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PubMed1998

Measures of hostility as predictors of facial affect during social interaction: evidence for construct validity.

We assessed the construct validity of several self-report measures and an interview-based measure of hostility (Interpersonal Hostility Assessment Technique [IHAT]) by evaluating their associations with a behavioral indicator of hostile emotions (facial expressions during social interaction). Participants in the study were 123 volunteers (44% males and 56% females) who were recruited from local community organizations. Self-report measures (Cook-Medley Hostility Scale, Rotter Interpersonal Trust Scale, Buss-Durkee Hostility Inventory, and Spielberger Anger Expression Scale) were represented by factor scores reflecting Overt Hostility, Covert Hostility, and Hostile Beliefs. A canonical correlation analysis identified significant associations between a set of facial affect scores reflecting animosity and various measures of hostility. Specifically, increases in anger and disgust expressions and decreases in happy facial expressions were associated with high IHAT scores and high scores on self-report measures of Hostile Beliefs and Covert Hostility. Women were more expressive than men, especially concerning positive affect, and women had lower scores on self-report measures of Hostile Beliefs and Overt Hostility. IHAT scores were uncorrelated with any of the self-report factors which suggests the two assessment techniques are tapping different aspects of the hostility construct.

Adult↗
PubMedDate not supplied

Hostile attitudes predict elevated vascular resistance during interpersonal stress in men and women.

OBJECTIVE: Existing research indicates that hostility is associated with enhanced blood pressure responses during social stress, but little is known about the hemodynamic patterns underlying these blood pressure increases, particularly in women. The present study examined hemodynamic responses to a low-anger interpersonal stressor, testing the hypotheses that hostile individuals show enhanced vascular responses and that low hostile individuals show enhanced myocardial responses. METHODS: Eighty undergraduate men and women were categorized as high or low in hostility on the basis of median splits of Cook-Medley Hostility Scale scores. Participants discussed a controversial topic with a confederate who disagreed with them, and hemodynamic responses were assessed with impedance cardiography. RESULTS: High hostile individuals exhibited greater increases in diastolic blood pressure and total peripheral resistance and smaller increases in cardiac output during an interpersonal stressor than did low hostile individuals. Systolic blood pressure and heart rate increases were greater among high hostile relative to low hostile females and comparable among low and high hostile males. Affective responses and task perceptions were generally similar for high and low hostile participants, but the relationship between task perception and hemodynamic responses varied on the basis of hostility level. CONCLUSIONS: These findings suggest that hostility in both men and women is associated with heightened vascular and dampened cardiac responsivity to interpersonal stress that is not deliberately anger provoking. Moreover, they indicate that the associations between task perception and hemodynamic responses vary between high and low hostile individuals.

Adult↗
PubMedDate not supplied

Patterns of change in hostility from college to midlife in the UNC Alumni Heart Study predict high-risk status.

OBJECTIVE: To examine hostility measured in college and patterns of change in hostility from college to midlife as predictors of high health-related risk later in midlife. METHODS: Logistic regression models were used to test hostility/risk associations. RESULTS: College hostility predicted being a current smoker, consuming more than two drinks of alcohol, low social support, achieving less than expected in career and in relationships, risk for depression, and appraisal of life changing for the worse in terms of family events at midlife. Change in hostility did not predict smoking and drinking; however, it did significantly predict social isolation, lower income (only for women), obesity, avoidance of exercise, high-fat diet, and negative changes in economic life, work life, and physical health events-all risk indicators measured during the next decade. Appraisals of social support, lowered expectations, risk for depression, and reports of family life changing for the worse were predicted at both time periods. When change in hostility was modeled with college hostility, all risk indicators were significantly predicted by college hostility. CONCLUSIONS: High hostility in college and change in hostility from college to midlife predicts a full range of health risk indicators. When compared with the average population decline in hostility, gains in hostility at midlife are related to increased risk while declines in hostility are related to reduced risk. Higher midlife hostility is associated with increased odds of being in the higher risk group. Future research should focus on developing interventions to reduce hostility.

Achievement↗
PubMed2003

Functional cerebral asymmetry in hostility: a dual task approach with fluency and cardiovascular regulation.

The influence of hostility levels on verbal and nonverbal fluency, and the concurrent cerebral regulation of autonomic nervous system functioning was examined in 48 right-handed males, half classified as low-hostile, and half as high-hostile. Recent research has supported inhibitory roles for the anterior right cerebrum in sympathetic regulation, and the anterior left cerebrum in parasympathetic regulation. Two neuropsychological tests purportedly mediated by left and right anterior cerebral systems, respectively, are the Controlled Oral Word Association Test and the Ruff Figural Fluency Test. Fluency and perseverative errors were assessed using these measures. Systolic and diastolic blood pressure, and heart rate were assessed with a digital blood pressure meter. It was predicted that high-hostile men would evidence interference on cardiovascular regulation concurrent with the nonverbal fluency task in comparison to low-hostile males. Further, interference was expected to manifest in the cognitive variable with more perseverative errors on the nonverbal fluency task in high-hostile males than in low-hostile males. The results support a capacity-limited prediction. High-hostile males evidenced significantly heightened systolic blood pressure during the nonverbal fluency task in comparison with low-hostile males. Further, high-hostile males displayed more perseverative errors in nonverbal fluency than did the low-hostile males. These results support the expectation that differences exist between high- and low-hostile males for right frontal functioning. These findings were discussed within the proposed anterior-posterior inhibition model of hostility.

Autonomic Nervous System↗
PubMedDate not supplied

Anger management style and hostility among patients with chronic pain: effects on symptom-specific physiological reactivity during anger- and sadness-recall interviews.

OBJECTIVES: We examined whether anger-in, anger-out, and hostility predicted symptom-specific muscle tension reactivity during anger induction (but not sadness induction) among patients with chronic low back pain (CLBP). For patients with CLBP, relevant muscles are the lower paraspinals (LPs). Anger-in x hostility and anger-out x hostility interactions were tested to determine whether particularly reactive groups of patients could be identified with a multivariable profile approach. METHODS: Ninety-four patients with CLBP underwent anger recall (ARI) and sadness recall (SRI) interviews, whereas LP and trapezius electromyography and systolic blood pressure, diastolic blood pressure, and heart rate were recorded. They completed anger-in, anger-out, hostility, and trait anger measures. RESULTS: Hierarchical regressions were used to test anger-in x hostility and anger-out x hostility interactions for physiological changes during the ARI and SRI. A significant anger-in x hostility interaction was found for LP change during the ARI (but not SRI) such that high anger-in/high hostility patients evinced the greatest reactivity. Effects for trapezius reactivity were nonsignificant. Significant anger-in x hostility interactions were also found for systolic blood pressure and diastolic blood pressure changes during the ARI such that high anger-in/low hostility patients showed the smallest changes. The anger-out x hostility interaction for diastolic blood pressure change during ARI was also significant such that high anger-out/low hostility patients showed the smallest changes. All effects remained significant with trait anger controlled. CONCLUSIONS: A multivariable profile approach may help identify especially vulnerable patient groups. Patients with CLBP who tend to suppress anger and are cynically hostile may be more likely to experience high levels of muscle tension near the site of pain and injury during anger, but not during sadness, than other groups.

Adaptation, Psychological↗
PubMedDate not supplied

Impact of aging on hostility in coronary patients and effects of cardiac rehabilitation and exercise training in elderly persons.

Hostility is a coronary artery disease (CAD) risk factor affecting recovery after major CAD events. Yet, few data exist on the impact of aging on hostility in CAD patients or the effects of cardiac rehabilitation on elderly patients with high hostility. The authors studied 500 consecutive patients following CAD events to determine the impact of aging on hostility scores, the prevalence of hostility symptoms, and the response of elderly persons with hostility symptoms to cardiac rehabilitation programs. Overall hostility scores (p<0.01) and prevalence of hostility symptoms (8% in 268 elderly vs. 28% in 81 younger patients [aged <50 years]) were inversely related to age (p<0.01). Elderly persons with hostility symptoms had greater weight (p=0.02), four times higher anxiety and depression scores (p<0.0001), two times higher scores for somatization (p<0.0001), and 17% lower scores for quality of life (p<0.001) compared with elderly persons without hostility symptoms. Marked reduction in hostility and improvements in other risk factors occurred following rehabilitation. These results demonstrate the inverse relationship between age and hostility symptoms in patients with CAD. Although hostility symptoms are relatively uncommon in elderly persons with CAD, these patients have more adverse CAD risk profiles and still have marked improvements following cardiac rehabilitation and exercise training programs.

Aged↗
PubMed2000

Assessment of hostility in patients with coronary heart disease.

One of the problems in efforts to more clearly conceptualize hostility is the amount of method variance, which ranges from self-report techniques to interview-based methods and mirrors the multidimensional nature of hostility and related constructs. In addition, rather few studies concerned with the assessment of hostility have specifically used samples of coronary heart disease (CHD) patients. The purpose of this study was, therefore, to examine the multidimensionality of the construct of hostility in a sample of male coronary patients with some frequently used instruments. Factor analysis was used to detect the relevant underlying constructs, which were assessed using a variety of hostility measures in a sample of cardiac patients undergoing baseline assessment in an ongoing health-education intervention study. Measurement included both questionnaires and interviews. Participants (N = 235) were divided into 3 diagnostic groups: patients who had recently undergone (a) a myocardial infarction, (b) coronary artery bypass grafting, or (c) percutaneous transluminal coronary angioplasty. A 4-factor solution appeared to provide the best fit, and the following factors were isolated: Anger-Out, Negative Affect, Coping, and Anger-In. All intercorrelations were less than .50. Medical diagnosis did not differ with regard to the 4 factors found. The total hostility construct as measured by the structured interview (SI) did not fit into the 4-factor model. This study was the first to show that dimensions of anger and hostility constitute valid and relevant aspects of the general construct of hostility for a representative group of CHD patients. The 4 aspects of hostility isolated using some well-known hostility questionnaires and the SI explained most of the observed variance. Although the SI appeared to tap more general state anger, the 4 aspects of hostility may be differentially related to health in those who are coronary prone. Future studies on the role of hostile or negative emotions in CHD patients should, therefore, pay greater attention to the multidimensional nature of hostility and may clearly benefit from the use of the 4-factor model described in this article.

Adult↗
PubMed1999

Effects of cardiac rehabilitation and exercise training programs on coronary patients with high levels of hostility.

OBJECTIVE: To determine the effects of cardiac rehabilitation interventions on patients with hostility, or unexpressed anger, a coronary heart disease risk factor that adversely affects morbidity and mortality after major coronary heart disease events. METHODS: Using validated questionnaires to evaluate behavioral characteristics and quality of life, we studied 500 consecutive patients before and after cardiac rehabilitation and compared a group of 65 patients with high levels of hostility with 435 patients with low levels of hostility. RESULTS: After rehabilitation, statistically significant improvements occurred in the total cohort in scores for anxiety, depression, and somatization, as well as total quality of life, but not in hostility score (-20%; P = .07). Patients with high levels of hostility had significant improvements in hostility scores as well as other behavioral characteristics (anxiety, depression, and somatization) and all quality-of-life components. These patients also improved exercise capacity, percent body fat, body mass index, and total cholesterol and high-density lipoprotein cholesterol levels. Compared with patients with low levels of hostility, those with high levels of hostility had greater relative improvements in hostility scores, as well as anxiety, general health, energy, mental health, and total quality-of-life scores, and had similar improvements in exercise capacity, obesity indexes, lipid levels, and other behavioral characteristics and quality-of-life measurements. After cardiac rehabilitation, the prevalence of high levels of hostility decreased by 40%, from 13% to 8% (P < .01). CONCLUSIONS: These data suggest that cardiac rehabilitation reduces hostility and significantly improves quality of life and other behavioral characteristics in patients with high levels of hostility. We believe that greater attention should be directed at behavioral characteristics, including hostility, to enhance the primary and particularly the secondary prevention of coronary heart disease.

Aged↗