Hostility, anger, aggressiveness, and coronary heart disease: an interpersonal perspective on personality, emotion, and health

The related traits of hostility, anger, and aggressiveness have long been suggested as risk factors for coronary heart disease (CHD). Our prior review of this literature (Smith, 1992) found both considerable evidence in support of this hypothesis and important limitations that precluded firm conclusions. In the present review, we discuss recent research on the assessment of these traits, their association with CHD and longevity, and mechanisms possibly underlying the association. In doing so, we illustrate the value of the interpersonal tradition in personality psychology (Sullivan, 1953; Leary, 1957; Carson, 1969; Kiesler, 1996) for not only research on the health consequences of hostility, anger, and aggressiveness, but also for the general study of the effects of emotion, personality and other psychosocial characteristics on physical health.     

Distinguishing narcissism and hostility: similarities and differences in interpersonal circumplex and five-factor correlates

Narcissism and hostility are both characterized by dysfunctional social interactions, including tendencies to perceive slights, experience anger, and behave aggressively. The aim of this study was to examine the similarities and differences of narcissism and hostility, using 2 conceptual tools-the interpersonal circumplex and the Five-factor model. In a sample of 292 undergraduate men and women, composite measures of hostility (i.e., Buss-Perry Aggression Questionnaire [Buss & Perry, 1992] and Cook-Medley Hostility [Cook & Medley, 1954] total scores) were inversely correlated with affiliation and unrelated to dominance. In contrast, composite narcissism scores (i.e., Narcissistic Personality Inventory) were positively correlated with dominance and inversely correlated with affiliation. Examination of components of these traits revealed additional similarities and differences, as did associations with other dimensions of the Five-factor model. These findings suggest that the traits of narcissism and hostility are distinguishable by their interpersonal referents, as are their components.     

Violent video games exposure and aggression: The role of moral disengagement,anger, hostility,and disinhibition

Based on the General Aggression Model (GAM), the current study investigated the interactive effect of personal factors (e.g., sensation-seeking) and situational factors (e.g., violent video games exposure [VVGE]) on the trait aggressive behavior, and the mediating role of individual difference trait (e.g., moral disengagement, anger, and hostility). We recruited 547 undergraduates (48.45% male) from five Chinese universities. The results showed that VVGE was positively associated with moral disengagement, disinhibition, and the four aggressive traits (physical aggression, verbal aggression, anger, and hostility), which were positively associated with each other. Moral disengagement was positively associated with both the disinhibition and the four aggressive traits. Disinhibition was positively associated with the four aggressive traits as well. When controlled for gender, moral disengagement, anger, and hostility wholly mediated the relationship between VVGE and aggression, but the moderation effect of disinhibition was not significant. These findings support the framework of GAM and indicate that moral disengagement, anger, and hostility may be the factors that increase the risk of a higher level of aggression following repeated exposure to violent video games.     

Heteronormativity,Disgust Sensitivity,and Hostile Attitudes toward Gay Men: Potential Mechanisms to Maintain Social Hierarchies

Within a social hierarchy based on sexual orientation, heteronormative ideology serves as a social force that maintains dominant group members’ status (e.g., heterosexual men). Disgust may be an emotional reaction to gay men’s violation of heteronormativity (i.e., same-sex sexual behavior) and motivate hostile attitudes toward gay men to promote interpersonal and intergroup boundaries. Based on this theoretical framework, we hypothesized that sexual disgust—compared to pathogen or moral disgust—would be most strongly associated with antigay hostility and would statistically mediate its relationship with heteronormativity. Heterosexual men in the United States (n?=?409) completed an online questionnaire assessing heteronormative ideology, disgust sensitivity, and hostile attitudes toward gay men. Results support the hypotheses and suggest that gay men’s sexual behavior is the most likely elicitor of disgust and antigay hostility, as opposed to a perceived pathogen threat or moral transgression. The findings indicate that heteronormative attitudes and sexual disgust are likely contributors to antigay hostility. Thus, intervention efforts should seek to improve tolerance of same-sex sexual behavior among heterosexual men, which may mitigate emotional reactions and hostile attitudes toward gay men.

     

Neuroticism and cardiovascular response in women: evidence of effects on blood pressure recovery

Neuroticism is a unifying personality trait that underlies a number of psychosocial risk factors for cardiovascular disease. One means by which Neuroticism may influence health risk is through effects on cardiovascular reactivity and recovery. Eighty-six women scoring high or low in Neuroticism took part in a paired interpersonal stressor task with a laboratory confederate. Conditions differed on the basis of the confederate's interpersonal behavior: hostile, neutral, or friendly. Neuroticism interacted with condition to affect blood pressure recovery such that women high in Neuroticism showed less recovery following hostile interactions and greater recovery following friendly interactions. Main effects of Neuroticism on anger and anxiety reactivity were found. Results indicate that Neuroticism is relevant to cardiovascular health in the context of valenced social interactions. Implications for future study of Neuroticism and interpersonal stressors as risk factors for cardiovascular disease are discussed.     

The relative importance of psychopathy-related traits in predicting impersonal sex and hostile masculinity

This paper reports the relative contributions of several facets of subclinical psychopathy (i.e., callous affect, erratic lifestyle, interpersonal manipulation), subclinical narcissism (i.e., entitlement, exploitation), and trait aggression (i.e., anger) to the prediction of four enduring attitudes towards women and sexual assault (i.e., hostility towards women, negative attitudes regarding women, sexual dominance, impersonal sex) and a behavioral indicator of an impersonal sexual behavior (i.e., number of one-night stands). Survey data were collected from 470 single men living in the Detroit Metropolitan area. The importance of personality traits varied as a function of the outcome with anger most predictive of hostility toward women; erratic lifestyle most predictive of impersonal sexual attitudes and behavior, and entitlement most predictive of sexual dominance and negative attitudes toward women. These outcome-specific findings are interpreted and directions for future research are discussed.     

Cynical hostility and vulnerability to disease: social support, life stress, and physiological response to conflict

Previous research has indicated that high scores on the Cook and Medley Hostility (Ho) scale are associated with increased risk of coronary heart disease and other illness. Our study attempts to clarify this relationship by providing additional evidence concerning the construct assessed by the Ho scale, examining the level of physiological reactivity during interpersonal conflict in high- and low-Ho groups, and assessing the psychosocial profile associated with this characteristic. Extremely high and low Ho groups were selected from a pool of male undergraduates. Consistent with previous findings, high-Ho participants reported greater anger proneness and a more cynical, disparaging view of others than did low-Ho participants. The high-Ho group also tended to be more hostile and less friendly during role-played interactions involving high and low levels of interpersonal conflict, respectively. High-Ho persons also displayed greater diastolic blood pressure reactivity during interpersonal conflict. Finally, the high-Ho group reported less social support and more negative life events and daily irritants then did the low-Ho group. These results support the interpretation of the Ho scale as a measure of cynical hostility and are consistent with the hypothesis that it is related to disease by way of excessive physiological reactivity and a generally stressful, unsupportive social network.     

The Relationship Between Male-Perpetrated Interparental Aggression,Paternal Characteristics,and Child Psychosocial Functioning

It is well established that children in homes where interparental violence is present are at increased risk for psychosocial (i.e., internalizing, externalizing, and attention) difficulties. However, previous studies have provided a limited view on the variety of factors that commonly co-occur in these environments (e.g., other characteristics of the parents and family) and how they may collectively impact children. Knowing this information could have implications for parental interventions aimed at preventing the continuation or initiation of psychosocial problems in children. Thus, the present study simultaneously examined the association between father-perpetrated interparental aggression, father characteristics, and child psychosocial functioning in a sample of 145 men arrested for domestic violence. Results showed that of all the variables examined, paternal antisocial personality traits and interpersonal hostility were uniquely associated with overall child psychosocial impairment, externalizing problems, and attention problems. Implications for intervention programs are discussed.     

Social influence, marriage, and the heart: cardiovascular consequences of interpersonal control in husbands and wives.

Human and experimental animal research suggests that social stress in general--and chronic, effortful attempts to exert social control in particular--may contribute to cardiovascular disease. We examined the effects of exerting social influence or control on cardiovascular responses in married couples. Compared to husbands discussing a problem with their wives, husbands attempting to influence or persuade their wives displayed larger increases in systolic blood pressure (SBP) before and during the discussion. Furthermore, these physiological effects were accompanied by increases in anger and a more hostile and coldly assertive interpersonal style. Although wives who engaged in social influence attempts displayed generally similar behavior, they did not show the elevated SBP response or anger. We discuss the results in terms of the social context of cardiovascular reactivity and potential marital factors in cardiovascular health.     

Person perception when aggressive or nonaggressive sports are primed

Previous research investigating the factors contributing to sports spectator violence has focused primarily on conscious processes such as the disinhibiting effects of aggressive models and physiological arousal. The current research borrows a methodology from social cognition work to examine the role of passive, category accessibility effects on fan hostility. Prior research has indicated that as a schema becomes more accessible in memory, the use of it to encode subsequent information is increased. It was therefore hypothesized that individuals for whom the category of hostility had been unobtrusively primed with aggressive-sports names (e.g., boxing) would rate an ambiguous target person as more hostile and as more likely to prefer hostile activities relative to persons who were primed with sports names which were not associated with violence (e.g., golf). The results supported the hypotheses, with subjects who were primed with aggressive-sports rating an unrelated target person's behavior as significantly more hostile and as more likely to prefer aggressive activities relative to subjects exposed to sentences containing references to nonaggressive-sports. Discussion includes the potential ramifications for spectator aggression at sporting events.     

Social status,everyday interpersonal processes,and coronary heart disease: A social psychophysiological view

Lower socioeconomic position is associated with increased risk of coronary heart disease. This robust gradient is found across levels of socioeconomic position and after controlling access to health care and traditional biological and behavioral risk factors. Thus, previous theory and research has examined the role of other, relatively static psychosocial factors (e.g., social isolation and negative emotional traits) that may account for this association. Utilizing an interpersonal perspective on psychosocial risk (Smith & Cundiff, 2011 ; Smith, Gallo, & Ruiz, 2003 ; Smith, Glazer, Ruiz, & Gallo, 2004 ), this review examines the role of recurring interpersonal experiences and their physiological effects as a pathway linking socioeconomic position and coronary heart disease. Specifically, we focus on proximal interpersonal experiences that may not only explain the increased prevalence of more chronic psychosocial vulnerabilities in lower socioeconomic environments and individuals but may also link those psychosocial vulnerabilities to the momentary physiological mechanisms (i.e., stress responses) that directly contribute to coronary heart disease. Recurring experiences of reduced support and increased conflict in important personal relationships, work stress, multiple aspects of interactions with higher‐status others, the effects of negative stereotypes about lower socioeconomic groups and individuals, greater use of suppressive strategies for emotion regulation and greater negative consequences for more direct and expressive social behavior, and greater engagement in perseverative cognition all plausibly combine to perpetuate psychosocial risk and produce overall greater physiological burden at lower levels of socioeconomic position.     

Moderators and mediators of the stress-aggression relationship: executive function and state anger

The present study examined the effects of executive function (i.e., EF) and anger/hostility on the relationship between stress (across individual stress domains, as well as at the aggregate level) and aggression. Two independent groups of participants-a college sample and a low-income community sample-were administered a battery of self-report measures concerning the subjective experience of stress, aggressive behaviors, and feelings of state anger and hostility in the last month, along with a battery of well-validated neuropsychological tests of EF. Across both samples, the stress domains that demonstrated the strongest associations with aggression were those involving chronic strains of daily living (e.g., job, financial, health) versus interpersonal stressors (e.g., family, romantic). In the community sample, analyses also revealed a significant interaction between perceived stress (aggregated across domains) and EF in predicting aggressive behavior. Specifically, participants with relatively low EF abilities, across different EF processes, showed a stronger relationship between different domains of stress and aggression in the last month. Similar effects were demonstrated in the college sample, although the interaction was not significant. In both samples, experiences of anger and hostility in the last month mediated the relationship between perceived stress (aggregate) and aggressive behavior among those low, but not high, in EF. These findings highlight the importance of higher-order cognitive processes in regulating appropriate affective and behavioral responses across different types of individuals, particularly among those experiencing high levels of stress.     

Decomposing coronary-prone behavior: Dimensions of type a behavior in the Videotaped Structured Interview

This study examined the factorial structure of data generated in the Videotaped Structured Interview for assessment of Type A behavior. Based on the literature, it was argued that there are at least three distinct concepts of Type A behavior, focused on competitiveness and pressured drive, speech characteristics, and hostility, respectively. These three concepts were clearly represented among the factors from factor analyses based on data from 282 subjects. Three factors represented speech and psychomotor characteristics, where the first reflected interactions between subject and interviewer (e.g., response latency, interruptions), the second tempo of speech (accelerating, dysrhythmic and rapid speech), and the third oral gestures (e.g., expiratory sighs). Hostility was reflected in two factors, one defined by emotional intensity (e.g., anger when recalling paat event) and the other hostility expressed towards the interviewer. Pressured drive dominated a content factor reflecting self-awareness of Type A behavior. Finally, there was one factor related to psychomotor tension. Through further factor and item analyses, it was possible to combine these factors into three homogeneous and moderately intercorrelated subscales of Type A behavior reflecting Hostility, Speech Characteristics, and Self-Awareness of Type A behavior. These scales showed good interrater agreement and stability over two years. The Self-Awareness Scale was highly correlated with self-report measures of Type A behavior. The Hostility Scale, on the other hand, was moderately related to measures of Type A behavior, anger and hostility, but was unrelated to anxiety. The Speech Characteristic Scale, finally, was virtually unrelated to psychometric measures.     

Lonely hearts and angry minds: Online dating rejection increases male (but not female) hostility

The present work explores the hostile tendencies elicited by romantic rejection in the increasingly common context of online dating. To empirically investigate this issue, we created an ad hoc online dating platform in which fictitious online dating partners romantically rejected heterosexual male and female participants. Results revealed that male—but not female—participants who were rejected by desired dating partners displayed increased hostility. This pattern of findings was consistent across different measures, which considered both aggressive tendencies against the rejecting partners and hostile attitudes against the opposite gender. Further, increased feelings of anger explained the relationship between online romantic rejection and increased male hostility. Our work and its findings have both theoretical and methodological implications for the understanding of interpersonal processes in online interactions and the growing body of literature on online dating.     

Alexithymia and Cardiovascular Risk in Older Adults: Psychosocial,Psychophysiological, and Biomedical Correlates

Psychosocial correlates of alexithymia were examined in 102 healthy, older adults (ages 53-83; 76% male). Alexithymic ( n = 26) and non-alexithymic ( n = 30) groups, defined by top ( S 70) and bottom ( h 54) quartiles of the distribution of Toronto Alexithymia Scale (26-item) scores, were compared with respect to psychosocial, psychophysiological, and biomedical risk factors for cardiovascular disease. Both categorical ratings and continuous scores of alexithymia were associated with significantly greater levels of trait anxiety, anger-in, neuroticism, hostility, perceived stress, depression, and lower levels of social support. Compared to non-alexithymics, alexithymics displayed significantly greater blood pressure responses to anger provocation and tended to have a greater percent body fat. The groups did not differ in resting cardiovascular parameters, heart rate reactivity, fasting glucose and lipoprotein lipids, body mass index, waist-to-hip ratio, social desirability, or trait anger. These findings suggest several psychosocial and psychophysiological pathways by which alexithymia may confer risk for cardiovascular disease among older adults.     

Are All Hostility Scales Alike? Factor Structure and Covariation Among Measures of Hostility1

Few studies have examined the correlational and structural relationships between measures of hostility that may predict coronary heart disease. Using data from a population-based study (N= 2,682), we examined the factor structure among the five subscales from Siegel's (1986) Multi-dimensional Anger Inventory, the three subscales from Spielberger et al.'s (1985) anger expression scales, a Cook-Medley (Cook & Madley, 1954) hostility subscale that measures cynicism, and items measuring hostility from four scales that assess Type A behavior. Eight separate factors were identified: hostile anger expression, perceived control over the expression of one's anger, frequency of anger, ease of anger provocation, brooding, hostile outlook, cynicism, and sullenness. These results suggest that the structure of hostility measures is more complex than previous factor analyses have suggested. Our findings point to the dangers in assuming that a factor structure can be generalized beyond the data on which it is based to provide theoretical statements about psychological structure. The new scales appear to be valid because they correlate with demographic variables and indicators of social support in the expected directions.