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PubMed2005

Do psychological factors predict occurrence of influenza-like symptoms in vaccinated elderly residents of a sheltered home?

OBJECTIVES: A previously shown relation between psychological factors and the occurrence of flu has not been tested in elderly people, who are at the greatest risk of mortality from flu complications. This study examined whether psychological factors predict the occurrence of influenza-like symptoms (ILS) in elderly residents. DESIGN: A prospective correlation design was used. METHOD: Our sample included 70 elderly residents of a sheltered home (mean age 83.0 years) who were vaccinated against influenza and assessed for background, biomedical factors (e.g. number of illnesses) and psychological factors (e.g. hostility, depression, life-events, and social support). The occurrence of ILS during 2 subsequent winter months was evaluated by a nurse blind to patients' psychological data, according to explicit valid criteria and physicians' notes. RESULTS: Seventeen patients (24.3%) developed ILS. Number of medications, little physical activity, hostility, depression, and little social support significantly predicted ILS. In a multivariate analysis, only number of drugs (relative risk, RR: 1.54; 95% confidence interval, CI: 1.06-2.22) and hostility (RR = 1.18; 95% CI: 1.00-1.38) significantly and independently predicted occurrence of ILS. CONCLUSIONS: Psychological factors (particularly hostility) predict occurrence of ILS in an elderly sample. Possible behavioural and immunological mechanisms linking hostility to development of ILS are discussed. These findings add to the literature on psychological factors and flu, and may have implications for the prediction and prevention of flu in elderly people.

Aged↗

PubMed1994

[Depression and aggression in Amish persons].

The Old Order Amish are a conservative, anabaptistic religious community of Swiss origin in the USA. They practise absolute pacifism and lead a life free of hostility and aggression. Depression, however, is as much as three times more frequent in Amish populations. In order to study the possible relationship between hostility and depression, we investigated 43 Amish people, using the Buss-Durkee Hostility Inventory and the Beck Depression Inventory. As expected, the total hostility score was significantly lower and the depression score significantly higher in comparison to the normal population. The positive correlation between the two scores (0.45; p < or = 0.002) indicates that the hypothesized reciprocal relationship between hostility and depression is unlikely in the Old Order Amish.

Adolescent↗

PubMed2000

Fatality trends in United Nations Peacekeeping Operations, 1948-1998.

CONTEXT: The rising number of deaths among United Nations (UN) peacekeeping forces after the Cold War has made some troop-contributing countries hesitant to participate in peacekeeping operations. While the number and scale of missions have increased, no data have demonstrated a parallel increase in risks to peacekeepers. OBJECTIVE: To determine the association of characteristics of UN peacekeeping operations with risks and mortality rates among UN peacekeeping forces in both the Cold War and post-Cold War periods. DESIGN, SETTING, AND PARTICIPANTS: Descriptive analysis of 1559 personnel deaths during 49 UN peacekeeping missions from 1948-1998 based on the casualty database maintained by Department of Peacekeeping Operations, UN Headquarters. MAIN OUTCOME MEASURES: Number and percentage of deaths by circumstance, total crude death rate, and crude death rate and relative risk of death by circumstance (hostile acts, unintentional violence, and illness or other causes) and time period (Cold War vs post-Cold War), geographic region, and nature of peacekeeping response; and regression analysis of mission variables (strength, duration, and humanitarian mandate) associated with total number of deaths. RESULTS: More deaths have occurred among UN peacekeeping forces in the past decade alone than in the previous 40 years of UN peacekeeping (807 vs 752), but crude death rates did not differ significantly by time period (Cold War vs post-Cold War, 21.8 vs 21. 2 deaths per 10,000 person-years; P =.58), level of peacekeeping response, or for geographic regions other than East Europe and Central America, where rates were lower (P<.001 for both regions). Unintentional violence accounted for 41.2% of deaths, followed by hostile acts (36.1%), and illness or other causes (22.7%). Deaths from hostile acts increased after the Cold War (relative risk [RR] 1. 51; 95% confidence interval [CI], 1.22-1.88), while rates for deaths caused by unintentional violence decreased (RR, 0.79; 95% CI, 0.67-0. 94) but remain high, particularly in the Middle East and Asia (RR, 1. 39; 95% CI, 1.15-1.69). Regression analysis showed a significant association between number of deaths and the strength (P<.001) and duration (P<.001) of a peacekeeping mission. CONCLUSION: The increase in number of deaths among UN peacekeeping personnel since 1990 can be attributed to the increased number and scale of missions after the Cold War rather than increased RR of death. Post-Cold War peacekeeping personnel have a higher risk of dying from hostile acts in missions where more force is required. In missions providing or facilitating humanitarian assistance, both the RR of deaths from all causes and deaths from hostile acts are increased. JAMA. 2000;284:598-603

Humans↗

PubMed1998

Psychosocial variables, age, and angiographically-determined coronary artery disease in women.

The present study explored the relationship between psychosocial measures and the degree of coronary stenosis in a sample of 59 women between the ages of 39 and 84. Coronary occlusion was correlated with elevated cholesterol and marginally correlated with age and was inversely associated with years of education. Based on hierarchical multiple regression, an interview-based measure of hostility was associated with coronary stenosis after controlling for traditional risk factors, and age moderated the hostility-stenosis relationship. Further, a second regression model suggested that trait anxiety was inversely correlated with degree of occlusion, perhaps because low-anxious women are referred for catheterization later in the course of the disease. Contrary to hypotheses, there was no evidence that repression of interview-based hostility or anxiety predicted coronary occlusion. Given the small sample size, results should be considered preliminary. Future studies should explore the degree to which anxiety and hostility are associated with coronary heart disease (CHD) in larger samples of women and the degree to which age moderates the hostility-occlusion association.

Adult↗

PubMed1995

The anger recall interview and cardiovascular reactivity in women: an examination of context and experience.

Recent research has focused on the role of hostility as a risk factor for coronary heart disease. Hostility has been linked independently to cardiovascular mortality and, as a component of Type A behavior, to atherogenesis and myocardial infarction; however, the mechanisms by which hostility manifests its effects on the cardiovascular system have not been determined. In addition, hostility has been evaluated as a trait measure, with little emphasis on how anger-provoking episodes may be perceived by individuals. The present study seeks to evaluate the affective experience of hostility, through an anger recall interview, and relate qualities of that experience to one potential mechanism of cardiovascular risk, cardiovascular reactivity. Fifty-eight women, classified by structured interview as Type A or B, participated in an anger recall interview while their heart rate and blood pressure were monitored. Type A women manifested greater systolic reactivity when their anger was in response to frustration of autonomy needs, while Type B women exhibited greater heart rate reactivity in response to frustration of affiliation needs. All women who suppressed anger expression experienced higher pressor responses than women who expressed anger assertively. Future investigations may find the content of an interview as useful as the procedure itself in studies of cardiovascular reactivity.

Adolescent↗

PubMed1992

The value of urodynamic studies in infants less than 1 year old with congenital spinal dysraphism.

The role and timing of urodynamic studies in infants with congenital spinal dysraphism are controversial. We reviewed 64 consecutive infants with a mean followup of 28 months who underwent video urodynamic study when they were less than 1 year old (50 of the 64 patients were less than 3 months old). A previously reported video urodynamic "hostility score" from 0 (best) to 10 (worst) was given to each study and compared with the outcome of the upper urinary tract and subsequent urodynamic studies. A larger fraction of these children with high hostility scores (5 or greater) had upper tract deterioration (39%) compared to those with low hostility scores (9%). Moreover, 6 of 14 patients in the low hostility group who underwent repeat video urodynamic studies after age 1 year had high hostility lower urinary tracts. We conclude that urodynamic studies during and after the first year of life are useful in the appropriate urological evaluation and management of infants with spinal dysraphism.

Female↗

PubMed1998

Stress and personality as factors in women's cardiovascular reactivity.

An experiment was conducted to investigate the relationships among Type A behavior, hostility and cardiovascular reactivity (CVR) in women. Changes in heart rate, blood pressure and skin conductance from baseline to task levels were used to assess reactivity. These measures were obtained from 96 women during a seated baseline period, a reaction time task and during an oral IQ quiz. Analyses indicated that Type A and high hostile women were more reactive to an oral IQ quiz and reaction time stressors than Type B and low hostile women. Specifically, Type As showed significantly greater increases in systolic blood pressure in the reaction time task and greater mean arterial pressure and systolic blood pressure increases in the IQ quiz. High hostiles evidenced significantly higher systolic blood pressure and diastolic blood pressure in the RT task and higher mean arterial pressure and diastolic blood pressure in the IQ quiz. It was concluded that Type A personality and hostility can predict greater reactivity in women to two different stressors. The oral quiz generated greater reactivity than the RT task and thus may be a more stressful task.

Adolescent↗

PubMed2001

An exploration of evolved mental mechanisms for dominant and subordinate behaviour in relation to auditory hallucinations in schizophrenia and critical thoughts in depression.

BACKGROUND: Mental mechanisms have evolved to enable animals (and humans) to be able to function in various social roles. It is suggested that the nature and functions of the mental mechanisms that enable animals to act as a hostile-dominant or threatened-subordinate can be distinguished. It is further suggested these can be internally activated and 'play off' against each other, such that a person 'attacks' themselves and then responds to their own internal attacks with subordinate defences. Hence, a depressed person can submit, feel defeated, belittled, beaten down, or want to run away (escape) from their own self-attacking thoughts, while psychotic voice hearers can feel similarly to their hostile voices. Such internal interactions may relate to depression in both psychotic voice hearers and depressed people. METHOD: A group of 66 voice hearers with a diagnosis of schizophrenia and 50 depressed patients were compared on a series of self-report questionnaires measuring the power of hostile self-directed thoughts/voices and the activation of defensive responses, especially fight/flight. RESULTS: We present evidence that schizophrenic, malevolent voice hearers and self-critical depressed people experience their hostile, internally generated voices/thoughts as powerful, dominating and controlling (i.e. have typical characteristics of a hostile dominant). Moreover, these voices/thoughts activate evolved subordinate defences such as fight/flight and these are associated with depression in both depression and schizophrenia. CONCLUSION: Conceptualizing aspects of depressed and psychotic thinking as relating to evolved mental mechanisms, which are role serving, but can internally play off against each other, may open new ways of investigating certain aspects of severe pathologies.

Adult↗

PubMed1984

Role of cervical mucus in human infertility.

The physiological role of cervical mucus in enhancing spermatozoal penetration at mid-cycle has been established. However, the involvement of cervical mucus in primary infertility is still controversial. Although immunological reactions against spermatozoa in the female have been offered to account for the immobilization of spermatozoa--an observation termed 'hostility' of the mucus--this is not always demonstrable. In addition, there are a number of microbial antigens that are similar to spermatozoal antigens. Antibodies to these antigens are found in the serum of the majority of females and males whose infertility is considered to be immunopathological in origin. There are also naturally-occurring antispermatozoal antibodies in both females and males that in some cases may contribute to immunological infertility. The overall spectrum of 'hostile' mucus reactions becomes more complex when we consider the biochemical structure of cervical mucus and its possible interaction with spermatozoa. This spermatozoa: mucus interaction may involve the transfer of spermatozoal components to 'hostile' mucus that should normally be transferred to the zona pellucida of the ova. In addition, there are also pH changes in some 'hostile' mucus that lead to spermatozoal immobilization. In contrast to the above, the cause of infertility in some cases is the inability of spermatozoa to survive in normal mid-cycle mucus. It is evident therefore that an understanding of the complex nature of 'hostile' cervical mucus will lead to a more objective approach in the treatment of infertility.

Antibodies↗

PubMed1983

Psychosomatic aspects of hyperprolactinemia.

A review of some recent studies on the psychosomatic aspects of hyperprolactinemia is presented. Women seem to be more prone to suffer from the behavioral effects of prolactin than males. Women with hyperprolactinemic amenorrhea rated themselves significantly more hostile, more depressed and more anxious than women with amenorrhea only and other control groups. Hyperprolactinemic males did not rate themselves more hostile and depressed than matched controls. Psychological distress and hostility appear to remit upon treatment with bromocriptine. Postpartum patients matched for prolactin levels with hyperprolactinemic women showed significantly less depression and anxiety but about the same levels of hostility. Hostility, depression and loss of libido may coexist in the same hyperprolactinemic patient but they may be also present independently.

Adaptation, Psychological↗

PubMed2002

Life course socioeconomic conditions and adult psychosocial functioning.

BACKGROUND: Various psychosocial factors have been linked to adult physical health and are also associated with socioeconomic position in adulthood. We evaluated the effect of socioeconomic conditions over the life course on measures of psychosocial functioning in adulthood. METHODS: Life course socioeconomic position was assessed by retrospective recall of parents' education and occupation when the respondent was age 10, and the respondents' education, occupation, and income in 2585 men from eastern Finland aged 42, 48, 54, and 60 years. Measures of psychosocial functioning were derived from scales measuring cynical hostility, hopelessness, and depressive symptoms. RESULTS: Men with both parents who had less than a primary school education or who both had unskilled manual jobs had higher age-adjusted levels of cynical hostility, hopelessness, and depressive symptoms in adulthood. Mutually adjusted analyses showed that parents' education and the respondents' education, occupation, and income all had statistically independent effects on adult levels of cynical hostility and hopelessness. For instance, men for whom neither parent had completed primary education had a 0.15 standard deviation (P = 0.006) higher cynical hostility score, and a 0.20 standard deviation (P = 0.00018) higher hopelessness score, after adjustment for education, occupation and income. In contrast, depressive symptoms in adulthood were only associated with the respondent's occupation and income. CONCLUSIONS: Childhood socioeconomic position was associated with adult psychosocial functioning, but these effects were specific to some aspects of adult psychosocial functioning--cynical hostility and hopelessness, but not depressive symptoms. Adult occupation and income were associated with all measures of psychosocial functioning. In addition to the impact of adult socioeconomic position, some aspects of poor psychosocial functioning in adulthood may also have socioeconomic roots early in life.

Adult↗

PubMed1980

Suicide, attempted suicide and antidepressant drugs.

The concepts of depression and hostility are reviewed. The relationship between the two has been clarified by the use of psychometric tests. Hostility levels are high in depressive illness, especially on the intropunitive scales. Both total hostility and the degree of intropunitiveness are reduced as the patient recovers from his illness. Suicidal acts are seen as aggression directed towards the self. In some patients a tendency to recurrent drug overdosage or other forms of self-punitive behaviour may be the result of pathological character traits caused in turn by abnormal development in infancy. Looking at the possibility of cutting down the incidence of suicidal behaviour we conclude that we must look at the influence of depression, total hostility and direction of hostility in precipitating self-damaging acts. It is possible that antidepressants vary in the extent to which they act on these various factors, as well as having different rates of action on the several components of the depressive syndrome. There are thus a priori grounds for predicting that the incidence of self-damaging behaviour will vary from drug to drug. We describe the results of a study of suicidal behaviour carried out in general practice. A differential association with the major antidepressant drug was observed. In particular low rates were seen with the imipramine group, and there was a tendency towards high rates with the dothiepin-doxepin group. We propose to investigate this relationship further.

Antidepressive Agents↗

PubMed1980

[Inhibitions or neurosis and masculine characteristics in women. Contributions to analysis of denial].

The first part of this paper describes the general qualities of the psychical apparatus in two groups of women, male character and inhibition or neurosis. A different attitude towards the realization of the sexual difference in the phallic phase originates these two groups. The girl with a male character identifies herself with the little boy and maintains an autoerotic attitude. In the case of inhibition or neurosis the girl undervaluates herself and renounces her pleasure in masturbation. In the second part we develop a pattern of analysis, the theory of the places within the psychical apparatus: ideal, wish object, assistant and rival of the subject. The ideal is defined as warrantor for the being, for the feeling of oneself. When this ideal-cathexis happens the subject is put in the place of assistant of the ideal, in order to be recognized, to get the identification, the being. The place of rival is occupied by the one whose wishes are identical with the subject's, with whom the former has an exclusion relationship. The place of wish object appears in a heterosexual link, as the consequence of a libidinous cathexis. The distribution of these places in inhibitions or neuroses and male characters is considered in the next three parts of the paper. In inhibitions and neuroses the girl takes her mother as ideal, and her desire is to complete her, in identification with her father. The latter becomes a hostile character for the girl, and his fate is destruction, loss of meaning. The idealized link with her mother, however, progressively becomes hostile while the Ego of the girl develops. The girl then looks for shelter in worthless and multiplied men, and afterwords in a single man, idealized. These characteristics already belong to male characters. An analysis of the metapsychology of denial (Verleugnug), main defense mechanism against the registry of a traumatic perception, is offered in the next part. This defense preassumes an equivalent of an action aimed at putting something in the place of the traumatic registry, therefore maintaining the idealization of somebody as ideal, warrantor for the being. This idealization is questioned by an existence and value judgement. A link is then established between the Ego and three positions: the ideal, whose idealization the Ego tries to keep (love link); a hostile ideal, who assures the traumatic perception (hostile link) and an assistant of the hostile ideal (link of denounciation and disqualification). Denial implies the splitting of the Ego together with the existence of two preconscious organizations with different rules. One of these systems is connected only with primary identifications and the other also includes object-cathexes. In the last item we study how denial works in inhibitions and neuroses and in male characters. The girl may deny as regards either her own body (male characters) or her father's (inhibitions and neuroses). What really happens in both groups is a double denial, and the real definitive Ego, the reflexive judgement, is left out...

Denial, Psychological↗

PubMed2000

An experimental investigation of the role of appraisal processes in adolescents and their mothers experiencing family conflict.

A social information processing perspective was used to investigate appraisal processes in family conflict situations. Fifty-five young adolescents (32 males and 23 females) and their mothers who were experiencing sufficient conflict to seek mediation assistance, were presented with hypothetical scenarios depicting common sources of conflict. Participants were randomly assigned to two time conditions. After reading each scenario, participants chose one of four interpretations (two hostile and two non-hostile). Time condition did not influence the number of hostile interpretations for mothers, but when instructed to respond quickly, adolescents were more likely to interpret their mother's behaviour as hostile. The findings highlight the need for investigation of specific stressors which influence appraisal processes in family conflict.

Adolescent↗

PubMed1992

Using college alumni populations in epidemiologic research: the UNC Alumni Heart Study.

The UNC Alumni Heart Study (UNCAHS) is a prospective study of the role of psychosocial factors, in particular hostility, in the development of coronary heart disease. The target population is composed of persons who completed the Minnesota Multiphasic Personality Inventory while attending the University of North Carolina in the mid-1960s. Logistic regression analyses were used to determine whether hostility, demographic and other variables were significant determinants of the subjects' locatability and participation. It was found that MMPI hostility scores at initial testing were unrelated to either potential or actual locatability or participation. Thus there is no evidence that hostility is the source of selection bias in the UNCAHS. Selection into the study was predicted by age, sex, degree status and variables concerned with the conditions under which the MMPI was administered. It is concluded that follow-up studies of college cohorts may have study-specific sources of selection bias.

Adolescent↗

PubMed1989

Personality structure disturbances and psychiatric manifestations in primary Sjögren's syndrome.

It has been recently suggested that primary Sjögren's syndrome (SS) patients present with a variety of personality structure disturbances and psychiatric symptoms. To evaluate this finding further, we assessed hostility structure and psychiatric symptoms in 33 Sjögren's syndrome patients and compared the results with those of 33 healthy women, and 41 women with solid malignant tumors. The utilized psychometric instruments were the hostility and direction of hostility questionnaire (HDHQ) and the symptom checklist 90R (SCL-90R). High levels of introverted hostility were reported by SS patients in relation to the other two groups. Cancer and SS patients reported higher scores on anxiety and depressive symptoms compared to the healthy women, but the differences were not significant. In addition, high scores on paranoid ideation, somatization and obsessive compulsive symptoms were found in SS patients compared to the cancer and healthy controls. The results strongly suggest that psychiatric disorders are common in primary SS patients, who may need appropriate therapy.

Anxiety↗

PubMed2007

Information-sharing among couples considering multifetal pregnancy reduction.

OBJECTIVE: To determine the information-sharing strategies of couples considering fetal reduction, and the impact of these strategies on the chances of encountering hostility in their social networks. DESIGN: Cross-sectional design of semistructured qualitative interviews, coded with respect to sharing strategies and level of personally directed hostility encountered. SETTING: Multiple Pregnancy Management Program, Comprehensive Genetics, New York, New York. PATIENT(S) AND INTERVENTION(S): Fifty women and their partners who were making a first visit to our maternal-fetal management facility, in order to consider the possibility of multifetal reduction as a pregnancy-management strategy. MAIN OUTCOME MEASURE(S): Development of information-sharing strategies, and the chances of encountering personally directed hostility regarding multifetal reduction associated with more and less selective strategies. RESULT(S): Four information-sharing strategies emerged from the analysis. Two of these strategies were relatively open (extended network, and both parents). Two other strategies were relatively selective (qualified family and friends, and defended relationship). The selective strategies were significantly less likely to encounter to encounter personally directed hostility (odds ratio, 3.88; 95% confidence intervals, 0.87-17.30). CONCLUSION(S): Selective sharing of information for couples considering multifetal prgnancy reduction is a potentially useful strategy for moderating potentially stressful relationships in their social networks. Clinics should find a way of integrating the discussion of selective sharing into their clinic's cultural repertoire of patient-support services.

Communication↗

PubMed2002

The effect of parental expressed emotion on glycaemic control in children with Type 1 diabetes. Parental expressed emotion and glycaemic control in children.

OBJECTIVE: To measure expressed emotion (EE) in parents of young children with diabetes and to examine the relation between EE and glycaemic control in children with Type 1 diabetes in a longitudinal study over 24 months. We hypothesised that good glycaemic control, as measured by low glycated haemoglobin levels, would be predicted by high parental emotional over-involvement, low frequency of critical comments and absence of hostility. We predicted that these effects would be stronger in maternal than paternal scores. METHODS: Forty-seven children attending a Paediatric Diabetes Clinic and their parents were studied over 24 months. Glycated haemoglobin was measured on three occasions, at the start of the study period, 12 and 24 months later. At 12 months, parental EE was measured using an adapted version of the Camberwell Family Interview, and child emotional and behavioural problems were measured using the parent version of the Child Behavior Checklist. Multiple regression models were used to test the hypotheses. RESULTS: Forty-three maternal and 33 paternal interviews of adequate quality for analysis were obtained. Paternal hostility was found to be associated with elevated glycated haemoglobin measured 12 months before interview and 12 months after interview, accounting for 22% and 29% of the variation in glycated haemoglobin respectively. CONCLUSIONS: We did not find that parental emotional over-involvement or criticism predicted glycaemic control. Presence of hostility was important, but in contrast to our hypothesis, this was paternal rather than maternal hostility. We suggest that (i) relatively absent, rejecting fathers play little role in diabetes management and children perceive this negatively, or (ii) mothers who are unsupported by fathers cannot in turn support their children in diabetes care.

Adolescent↗