins Activity Survey, represent a core set of correlates common to both. The meaning of hostility must be clarified before this construct's link to coronary heart disease can be defined.

Adult↗