Cook-Medley Hostility Research Articles

Cynical hostility increases whereas sense of coherence decreases the odds for current suicidal thoughts: A cross-sectional study of the general adult population sample.

Earlier, somatic diseases and mental disorders have been associated with cynical hostility as well as sense of coherence, but there is a gap of knowledge, whether they contribute to suicidality at population level. A random sample of adults, representative of the general population living in Finland, participated in a nationwide health examination study. For 4387 participants aged 18-97 years, we analyzed, after controlling for confounding factors, whether cynical hostility, as assessed with the 8-item Cook-Medley Hostility Scale, or sense of coherence, as assessed with the 13-item Sense of Coherence Scale, contributed to current suicidal thoughts during the past 7 days as scored on the 25-item Hopkins Symptom Checklist. Suicidal thoughts (current thoughts of ending one's life) were associated significantly with cynical hostility (p < 0.001) as well as with sense of coherence (p < 0.001). Of the specific items of cynical hostility, the item "I am sure that most people do not have problems with lying for their own good" was associated most strongly with current suicidal thoughts (p < 0.001). Cynical hostility predicted current suicidal thoughts in a population-based sample of adults aged 18-97 years. Sense of coherence protected from current suicidal thoughts.

Comparison of the effect of hostility on the level of depression of drug addicts and non-addicts and the mediating role of sense of life meaning between them

BackgroundThe level of depression among drug addicts is generally higher than normal. Hostility and sense of life meaning may influence depression and become risk factors for depression. This study has three research purposes. First, to analyze whether drug use can aggravate hostility and depression levels. Second, to assess whether the hostility has different effects on depression among drug addicts and non-addicts. Third, to examine whether the sense of life meaning has a mediating role between different groups (drug addicts and non-addicts).MethodsThis study was conducted from March to June 2022. 415 drug addicts (233 males and 182 females) and 411 non-addicts (174 males and 237 females) were recruited in Chengdu, Sichuan Province. After signing informed consent, their psychometric data were obtained using the Cook-Medley Hostility Scale (CMI), Beck Depression Inventory (BDI) and Meaning in Life Questionnaire (MLQ) questionnaires. Linear regression models were used to assess the impact of hostility and depression among drug addicts and non-addicts. Bootstrap mediation effect tests were used to further test the mediation effect of sense of life meaning between hostility and depression.ResultsThe results showed four main outcomes. First, compared with non-addicts, drug addicts had higher levels of depression. Second, hostility exacerbated depression in both drug addicts and non-addicts. Compared with non-addicts, hostile affect had a greater effect on depression in drug addicts. Third, the sense of life meaning among females was higher than males. Fourth, for drug addicts, the sense of life meaning showed a mediating effect between social aversion and depression, while for non-addicts, the sense of life meaning showed a mediating effect between cynicism and depression.ConclusionsDepression is more severe in drug addicts. More attention should be paid to the mental health of drug addicts, because the elimination of negative emotions is conducive to reintegration into society. Our results provide a theoretical basis for reducing depression among drug addicts and non-addicts. As a protective factor, we can reduce their hostility and depression by improving the sense of life meaning.

Hostility and prevalent diabetes among black adults: The Jackson Heart Study

Background and aimsThe relationship between hostility and the prevalence of diabetes mellitus (DM) among black adults was investigated using the Jackson Heart Study (JHS) cohort. We hypothesized that Cook-Medley Hostility scores will be positively related with the prevalence of DM. Methods and resultsA total of 3232 black adults who completed at least one question for each of the three subscales of the Cook-Medley Hostility Scale and had data available regarding DM status were included. Using multivariate logistic regression, we studied the cross-sectional relationship between the overall Total Cook-Medley Hostility scores and individual subscales, hostile affect (n = 3232), aggression (n = 3119) and cynical distrust (n = 3085), with prevalent DM, adjusting for known DM confounders. Our population was 36% male with a mean age of 53.5 ± 0.9 years. In risk-factor adjusted models, each point higher in the overall Total Cook-Medley Hostility scores was associated with increased odds of having DM [Adjusted OR 1.02, 95%CI 1.00–1.04, P = 0.03]. Higher scores of cynicism were independently associated with prevalent DM [Adjusted OR 1.04, 95%CI 1.01–1.07, p = 0.021]. ConclusionsThere was a positive relationship between overall hostility levels and prevalent DM. Future studies should investigate the extent to which additional social determinants may impact the relationship between hostile affect and prevalent DM.

Propensity to Extremism in the Context of Socio-Psychological Maladjustment

The study is devoted to the definition of individual psychological characteristics of propensity to extremism in the context of socio-psychological maladaptation. The attractiveness of the Columbine subculture and extremist movements is associated with the socio-psychological maladaptation of the individual. This actualizes the task of early identification of a risk group for the provision of psychological assistance in order to prevent the radicalization of the individual. Research hypothesis: students with a tendency to extremism have individual psychological characteristics of the personality, indicating the specifics of their socio-psychological maladaptation. We studied 578 students of 1–6 courses of study at universities in Primorsky Krai, Khabarovsk Krai, the Republic of Dagestan and Moscow. The following methods were used: Propensity of extremism detection screening method; R. Cattell’s The Sixteen Personality Factor Questionnaire (16 PF), form A; Temperament Feature Accentuation Test (TFAT); The Cook-Medley Hostility Scale (CMHS); A. Ellis&amp;apos; technique for diagnosing irrational attitudes and projective technique “12 archetypes plus” (12A+) by R.V. Kadyrov, T.V. Kapustina. It was found that the specificity of the socio-psychological maladjustment of students prone to extremism is determined by the following individual psychological characteristics: underestimation of one&amp;apos;s own capabilities, painful sensitivity to criticism, isolation, alienation, a tendency to subject others to strict evaluation, denying them trust, a low threshold of emotional stability, emotional lability, suspicion and irritability, the desire to act in their own interests, neglecting social norms, rules and standards, as well as a combination of conceit and self-criticism, a combination of low tolerance for frustrating situations with an exaggeration of one&amp;apos;s stress resistance. These students show signs of depression: depression, anxiety, a tendency to self-flagellation, immersion in gloomy experiences.

Профилактика агрессивности и враждебности сотрудников полиции при помощи технологии развития способностей к эмоционально-волевой саморегуляции

Introduction. Aggressiveness is one of the forms of manifestation of the personality deviations and is differentiated by the degree of intensity from its normal indicators to extreme ones. In the activities of police officers, aggressiveness acts as a defense mechanism, which often exceeds the limits of moderately protective reactions and reaches the level of extreme aggression, manifested as an inadequate response to the exposure of the environmental stimuli. Theoretical analysis of the phenomena of aggressiveness and hostility, as well as the peculiarities of their manifestation in the professional activities of police officers shows the propensity of employees to aggressive and hostile forms of behavior, characterized by stability and stereotypes, determined by both the emotions of fear and formed personality deformities, pathological properties of character. The need for self-control of emotional reactions and lack of competence in assessing the emotional states of others increases the risks of aggressiveness and deviant behavior of police officers and forms a type of destructive personality. For the sphere of professional activity this is a significant obstacle in ensuring its effectiveness and reliability. Prevention of aggressiveness and hostility requires the development and implementation of technology that ensures the development of negative affects regulation skills, emotional states and behavior.&#x0D; The purpose of the study was to identify the degree of intensity of various indicators of aggressiveness and hostility of police officers, as well as to analyze their changes due to the application of the technology development abilities of emotional-volitional self-regulation.&#x0D; Methodology, methods and techniques. A complex of empirical and mathematical methods was used in the analysis of changes in the aggression indicators. Empirical data were obtained with the following techniques: the scale of neuropsychic adaptation (J.N. Gurvich), the method «Types of aggressiveness» (L.G. Pochebut), the Cook-Medley Hostility Scale. Data processing was performed using a specialized software package IBM SPSS Statistics 23 and Microsoft Excel. The research used a comparative analysis of empirical data. A group of employees (n=82) with signs of neuropsychic maladaptation of a nonpathological nature was separated from the total sample of subjects (n=253) and divided into an experimental (n=41) and a control group (n=41). In the experimental group, classes were organized for the development of abilities to emotional-volitional self-regulation (forming experiment).&#x0D; Results and interpretation. A comparative analysis of the values of aggressiveness and hostility of police officers before and after the experiment showed reliable differences for 3 indicators out of 9 (33.33%): self-aggression, total aggressiveness index, and hostility. In the values of the control and experimental groups during the realization of the ascertaining experiment no reliable differences were revealed, after the experiment statistically significant differences in the indicators were found: verbal aggression, emotional aggression, self-aggression, total aggressiveness index, cynicism, aggressiveness, hostility.&#x0D; Scientific novelty of the study lies in identifying the indicators of aggression and hostility of police officers experiencing states of neuropsychic maladaptation, in clarifying the role of abilities to emotional and volitional self-regulation in the prevention of aggression and hostility, in determining the parameters of changes in the intensity of aggressive and hostile manifestations in the experiment.&#x0D; Practical Significance. The change in the indicators of aggressiveness and hostility, identified as a result of the forming experiment, indicates the effectiveness of the technology development abilities to emotional and volitional self-regulation and on this basis allows to develop author programs to manage negative emotions and implement the prevention of deviant behavior of police officers.

Development and Validation of a Measure of Passive Aggression Traits: The Passive Aggression Scale (PAS)

Although passive aggression is known as a pathological personality trait, the concept is unclear, and there is a lack of tools to measure it comprehensively. Thus, this study developed and validated a tool for measuring passive-aggressive behaviors. Data on basic information about passive aggression traits were collected from 20 experts using open-ended questions. To verify content validity, Delphi surveys were conducted twice with five experts. Data for item analysis were collected from 123 Korean adults. Reliability and validity were analyzed using data obtained from 408 Korean adults. The three-factor model for the passive aggression scale (PAS) showed satisfactory model fits. Cronbach’s αs for inducing criticism, avoiding/ignoring, and sabotaging subscales, and the total PAS, were 0.91, 0.91, 0.92, and 0.93, respectively. The test–retest coefficient of the PAS also indicates that this tool is reliable. Analyses of the criterion-related validity revealed that the PAS was closely correlated with the scores of some scales that measure passive aggression with a single factor. In addition, the correlations between the PAS, Cook-Medley Hostility Scale, and State-Trait Anger Expression Inventory scores supported our understanding of the concept of passive aggression. This study highlights the utility of PAS as a useful and comprehensive measure of passive-aggressive behaviors to be adopted by researchers and clinicians.

RIGIDITY AND CYNICISM AS EMOTIONAL MARKERS OF A PERSON's EXPERIENCE OF A CRITICAL LIFE SITUATION

The article presents an analysis of the emotional markers of experiencing divorce as a critical life situation. The situation of a dissolved marriage changes the rules of a person's life (destroys the habitual way of life; contributes to the uncertainty of the future), changes the emotional sphere, limiting its autonomy. The aim of the research was to study the emotional markers of experiencing a critical life situation of a person in a dissolved marriage. Theoretical and methodological analysis of the critical life situation of the individual was carried out on the basis of the leading psychological positions of stress, frustration, conflict and crisis using methods of categorical generalization, comparison and modeling. To diagnose an emotional marker of experiencing a critical life situation, such as cynicism, the Cook-Medley hostility scale was used; rigidity - a technique for diagnosing self-assessment of mental states (according to G. Aizenk)). The total sample size of the subjects was 130 people aged 25 to 65 years: 1) experimental group - 72 people (women and men who survived a divorce); 2) control group - 58 people (subjects without conditions of a dissolved marriage). A conceptual model of psychological mechanisms of a critical life situation of a person in conditions of a dissolved marriage is highlighted. It is revealed that against the background of general dissatisfaction in the emotional sphere of the individual in the situation of divorce, unproductive emotional markers of experiencing a critical life situation, such as rigidity and cynicism, dominate. The results obtained allowed to determine the directions and content of the program of psychological support of the individual in the conditions of a dissolved marriage, taking into account the emotional markers of experiencing a critical life situation.

Psychodiagnostics of Extremist Personality Tendencies in School Environment

This research featured the psychodiagnostics of extremist tendencies in school environment. Extremism is a dangerous international phenomenon that can take many forms, especially on the Internet. Students prone to extremism should be detected as soon as possible and be subjected to a proper psychological correction in order to prevent illegal actions in the future. The detection procedure requires a set of reliable psychodiagnostic tools. The present research objective was to study the extremist tendencies of students and describe them in the context of socio-psychological maladjustment. The express screening of extremist tendencies was based on an authentic questionnaire, which included the following criteria: loneliness, signs of depression, dehumanization of the other, declaration of one’s own superiority, attraction to violence, and antisocial sentiment. The empirical study involved 157 high school students of Vladivostok (Russia), of whom 29 demonstrated extremist tendencies. Other techniques included G. Eysenck's EPI personality questionnaire, R. Cattell's 16-factor personality questionnaire (form C), Cook-Medley hostility scale, A. Ellis's method of diagnosing irrational attitudes, and Twelve Archetypes+ projective method developed by R. V. Kadyrov and T. V. Kapustina. Nonparametric Mann-Whitney U-test (≤0,05) and STATISTICA 10.0 were used for statistical processing. The results obtained revealed the state of crisis and social maladjustment of students prone to extremism, who may choose radical and violent actions to cope with this state. The developed method proved to be a sensitive and reliable tool for diagnosing extremist tendencies in the context of socio-psychological maladjustment in school environment.

Cynical hostility relates to a lack of habituation of the cardiovascular response to repeated acute stress.

Hostility is associated with increased risk for cardiovascular disease. Heightened cardiovascular reactivity to psychological stress has been proposed as a potential mechanism. Recent work has emphasized a need to measure cardiovascular reactivity across multiple stress exposures to assess potential habituation over time. The aims of the current study were (a) to examine the relationship between each of the three main components of hostility (i.e., emotional, cognitive, and behavioral) and cardiovascular reactivity at two separate stress testing visits and (b) to examine the relationship between hostility components and cardiovascular reactivity habituation. This study utilized previously collected data from the Pittsburgh Cold Study 3. One hundred and ninety-six participants (Mean (SD)[range] age=29.9 (10.8)[18-55] years, 42.9% female, 67.3% Caucasian) completed 2 separate, identical laboratory sessions, consisting of a 20-min baseline and 15-min stress (Trier Social Stress Test). Heart rate and systolic/diastolic blood pressure were recorded throughout. Reactivity was calculated separately for heart rate, systolic, and diastolic blood pressure (stress-baseline). Participants also completed a modified version of the Cook-Medley Hostility Scale. Results indicated that greater cognitive hostility (i.e., cynicism) was associated with blunted cardiovascular reactivity at Visit 1 and less cardiovascular reactivity habituation between visits, even when controlling for confounding variables. No significant relationships to cardiovascular reactivity or habituation were found for emotional (i.e., hostile affect) or behavioral (i.e., aggressive responding) components. Outcomes for total hostility did not survive adjustment for confounders. These results identify a potential pathway through which hostility, particularly cynicism, contributes to disease risk.

Serum 25-Hydroxyvitamin D Concentrations Are Associated with Mental Health and Psychosocial Stress in Young Adults.

We aimed to test the hypothesis that serum 25-hydroxyvitamin D3 (25(OH)D) concentration is associated with mental health and life stress measures in young adults and investigate gender and racial disparities in these associations. This study comprised 327 black and white participants. Depression, trait anxiety, perceived stress, and hostility were measured by the following validated instruments: Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS), and Cook–Medley Hostility Scale (CMHS). Linear regression was used to estimate correlations between serum 25(OH)D concentration and mental health measurements in the total population and in subgroups stratified by gender and race. In this sample (28.2 ± 3.1 years, 52% female, 53% black), serum 25(OH)D concentration was negatively related to BDI, STAI, PSS, total CMHS score, and the majority of CMHS subscale scores (p-values < 0.05). Stratified by gender, most of these associations remained significant only in women (p-values < 0.05). Stratified by race, higher 25(OH)D concentrations in white participants were significantly related to lower BDI, STAI, PSS, and CMHS-cynicism subscales (p-values < 0.05); 25(OH)D concentrations in the black participants were only inversely associated with CMHS and most CMHS subscales (p-values < 0.05) but not with BDI, STAI, and PSS. We present novel findings of consistent inverse relationships between serum 25(OH)D concentration and various measures of mental health and life stress. Long-term interventional studies are warranted in order to investigate the roles of vitamin D supplementation in the prevention and mitigation of depression, anxiety, and psychological stress in young adults.

Can Hostile Attitudes and Hostile Affections Lead to Depressive Symptoms Under Stress? A Study Based on Racial/Ethnic and Gender Differences.

Stress has a significant influence on the development of depressive symptoms. An individual's coping style and resilience may moderate the symptoms of depression. This study is aimed to investigate the role of coping styles and resilience to depressive symptoms when individuals are facing stress in life based on racial/ethnic and gender differences. Enrolled individuals were assessed using the Unfairness Scale, City Stress Inventory, Cook-Medley Hostility Scale, Conner-Davidson Resilience Scale, and Beck Depression Inventory (BDI). Three hundred ninety-six individuals completed the rating scales. There were significant interactions between race and unfairness, city stress (P= 0.006, P< 0.001), and between gender and city stress (P= 0.016). AAs and males suffer more stress than EAs and females. Hostile attitudes and affects act as mediators and significantly affect the relationship between stress and depressive symptoms (indirect effect: B = 0.812, P < 0.001; direct effect: B = 1.015, P < 0.001). Individuals with high resilience reported lower BDI scores. AAs with high stress and medium resilience had a buffer effect on depressive symptoms, while EAs did not. The racial and gender effects of stress on depressive symptoms were significant. Individuals who have frequently experienced stress exhibited a more hostile attitude/affect compared to those who have experienced less stress. Furthermore, individuals who had a more hostile attitude/affect were more likely to be affected by depressive symptoms. Resilience has a protective factor for all participants, and medium resilience had a better buffer effect for AAs compared to EAs. There should be training for boosting resilience in schools and in vulnerable communities.

Association of psychosocial traits with coronary artery calcium development and progression: The Multi-Ethnic Study of Atherosclerosis

BackgroundCoronary artery calcium (CAC) is a well-established quantifiable risk factor for cardiovascular disease (CVD). We examined the association of anger, hostility, anxiety, and depression with the development and progression of CAC. MethodsWe studied the association of these psychosocial traits with CAC among participants in the Multi-Ethnic Study of Atherosclerosis (MESA). Anger was measured using the Spielberger Trait Anger questionnaire, hostility using a modified Cook-Medley Hostility questionnaire, anxiety using the Spielberger Trait Scale, and depression using the Center for Epidemiological Studies Depression Scale (CES-D). Among the subsample of participants with CAC = 0 at the beginning of the study period, Poisson regression models were used to determine the relative risk of developing CAC>0 over the study period. In the subsample that developed CAC>0, we used linear regression models to estimate the average increase in CAC associated with a unit increase in psychosocial trait. ResultsMedian time of follow-up was 9.4 years (range 8.0–11.4 years). Cross-sectional analyses at baseline revealed no association of any of the psychosocial traits with the presence or magnitude of CAC (anger: RR 0.98, p < 0.01; hostility: RR 1.01, p = 0.25; anxiety: RR 0.99, p < 0.01; depression: RR 0.99, p < 0.01 [not statistically significant after adjustment for covariates]). No association was detected between the traits and development of CAC (anger: RR 0.99, p = 0.23; hostility: RR 1.01, p = 0.68, anxiety: RR 1.00, p = 0.49; depression: RR 1.00, p = 0.51). We also found no association between any of the traits and progression of CAC (anger: beta −3.21, p = 0.08; hostility: beta 2.28, p = 0.43; anxiety: 3.45, p = 0.02 [not statistically significant after adjustment for covariates]; depression: beta −1.46, p = 0.11). ConclusionsWe found no association between anger, hostility, anxiety, or depression and CAC, suggesting these personality traits are not independent risk factors for CVD.

The role of vital exhaustion in predicting the recurrence of vascular events: A longitudinal study

Background/objectiveThe aim of this study was to examine the role of vital exhaustion in predicting the recurrence of vascular events. MethodThe sample comprised of 816 individuals (65.3% female, Mage=43.2 years, SD=14.7 years), 395 (48.4%) of whom reported treatment for the reoccurrence of a vascular event during the four-year follow-up period. Concurrent effects of baseline vital exhaustion (measured by a shortened version of the Maastricht Questionnaire), depression (assessed by a shortened version of the BDI), anxiety (assessed by the HADS), and hostility (assessed by a shortened version of the Cook-Medley Hostility Scale) in predicting the recurrence of T2 vascular events were examined. The analyses were also controlled for traditional risk factors, such as age, education, body mass index, smoking, alcohol use, and lack of physical activity. ResultsThe regression analyses showed that vital exhaustion scores significantly predicted the reoccurrence of vascular events even after controlling for all covariates. None of the other psychological predictors (depression, anxiety, and hostility) was significant in the final model. ConclusionsThese results suggest that despite the partial conceptual overlap with several similar constructs, vital exhaustion is a distinct phenomenon that deserves consideration when planning and implementing interventions to reduce the risk of vascular diseases.

Isolation, Not Loneliness or Cynical Hostility, Predicts Cognitive Decline in Older Americans.

Objective: To jointly examine isolation, loneliness, and cynical hostility as risk factors for cognitive decline in older adults. Method: Data came from the 2006 to 2012 waves of the Health and Retirement Study (HRS), a longitudinal study of U.S. older adults (age ⩾ 65 years, n = 6,654). Measures included frequency of contact with social network (objective isolation), the Hughes Loneliness Scale (loneliness), a modified version of the Cook-Medley Hostility Inventory (cynical hostility), and a modified version of the Telephone Interview for Cognitive Status (cognitive function). Multilevel modeling (random slope + intercept) was used to examine the association between these factors and trajectories of cognitive function. Results and Discussion: After controlling for demographic characteristics, self-reported health, and functional limitations, loneliness (β = -.34, 95% confidence interval [CI] = [-0.56, -0.11), and cynical hostility (β = -.14, 95% CI = [-0.24, -0.04) correlated with lower cognitive function, but none predicted change in cognitive function. Objective social isolation was associated with lower cognitive function (β = -.27, 95% CI = [-0.41, -0.12]) and steeper decline in cognitive function (β = -.09, 95% CI = [-0.16, -0.01]).

Family Socialisation Styles and Hostility in the Adolescent Population

The affective involvement of parents in the socialization of their children is fundamental for the proper psychological and emotional adjustment of adolescents, although we know that it is difficult to study. In this research, the relationship between parenting style and hostility was analysed in Spanish adolescents. Five-hundred and thirty-six adolescents participated in this study (53.7% males and 46.3% females), between the ages of 12 and 18 (M = 15.76, SD = 1.43), enrolled in 4 compulsory Secondary Education centers of the Castellon province. Family socialization was evaluated through the parental styles: authoritative, indulgent, authoritarian and negligent, and hostility, through the Cook–Medley Hostility Scale Criteria assessment. A multivariate analysis of variance (MANOVA) was carried out with multiple regression analysis. The results showed that hostility and compound hostility are higher in adolescents from authoritarian and authoritative families than in adolescents from indulgent families. It was also observed that the Mother’s Strictness/Imposition had the greatest effect on hostility, as well as a low acceptance/involvement of the father. Regarding parental styles, it was observed that mother’s deprivation, physical coercion, and mother’s verbal coercion were the greatest predictors of hostility. No differences were observed depending on the gender.

Impact of hostility on mortality of patients with coronary artery disease after percutaneous coronary intervention

Aim. The study focuses on the assessment of associations of hostility with clinical and instrumental variables in patients with coronary artery disease after percutaneous coronary intervention, as well as on its effect on the risk of death for the patients in one year after surgery.Methods. The prospective study included 1,018 patients with coronary artery disease (764 men and 254 women, mean age 58.9±9.7 years) who had undergone percutaneous coronary intervention. Mean duration of follow-up was 12.0±1.8 months. Hostility was assessed by Russian version of Cook and Medley hostility scale. To investigate the relative risk (RR) of death from all causes and cardiovascular disease was used Cox's multivariate regression model of proportional risk.Results. The mean score on the Cook-Medley hostility scale was 15.1±3.9. A high level of hostility was observed in 189 patients (20.0%). There was no difference in age, gender and main clinical and instrumental variables between reference group and group of patients with a high level of hostility. No difference was found in echocardiographic parameters and coronary angiographic data between the groups. At admission, acute coronary syndrome was more often observed in patients with a high level of hostility as compared to those in the reference group (39.2% vs. 31.0%, p = 0.03). During the follow-up, 24 patients (2.4%) died from all causes and 21 patients (2.2%) died from cardiovascular disease. Depending on the level of hostility, RR of death from all causes was 1.10 (95% confidence interval [CI] 0.99–1.22, p = 0.09) and 1.12 (95% CI 1.01–1.27, p = 0.04) from cardiac causes. When analyzing categorical indicators, in patients with a high level of hostility, the relative risk of death, both for all causes (RR = 2.65, 95% CI 1.09–6.45, p = 0.03) and cardiovascular disease (RR = 3.38, 95% CI 1.29–8.82, p = 0.01), was significantly higher in comparison with patients in the reference group.Conclusion. PAcute coronary syndrome was more frequently diagnosed in patients with a high level of hostility. The hostility was significantly and independently associated with the risk of death from cardiovascular disease in patients with coronary artery disease after percutaneous coronary interventions. In patients with high levels of hostility, the risk of all-cause and cardiovascular mortality was significantly higher.Received 30 May 2018. Revised 5 July 2018. Accepted 9 July 2018.Funding: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interest.

Social avoidance in policing

PurposeThe purpose of this paper is to examine the association of social avoidance among police, cardiovascular disease (CVD) (metabolic syndrome (MetSyn)), and social support.Design/methodology/approachParticipants were officers from the Buffalo Cardio-Metabolic Occupational Police Stress study (n=289). Social avoidance (defined as the tendency to avoid social contact) and other subscales from the Cook-Medley Hostility Scale were analyzed. The mean number of MetSyn components across tertiles of the Cook-Medley scales was computed using analysis of variance and analysis of covariance. Social support was measured with the Social Provisions Scale, categorized as high or low based on the median.FindingsThe mean number of MetSyn components increased significantly across tertiles of social avoidance (1.51±0.18, 1.52±0.12, and 1.81±0.12); the only Cook-Medley subscale that remained significantly associated with MetSyn following adjustment for age and gender. Participants high in social avoidance reported significantly lower social support (79.9±8.5 vs 85.8±8.6; p=0.001).Research limitations/implicationsThe study is cross-sectional and therefore precludes causality. The authors were unable to determine the direction of associations between social avoidance and MetSyn. The measure of social support was unidimensional, including only perceived support; additional types of social support measures would be helpful.Practical implicationsThis study suggests that occupational-based police social isolation is associated with health outcomes and lower support. Several suggestions are made which will help to improve communication between the police and public. Examples are the use of social media, training in communication techniques, and changing the police role to one of public guardians.Originality/valueSocial avoidance is the least studied the Cook-Medley subscale associated with CVD. It is important for the health of officers to maintain a social connection with others.

Blood pressure responses of defensive hostile women when facing a real stress task

Objective: This study investigated the importance of the combination of the hostility and defensiveness variables as psychosocial factors that predict the risk of cardiovascular dysfunction. We examined the impact of a stressful situation on blood pressure responses, using a continuous psychophysiological assessment approach.Design: We measured the evolution of these responses over three experimental phases (adaptation, task and recovery), also considering a minute-by-minute analysis within each phase.Main Outcome Measures: We used the Cook-Medley Hostility Scale and the Social Desirability Questionnaire to form four groups (high hostility and high defensiveness, high hostility and low defensiveness, low hostility and high defensiveness, and low hostility and low defensiveness).Results: We expected the group of hostile defensive women to record higher activation (task phase: an academic exam) and slower habituation (recovery phase) compared to the other groups. The results confirmed our hypothesis, as the profile of the hostile defensive individuals was one of constant or sensitization during the task phase, while during the recovery phase those individuals underwent a slow recovery.Conclusion: Therefore, it can be indicated that the low hostility and low defensive group is the most adaptive, as recorded very little activation in response, and rapid recovery.

Impact of Racial Discrimination and Hostility on Adrenergic Receptor Responsiveness in African American Adults.

Racial discrimination is increasingly recognized as a contributor to increased cardiovascular disease (CVD) risk among African Americans. Previous research has shown significant overlap between racial discrimination and hostility, an established predictor of CVD risk including alterations in adrenergic receptor functioning. The present study examined the associations of racial discrimination and hostility with adrenergic receptor responsiveness. In a sample (N = 57) of young to middle-aged African American adults (51% female) with normal and mildly elevated blood pressure, a standardized isoproterenol sensitivity test (CD25) was used to evaluate β-AR responsiveness, whereas the dose of phenylephrine required to increase mean arterial pressure by 25 mm Hg (PD25) was used to assess α1-AR responsiveness. Racial discrimination was measured using the Perceived Racism Scale and hostility was assessed using the Cook-Medley Hostility Scale. In hierarchical regression models, greater racial discrimination, but not hostility, emerged as a significant predictor of decreased β-adrenergic receptor responsiveness (β = .38, p = .004). However, moderation analysis revealed that the association between racial discrimination and blunted β-adrenergic receptor responsiveness was strongest among those with higher hostility (β = .49, 95% confidence interval = .17-.82, p = .004). In addition, hostility, but not racial discrimination, significantly predicted α1-AR responsiveness. These findings suggest racial discrimination was associated with blunted β-adrenergic receptor responsiveness, providing further evidence of the potential contribution of racial discrimination to increased CVD risk among African Americans. The adverse effects of discrimination on cardiovascular health may be enhanced in individuals with higher levels of hostility.

Anger, hostility, and hospitalizations in patients with heart failure.

Heart failure patients have a high hospitalization rate, and anger and hostility are associated with coronary heart disease morbidity and mortality. Using structural equation modeling, this prospective study assessed the predictive validity of anger and hostility traits for cardiovascular and all-cause rehospitalizations in patients with heart failure. 146 heart failure patients were administered the STAXI and Cook-Medley Hostility Inventory to measure anger, hostility, and their component traits. Hospitalizations were recorded for up to 3 years following baseline. Causes of hospitalizations were categorized as heart failure, total cardiac, noncardiac, and all-cause (sum of cardiac and noncardiac). Measurement models were separately fit for Anger and Hostility, followed by a Confirmatory Factor Analysis to estimate the relationship between the Anger and Hostility constructs. An Anger model consisted of State Anger, Trait Anger, Anger Expression Out, and Anger Expression In, and a Hostility model included Cynicism, Hostile Affect, Aggressive Responding, and Hostile Attribution. The latent construct of Anger did not predict any of the hospitalization outcomes, but Hostility significantly predicted all-cause hospitalizations. Analyses of individual trait components of each of the 2 models indicated that Anger Expression Out predicted all-cause and noncardiac hospitalizations, and Trait Anger predicted noncardiac hospitalizations. None of the individual components of Hostility were related to rehospitalizations or death. The construct of Hostility and several components of Anger are predictive of hospitalizations that were not specific to cardiac causes. Mechanisms common to a variety of health problems, such as self-care and risky health behaviors, may be involved in these associations. (PsycINFO Database Record