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PubMed1991

The interactive effects of Type A behavior and hostility on bleeding time thromboxane and prostacyclin formation.

Sixty-six male university students were classified as Type A or B on the basis of the Structured Interview of Rosenman and as hostile or non-hostile on the basis of the Cook-Medley scale. Vascular production of prostacyclin and platelet thromboxane in response to a standard vessel injury was evaluated. Basal thromboxane production, measured as the primary metabolite, thromboxane B2, in blood oozing from the bleeding-time site, was highest among hostile Type A subjects with significantly lower thromboxane production in hostile Type Bs and all non-hostile groups combined. Following an exercise treadmill test hostile subjects produced more thromboxane than non-hostile ones, and hostile Type As had significantly shorter bleeding times than hostile Type Bs. No significant differences on any measure were observed following a stressful color naming task. The observed interaction of hostility and Type A behavior on bleeding time thromboxane formation links behavior to an adverse aspect of a thrombosis-related parameter thought to be involved in the genesis of cardiovascular disease.

6-Ketoprostaglandin F1 alpha↗

PubMed1996

Dimensions of hostility and cardiovascular response to interpersonal stress.

Emerging research suggests that hostility is a multidimensional construct with different dimensions conferring different cardiovascular disease risk. This study examined two dimensions of hostility, expressive and neurotic, and their hemodynamic response patterns upon exposure to interpersonal stress. Fifty-seven male undergraduates were categorized into high and low expressive hostility (HiEH, LoEH) and high and low neurotic hostility (HiNH, LoNH) groups based on their Buss-Durkee Hostility Inventory scores. Subjects engaged in a mathematical subtraction task, with half of the subjects harassed through anger-provoking statements. Separate analyses were conducted for the expressive and neurotic hostility groupings. For expressive hostility, results indicated that HiEH/harassed subjects exhibited greater systolic blood pressure, heart rate, and cardiac output responses than did HiEH/nonharassed subjects or LoEH subjects irrespective of harassment. Neurotic hostility analyses revealed elevated forearm blood flow in HiNH/harassed subjects as compared to HiNH/nonharassed subjects or LoNH subjects in either harassment condition. The hemodynamic response pattern of expressive hostiles is consistent with their risk for heart disease. The response pattern of neurotic hostiles may indicate risk for hypertension, though this remains to be established.

Adult↗

PubMed1995

Cynical hostility influences anger, but not cardiovascular reactivity during competition with harassment.

Cynical hostility has been linked to coronary heart disease (CHD), and there is mixed support for the hypothesis that cynical hostility may contribute to CHD through exaggerated cardiovascular responses to anger-provoking stressors. The present study tested the influences of cynical hostility on affective and cardiovascular responses to provocation in 68 undergraduate men. Subjects were divided into high and low cynical hostility groups by a median split on Cook-Medley Hostility Scale scores, and half of the subjects in each group were harassed during competition on a video game. High hostile subjects reported greater anger than low hostile subjects during the competition, independently of harassment, and harassment produced stronger feelings of mistreatment, independently of hostility. Harassed subjects experienced larger systolic blood pressure responses only during an affect rating period after the competition, but the responses were not influenced by hostility. These findings provide further evidence that cynical hostility, anger, and cardiovascular reactivity are not simply nor consistently related.

Adult↗

PubMed2003

Hostility, unemployment and health status: testing three theoretical models.

This study examined three theoretical models of hostility, health and life context. According to the psychosocial vulnerability hypothesis, there is an interaction between hostility and adverse conditions. The increased health risk in hostile individuals is assumed to stem from their lower ability to benefit from existing psychosocial resources. The second hypothesis, called here the social context model, considers adverse conditions as an antecedent of both hostility and health problems. The third model states that hostility is a predictor of being selected to adverse conditions involving risk to health (the selection hypothesis). The results from a survey of a population-based random sample (2153 non-institutionalized citizens aged 18-64 years) in Finland, showed that hostile men had a high prevalence of non-optimal health, irrespective of employment status. In non-hostile men, employment was associated with better health than unemployment. This association between hostility and unemployment was not found in women. Corresponding findings were obtained from a 1959-born cohort of 311 individuals followed up for 27 years. The combination of high hostility at school age and unemployment in adulthood had an additive effect on poor health in adult men but not in adult women. Hostility in childhood was not significantly associated with unemployment in adulthood. Thus, this study supported the psychosocial vulnerability model in men.

Adolescent↗

PubMed2002

Asymmetry in hand grip strength and fatigue in low- and high-hostile men.

The present study examined the relationship between hostility level and cerebral hemispheric motor functioning of 70 left-cerebral dominant men. Using the Cook-Medley Hostility Scale, the subject group was divided into thirds: One-third (N = 23) were classified as low-hostile, one-third (N = 23) were classified as high-hostile, and the remainder (N = 24) were excluded from analysis. A hand dynamometer was used to assess hand grip strength, perseveration, and fatigue, as measures of hemispheric motor functioning. Results yielded a hand-by-hostility group interaction, which indicated that high-hostile men evidenced significantly less hand grip strength at the right hand and significantly greater hand grip strength at the left hand relative to low-hostile men. These results suggest that high-hostile men may experience relatively greater right-cerebral arousal relative to their low-hostile counterparts. In other results, both groups showed greater perseveration at the left hand than at the right hand. Both groups also showed significant fatigue across trials at both hands. Analysis also revealed a hand-by-trial interaction, indicating that the right hand fatigued more quickly than the left hand across trials. Resistance to fatigue at the left hand and overestimation or relative imprecision in motor movement at the left hand are discussed in terms of arousal theory. These results and others are cited as contributing inroads into distinguishing between the emotional problems of depression, anxiety, and hostility.

Adult↗

PubMed1992

Hostility: relationship to lifestyle behaviors and physical risk factors.

The relationship between hostility and coronary artery disease may be partially mediated by unhealthy lifestyle behaviors. This study examined the relationship between hostility, lifestyle behaviors, and physical risk factors in 138 adult men and women. Subjects completed the Cook and Medley Hostility Scale (Ho scale) and self-reports of their dietary habits, consumption of alcohol and cigarettes, and physical activity. Recent findings indicated that a composite hostility score from three rationally derived subscales of the Ho scale tapping the dimensions of cynicism, hostile affect, and aggressiveness was a better predictor of mortality than the total Ho score. Thus, this composite measure of hostility and the total Ho score were used in data analyses. Measures of resting blood pressure, height, weight, and adiposity were also obtained. In men and women, both measures of hostility were positively associated with cholesterol intake and vigorous physical activity. Among women, both hostility measures were positively related to animal fat intake and negatively related to fiber intake. The composite measure was positively related to their resting systolic pressures. Among men, both hostility measures were positively related to cigarette smoking and sugar intake and negatively associated with systolic blood pressure and calcium intake. Findings are discussed in terms of previous research linking hostility to lifestyle behaviors and CAD.

Adult↗

PubMedDate not supplied

Components of hostility and the severity of coronary artery disease.

Previous research has linked various measures of hostility to the prevalence and incidence of coronary heart disease (CHD). The present study sought to determine whether some dimensions of hostility are differentially related to angiographically documented severity of coronary artery disease (CAD). Specifically, a hostility measure that correlates with indices of neuroticism was compared with a hostility measure unrelated to neurotic tendencies. For patients 60 years and younger, results were significant, revealing that neurotic hostility was inversely associated with severity of CAD whereas nonneurotic hostility scores were positively related to extent of disease. Overall hostility scores derived from the combination of the two kinds of hostility measures were unrelated to CAD severity. Results suggest that the multidimensional nature of the hostility construct should be appreciated in attempts to associate measures of hostility with manifestations of CHD.

Adult↗

PubMedDate not supplied

Dimensions of hostility in men, women, and boys: relationships to personality and cardiovascular responses to stress.

Ratings of Potential for Hostility and Hostile Style based on responses during the Type A Structured Interview (SI) are related to incidence of coronary heart disease morbidity and mortality. As there are very limited data on what precisely the SI ratings of hostility mean, the present study evaluated, in a sample of middle-aged men and women, and adolescent boys, a) the distributions of SI ratings of hostility according to gender and age group; b) their relationships to other hostility and personality scores; and c) their relationships to heightened cardiovascular responses to psychological stressors, which are thought to be a major mechanism linking behavior and coronary heart disease. Results showed that men are higher than women and boys in Potential for Hostility and Hostile Style ratings, which are, by and large, unrelated to standardized questionnaire measures of hostility and anger expression. Men (but not women or boys) who exhibited elevated systolic blood pressure during standardized laboratory stressors tended to be rated as high on Hostile Style. We conclude that SI Hostile Style ratings are measuring a unique aspect of personality, one with apparent importance for coronary heart disease and perhaps for men's cardiovascular responses during stress.

Adolescent↗

PubMedDate not supplied

Familial resemblance for hostility: the National Heart, Lung, and Blood Institute Family Heart Study.

OBJECTIVE: The purpose of this study was to examine whether several aspects of hostility as measured by the Cook-Medley Hostility Scale (ie, aggressive responding, hostile affect, cynicism, and overall hostility score) were determined in part by family factors (ie, genes and/or familial environments). METHODS: Analyses were based on 680 European-American families (2525 individuals) from the NHLBI Family Heart Study (FHS), a population-based study of genetic and nongenetic determinants of CHD, atherosclerosis, and cardiovascular risk factors. The influence of family relationships, age, and education on the variation in each of the four hostility scores were estimated. RESULTS: Significant familial resemblance in all hostility scores was found, accounting for 42% of the variance in total hostility, 30% in cynicism, 38% in aggressive responding, and 18% in hostile affect. Very little of this resemblance could be explained by similarities in education. Familial resemblance for cynicism was solely due to significant parent-offspring and sibling correlations (ie, no spouse resemblance), suggesting the possibility of genetic influences. Gender and generation differences were also evident in the familial correlations. CONCLUSIONS: Hostility aggregates in families. Both family environmental and genetic sources of resemblance are suggested for hostility.

Adult↗

PubMed2005

Association between hostility and plasma total homocysteine concentrations in a general population sample.

OBJECTIVE: The present study focuses on testing the association of hostility with plasma homocysteine levels in a general population sample. METHOD: Four hundred and ten healthy adults (200 men and 210 women), participating in a health survey in Greece, had blood samples taken for homocysteine concentrations and also completed a multidimensional hostility questionnaire, assessing direction of hostility ('extra- and intropunitive') as well as total hostility and its ingredients, i.e. urge to act out hostility, criticism of others, delusional hostility, self-criticism and delusional guilt. Multivariate relationship was tested between hostility components and homocysteine, after statistically controlling for potential confounders such as age, gender, educational status, smoking and body mass index. RESULTS: Total hostility, delusional guilt as well as extrapunitive direction of hostility were positively related to homocysteine levels. Self-criticism was negatively related to homocysteine. CONCLUSION: The study provides further evidence that particular dimensions of hostility are associated with increased plasma homocysteine levels, thus deserving a place within the spectrum of the coronary heart disease risk factors.

Adult↗

PubMed2006

Dimensions of hostility in Japanese undergraduate students.

Japanese undergraduate students (N = 512) completed the Japanese versions of 4 hostility questionnaires: Aggression Questionnaire (Ando et al., 1999); State-Trait Anger Expression Inventory (Suzuki & Haruki, 1994); Müller Anger Coping Questionnaire (Otake et al., 2000); and Cynicism Questionnaire (Izawa & Nomura, 2004). Dimensions of hostility, determined by factor analysis for the 12 subscales of the 4 questionnaires, revealed a 4-factor solution: Expressive Hostility, Inhibitive Hostility, Assertiveness, and Hostile Cognition. Prior studies with Western participants had suggested a 2-factor solution of Expression and Experience dimensions of hostility. However, our results forcing a 2-factor solution showed a different pattern: The first factor included Expressive Hostility and Hostile Cognition, and the second factor included Inhibitive Hostility. These results indicate that the dimensions of hostility in Japanese students differed from those in American and European participants. This may be related to characteristics of Japanese society that emphasize cooperative behavior and not expressing angry emotions.

Adult↗

PubMed2003

Hostility disturbs learning.

Many studies have shown that there is a strong correlation between hostility and coronary artery disease; however, the pathogenic mechanisms by which hostility causes coronary artery disease have not been identified. Several studies have shown that hostility is associated with increased cardiovascular reactivity to mental stress. Sloan and colleagues used mental arithmetic and the Stroop Color-Word Task as psychological stressors and suggested that hostility is associated with diminished cardiac vagal control. It is supposed that the diminished cardiac vagal control results in uncontrollability of increased heart rate under stressful conditions so performance on mental stress tasks is poor. However, performance was not analyzed on the Stroop Color-Word Task. If hostility influences the autonomic nervous system, the performance of this mental stress task may also differ according to extent of hostility. In the present study, whether hostility disturbed performance of a mental stress task and the practice on it was examined. Subjects completed the Cook-Medley Hostility Scale and were divided into three groups (High, Middle, and Low) by their total scores and three subscales (Cynicism, Hostile Affect, and Aggressive Responding). They also completed the Stroop Color-Word Task. Analysis showed practice by High and Middle scoring groups on Aggressive Responding had a significantly smaller effect than that by Low scoring groups. The pathogenic mechanisms by which hostility may underlie coronary artery disease were discussed.

Adult↗

PubMed2005

Prevalence of hostility in young coronary artery disease patients and effects of cardiac rehabilitation and exercise training.

OBJECTIVE: To determine the prevalence of hostility symptoms in young patients with coronary artery disease (CAD), the associated risk factor profile in these patients, and the effects of a formal phase 2 cardiac rehabilitation and exercise training program. PATIENTS AND METHODS: Our study included consecutive CAD patients referred for cardiac rehabilitation from May 1999 through December 2000. At baseline and after rehabilitation, behavioral factors and quality of life were assessed by validated questionnaires, and standard CAD risk factors were measured, including exercise capacity. We specifically evaluated detailed data for young patients. RESULTS: A total of 500 patients were included in the study. Hostility scores were 2.5 times higher (P<.001) in the 81 young patients (< 50 years; mean +/- SD age, 45 +/- 5 years) than in the 268 elderly patients (> or = 65 years; mean +/- SD age, 70 +/- 4 years), and the prevalence of hostility symptoms was 3.5 times higher in young patients (28% vs 8%; P<.001). Young patients with hostility symptoms also had more adverse CAD risk profiles, including higher total cholesterol levels, triglyceride levels, total cholesterol/high-density lipoprotein cholesterol ratios, fasting glucose levels, and glycosylated hemoglobin levels and lower quality-of-life scores compared with young patients with low hostility scores. After cardiac rehabilitation, young patients with hostility symptoms had marked improvements in CAD risk factors, behavioral characteristics (including hostility), and quality of life, and a nearly 50% (P=.005) reduction in the prevalence of hostility symptoms occurred. CONCLUSIONS: Young CAD patients have a high prevalence of hostility symptoms and adverse CAD risk profiles. Reducing hostility symptoms and other parameters of psychological distress in young CAD patients should be emphasized, and the potential benefits of cardiac rehabilitation programs in the secondary prevention of CAD should be highlighted.

Aged↗

PubMed2004

Increased plasma homocysteine concentrations in healthy people with hostile behavior: the ATTICA study.

BACKGROUND: One of the psychological factors showing significant association with the development of coronary heart disease is hostility. However, the pathway by which hostility may affect coronary risk is not fully understood. Thus we evaluated the association between hostility and inflammation (thrombotic marker) in a population-based sample of males and females with no clinical evidence of cardiovascular disease. MATERIAL/METHODS: The ATTICA study is a health and nutrition survey carried out in the province of Attica, Greece, during 2001-2002. 410 participants (200 men 39+/-12 years old, and 210 women 35+/-10 years old) completed the Hostility and Direction of Hostility questionnaire (range 0-55) and had blood taken for the assessment of high sensitivity C--reactive protein, fibrinogen, white blood cell counts, and plasma homocysteine concentrations. RESULTS: 111 (27%) of the participants were classified in the upper quartile of the hostility scale (>21 score) and 119 (29%) were classified in the lower quartile (<11 score). Multivariate linear regression analysis revealed that hostility score associated positively only with homocysteine levels (standardized Beta=0.124, adj. R2=6%, p=0.015), after controlling for age, gender, educational status, body mass index, physical activity levels, and dietary habits of the participants. In particular, a 10-unit increase in the hostility scale was associated with a 2.9 micromol/l rise in homocysteine levels. CONCLUSIONS: Our findings suggest a positive relationship between homocysteine and hostility; however, whether hostility influences inflammation or the thrombotic process remains to be evaluated by future prospective studies.

Adult↗

PubMed1984

Prolactin, aggression and hostility: a discussion of recent studies.

Several studies are summarized in which the relationship of high prolactin levels and self-rated anger-hostility was examined. The Symptom Questionnaire, a state measure which contains an anger-hostility scale, was included in all studies. Women with hyperprolactinemic amenorrhea were found to have higher hostility scores than amenorrheic women with normal prolactin levels. In another study, hyperprolactinemic women were found to have higher hostility scores than female family practice patients, random employees and there was a nonsignificant trend for higher hostility scores than in female nonpsychotic psychiatric outpatients. In both studies, depression and anxiety were also significantly higher. When bromocriptine, a prolactin lowering drug, was administered to hyperprolactinemic women in a double blind crossover study, there was a significant and progressive decrease of hostility, depression and anxiety while on bromocriptine, parallel with the decrease in prolactin and no change on placebo. Post-partum women who had high prolactin levels were significantly more hostile than a control group of employees and as hostile as hyperprolactinemic women. Hyperprolactinemic males were no more hostile than controls. The relationship of prolactin to post-partum aggression in mammals is briefly reviewed. The findings are inconclusive; in the three species studied, postpartum aggression is perhaps enhanced, but does not depend on high prolactin levels. There are no studies on the relationship of prolactin levels and violence in women. Hostility associated with high prolactin levels in postpartum women is perhaps a phylogenetic remnant which may have had the evolutionary advantage of protecting the young.

Aggression↗

PubMed1992

Dimensions of anger-hostility and cardiovascular reactivity in provoked and angered men.

This study investigated the relationship between two dimensions of anger-hostility--the expression of anger-hostility and the experience of anger-hostility--and cardiovascular reactivity in provoked and angered men. A serial subtraction task was administered to 41 male undergraduates who were provoked and angered. A measure of the expression of anger-hostility correlated positively and significantly with systolic and diastolic blood pressure (BP) reactivity. There were no significant correlations between a measure of the experience of anger-hostility and cardiovascular reactivity. The two types of anger-hostility were also found to relate differentially to life-style variables that have been identified as risk factors for coronary heart disease (CHD), with only the expression of anger-hostility showing positive relationships with these life-style CHD risk factors. These findings are discussed within the context of a similar differential relationship between the two dimensions of anger-hostility and CAD and CHD. Finally, significant negative relationships were obtained between the experience of anger-hostility and resting BP and heart rate levels. These findings are discussed within the context of other data suggesting that trait anxiety-neuroticism may have protective properties.

Adult↗

PubMed2005

Prospective cohort study of hostility and the risk of cardiovascular disease mortality.

BACKGROUND: Recent literature reviews have questioned hostility as a risk factor for heart disease. However, controversy persists due to the rarity of large-scale prospective cohort studies of initially healthy populations. METHODS: We prospectively investigated the association between hostility and cardiovascular (and all-cause) mortality among 20,550 men and women, 41-80 years of age, participating in the European Prospective Investigation into Cancer and Nutrition in Norfolk (EPIC-Norfolk), United Kingdom study. Participants were recruited by post from general practice age-sex registers and subsequently attended health checks that included the assessment of coronary disease risk factors. Hostility assessment was completed by postal questionnaire. RESULTS: During mean follow-up of 6 years, 1284 deaths were recorded including 481 from cardiovascular disease (CVD). Hostility was not associated with CVD mortality, after adjustment for age and prevalent disease, in either men (rate ratio for a 1 SD decrease in hostility score, representing increased hostility, 1.09; 95% confidence interval 0.98-1.22) or in women (rate ratio 1.00; 95% confidence interval 0.86-1.26). Subgroup analysis suggested hostility may be associated with CVD mortality (independent of age, prevalent disease and cigarette smoking) for participants reporting very high hostility and for those aged less than 60 years. CONCLUSIONS: Hostility was not associated with an increased risk of cardiovascular mortality in this population study of older adults.

Adult↗

PubMed2005

The relationship of hostility, negative affect and ethnicity to cardiovascular responses: an ambulatory study in Singapore.

This study tested the hypotheses that ambulatory heart rate and blood pressure would be higher for individuals high but not low in hostility when they experienced negative affect or social stress and that this interaction would be stronger for Indians compared with other Singapore ethnic groups. Ambulatory blood pressure monitoring was done on 108 male Singapore patrol officers as they went about their daily duties. After each BP measurement participants completed a computerized questionnaire including items on emotional experience. Individuals high in hostility showed higher systolic blood pressure when reporting negative affect whereas this was not true for those low in hostility. Ethnic differences were obtained such that Indians showed an increase in mean arterial pressure when angered whereas MAP was negatively related to anger for Malays and unrelated for Chinese. Also a three-way interaction between ethnicity, hostility, and social stress indicated that hostility and social stress interacted in their effects on DBP for Indian participants but not for Chinese or Malays. Finally, a three-way interaction was obtained between ethnicity, hostility and negative affect for heart rate in which heart rate increased with increasing levels of negative affect for Chinese high in hostility and Malays low in hostility but decreased with increasing negative affect for all other participants. These data are consistent with higher CHD rates among individuals high in hostility and also provide additional evidence on ethnic differences in cardiovascular reactivity in Singapore.

Adult↗