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PubMed1985

What's so unhealthy about hostility? Construct validity and psychosocial correlates of the Cook and Medley Ho scale.

The Cook and Medley (1954) Hostility (Ho) scale, a measure of hostility derived from the Minnesota Multiphasic Personality Inventory (MMPI), was recently found in one cross-sectional study to be related to the severity of coronary artery disease and in two prospective studies to predict the development of coronary heart disease. Unfortunately, little information is available to clarify the meaning of the scale, and little is known about the psychosocial characteristics of individuals with high Ho scores. As a result, interpretation of the previous studies is difficult. Our two studies attempted to address these concerns. In Study 1, the Ho scale demonstrated convergent and discriminant validity. Data indicated that the scale primarily assesses suspiciousness, resentment, frequent anger, and cynical distrust of others rather than overtly aggressive behavior or general emotional distress. In Study 2, individuals with high scores displayed comparatively more anger, less hardiness, more frequent and severe hassles, and fewer and less satisfactory social supports. Thus, we propose that the Ho scale assesses cynical hostility and conclude that high scores are associated with a particularly unhealthy psychosocial risk profile. These findings refine our understanding of the Ho scale and assist in the interpretation of previous studies using this measure.

Anger↗

PubMed1988

Cynical hostility and vulnerability to disease: social support, life stress, and physiological response to conflict.

Previous research has indicated that high scores on the Cook and Medley Hostility (Ho) scale are associated with increased risk of coronary heart disease and other illness. Our study attempts to clarify this relationship by providing additional evidence concerning the construct assessed by the Ho scale, examining the level of physiological reactivity during interpersonal conflict in high- and low-Ho groups, and assessing the psychosocial profile associated with this characteristic. Extremely high and low Ho groups were selected from a pool of male undergraduates. Consistent with previous findings, high-Ho participants reported greater anger proneness and a more cynical, disparaging view of others than did low-Ho participants. The high-Ho group also tended to be more hostile and less friendly during role-played interactions involving high and low levels of interpersonal conflict, respectively. High-Ho persons also displayed greater diastolic blood pressure reactivity during interpersonal conflict. Finally, the high-Ho group reported less social support and more negative life events and daily irritants then did the low-Ho group. These results support the interpretation of the Ho scale as a measure of cynical hostility and are consistent with the hypothesis that it is related to disease by way of excessive physiological reactivity and a generally stressful, unsupportive social network.

Blood Pressure↗

PubMed2005

The contributions of ineffective discipline and parental hostile attributions of child misbehavior to the development of conduct problems at home and school.

Data were collected in a longitudinal study of 134 boys and 132 girls and their families during kindergarten and first grade. Four hours of parent-child interaction were coded to ascertain parent discipline practices. A structured interview assessed maternal attributions about child behavior. Maternal ratings of child conduct problems at kindergarten entry reliably predicted the mother's subsequent hostile attributions concerning child misbehavior and use of ineffective discipline tactics. Ineffective maternal discipline and the interaction of ineffective discipline and hostile attribution predicted growth in child conduct problems at home during kindergarten and first grade. Changes in teacher-reported and observed child conduct problems at school during kindergarten and first grade were predicted by growth in conduct problems at home and by the interaction of ineffective discipline and hostile attribution.

Child↗

PubMed2006

Sex differences in the relation of depressive symptoms, hostility, and anger expression to indices of glucose metabolism in nondiabetic adults.

This study examined the relation of depressive symptomatology, hostility, and anger expression to indices of glucose metabolism and tested whether gender moderates these associations in a sample of 135 healthy, nondiabetic adults (75 men, 60 women). The severity of depressive symptoms, hostility, and anger expression was positively associated with estimated insulin resistance (IR) and insulin in women but not in men. Anger expression was positively associated with glucose in women only. A summary score of depressive symptoms, hostility, and anger expression was positively associated with estimated IR, insulin, and glucose in women but not in men. Hence, in women, IR and elevated levels of fasting insulin and glucose may be one pathophysiological mechanism mediating the increased risk of cardiovascular disease and Type 2 diabetes associated with these psychological attributes.

Adolescent↗

PubMed2006

Hostility and withdrawal in marital conflict: effects on parental emotional unavailability and inconsistent discipline.

This study examined the nature of pathways between marital hostility and withdrawal, parental disagreements about child rearing issues, and subsequent changes in parental emotional unavailability and inconsistent discipline in a sample of 225 mothers, fathers, and 6-year-old children. Results of autoregressive, structural equation models indicated that marital withdrawal and hostility were associated with increases in parental emotional unavailability over the one-year period, whereas marital hostility and withdrawal did not predict changes in parental inconsistency in discipline. Additional findings supported the role of child rearing disagreements as an intervening or mediating mechanism in links between specific types of marital conflict and parenting practices. Implications for clinicians and therapists working with maritally distressed parents and families are discussed.

Adult↗

PubMed1992

Mothers with hostile, Type A predisposing child-rearing practices.

The authors examined characteristics of Finnish mothers (N = 924) who use hostile child-rearing practices (i.e., they ignore the child, are punitive and irritable, and perceive the child as a burden), practices that have been shown (Räikkönen & Keltikangas-Järvinen, 1992) to predispose children to Type A behavior. The results of this study indicate that two factors--Type A behavior in the mothers and the mothers' sociodemographic background (low occupational status, low educational level and young age)--increase the probability of the mothers' treating their children in a hostile manner. Also, the mothers of boys in this study reported more hostile child-rearing practices than the mothers of girls did.

Adult↗

PubMed2005

Depression, anxiety, hostility and hysterectomy.

Sixty-five women (aged 32 - 54 yrs) were assessed at 2 months before to 8 months after total abdominal hysterectomy on four separate occasions. Beck's Depression Inventory (BDI), Taylor's Manifest Anxiety Scale (TMAS), the Buss-Durkee Hostility Inventory (BDHI), Measurement of Masculinity-Femininity (MF), Likert scales and semantic differentials for psychological, somatic and sexual factors varied as assessment tools. High-dysphoric and low-dysphoric women were compared with regard to hysterectomy outcomes. Married nulliparae suffered from enhanced depression post-surgery. Pre-surgery anxiety, back pain and lack of dyspareunia contributed to post-surgery anxiety. Pre-surgery anxiety was related to life crises. Pre- and post-surgery hostility occurred in conjunction with poor sexual gratification. Post-hysterectomy health improved, but quality of sexual relationship was impaired. Partner support and knowledge counteracted hysterectomy aftermath. Post-hysterectomy symptoms constituted a continuum to pre-surgery signs of depression, anxiety or hostility.

Adult↗

PubMedDate not supplied

Psychometric testing of the adolescent version of the Cook-Medley hostility scale.

Hostility, a phenomenon that has been linked to cardiovascular disease and all-cause mortality, is often measured by the Cook-Medley hostility (Ho) scale. Although there is an adolescent version of the Ho scale, it has had little testing with only Anglo-American samples. This pilot study tested the reliability and validity of the adolescent version of the Ho scale with a multiethnic sample of adolescents. Sixty adolescents participated. Reliability was measured using Chronbach's alpha. The Ho scale was correlated with the Speilberger State-Trait Anger Expression Inventory (1988) scales to determine concurrent validity. A factor analysis assessed construct validity; content validity was assessed by analyzing tape-recorded descriptions of a circumstance that provoked anger, as remembered by each adolescent. Internal consistency reliability was .75. The hostility measure was most highly correlated with anger expression (r = .62, p = .000) and trait anger (r = .50, p = .000). The factor analysis generated three factors (suspicious alienation, cynical aggression and justified mistrust), that accounted for 34.5% of the variance. The content analysis resulted in five anger-provoking themes: aggression, unfulfilled personal expectations, mistrust/lying, criticism of effort, and rejection. The majority of items in the scale (74%) were related to one of the themes.

Adolescent↗

PubMed1988

A link between hostility and disease: poor health habits?

The Cook and Medley Hostility (Ho) Scale has been found to predict the occurrence of coronary heart disease, as well as total mortality, and to be related to the severity of coronary artery disease. It has been proposed that the relationship between Ho scores and health status is mediated by an unhealthy psychosocial risk profile. The present study investigated the health habits of 202 young adults; it used a shortened version of TestWell, a self-report inventory of health behaviors. Subjects were classified as high or low scorers on the Ho scale and their overall TestWell scores and those of four subscales were compared. High scorers reported poorer health habits overall (p = .003) and on three of the four subscales (Physical Fitness, p = .04; Self-Care, p = .04; Drugs and Driving, p = .0001). These results suggest that the poor health habits of individuals with high hostility scores may be an additional explanation of the link between hostility and subsequent disease to the psychosocial risk profile explanation recently proposed.

Alcoholism↗

PubMed1992

Anger expression, hostility, anxiety, and patterns of cardiac reactivity to stress.

The majority of studies investigating the relationships between psychological characteristics and cardiovascular reactivity to stress use a research strategy in which discrete traits are evaluated in isolation. The present study examined the effects of additive and/or interactive relationships among traits on cardiac reactivity to a mental arithmetic task. In addition, impedance cardiographic techniques were employed to examine potential relationships between such psychological traits and a specific measure--pre-ejection period (PEP)--of sympathic influence on the heart. Forty-nine undergraduate men performed a mental arithmetic task while continuous measures of PEP and interbeat interval (IBI) were collected. The subjects then completed questionnaires measuring anger expression, hostility, and trait anxiety. Analyses of variance (ANOVAs) showed a significant main effect for anger-out on PEP change from baseline, but not for IBI. Results also showed that anger-in interacted with anger-out and hostility to affect both PEP and IBI changes significantly. Other results indicated that subjects in the high anger-in/low anger-out and high anger-in/low hostility groups did not show significant PEP change, although they nevertheless showed significant IBI change. These results highlight the importance of the consideration of interactions among traits in predicting cardiac reactivity and of the importance of measuring specific indexes of sympathetic arousal.

Adolescent↗

PubMed2007

Cluster C personality disorders in major depressive episodes: the relationship between hostility and suicidal behavior.

There is some evidence for an association between Cluster C Personality Disorders (CCPD) and suicidal behavior. We compared depressed inpatients with and without CCPD in terms of suicidal behavior and associated psychopathology. Cluster A or B personality disorder co-morbidity were exclusion criteria for both groups (cases and controls). Depressed inpatients with "pure" CCPD had higher levels of suicidal ideation but not more previous suicide attempts compared with patients without CCPD. Greater suicidal ideation in depressed patients with CCPD in our study was associated with more hostility. Future studies examining the relationship between suicidal ideation and hostility in CCPD may clarify whether treatment focused on hostility might be of use for decreasing suicidal ideation in depressed patients with CCPD (Spitzer, Williams, Gibbon et al., 1990).

Adult↗

PubMed2003

Childhood experiences of trauma and loss have different relations to maternal Unresolved and Hostile-Helpless states of mind on the AAI.

This study of 45 high-risk mothers and infants examined the current indirect effects model of intergenerational transmission of disorganized attachment, which posits that maternal childhood experiences of loss or trauma contribute to maternal states of mind on the AAI which in turn contribute to infant disorganization. The severity of experiences of both abuse and loss were examined in relation to both Unresolved states of mind and Hostile-Helpless states of mind on the AAI and to infant disorganization at both 12 and 18 months. Neither the experience of parental death in childhood nor the severity of abuse in childhood was related to Unresolved states of mind on the AAI. Instead, an Unresolved state of mind and the experience of parental death contributed independently and additively to the prediction of infant disorganization at 12 months. At 18 months, an indirect effects model was supported in relation to Hostile-Helpless but not Unresolved states of mind, in that severity of trauma had no direct relation to infant disorganization but severity of trauma was related to Hostile-Helpless states of mind which in turn predicted infant disorganization. Unresolved states of mind and experiences of parental loss did not add to prediction of disorganization at 18 months. The findings suggest that the influence of maternal trauma on infant attachment may become more prominent at 18 months as the infant makes the transition to toddlerhood. The results also suggest that a more complex etiologic model may be needed of the aspects of early experience that contribute to adult Unresolved states of mind on the AAI.

Child Behavior Disorders↗

PubMed1997

Adolescents with inflammatory bowel disease: the roles of negative affectivity and hostility in subjective versus objective health.

Examination of how psychological factors relate to illness severity among adolescents with inflammatory bowel disease (IBD) is rare. Further, studies have not accounted for the pervasive influence of negative affectivity (NA) or distinguished among subjective, behavioral, and objective measures of IBD severity. We examined how NA, positive affectivity, expressed hostility, and negative life events were related to subjective (pain, fatigue, disability), behavioral (health care contacts), and objective (erythrocyte sedimentation rate) illness severity among 56 adolescents with IBD. NA was positively related to subjective illness, and expressed hostility was inversely related to objective illness. Other relationships were eliminated after controlling for NA. Data suggest that NA and subjective illness are comanifestations of a single disposition, but that expressed hostility has an independent relationship with disease activity among adolescents with IBD.

Adaptation, Psychological↗

PubMed1991

Self-ratings of anger and hostility in borderline personality disorder.

Forty-six patients with borderline personality disorder with and without major depression and 27 normal volunteers completed the Buss-Durkee Hostility Inventory, a self-rating scale of anger and hostility. The patients with borderline personality had significantly higher scores than the normal volunteers. The scores of the patients with borderline personality disorders were not related to gender, treatment or research setting, the degree of acute distress, or the presence of major depression. These findings suggest that a proneness to anger and hostility are enduring characteristics of borderline personality disorder and that anger and depression may represent independent clinical conditions with independent biological mechanisms regulating these two affective states.

Adult↗

PubMed1996

Defense styles, hostility, and psychological risk factors in male patients with personality disorders.

The purpose of this study was to compare ratings of defense styles and hostility in male patients with personality disorders, to determine whether either of these is related to a borderline diagnosis, or to specific psychological risk factors. Subjects with personality disorders were divided into borderline personality disorder (BPD) (N = 61) and non-BPD (N = 60) groups were given both the Defense Style Questionnaire (DSQ) and the Buss-Durkee Guilt-Hostility Inventory (BDHI). Risk factors were measured by a developmental interview and the the Parental Bonding Index. The BPD group reported more maladaptive and image distorting defenses on the DSQ, as well as higher ratings on the BDHI. Ratings on both dependent measures were strongly related to diagnosis, and more weakly to measures of psychological risk factors. Thus, in men with personality disorders, immature defense styles and high levels of hostility are strongly associated with a borderline diagnosis.

Adolescent↗

PubMedDate not supplied

Hostility and differences between clinic, self-determined, and ambulatory blood pressure.

This study examined the role of personality factors in differences between three methods of assessing blood pressure (clinic, self, ambulatory) in 45 patients with mild hypertension. The data were obtained after the patients were withdrawn from antihypertensive medications and had achieved stable clinic diastolic blood pressure levels of 95 to 110 mm Hg, averaged over three visits in 2 to 4 weeks. Significant differences were obtained in systolic blood pressure (SBP) and diastolic blood pressure (DBP) as a function of method of assessment. These differences in both systolic blood pressure (SBP) and diastolic blood pressure (DBP) were associated with individual differences in the total score and several subscales of the Buss-Durkee Hostility Inventory (Assault, Resentment, Guilt), but not in anxiety, depression, or other characteristics. High hostile subjects had consistently high blood pressure values in both clinic, self, and ambulatory recordings. Low hostile subjects were significantly lower in self-recorded blood pressure readings taken at home and in ambulatory recordings, compared with clinic values. Implications of these findings for "white coat hypertension" are discussed.

Adult↗

PubMedDate not supplied

Caffeine and cholesterol: interactions with hostility.

The consumption of caffeinated beverages has been linked to elevated serum cholesterol and an increased risk of coronary disease, although the relationships are inconsistent across studies and remain controversial. The effect of caffeine on cholesterol and coronary disease risk may be modulated by other factors. Using cohort data from a subsample of the University of North Carolina Alumni Heart Study, we investigated whether the relationships between caffeinated beverage consumption and serum lipid and lipoprotein levels in middle-aged men and women were modulated by levels of trait hostility. After adjustment for other risk factors, higher caffeinated beverage intake was associated with higher low-density lipoprotein cholesterol levels and a higher ratio of total to high-density lipoprotein cholesterol, both indicative of greater coronary disease risk. The interactive effects of hostility and caffeine intake were ambiguous, although there were trends for caffeine intake to have stronger effects on low-density lipoprotein and on total cholesterol in people with less hostility. Additional studies of personality characteristics and other factors that can modulate the cholesterol-raising effects of coffee drinking may be warranted because they might clarify the health consequences associated with coffee drinking and lead to the identification of individuals who would benefit most from changes in their coffee drinking.

Adult↗

PubMedDate not supplied

Neuroendocrine, cardiovascular, and emotional responses of hostile men: the role of interpersonal challenge.

OBJECTIVE: We examined the effects of hostility and harassment on neuroendocrine, cardiovascular, and emotional responses in 52 healthy white men. METHODS: Subjects were preselected on the basis of scores in the top and bottom quartiles (above 23 and below 15, respectively) on the Cook and Medley Hostility (Ho) scale. Subjects participated in a solvable anagram task. Thirty subjects were harassed by the technician during the task. RESULTS: Harassed subjects with high Ho scores exhibited enhanced and prolonged blood pressures, heart rate, forearm blood flow, forearm vascular resistance, norepinephrine, testosterone, and cortisol responses relative to low-Ho subjects in the harassed condition and high and low-Ho subjects in the nonharassed condition. Heightened physiological reactivity in high-Ho subjects was correlated with arousal of negative affects. CONCLUSIONS: The findings are consistent with the general hypothesis that high hostile men show excessive behaviorally-induced cardiovascular and neuroendocrine responsivity to interpersonal challenging situations. Moreover, in high-Ho men, the stress-induced cardiovascular and neuroendocrine hyperreactivity is associated with the arousal of negative affects such as anger.

Adolescent↗