Interpersonal Hostility Assessment Technique: Description and Validation Against the Criterion of Coronary Artery Disease

High levels of hostility are associated with adverse health outcomes. The Interpersonal Hostility Assessment Technique (IHAT; Barefoot, 1992) measures hostility from verbal behavior during a standardized interview. Four types of behaviors are scored as hostility: evading the question, irritation, and indirect and direct challenges to the interviewer. The sum of the frequencies of these acts is a Hostile Behavior Index (HBI), which is divided into two components: verbal, scored with speech content in mind, and paraverbal, based on vocal stylistics. This study examined characteristics of IHAT assessments in 129 male coronary patients. Satisfactory interrater reliabilities were obtained. The HBI correlated highly (.58) with coronary artery disease severity after controlling for traditional risk factors. This relation was not affected by question topic or by differential weighting of the four hostile, behaviors. Both HBI components were significantly correlated with disease. Results are discussed in terms of their implications for hostility assessment.     

Interpretation of white space responses in children's Rorschach protocols

While most texts continue to assert that the Rorschach white space response (S) indicates hostility and oppositionality, several studies suggest that such responses are more accurately reflective of cognitive differentiation and autonomous strivings. In addition, there are no studies which have systematically explored the significance of S responses in children's protocols. To shed light on these issues, 47 children (7 to 13 yr.) were administered the Rorschach, Thematic Apperception Test, and the WISC-R, while their parents completed a behavioral checklist. Subjects with high S-response, independent of age, IQ, or perceptual accuracy, used the whole blot more often than those who made less frequent use of white space. They also had higher frequencies of shading determinants and blends and used more content categories. These results were interpreted as suggesting a tendency for subjects showing high S-response to construe the world in more complex terms. No differences were found between subjects high and low on S-response on either behavioral ratings or projective indices of hostility or negativism.     

The short-term effects of a hostility-reduction intervention on male coronary heart disease patients.

This preliminary study examined the effects of a hostility-reduction intervention on patients with coronary heart disease (CHD). Twenty-two high-hostile CHD men were matched on age and hostility and then randomly assigned to a hostility intervention (N = 10) or an information-control group (N = 12). Patients were reassessed immediately and 2 months posttreatment on hostility (with self-report and structured interview) and resting blood pressure. The intervention's overall effect size was moderately strong (d' = .62). Intervention patients reported at both reassessments and were observed at follow-up to be less hostile than controls. At follow-up, intervention patients had significantly lower diastolic blood pressure (DBP) than controls. Finally, reductions in hostility were significantly and positively correlated with reductions in DBP. Replication with a larger sample and CHD outcomes is recommended.     

The effects of acute plasma tryptophan manipulation on hostile mood: The influence of trait hostility

The effects of acute plasma tryptophan manipulation on changes in hostile, anxious, and depressive mood were studied in 48 males. Subjects consumed tryptophan-free or nutritionally balanced amino acid mixtures as a means of manipulating brain serotonin levels. Mood (hostility, anxiety, depression) was assessed pre- and 5 hr post-ingestion using the Multiple Affect Adjective Checklist. Overall, the tryptophan manipulation resulted in significant changes in hostile mood. Analyses also revealed a stronger association between changes in plasma tryptophan and changes in hostility in subjects with high levels of pre-existing hostile traits compared with low levels of hostile traits, and in subjects with high vs. Low antisocial traits. There was no significant association between changes in plasma tryptophan and changes in depression. The results suggest that persons with high levels of trait hostility may be more susceptible to the effects of acute manipulation of plasma tryptophan on hostile mood. Aggr. Behav. 24:173–185, 1998. © 1998 Wiley-Liss, Inc.     

Multimethod assessment of depression in sexually abused girls

This study measured depression in sexually abused Black girls using the Children's Depression Inventory (Kovacs & A. T. Beck, 1977), the Internalization scale of the Child Behavior Checklist (Achenbach & Edelbrock, 1983), and the Rorschach Depression Index (Exner, 1986). There were no significant correlations between these self-report, behavior observation (by parental report), and projective measures. The abused subjects had high scores on the behavior observation and Rorschach scales. Consistent with past research, negative results were obtained with the self-report instrument. We suggest that the low scores on self-report measures of distress produced by sexually abused children may be the result of guardedness or defensiveness rather than a genuinely low level of dysphoria in this population. There were no significant relations between abuse characteristics and scores on the depression measures. Scores on Rorschach measures of organizational activity (Zf) and available coping resources (EA) were generally positively related to depression within the abuse group and negatively related to depression within the control group.     

Multimethod Assessment of Depression in Sexually Abused Girls

This study measured depression in sexually abused Black girls using the Children's Depression Inventory (Kovacs & A. T. Beck, 1977), the Internalization scale of the Child Behavior Checklist (Achenbach & Edelbrock, 1983), and the Rorschach Depression Index (Exner, 1986). There were no significant correlations between these self-report, behavior observation (by parental report), and projective measures. The abused subjects had high scores on the behavior observation and Rorschach scales. Consistent with past research, negative results were obtained with the self-report instrument. We suggest that the low scores on self-report measures of distress produced by sexually abused children may be the result of guardedness or defensiveness rather than a genuinely low level of dysphoria in this population. There were no significant relations between abuse characteristics and scores on the depression measures. Scores on Rorschach measures of organizational activity (Zf) and available coping resources (EA) were generally positively related to depression within the abuse group and negatively related to depression within the control group.     

Rejection Sensitivity and Vulnerability to Self‐Directed Hostile Cognitions Following Rejection

We examined the hypothesis that rejection increases self‐directed hostile cognitions in individuals who are high in rejection sensitivity (RS). In four studies employing primarily undergraduate samples (Ns = 83–121), rejection was primed subliminally or through a recall task, and self‐directed hostile cognitions were assessed using explicit or implicit measures. Negative or neutral control conditions were used in three of the studies. Measures of RS were obtained in pretesting. High RS participants were more likely than low RS participants to report or show greater self‐directed hostile cognitions in rejection conditions, compared to control conditions. Results held when controlling for depressive symptoms, history of self‐directed hostile cognitions, and general hostility. RS may represent a unique vulnerability for self‐directed hostile cognitions, a predictor of self‐harmful behavior.     

Familial environment associated with type A behaviors and psychophysiological responses to stress in children

This study tested two major hypotheses regarding the characteristics of family environments associated with children's Type A behaviors, anger frequency and expression, hostile outlook, hostility displayed during an interview, and cardiovascular responses to laboratory stressors. Two measures of family environment, Positive Affiliation and Authoritarianism, were derived by a factor analysis of the Family Environment Scale completed by parents. The sample consisted of 66 girls and 48 boys enrolled in Grades 2 through 12 from 114 families residing in a predominantly White, upper-middle-class suburb of Pittsburgh. Analyses largely supported the first hypothesis--that a less supportive and positively involved family climate would be associated with attributes of potential coronary heart disease (CHD) risk in children. Families scoring low on Positive Affiliation had children who were assessed as more angry and hostile on the basis of questionnaires and interview. Boys from these families had a more pronounced heart rate response to all laboratory stressors. The second hypothesis--that authoritarianism, in the absence of positive involvement and supportiveness in the family, would be associated with attributes of potential CHD risk in children--received support in regard to boys' heart rate responses to the serial-subtraction and mirror-image-tracing tasks. High Authoritarianism scores in combination with low Positive Affiliation scores in families predicted a heightened heart rate response in boys. Sex differences in the pattern of associations among family and child characteristics were also found. Results suggest that factors in the family environment may be important influences in children's development of characteristics that may, in adulthood, place them at risk for CHD.     

A principal components analysis of Rorschach aggression and hostility variables

We examined the structure of 9 Rorschach variables related to hostility and aggression (Aggressive Movement, Morbid, Primary Process Aggression, Secondary Process Aggression, Aggressive Content, Aggressive Past, Strong Hostility, Lesser Hostility) in a sample of medical students (N= 225) from the Johns Hopkins Precursors Study (The Johns Hopkins University, 1999). Principal components analysis revealed 2 dimensions accounting for 58% of the total variance. These dimensions extended previous findings for a 2-component model of Rorschach aggressive imagery that had been identified using just 5 or 6 marker variables (Baity & Hilsenroth, 1999; Liebman, Porcerelli, & Abell, 2005). In light of this evidence, we draw an empirical link between the historical research literature and current studies of Rorschach aggression and hostility that helps organize their findings. We also offer suggestions for condensing the array of aggression-related measures to simplify Rorschach aggression scoring.     

Assessment of hostility in patients with coronary heart disease

One of the problems in efforts to more clearly conceptualize hostility is the amount of method variance, which ranges from self-report techniques to interview-based methods and mirrors the multidimensional nature of hostility and related constructs. In addition, rather few studies concerned with the assessment of hostility have specifically used samples of coronary heart disease (CHD) patients. The purpose of this study was, therefore, to examine the multidimensionality of the construct of hostility in a sample of male coronary patients with some frequently used instruments. Factor analysis was used to detect the relevant underlying constructs, which were assessed using a variety of hostility measures in a sample of cardiac patients undergoing baseline assessment in an ongoing health-education intervention study. Measurement included both questionnaires and interviews. Participants (N = 235) were divided into 3 diagnostic groups: patients who had recently undergone (a) a myocardial infarction, (b) coronary artery bypass grafting, or (c) percutaneous transluminal coronary angioplasty. A 4-factor solution appeared to provide the best fit, and the following factors were isolated: Anger-Out, Negative Affect, Coping, and Anger-In. All intercorrelations were less than .50. Medical diagnosis did not differ with regard to the 4 factors found. The total hostility construct as measured by the structured interview (SI) did not fit into the 4-factor model. This study was the first to show that dimensions of anger and hostility constitute valid and relevant aspects of the general construct of hostility for a representative group of CHD patients. The 4 aspects of hostility isolated using some well-known hostility questionnaires and the SI explained most of the observed variance. Although the SI appeared to tap more general state anger, the 4 aspects of hostility may be differentially related to health in those who are coronary prone. Future studies on the role of hostile or negative emotions in CHD patients should, therefore, pay greater attention to the multidimensional nature of hostility and may clearly benefit from the use of the 4-factor model described in this article.     

Assessing Object Representations as a Continuous Variable: A Modification of the Concept of the Object on the Rorschach Scale

Current methods for assessing the quality of internalized object representations have not provided a continuous variable that simultaneously includes both an accuracy and a maturity component. A modification of Blatt, Brooks, Brenneis, and Schimek's (1976) Concept of the Object on the Rorschach scale that would combine the two components by weighting the quality of each response according to its form level was proposed. Initial discriminant and convergent validity of this modification was checked through correlations and multiple regression analyses using behavioral, diagnostic, and demographic data from 84 adolescent inpatients as dependent variables. Results indicate the modified score was directly related to measures of peer relatedness, intelligence, psychological health, and reality testing, and indirectly related to measures of psychosis and hostile, unmanageable behavior. The results support the utility of the modification for providing a continuous score that assesses both developmental maturity and accuracy, the two dimensions on which the concept of object representation is based.     

Assessing object representations as a continuous variable: a modification of the concept of the object on the Rorschach scale

Current methods for assessing the quality of internalized object representations have not provided a continuous variable that simultaneously includes both an accuracy and a maturity component. A modification of Blatt, Brooks, Brenneis, and Schimek's (1976) Concept of the Object on the Rorschach scale that would combine the two components by weighting the quality of each response according to its form level was proposed. Initial discriminant and convergent validity of this modification was checked through correlations and multiple regression analyses using behavioral, diagnostic, and demographic data from 84 adolescent inpatients as dependent variables. Results indicate the modified score was directly related to measures of peer relatedness, intelligence, psychological health, and reality testing, and indirectly related to measures of psychosis and hostile, unmanageable behavior. The results support the utility of the modification for providing a continuous score that assesses both developmental maturity and accuracy, the two dimensions on which the concept of object representation is based.     

Children's perceptions of the sibling relationship in middle childhood: Connections within and between family relationships

Although sibling warmth and hostility have been shown to be statistically independent, they are intertwined in children's everyday experiences. We developed a multidimensional characterization of children's perceptions of their sibling relationships and examined differences in other family relationship measures as a function of different combinations of sibling hostility and warmth. Participants included 91 firstborn children between 10 and 11 years of age with younger siblings between 6 and 10 years of age. Children reported their levels of satisfaction, intimacy, and rivalry in their sibling relationships and their satisfaction with parent-child relationships. Parents rated their marriages. As compared with children in families with “affect-intense” sibling relationships (high hostility/high warmth), children in “hostile” sibling relationships (high hostility/low warmth) rated their sibling and parent-child relationships more negatively, and their parents rated their marriages more negatively. Results are discussed in terms of the role of hostility in sibling experiences and the importance of understanding multidimensional patterns in the sibling relationship.     

Effects of Changes in Instructions and Pictorial Variations on Story-telling Performance of Paranoid Schizophrenics

The purpose of this study was to investigate the effects of variations in instructions and pictorial stimuli on the story-telling performance of paranoid schizophrenic patients to TAT-like cards dealing with the dimensions of sex and hostility.

Twelve TAT-like pictures, six depicting sexual scenes and six representing hostile content were administered to 68 paranoid schizophrenics. One group of 34 Ss was instructed to tell stories in the first-person, while a different group of 34 Ss told stories in the third-person. Two criterion measures were examined; initial reaction time and total number of words.

Initial reaction time was significantly slower under first-person instructions, but only for the hostile pictures.

Initial reaction time was shortest for the moderately sexual pictures and verbal output was greatest for the least sexual pictures.

For the hostile pictures, neither the main effect of instructions nor the degree of hostility significantly affected any of the criterion measures.     

What does the cook and medley hostility scale measure? Affect, behavior, and attributions in the marital context

The Cook and Medley (1954) Hostility (Ho) scale has been used in several important studies evaluating potential health consequences of hostility. A relative lack of compelling information about the construct validity of the Ho scale, however, has raised concerns about the appropriate interpretation of previous research. In this study, 60 married couples discussed a low conflict topic, a high conflict topic, and then a second low conflict topic. High Ho men responded to the high conflict topic with significant increases in self-reported anger and anxiety and overt hostile behavior, but low Ho men did not. Furthermore, compared to low Ho men, high Ho men blamed their wives more for their usual disagreements on the high conflict topic and saw their disagreement-engendering behavior as more intentional. Among women, Ho scores were weakly related only to overt hostile behavior. Finally, couples consisting of two low Ho persons displayed a uniquely agreeable interactional style.     

High Hostility Among Smokers Predicts Slower Recognition of Positive Facial Emotion

High levels of trait hostility are associated with wide-ranging interpersonal deficits and heightened physiological response to social stressors. These deficits may be attributable in part to individual differences in the perception of social cues. The present study evaluated the ability to recognize facial emotion among 48 high hostile (HH) and 48 low hostile (LH) smokers and whether experimentally-manipulated acute nicotine deprivation moderated relations between hostility and facial emotion recognition. A computer program presented series of pictures of faces that morphed from a neutral emotion into increasing intensities of happiness, sadness, fear, or anger, and participants were asked to identify the emotion displayed as quickly as possible. Results indicated that HH smokers, relative to LH smokers, required a significantly greater intensity of emotion expression to recognize happiness. No differences were found for other emotions across HH and LH individuals, nor did nicotine deprivation moderate relations between hostility and emotion recognition. This is the first study to show that HH individuals are slower to recognize happy facial expressions and that this occurs regardless of recent tobacco abstinence. Difficulty recognizing happiness in others may impact the degree to which HH individuals are able to identify social approach signals and to receive social reinforcement.     

Indications of depression and distress in divorce and nondivorce children reflected by the Rorschach test

The appearance of depressive features, as reflected by responses to the Rorschach test, were explored in two groups of children from divorced and nondivorced families (referred to here as divorce and nondivorce children). The relationships between the depression scores and the children's hostility, aggression, and anxiety levels were also studied. The Rorschach Inkblot Test was individually administered to a nonclinical sample of 108 Swedish school children between 10 and 12 years old. The subjects constituted two groups, a divorce group (27 girls, 27 boys) and a nondivorce group (27 girls, 27 boys). Divorce children scored significantly higher on Exner's (1986) Depression Index than their nondivorce peers. Furthermore, divorce children with depressive features in their Rorschach responses were found to have a high level of hostility and aggression (as manifested in their Rorschach protocols), whereas no such associations were found among nondivorce children.     

Teacher Versus Peer Models

Female Ss (N=80) observed either a teacher or a peer model (M) demonstrate a motor task with either high or low performance ability. The effects’ of viewing these live performances on S’s subsequent motor performances were examined. After the observation of M, S’s performance in the presence or absence of the observed M was investigated. A Control Group consisting of 20 Ss, viewing no M, was compared to ail other groups for analysis. Results of the M Type × M’s Ability Level × M Presence design indicated that those in the Control Group had significantly lower performances than all other groups on all blocks of trials. In addition, across all trial blocks, S’s performances were enhanced subsequent to having viewed a skillful teacher M. Upon observing M’s demonstration, Ss exhibited increased matching responses and better performances when performing in the presence of M.