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

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

Cynical hostility: developmental factors, psychosocial correlates, and health behaviors

Examined potential differences between individuals with high and low Cook and Medley (1954) Hostility (Ho) scale scores in regard to (a) self-esteem and particular developmental experiences; (b) utilization of social support, experience of anger, and the manner in which anger is managed; and (c) potentially health-damaging behaviors. Individuals with high Ho scale scores were found to be low in covert self-esteem and reported behavior on the part of their parents that reflected (a) less genuine acceptance, (b) more interference in the person's desires as a child, and (c) more punitiveness. In addition, the results indicated that high Ho score individuals avoid seeking or accepting social support, experience anger that is excessive and that occurs in a wide variety of situations, and suppress expression of anger. Finally, it was found that hostile individuals tended to drink more alcohol and drive a car more frequently after drinking and to have greater relative weight.     

Hostility and health: current status of a psychosomatic hypothesis.

Recent research has renewed interest in the potential influence of hostility on physical health. This review indicates that the evidence available from prospective studies, although not entirely consistent, suggests that hostile persons may be at increased risk for subsequent coronary heart disease and other life-threatening illnesses. Further, several plausible mechanisms possibly linking hostility and health have been articulated and subjected to initial evaluation. Hostile individuals display heightened physiological reactivity in some situations, report greater degrees of interpersonal conflict and less social support, and may have more unhealthy daily habits. Additional research is needed, and it must address a variety of past conceptual and methodological limitations. Perhaps the most central of these concerns are the assessment of individual differences in hostility and the role of social contexts in the psychosomatic process.     

Cynical Hostility: A Risk Factor in HIV-1 Infection?1

The aims of this study of HIV-1 positive and HIV-1 negative gay males without disease were (a) to determine whether cynical hostility in these groups (measured by the Cook-Medley Ho scale) is associated with psychosocial deficits that potentially could influence the course of HIV infection; and (b) to examine the construct validity of the sum of three Ho subsets in this sample. Correlational analyses on the full samples, and multivariate analyses of high- and low-hostility groups (formed using Ho scale cutoffs from previous research), examined person variables (traits, coping style), environmental variables (social support, stressors), and affect. In all domains other than stressors (traits, coping styles, social support, and affect), cynical hostility was associated with psychosocial deficits, with results generally stronger for the full Ho scale than for the subset sum. Results support previous research on psychosocial deficits of the cynically hostile, extend findings to HIV-infected gay males, and enlarge our understanding of the trait and coping style correlates of cynical hostility. Implications of these findings for HIV infection are discussed.     

Is compassion for others stress buffering? Consequences of compassion and social support for physiological reactivity to stress

The present study examined the role of compassion for others and social support in physiological stress reactivity. In this experiment, participants who had previously completed an online assessment of compassion experienced a social stress task in front of either two supportive or neutral evaluators, while their blood pressure, cortisol, high frequency heart rate variability (HF-HRV), and liking for the evaluators were monitored. Participants’ compassion for others interacted with social support condition to buffer their physiological reactivity to stress. When provided with social support during the task, higher trait compassion was associated with lower blood pressure reactivity, lower cortisol reactivity, and higher HF-HRV reactivity. Higher compassion was also associated with greater liking for the supportive evaluators. These relationships were not observed for participants in the neutral condition, regardless of their trait compassion. Compassion for others may increase our ability to receive social support, which may lead to more adaptive profiles of stress reactivity.     

Responses to false physiological feedback in individuals with panic attacks and elevated anxiety sensitivity

Participants with elevated anxiety sensitivity and a history of panic attacks were compared to a low anxiety comparison group with respect to physiological and subjective reactivity to false heart-rate feedback and reactivity to a priming procedure. Whereas accurate heart-rate feedback elicited minimal responses, participants across groups showed significant physiological and subjective responses to false feedback. High risk and low risk participants did not differ in heart-rate responses to false feedback, though panic attack frequency did predict physiological and subjective reactions to false feedback in the high risk group. Self-reported nonspecific anxiety was significantly higher in high risk female participants than in low risk female participants, while males did not different in general subjective anxiety. However, high risk participants reported more panic-specific symptoms during the false feedback task than low risk participants, regardless of the sex of the participant. Therefore, although the experimental paradigm appeared to trigger nonspecific anxiety in high risk female participants, panic attack symptoms in reaction to the task were specific to risk group, not sex, and consistent with hypotheses. Surprisingly, the priming procedure did not influence physiological or subjective responses to false feedback in either group. These results raise additional questions regarding the process and impact of interoception in individuals with panic attacks, and suggest that false perception of internal changes may contribute to risk for panic disorder when exposed to believable cues.     

Parental Representations and Support-Seeking Behaviors Related to Dependency and Self-Criticism

Cognitive and interpersonal models of depression were integrated by examining the links between parental representations and the interpersonal behaviors of individuals at risk for depression. Study 1 assessed the quantity and type of social support associated with Dependency and Self-Criticism. Study 2 examined the parental representations related to these personality styles, in an effort to document cognitive variables that might contribute to interpersonal behaviors. Self-critics were found to be more dysphoric over a 21-day, self-monitoring period, made fewer requests for social support, and showed lower perceptions of support. Peers did not report providing less support to self-critics, but found them less expressive and did not know them as well. Study 2 found pervasive, negative parental representations associated with Self-Criticism providing a cognitive underpinning to social distancing. Dependent participants reported higher levels of support, which was corroborated by the peer reports. Study 2 found Dependency to be related to favorable representation of parents for friendly and submissive, but not hostile, situations. The impact of cognitive representations for interpersonal functioning is highlighted, and reciprocal processes between the two are discussed.     

Interpersonal Justice,Relational Conflict,and Commitment to Change: The Moderating Role of Social Interaction

Drawing from Conservation of Resources theory, this study examines the hitherto unexplored mediating role of relational conflict in the link between interpersonal justice and commitment to change, as well as how social interaction might moderate this mediating effect. Data were captured from employees directly affected by a large‐scale restructuring in a European‐based organisation. The analyses show that interpersonal justice positively affects commitment to change and that relationship conflict fully mediates the relationship. Further, social interaction moderates both the interpersonal justice–relational conflict and the relational conflict–commitment to change relationships, such that they get invigorated at higher levels of social interaction. The findings also reveal that the indirect effect of interpersonal justice on commitment to change, through relational conflict, is more pronounced at higher levels of social interaction, in support of a moderated mediation effect. These findings have significant implications for research and practice.     

ROMANTIC PARTNERS' COPING STRATEGIES AND PATTERNS OF CORTISOL REACTIVITY AND RECOVERY IN RESPONSE TO RELATIONSHIP CONFLICT

Stress in close relationships can have significant negative consequences for mental health, physical health, and long-term relationship functioning. Dysregulated physiological responses to stress are potential pathways through which relationship stress may lead to these kinds of outcomes, and the ways in which individuals attempt to cope with relationship stress are likely to impact their physiological responses. However, our understanding of the specific coping strategies that predict physiological reactivity and recovery in these contexts is rather limited. This study explored relations between young adult college students' self-reported methods of coping with stress in their romantic relationships and their physiological reactivity to and recovery from negotiating conflict with their romantic partners. Partners' coping styles were also examined as predictors of physiological stress responses. One hundred and ninety opposite-sex couples (N = 380; modal length of relationship = 1-2 years) participated in an experimental conflict discussion task. Physiological stress reactivity to the task was assessed using salivary cortisol, a primary hormonal product of the hypothalamic-pituitary-adrenocortical (HPA) axis. Growth modeling of the cortisol levels before, during, and after the conflict task indicated that men who typically coped with relationship stress by seeking social support showed greater physiological reactivity to the conflict task. Partners' need for social support predicted stronger stress responses for both men and women, as well. While seeking social support is generally thought to be an adaptive coping strategy for couples, the results suggest that within the context of conflict negotiation in which receiving and providing support may be more difficult, seeking support from a partner is associated with greater phyisological stress.     

Social networks in borderline personality disorder

The interpersonal dysfunction that characterizes borderline personality disorder (BPD) has generally been studied using broad global measures, leading to a lack of precision. We report on a novel methodology using social network analysis (SNA) to quantify interactions with others in the patient's social world. We assessed the social networks of 22 clinical patients, diagnosed with either BPD (N = 11) or no personality disorder (No PD; N = 11). The social networks of patients with BPD contained a greater number of former romantic partners, and a greater number of relationships that had been terminated. Mixed model analyses found that the No PD group reported higher levels of positive relationships (e.g., trust, social support) with more central members of their social networks, whereas the BPD group did not discriminate among members of their networks. Results suggest deficits in social cognition for positive relations, but not for negative relations such as interpersonal conflict.     

Toward an Understanding of Gender Differences in the Impact of Marital Conflict on Health

The present paper addresses the consistent finding that men derive more benefit from marriage in terms of both morbidity and mortality compared to women in U. S. society. Based on the evidence that spousal conflict adversely influences physiology and health, with greater negative impact on wives compared to husbands, we propose that the stronger impact of relationship negativity contributes to the decreased marriage benefit for women. Evidence bearing on two explanations for this differential impact of conflict is reviewed. The relational-interdependence view, proposed by Kiecolt-Glaser and Newton (2001), holds that women are more affected by marital conflict because of their more relationally interdependent self-representations. An alternative view, which we call the subordination-reactivity hypothesis, suggests that women experience greater physiological and psychological reactivity to marital discord because they typically occupy subordinate (lower status and less powerful) positions relative to their husbands. A review of the evidence on the physiological effects of social status is combined with that of the relationship between gender and status, both within society at large and interpersonal relationships specifically, to support the subordination-reactivity hypothesis. Specifically, there is evidence that low social status negatively impacts health and that women generally occupy subordinate status. The relational-interdependence view is re-evaluated and its intersection with the subordination-reactivity hypothesis is explored. Finally, implications and future directions are discussed.     

Is there less to social anxiety than meets the eye? Emotion experience,expression, and bodily responding

Emotions are widely held to involve changes in experiential, behavioural, and physiological systems. It is not clear, however, just how tightly coupled these changes are during emotional responding. To examine this issue, we induced social anxiety in 47 high trait social anxiety (HTSA) and 50 low trait social anxiety (LTSA) participants using an impromptu speech paradigm. We assessed anxiety experience, behaviour, perceived physiological activation, and actual physiological activation. HTSA participants felt more anxious, perceived greater physiological activation, and exhibited more anxiety behaviour than LTSA participants. Unexpectedly, the two groups did not differ in objectively measured physiological responding. Internal analyses indicated that for both HTSA and LTSA participants, anxiety experience was associated with perceived physiological activation, but not with actual physiological responding. These results suggest that anxiety experience and perceived physiological activation may be less tightly coupled with actual physiological responses than is typically thought.     

Effects of Interpretation Training on Hostile Attribution Bias and Reactivity to Interpersonal Insult

Research suggests that individuals high in anger have a bias for attributing hostile intentions to ambiguous situations. The current study tested whether this interpretation bias can be altered to influence anger reactivity to an interpersonal insult using a single-session cognitive bias modification program. One hundred thirty-five undergraduate students were randomized to receive positive training, negative training, or a control condition. Anger reactivity to insult was then assessed. Positive training led to significantly greater increases in positive interpretation bias relative to the negative group, though these increases were only marginally greater than the control group. Negative training led to increased negative interpretation bias relative to other groups. During the insult, participants in the positive condition reported less anger than those in the control condition. Observers rated participants in the positive condition as less irritated than those in the negative condition and more amused than the other two conditions. Though mediation of effects via bias modification was not demonstrated, among the positive condition posttraining interpretation bias was correlated with self-reported anger, suggesting that positive training reduced anger reactivity by influencing interpretation biases. Findings suggest that positive interpretation training may be a promising treatment for reducing anger. However, the current study was conducted with a non-treatment-seeking student sample; further research with a treatment-seeking sample with problematic anger is necessary.     

Role of Religious Attendance and Identity Conflict in Psychological Well-being

A sample of individuals who identified as gay or lesbian were administered measures of church attendance, their religious organization’s view of homosexuality, perceived conflict between religious faith identity and sexual orientation identity, social support, depression, and generalized anxiety. Among participants who rated their church as rejecting of homosexuality, greater frequency of attendance was related to a higher incidence of GAD symptoms, but not depression. No correlation was found for those attending accepting faith communities. Those who attend rejecting faith communities attended services less often, experienced greater identity conflict, and reported significantly less social support than those of the Accepted group. Regression analyses indicated that identity conflict and social support did not fully account for the relationship between attendance and GAD symptoms. Overall, findings from the current study support previous suggestions that participation in conservative or rejecting religious communities may adversely affect the emotional well-being of GL individuals.     

The role of stress,social support,and family environment in adolescent mothers' parenting

Adolescent childbearing is a major social and economic problem in the US. The authors assessed the role of stress, social support, and family environment upon adolescent mothers' parenting behaviors. 75 African-American, mother-infant pairs participated in the study. Each mother was administered a questionnaire and observed in a ten-minute teaching task with her baby. The study found that the adolescent mother's mother was the most frequent provider of support and the baby's father was the most frequent source of conflict. Mothers who identified more individuals as a source of conflict tended to have less positive parenting behaviors. Child age and interpersonal conflict were found through analysis to be significant predictors of maternal behavior. Furthermore, social support moderated the effects of interpersonal conflict when conflicted networks were large. Parenting stress was not a significant predictor of maternal behavior.     

Affect dysregulation in individuals with borderline personality disorder: persistence and interpersonal triggers

We hypothesized that affect dysregulation among individuals with borderline personality disorder (BPD) would involve greater persistence of negative affect between interpersonal events and heightened reactivity to stimuli indicating risk of rejection or disapproval, specifically perceptions of others' communal (agreeable-quarrelsome) behaviors. A total of 38 participants with BPD and 31 controls collected information about affect and perceptions of the interaction partner's behavior during interpersonal events for a 20-day period. Negative and positive affect persisted more across interpersonal events for individuals with BPD than for controls. In addition, individuals with BPD reported a greater increase in negative affect when they perceived less communal behavior and a smaller increase in positive affect when they perceived more communal behavior in others. Findings indicate the importance of interpersonal perceptions in the affect dysregulation of individuals with BPD.     

Stress reactivity and coping in seasonal and nonseasonal depression

Stress, stress reactivity, and coping skill use were examined in individuals with seasonal depression, nonseasonal depression, and nondepressed controls. Although participants in the two depressed groups reported using more avoidance coping strategies than controls, only participants in the seasonal depressed group reported using more season-specific coping (i.e., light-related strategies) than participants in the nonseasonal depressed and control groups. Individuals in the seasonal depressed group also reporting using acceptance coping strategies less frequently than individuals in the control group. Only participants in the nonseasonal depressed group, however, exhibited greater psychophysiological arousal in reaction to a laboratory stressor (i.e., unsolvable anagram task) when compared to participants in the seasonal and nondepressed control groups. Participants in both depressed groups reported greater impact of negative life events during the past 6 months than did controls. Similarities and differences in the two types of depression may have implications for the conceptualization and treatment of seasonal depression.