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Hostility, social support, and adrenergic receptor responsiveness among African-American and white men and women.

OBJECTIVE: We examined the relationship between beta-adrenergic receptor responsiveness and hostility and social support in African American and white men and women. METHODS: The participants were 149 men and women, aged 25 to 45 years with SBP < 160 and DBP < 105. Hostility and social support were assessed with standardized self-report measures. An isoproterenol challenge was used to evaluate beta-adrenergic receptor responsiveness, and a phenylephrine challenge was used to evaluate alpha-adrenergic receptor responsiveness. RESULTS: Hostility and social support were unrelated to alpha-adrenergic receptor responsiveness. Hostility and satisfaction with perceived social support predicted beta-adrenergic receptor responsiveness in multiple linear regression analyses controlling for race, gender, age, SBP, and resting heart rate. High hostility was associated with reduced cardiac beta-adrenergic receptor function among both white and African American men. Low levels of satisfaction with social support were associated with reduced cardiac beta-adrenergic receptor responsiveness among men and women. Hostility and satisfaction with social support shared some variance in models predicting beta-adrenergic receptor responsiveness. CONCLUSIONS: Reduced beta-adrenergic receptor responsiveness is associated with higher levels of hostility among men, and is associated with lower levels of satisfaction with social support among men and women. Impaired beta-adrenergic receptor function, which is a common characteristic of cardiovascular disease, may be a marker of increased cardiovascular disease risk among individuals high in hostility and low in social support.

Adrenergic alpha-Agonists↗

Hostility is related to blunted beta-adrenergic receptor responsiveness among middle-aged women.

OBJECTIVE: Based on previous findings in men, the hypothesis that hostility would be associated with blunted responsiveness of cardiovascular beta-adrenergic receptors was tested in a study sample of middle-aged women. The roles of the sympathetic nervous system and of social support in this putative relationship were also evaluated. METHODS: Subjects were 80 healthy women (n = 23 African American; n = 57 white), aged 47 to 55 years. Hostility was assessed using the Cook-Medley Hostility Scale and social support was assessed with the Brief Social Support Questionnaire. Intravenous isoproterenol challenge was used to evaluate cardiac and vascular beta-adrenergic receptor responsiveness. Twenty-four-hour urinary catecholamine excretion was used to index sympathetic nervous system activity. RESULTS: Hostility was related to blunted cardiac (R = 0.33, p <.01) and vascular (R = 0.23, p <.05) beta-adrenergic receptor responsiveness in simple correlation analysis and in hierarchical regression analyses controlling for race, menopausal status, weight, and resting heart rate. Low social support was also related to blunted beta-adrenergic receptor responsiveness (R = 0.3, p <.01). Twenty-four-hour norepinephrine excretion was related both to hostility (R = 0.32, p <.01) and to cardiac (R = 0.25, p <.05) and vascular (R = 0.24, p <.05) beta-adrenergic receptor responsiveness. CONCLUSIONS: These observations replicate and extend previous findings in men by demonstrating that higher levels of hostility and low levels of social support are associated with blunted beta-adrenergic receptor responsiveness in middle-aged women. They also suggest that heightened sympathetic nervous system activity associated with hostility may contribute to beta-adrenergic receptor blunting. Because blunted beta-adrenergic receptor sensitivity is a characteristic feature of a broad range of cardiovascular diseases, these findings may reflect an early preclinical manifestation of pathophysiology accompanying hostility and low social support.

Adrenergic beta-Agonists↗

Mental symptoms, hostility features and stressful life events in people with cancer.

Hostility features, mental symptoms, and stressful life events were investigated in 100 patients (59 men and 41 women) suffering from cancer. Fifty-seven healthy men (n = 26) and women (n = 31) were used for comparison purposes. The assessment instruments were the Hostility and Direction of Hostility Questionnaire, the Delusions Symptoms States Inventory/states of anxiety and depression and a modified version of the Schedule of Life Experiences. Women patients reported lower scores than healthy women on total hostility, but men patients reported higher scores than healthy men. Introverted hostility was increased in both male and female patients, but due to different patterns: in women due to lower scores on extroverted hostility subscales, especially acting-out hostility, whereas in men due to higher scores on introverted hostility subscales, especially guilt. Female patients, compared with healthy women, reported significantly higher scores on the depressive and anxiety subscales, whereas in the man the differences were not statistically significant even though patients reported higher scores than normals. On the Schedule of Life Experiences, female patients reported statistically significant higher scores than healthy women.

Adult↗

Psychosocial vulnerability, hostility, and family history of coronary heart disease among male and female college students.

This study evaluated the utility of the psychosocial vulnerability model for understanding the hostility-coronary heart disease (CHD) relationship among college students at risk for CHD. Interrelationships of cognitive, affective, and behavioral hostility with structural and functional social support were examined. College undergraduates with a parental history of CHD (n = 121) and a control group of 125 students with no CHD family history completed measures of hostility and social support. Among women, a significant negative correlation was found between affective-experiential hostility and functional support. Among men, a significant negative correlation was observed between cognitive-experiential hostility and structural support. Path analyses revealed a significant positive effect of expressive hostility on functional support for CHD-negative men and CHD-positive women. CHD family history was not associated with hostility or family environment. CHD-positive participants reported less support satisfaction than did CHD-negative participants. Thus, results indicated qualified support for the psychosocial vulnerability model of the hostility-CHD relationship.

Adult↗

Hostility measurement and its relationship to fantasy capacity.

Two-hundred and three male high school freshmen and sophomore students were administered a daydreaming questionnaire, Buss-Durkee Hostility Inventory, and Rotter ISB. The latter was scored for hostility by the Renner, Maher, and Campbell method. The Subjects also rated one another on a sociometric scale measuring behavioral hostility. Subjects were divided into high and low fantasy groups. Analyses of variance were computed on the hostility measure data for 108 Subjects. The independent variables were obtained for the fantasy capacity measure and not for the peer rating measure. There was no positive correlation between the sociometric ratings and the hostility measures. In view of the results, the hostility measurement instruments are interpreted as measures of an individual's capacity to regard himself as hostile, rather than as measures of the actual hostility of his behavoir.

Aggression↗

Explaining unexpected gender differences in hostility among persons seeking treatment for substance use disorders.

OBJECTIVE: Gender differences in depression and anxiety are found among patients seeking treatment for substance use disorders, but few data exist on differences in hostility. As part of a larger study describing substance abuse treatment seekers, analyses investigated whether women would be more depressed and anxious than men, but less hostile. METHOD: Data were collected at baseline from 336 outpatients (62% men) at an addiction treatment agency. Most of the outpatients (81%) had DSM-IV chart diagnoses of alcohol dependence or abuse. RESULTS: On the depression, anxiety and hostility subscales of the Brief Symptom Inventory, women had significantly higher scores than did men. When scores were converted to gender-keyed T scores standardized on a normal sample, differences in depression and anxiety were no longer significant. However, differences in hostility remained. A regression analysis indicated that hostility scores were explained not by gender, but by greater severity of adverse consequences from substance use, insomnia, lack of social support, and being married. A childhood history of physical or sexual abuse, although more common in women than men, did not explain gender differences in hostility after controlling for other variables. CONCLUSIONS: The women in this study did not appear to be more anxious and depressed than did the men after controlling for gendered population norms. However, the women were more hostile than the men. Women's greater hostility was explained not by gender per se, but by personal and social factors that were differentially distributed across genders. Treatment implications are reviewed.

Adult↗

Hostility in depression.

Subjects (39 men and 30 women) from two university counseling centers and one university medical center were administered the Hamilton Rating Scale for Depression, the Buss-Durkee Hostility Inventory, the State-Trait Anger Scale, and the Hostility and Direction of Hostility Questionnaire. Results showed significant positive correlations between self-reported severity of depression and all subtypes of hostility including behavior, attitude, affect, intropunitiveness, and extrapunitiveness. Hierarchical regression analysis using demographic and hostility variables as predictors of depression scores showed increasing age, lower education, and female gender to account for 50% of the explained variance. The Intropunitive subscale from the Hostility and Direction of Hostility Questionnaire accounted for an additional 19% of the explained variance and was the single most powerful predictor of depression. Correlational analysis showed women tending to have higher scores on most hostility measures. Implications of these results with respect to theory and clinical practice are discussed.

Anger↗

Cynical hostility and the metabolic syndrome: a case-control study.

BACKGROUND: Evidence suggests that metabolic syndrome and hostility are independent risk factors for the development of coronary heart disease. Recently, the combined effect of metabolic syndrome and hostility has shown to predict the incidence of myocardial infarction. This study tested whether cynical hostility was associated with the metabolic syndrome in a sample of Italian adults. METHODS: 992 subjects participated in the study. Among them, 546 participants were classified as having metabolic syndrome and 446 as controls, not having any of the risk factors that constitute the metabolic syndrome. Cynicism, the cognitive component of hostility, was measured with a self-report questionnaire derived from the Cook-Medley Hostility Scale. Metabolic syndrome was based on having the following risk factors: obesity, hyperinsulinemia, dyslipidemia, and elevated arterial blood pressure. RESULTS: The cross-sectional association of cynical hostility with metabolic syndrome was statistically significant (p < 0.0001). Hostility was also associated with age (p < 0.0001) and educational level (p < 0.02). Predictors of having metabolic syndrome were higher cynicism (O.R. 1.12), older age (O.R. 1.39), and lower educational level (O.R. 1.05). CONCLUSIONS: The results highlight the potential importance of intervention on psychological factors (i.e. hostility) to prevent coronary heart disease.

Adult↗

[Study on self and other ratings of hostility].

The purpose of this study was to investigate the validity of hostility ratings made by others. The rating measure was considered essential for the study of correlation between hostility and coronary heart disease. Undergraduate and graduate students, 81 in all, completed a questionnaire of hostility and social desirability. The scales included were Buss-Perry Aggression Questionnaire (BAQ), Müller Anger Coping Questionnaire (MAQ), and Marlowe-Crowne Social Desirability Scale (MCSD). Acquaintances also rated them using BAQ and MAQ. Correlations between self and other ratings were moderate, and self-rated hostility scores correlated negatively with MCSD scores, while other-rated hostility scores did not. Results of ANOVA indicated that self-rated hostility scores were higher than other-rated hostility scores. However, the differences decreased as the degree of closeness between them increased, and no difference was found in long-term close relationship. These results suggested that other ratings of hostility could be an objective measure in Japan, as in western countries.

Adult↗

Development and testing of a new hostility scale.

Evidence suggests that assessment of global type A behaviour as a coronary risk factor may not be the most fruitful strategy because some components, particularly hostility, may be more harmful than others. Measurement of hostility has been primarily through two types of instrumentation: the Type A Structured Interview (SI) and the Cook-Medley (Ho) scale. Deficiencies in the measurement of hostility have resulted from a lack of conceptual clarity because definitions of hostility have been blurred by overlap with the concepts of anger and aggression. The main objective of this study was to develop and test an instrument that focuses hostility on attitude rather than emotion or behaviour. Psychometric properties of the Hostile Attitude Scale (HAS) were Cronbach's alpha, 0.80, and correlation of 0.56 with the Ho scale and 0.43 with the SI. In a clinical investigation that used the HAS, SI and Ho scale, all measures were significantly correlated with angiogram outcome, although the strongest relationship was with the HAS. Hostile attitude alone (HAS) accounted for 6% of explained variance in angiogram outcome based on regression analysis. The HAS is offered as a short, easily administered measure of hostility, with particular emphasis on cognitive aspects of the construct.

Coronary Disease↗

Repression, hostility, and autonomic recovery from a laboratory stressor.

The current study investigated hostile mood, response style (repression-sensitization [RS]), and cardiovascular (blood pressure and heart rate) as well as endocrine recovery (cortisol, norepinephrine, and epinephrine) from a 10-minute mental task in 57 healthy, adult women. Emphasis was placed on resting levels and recovery from, rather than the more frequently studied initial responses to, mental stress tasks. The task consisted of the "Electrocardiogram Quiz" (shortened version) and mental arithmetic (serial subtraction) of equal length, totaling 10 minutes. Physiological/biochemical samples were collected at the end of a 15-minute adaptation phase (i.e., the designated baseline), at the end of the mental task phase and at 5-minute and 30-minute recovery. R-S and hostility scale scores were not correlated and permitted the creation of four subsamples: 1) repressor-low expressed hostility; 2) repressor-high expressed hostility; 3) sensitizer-low expressed hostility; and 4) sensitizer-high expressed hostility. Results indicated that tonic levels of SBP and DBP were consistently higher in subjects with low expressed hostility. Cortisol level and phasic activity discriminated between high expressed hostility-sensitizers and the other three samples, with the former displaying more cortisol activity at baseline and at 30-minute recovery. Women on birth control pills had consistently elevated levels of cortisol secretion throughout.

Adolescent↗

Effect of trait hostility on cardiovascular responses to harassment in young men.

Hostile individuals may experience more extreme and frequent episodes of anger than nonhostile persons and thus may have exaggerated physiological responses to their environments. Such responses may be associated with increased risk of cardiovascular disease. This study examined cardiovascular responses of 24 low- versus 21 high-hostile young men to a mental arithmetic task administered with and without provocation in 2 x 2 (groups x Tasks) repeated measure design. hostility classifications were based on weighted interview ratings of Potential for Hostility. As predicted, high-hostile men showed differentially greater heart rate, blood pressure, and rate-pressure product changes only in response to the task administered with harassment (ps < .05). Similarly, high-hostile men reported more distress, tenseness, irritation, and greater concentration during the harassing task, compared to low-hostile men (ps < .05). Also, the harassing task elicited greater increases in vascular resistance and greater increases in stroke volume for all subjects, relative to the neutral task (ps < .003). Results suggest that hostile persons faced with anger evoking situations may produce a constellation of exaggerated cognitive-emotional and cardiovascular responses consistent with increased risk of cardiovascular disease.

Journal Article↗

Differential responsivity of monocyte cytokine and adhesion proteins in high- and low-hostile humans.

This study tested the general hypothesis that high- and low-hostile respondents would show different patterns of change in monocyte cytokine and adhesion protein (MCAP) expression in response to pharmacologically induced alterations in sympathetic nervous system (SNS) and parasympathetic nervous system (PNS) balance. On 3 separate days, 4 high- and 4 low-hostile respondents received isoproterenol infusions after saline, atropine (PNS blockade), or neostigmine (PNS stimulation) pre-treatment. Dual color flow cytometry with fluorescently labeled monoclonal antibodies to CD 14 (monocyte market), interleukin-1, leukocyte function activator (LFA-1), Class II major histocompatibility complex (MHC-II), and tumor necrosis factor was used to quantify cytokine and adhesion protein expression on monocytes in blood samples drawn before and after the combination drug infusions on the 3 test days in each respondents. Following PNS stimulation and istoproterenol infusion there was a decrease (compared to saline pretreatment) in MHC II expression in high hostiles that was significantly (p<.02) different from an increase in low hostiles. A similar trend (p = .08) was seen for LFA-1 expression, with high hostiles showing an increase and low hostiles a decrease. These findings support the broad hypothesis that high-and low-hostile respondents will show different MCAP responses to pharmacologically induced alterations in SNS-PNS balance. Such differences could contribute to accelerated atherogenesis among high-hostile individuals.

Journal Article↗

Increasing constructive anger verbal behavior decreases resting blood pressure: a secondary analysis of a randomized controlled hostility intervention.

We hypothesized that increasing anger verbal behavior in an assertive, constructively motivated style should decrease resting blood pressure (BP) and that this behavior may be one mechanism through which hostility relates to BP. We tested this hypothesis by conducting secondary analyses on a single-blind, matched, randomized controlled study of hostility modification and BP. A total of 22 high-hostile male patients with coronary heart disease were matched on age and hostility level and were randomly assigned to either an 8-week cognitive-behavioral hostility treatment (n = 10) or an information-control group (n = 12). Patients were reassessed after treatment and at 2-month follow-up on hostility, observed anger expression, and resting BP. We found that decreases in hostility predicted increases in constructive anger behavior-verbal component, which in turn predicted decreases in resting BP at follow-up. Thus, one of the mechanisms underlying the hostility-BP association may be the lack of constructive anger expression.

Journal Article↗

A hostility scale for the California Psychological Inventory: MMPI, observer Q-sort, and big-five correlates.

Using two samples, we developed and validated a hostility scale that can be scored from the California Psychological Inventory (CPI) and serves as an alternate for the Cook-Medley Hostility Scale (Ho; Cook & Medley, 1954). The CPI Hostility (H) scale consists of 33 items that are either duplicates or close equivalents of specific Ho items, and the two scales correlate at least .90 in samples differing in sex. The H and Ho scales show a similar pattern of correlations with conceptually relevant MMPI scales and with observer-rated personality attributes tapping Barefoot, Peterson, et al.'s (1991) five hostility categories of Hostile Affect, Cynicism, Aggressive Responding, Social Avoidance, and Hostile Attributions. These findings provide evidence for the equivalence of the two hostility scales, as well as external validation for those personality characteristics that are purported to underlie the construct of hostility as tapped by both the original Ho scale and the new CPI H scale.

Adolescent↗

Childhood Economic Mobility and Systemic Inflammation Among Men Who Experienced Low Income in Toddlerhood: The Moderating Role of Trait Hostility.

OBJECTIVE: Childhood economic upward mobility (ie, increases in family income across childhood) may attenuate links between childhood poverty and systemic inflammation in adulthood, the extent of which may vary depending on inter-individual differences in personality characteristics, including hostility. METHODS: Men who experienced low income in toddlerhood (N=171) were followed prospectively into adulthood. Annual family income was collected 12 times when men were 1.5 to 17 years old. Men completed the Cook-Medley Hostility Scale and had their fasting blood drawn to measure circulating levels of C-reactive protein (CRP) at age 32. Multiple linear regression analyses examined main and moderation effects of childhood economic upward mobility and adult hostility on CRP levels adjusting for income at 1.5 years, race, parent educational attainment, and adult income, education, waist circumference, and smoking status. RESULTS: Main effects were nonsignificant, but an interaction effect emerged. Counter to expectations, childhood economic upward mobility related to greater adult CRP as trait hostility decreased ( &#x3b2; =-0.203, P =.018). Simple slope analyses further revealed that childhood economic upward mobility was positively associated with CRP among men lower in hostility ( &#x3b2; =0.23, SE=0.09, P =.020) but was unrelated to CRP among men higher in hostility. Results of post hoc sensitivity analyses are also discussed. CONCLUSIONS: Counterintuitive findings suggest that for men who experience poverty in toddlerhood, the association between childhood economic upward mobility and adult CRP may be nuanced and even in the positive direction for men low in hostility, which aligns with work on unintended health consequences of upward mobility.

Humans↗

Effects of chlordiazepoxide and oxazepam administration on verbal hostility.

We compare the effects of chlordiazepoxide, oxazepam, and placebo on hostility, as both an inner motivational or potential state and verbal interpersonal behavior. This article reports the findings relevant to the latter dimension of hostility and integrates them with those findings, presented in an initial report, relevant to hostility as an inner motivational state. The verbal data again support the hypothesis that chlordiazepoxide-induced increases in verbal interpersonal hostility, following frustration, are greater than those associated with placebo. With regard to oxazepam, the verbal hostility data were consonant with the motivational data that suggested that oxazepam does not substantially disinhibit hostility but did not as consistently differentiate oxazepam and chlordiazepoxide at the level of overt hostile behavior.

Adult↗

Cynical hostility, attempts to exert social control, and cardiovascular reactivity in married couples.

Chronically hostile persons may be at greater risk of cardiovascular illness, perhaps because of their more pronounced physiologic responses to interpersonal stressors. The present study of married couples examined the association between Cook and Medley Hostility (Ho) Scale scores and cardiovascular reactivity while couples were engaged in a discussion task with or without an incentive to exert control over their partner. Cynical hostility was associated with greater heart rate (HR) reactivity among husbands in both conditions and with greater systolic blood pressure (SBP) reactivity among husbands attempting to influence their wives. Further, husbands' cynical hostility was associated with greater SBP reactivity in their wives. Wives' cynical hostility was unrelated to their own or their husbands' reactivity. These results underscore the importance of social contexts in the association between hostility and psychophysiologic processes and suggest that the motive to exert social control may be important for hostile persons.

Adult↗