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PubMed2004

Bad but bold: Ambivalent attitudes toward men predict gender inequality in 16 nations.

A 16-nation study involving 8,360 participants revealed that hostile and benevolent attitudes toward men, assessed by the Ambivalence Toward Men Inventory (P. Click & S.T. Fiske, 1999), were (a) reliably measured across cultures, (b) positively correlated (for men and women, within samples and across nations) with each other and with hostile and benevolent sexism toward women (Ambivalent Sexism Inventory, P. Click & S.T. Fiske, 1996), and (c) negatively correlated with gender equality in cross-national comparisons. Stereotype measures indicated that men were viewed as having less positively valenced but more powerful traits than women. The authors argue that hostile as well as benevolent attitudes toward men reflect and support gender inequality by characterizing men as being designed for dominance.

Adolescent↗

PubMed2006

Predicting marital distress and dissolution: refining the two-factor hypothesis.

Measures of communication, hostility, and neuroticism taken from 85 couples from Germany before marriage were used to predict marital outcomes 5 years later. Hostility and neuroticism discriminated between couples who separated or divorced after 5 years and those who remained married, whereas communication discriminated between married-satisfied and married- dissatisfied couples. Only hostility and neuroticism predicted marital satisfaction at 18 months, suggesting that these factors contribute to rapid, early declines in marital functioning. The authors conclude that poor communication alone cannot account for the full range of marital outcomes and that skill-based models of marriage can be strengthened by considering relatively rare exchanges between partners (e.g., aggression) and their enduring vulnerabilities (e.g., neuroticism).

Communication↗

PubMed2003

Differences in anger expression between individuals with and without headache after controlling for depression and anxiety.

OBJECTIVE: To evaluate whether anger and anger expression are different between persons with and without headache after controlling for depression and anxiety. BACKGROUND: Persons with headache may experience more problems with anger and its expression when compared with persons without headache. It is important to establish whether differences exist for persons with and without headache on trait anger and anger expression independent of depression and anxiety. To date, however, this issue has received little attention in the empirical literature. The current study measured trait anger, anger-in, hostility, anxiety, and depression among persons with and without headache, and evaluated whether trait anger and anger-in differentiated groups independent of depression and anxiety. METHODS: Participants were 422 adults recruited from a larger study within a university setting. Of those, 171 suffered from headache (mean age, 21 years; 81% were female; 69% were white; mean years with pain, 7.53). Another 251 sex-matched individuals (mean age, 21 years; 81% female; 62% white) met criteria for the headache-free group. Participants provided information regarding their headache characteristics and were administered affective trait measures (Trait version of the State-Trait Anxiety Inventory, Brief Symptom Inventory-Depression), trait anger measures (Trait Anger Scale, Cook-Medley Hostility Scale), and a measure of the extent to which individuals hold their anger in. RESULTS: Multivariate analysis of variance revealed significant differences between the 2 groups (Wilks lambda =.86, P <.001, eta2 =.14). Step-down analysis revealed that even after controlling for all other variables, those in the headache group had higher levels of anger-in (P <.001, eta2 =.08; mean, 18.98 versus 15.68). Trait anger and hostility did not differ between groups after controlling for depression and anxiety. Logistic regression revealed that anger-in contributed most to predicting headache status (P <.001; partial r =.23). CONCLUSIONS: The current findings indicate that persons with headache hold their anger in more than those without headache even after controlling for levels of trait anger, depression, and anxiety. However, after controlling for depression and anxiety, individuals no longer differed on trait anger. Also, anger-in was the strongest predictor of headache. The current findings suggest that holding anger in is more common among headache sufferers. Given recent findings regarding the negative effect of holding anger in among persons with pain conditions, this may be an important factor to evaluate when considering psychological/emotional factors affecting headache.

Adult↗

PubMed1980

[Drug-response differences of high and standard dosage of fluphenazine-decanoate in relation to schizophrenic symptoms (author's transl)].

The treatment of schizophrenic patients with high-dosed neuroleptics is discussed. The drug-response difference between a low dose and a high dose of Fluphenazine-Decanoate was investigated in 40 chronic schizophrenic patients. All patients were resistant to standard doses of neuroleptics and were therefore treated with higher doses. All patients entering the study were treated for at least three months with high doses of Fluphenazine-Decanoate, i.e. 100 mg or more within three weeks. From this pool of 40 patients two groups were created at random for the doubleblind study: In one group the high dose was continued (average dose 225 mg/in 14 days), in the other group Fluphenazine-Decanoate was reduced to a standard-dose of 25 mg in 14 days. During the 24 weeks of investigation the somatic and psychopathological state of the patient was evaluated by means of the AMP-System. Furthermore the self-rating scale EWL-K was used. After 24 weeks the patients of the high-dosed group were more often rated as unchanged, while the patients in the standard-dosed group were evaluated significantly more often as better or worse. Average condition-differences between the both groups could not be found in a covariance-analysis. A factorial covariance-analysis showed that differences in the initial hostility-syndrome and catatonic-syndrome scores are predictors for a syndrom-relevant differential dosage per group. Patients with low hostility- and low catatonic-syndrome-scores improved after reduction of the doses in the apathic, the halluzinatoric-desintegrative and the neurological syndrome, whereas patients with high initial hostility- and catatonic-syndrome-scores became psychopathologically worse after dosage reduction. Finally the possibilities of generalizing from the results obtained to the relevance of high and standard neuropletic therapy are discussed.

Adult↗

PubMed2000

Lack of correlation between psychological factors and subclinical coronary artery disease.

BACKGROUND: The relation between psychological variables and clinically evident coronary artery disease has been studied extensively, although the potential mechanisms of such a relation remain speculative. We studied the relation between multiple psychological variables and subclinical coronary artery disease to assess the possible role of such variables in atherogenesis. METHODS: We conducted a prospective study of 630 consecutive consenting, active-duty U.S. Army personnel, 39 to 45 years of age, without known coronary artery disease. Each participant was assessed for depression, anxiety, somatization, hostility, and stress. Subclinical coronary artery disease was identified by electron-beam computed tomography. RESULTS: The mean (+/-SD) age of the subjects was 42+/-2 years; 82 percent were male, and 72 percent were white. The prevalence of coronary-artery calcification was 17.6 percent (mean calcification score, 10+/-49). The prevalence of prior or current psychiatric disorders was 12.7 percent. There was no correlation between the coronary-calcification score and the scores measuring depression (r= -0.07, P=0.08), anxiety (r=-0.07, P=0.10), hostility (r=-0.07, P=0.10), or stress (r=-0.002, P=0.96). Somatization (the number and severity of durable physical symptoms) was inversely correlated with calcification scores (r=-0.12, P=0.003), even after we controlled for age and sex. In multivariate logistic-regression models, a somatization score greater than 4 (out of a possible 26) was independently associated with the absence of any coronary-artery calcification (odds ratio, 0.49; 95 percent confidence interval, 0.25 to 0.96). CONCLUSIONS: Our data suggest that depression, anxiety, hostility, and stress are not related to coronary-artery calcification and that somatization is associated with the absence of calcification.

Adult↗

PubMed1997

Anger expression correlates with platelet aggregation.

Potential relationships between increased platelet aggregability and such psychological characteristics as hostility and anger were investigated as part of a larger intervention study investigating the potential efficacy of stress-reduction treatments. Participants performed 6-minute mental arithmetic tests under time pressure. Blood was sampled during the first minute of the task and whole blood platelet aggregation was measured in an aggregometer, using collagen and ADP. To assess anger and hostility, the authors used Spielberger's State-Trait Anger and Anger Expression scales together with the Cook-Medley Hostility Scale. The authors found positive correlations between collagen-induced platelet aggregation and outwardly expressed anger, as measured by the Anger Expression Scale. The findings suggested that modes of anger expression may be associated with increased platelet aggregation. If confirmed by future studies, this finding could provide a mechanism for the putative connection between anger/hostility and coronary heart disease.

Adolescent↗

PubMed1997

Psychological predictors of peptic ulcer incidence in the Alameda County Study.

It has often been suggested that mood and personality predispose to peptic ulcer, but little prospective evidence exists. We used longitudinal data from the Alameda County Study to seek associations of psychological characteristics with later ulcer development, taking into account the possible confounding or mediating, taking into account the possible confounding or mediating roles of nonpsychological factors. Among 4,595 Alameda County Study subjects ulcer-free in 1965, we studied five baseline psychological measures (depression, hostility, ego resiliency, social alienation or anomy, and personal uncertainty) with respect to reported ulcer in 1973-1974. All five measures had significant age-adjusted associations with incident ulcer [odds ratio (O.R.) 1.8-2.6]. After adjustment for smoking, drinking, skipping breakfast, lack of sleep, painful medical conditions, and liver disease, three measures remained significant: depression, anomy, and hostility. The age-adjusted O.R. of 2.8 [95% confidence interval (C.I.) 1.6, 4.8] for an upper versus a lower tertile index of independently predictive psychological factors fell to 2.1 with adjustment for health-related behaviors and medical conditions, and reached 1.7 (C.I. 1.0, 3.1) after addition of education to the model. We conclude that depression, maladjustment, and hostility are prospectively associated with peptic ulcer. These associations are partially accounted for by confounding or mediation by standard risk factors, and are to some extent related to socioeconomic status.

Adult↗

PubMed1981

The Psychological Stress Evaluator as a clinical assessment instrument. Evaluation and implications.

Efficient clinical assessment of anxiety and hostility could be facilitated through the use of a mechanical measurement instrument with known validity and reliability. Preliminary evaluation of the Psychological Stress Evaluator (PSE) has indicated that it could be used for this purpose. The present study reports the results of a correlational analysis between a PSE generated stress indicator (blocking pattern mode III) and the Gottschalk-Gleser Free Association Test, a verbal content-analysis measure of anxiety and hostility in psychotherapy patients. Findings do not show any correlation between these measures and suggest that the PSE may have only limited use as a valid and reliable assessment instrument for anxiety and hostility. Methodological problems inherent in the calculation and interpretation of PSE scores are elaborated in a review of current PSE scoring systems. A brief discussion of the theoretical assumptions underlying the development of the PSE and associated scoring protocols suggests directions for future research.

Adult↗

PubMedDate not supplied

Predictors of noncompliance to exercise training in heart failure.

BACKGROUND/OBJECTIVES: Exercise training is an emerging therapy in heart failure (HF). However, factors influencing noncompliance to exercise have not been evaluated. We assessed clinical factors, functional status, and emotional predictors of noncompliance to a 12-week home walking exercise program. METHODS: Using a correlational design, we evaluated noncompliance of 39 HF patients (aged 63.2 +/- 10.1 years, left ventricular ejection fraction 29.5% +/- 8.0%, peak oxygen consumption 14.1 +/- 3.7 mL/kg/min, HF duration 37.5 +/- 32.9 months, 74% New York Heart Association class II) to home walking exercise. Noncompliance was defined as (1) completion of the 12-week program with 60% or less of prescribed weekly walking duration (noncompliant completers); or (2) failure to complete the 12-week program (dropouts). Univariate analyses (chi-square or t test) and multivariate backward logistic regression were performed to identify clinical factors (body mass index, comorbidities, and HF duration), functional status (peak VO2), and emotional dysphoria (anxiety, hostility, depression) predictive of noncompliance to training. RESULTS: Mean compliance was 35% +/- 30% (945/2700 minutes) for noncompliant patients (n = 13) and 99% +/- 13% (2673/2700 minutes) for compliant patients (n = 26). In the multivariate analysis, higher comorbidity (odds ratio [OR]: 2.7, confidence interval [CI]: 1.11-6.71), longer HF duration (OR: 1.1, CI: 1.01-1.13), lower hostility (OR: 0.47, CI: 0.24-0.91), and lower body mass index (OR: 0.76, CI: 0.58-0.98) were predictive of noncompliance to exercise training in patients with HF. CONCLUSIONS: Noncompliance should be monitored carefully in HF patients with multiple comorbidities, longer HF duration, lower body mass index, and lower hostility scores. In this subgroup of HF patients, tailored exercise prescriptions may enhance compliance to an exercise program.

Activities of Daily Living↗

PubMedDate not supplied

Familial resemblance in components of the type A behavior pattern: a reanalysis of the California type A twin study.

Rosenman and colleagues reported no heritability of global Type A behavior assessed by the Structured Interview (SI) method, although some of the self-report scales correlated with global Type A behavior did have heritable components. Recent factor analyses of coded SI responses revealed four independent dimensions: clinical ratings, primarily of speech stylistics; and self-reports of pressured drive, anger, and competitiveness. It may be that some of these dimensions have a heritable base, whereas others do not. We report here reanalyses of the available SI responses from the Rosenman sample. In this subsample, tape recorded interviews with 80 monozygotic and 80 dizygotic twin pairs were scored for the extent of self-reported Type A behaviors, the major speech stylistics considered to be indicative of Pattern A, and the observable Type A behaviors (e.g., signs of hostility). Then scores for the major dimensions measured by the SI were calculated and scores for which there were sufficient data were subjected to twin analyses by the method of Christian et al. These analyses showed that individual differences in the clinical ratings factor and certain ratings loading on it--specifically, loudness of speech, competition for control of the interview, and potential for hostility--might have a heritable component. These results are discussed in the context of the importance of hostility as a predictor of subsequent coronary heart disease events as well as of total mortality, other data on the heritability of emotionality, and a temperament approach to understanding the origins of the Type A behavior pattern.

Adult↗

PubMedDate not supplied

Coronary-prone behaviors in the Western Collaborative Group Study.

Two-hundred-fifty CHD cases and 500 matched controls from the Western Collaborative Group Study were studied to assess the 8.5-yr prospective relationship of specific behavioral dimensions to the incidence of coronary heart disease. Type A structured interviews administered at intake were reevaluated in terms of 12 operationally defined components, which include previously described facets of the Type A behavior pattern. Univariate risk analyses using the matched logistic model found hostility (RR = 1.92, p less than 0.001), speaking rate (RR = 1.66, p = 0.003), immediateness (RR = 1.62, p = 0.009), competitiveness (RR = 1.50, p = 0.013), and Type A content (RR = 1.38, p = 0.045) to be significantly related to CHD incidence. Of these, only hostility remained a significant risk factor (RR = 1.93, p less than 0.001) when all 12 components were included in the model. The original Type A global ratings and traditional CHD risk factors were also analyzed in conjunction with the components. The Type A behavior pattern comprises both benign and coronary-prone facets, with the latter most exemplified by hostility.

Adult↗

PubMedDate not supplied

Anger and incident heart disease in the caerphilly study.

OBJECTIVE: The idea that anger may predict ischemic heart disease (IHD) is more than 30 years old. Some, but not all, prospective studies have supported this suggestion. Attention has focused on hostility as the critical component of anger for IHD risk. This idea is explored using prospective data from the Caerphilly study. METHODS: A sample of 2890 men aged 49 to 65 years living in and around Caerphilly, South Wales, was identified. Anger was assessed using the Framingham scales comprising "anger symptoms," "anger in," "anger out," and "anger discuss." A new "suppressed anger" scale was also constructed. Cardiovascular risk factors assessed included baseline blood pressure, total and high-density lipoprotein cholesterol, fibrinogen, white cell count, psychiatric caseness as assessed by the General Health Questionnaire, social support, smoking habit, alcohol consumption, leisure exercise, body mass index, and calorie intake. Prediction of IHD, measured as the occurrence of a major event over a follow-up period of 9 years, was assessed using multiple logistic regression analysis. RESULTS: A low anger out score predicted increased risk of a major IHD event (relative odds (RO) = 1.70; 95% confidence interval = 1.26-2.29 for all RO). This association was unchanged on controlling for physiological risk factors (RO = 1.74), psychosocial risk factors (RO = 1.72), and behavioral risk factors (RO = 1.69). Suppressed anger showed associations with incident IHD similar to those of anger out but identified the population at risk more closely. CONCLUSIONS: Anger out and suppressed anger were predictive of incident IHD. Neither of these constructs are overtly similar to hostility. These findings suggest there may be mechanisms other than hostility by which anger predicts IHD risk and that a conceptually varied approach to anger is currently appropriate.

Aged↗

PubMedDate not supplied

Psychological risk factors may moderate pharmacological treatment effects among ischemic heart disease patients. Canadian Amlodipine/Atenolol in Silent Ischemia Study (CASIS) Investigators.

BACKGROUND: Numerous research findings support the proposed connection between such psychological characteristics as stress and hostility and the manifestation of disease. However, less evidence is available concerning the role(s) psychological factors might play in the process of disease recovery. METHODS: Eighty patients with known coronary disease and exercise-induced ischemia underwent treadmill exercise testing and 48-hour ambulatory electrocardiographic monitoring and completed a battery of standardized psychological tests assessing hostility, depression, and daily stress on four occasions during a 12-week pharmacological treatment study. After withdrawal of antiischemic drugs at baseline, patients returned for subsequent tests at 3-week intervals. During the second and third intervals, patients were prescribed one of two antiischemic medications, atenolol or amlodipine, or given a placebo. All patients were then placed on a combination treatment protocol for the 3 weeks before the final testing date. RESULTS: The combination treatment produced highly significant benefits across all measured cardiac variables (20.3% improvement in exercise performance, 13% reduction in reported angina, 64.0% reduction in the frequency of ischemic episodes; for all, p < .01). However, results showed that high baseline levels of daily stress were associated with reliably smaller treatment effects on measures of ischemia frequency and treadmill exercise time and with a significantly greater likelihood of reporting angina after treatment (r = -0.24, -0.25, and -0.33, respectively; p <.05). In addition, high baseline hostility predicted significantly smaller diastolic blood pressure improvements (r = -0.29, p < .05). CONCLUSIONS: These results indicate that psychological risk factors may have globally negative effects on the course of treatment and suggest particular factors that may warrant attention in trials targeting cardiac symptom reduction.

Adrenergic beta-Antagonists↗

PubMedDate not supplied

Covariation of psychosocial characteristics associated with cardiovascular disease: genetic and environmental influences.

OBJECTIVE: Three psychosocial characteristics associated with cardiovascular disease (CVD)-depression, hostility, and social support-tend to correlate with one another. However, the causes of each characteristic and why they tend to co-occur are not completely understood. Therefore, the current study used a twin design to examine the relative contributions of genetic and environmental influences to the variation and covariation of these three psychosocial characteristics. METHODS: The sources of variation and covariation among the Beck Depression Inventory, the Cook-Medley Hostility Scale, and the Interpersonal Support Evaluation List were examined in a young adult community sample of 157 monozygotic and 75 dizygotic twin pairs. RESULTS: Phenotypic confirmatory factor analysis indicated that a single latent factor could account for their moderate intercorrelations. Twin analyses indicated that the Beck Depression Inventory and Interpersonal Support Evaluation List were each influenced by genetic and nonshared environmental factors, whereas the Cook-Medley Hostility Scale was influenced by familial (genetic and/or shared environmental) and nonshared environmental factors. Bivariate associations between these scales were largely determined by common genetic effects and, to a lesser degree, common nonshared environmental effects. Covariation among the three scales could be explained by a single common genetic factor and a common nonshared environmental factor. Environmental factors shared within families did not contribute to covariation among the psychosocial characteristics. CONCLUSIONS: The results challenge the conventional approach of examining these psychosocial variables as independent risk factors for cardiovascular disease and argue for the importance of investigating specific causes for their covariation.

Adult↗

PubMed2004

Suicidal behavior and mild traumatic brain injury in major depression.

Traumatic brain injury (TBI) is associated with psychiatric illness, suicidal ideation, suicide attempts, and completed suicide. We investigated the relationship between mild TBI and other risk factors for suicidal behavior in major depressive episode. We hypothesized that mild TBI would be associated with suicidal behavior at least partly because of shared risk factors that contribute to the diathesis for suicidal acts. Depressed patients (N = 325) presenting for treatment were evaluated for psychopathology, traumatic history, and suicidal behavior. Data were analyzed using Student t -test, chi-square statistic, or Fisher exact test. A backward stepwise logistic regression model (N = 255) examined the relationship between attempter status and variables that differed in the TBI and non-TBI patients. Forty-four percent of all subjects reported mild TBI. Subjects with TBI were more likely to be male, have a history of substance abuse, have cluster B personality disorder, and be more aggressive and hostile compared with subjects without TBI. They were also more likely to be suicide attempters, although their suicidal behavior was not different from that of suicide attempters without TBI. Attempt status was mostly predicted by aggression and hostility, but not the presence of TBI. Of note, for males, a history of TBI increased the likelihood of being a suicide attempter, whereas the risk was elevated for females regardless of TBI history. Our data suggest that suicidal behavior and TBI share antecedent risk factors: hostility and aggression. Future studies may yield confirmation using a prospective design.

Adult↗

PubMed2004

Activation symptoms and discharge in elderly chronic schizophrenic inpatients.

Three hundred thirty-three elderly schizophrenic inpatients were rated on the Positive and Negative Syndrome Scale (PANSS), and those remaining in the hospital after 1 year (N = 267) were rated and followed for an additional year. Based on previous studies showing that aggressive episodes and hostile behavior predicted inability to discharge schizophrenics, we hypothesized that low discharge rates would be correlated with high baseline ratings on the activation factor of the PANSS (PANSS-AF), obtained by summing six items (hostility, poor impulse control, excitement, uncooperativeness, poor rapport, and tension). Baseline PANSS-AF scores were found to be inversely correlated with discharge rates, independent of ratings on other symptom dimensions. PANSS-AF scores were a better predictor of outcome than any individual PANSS item (e.g., hostility), and individual item scores did not add significantly to prediction of discharge. Attention to and development of treatments for activation symptoms, highly prevalent in schizophrenia but not included in our present diagnostic systems, may increase the chances of elderly inpatients with schizophrenia of moving to community settings.

Brief Psychiatric Rating Scale↗

PubMed2006

Covariation of psychological attributes and incident coronary heart disease in U.S. Air Force veterans of the Vietnam war.

OBJECTIVE: The purpose of the present investigation was to examine the prospective associations of hostility, anger, depression, and anxiety, alone and in combination, to incident coronary heart disease (CHD). METHODS: Subjects were 2105 men who participated in the Air Force Health Study, a 20-year study designed to evaluate the effects of herbicide exposure on various health outcomes in Air Force veterans of Operation Ranch Hand. Psychological attributes were assessed in 1985 using scales constructed from the Minnesota Multiphasic Personality Inventory. Participants were followed for an average of 15 years for evidence of ischemic heart disease (International Classification of Diseases codes 410-414, 428.4, or 36). The relation between psychological attributes and CHD was examined with Cox proportional hazard models. RESULTS: Adjusting for CHD risk factors, depression, anxiety, hostility, and trait anger were significant predictors of incident CHD. In addition, a factor analytically derived psychological risk factor composite score was the strongest predictor of CHD. CONCLUSIONS: These results suggest that the covariation of hostility, anger, depression, and anxiety accounts for the increased risk of CHD associated with each individual factor. The results of this study challenge the conventional approach of examining these psychological attributes in isolation.

Adult↗

PubMedDate not supplied

Relationally and physically aggressive children's intent attributions and feelings of distress for relational and instrumental peer provocations.

Numerous studies have demonstrated that physically aggressive children exhibit hostile attributional biases in response to instrumental peer provocations, a social information-processing pattern that has been recognized as a contributor to peer-directed aggression. The present studies (N = 127 and N = 535) were designed to extend past research by evaluating the intent attributions and feelings of emotional distress of relationally and physically aggressive children in response to instrumental and relational provocation contexts. Results indicated that physically aggressive children exhibited hostile attributional biases and reported relatively greater distress for instrumental provocation situations, whereas relationally aggressive children exhibited hostile attributional biases and reported relatively greater distress for relational provocation contexts. Implications of these findings for the understanding of factors that may contribute to relational as well as physical aggression are discussed.

Aggression↗