Cook-Medley Hostility Research Articles

Abstract P058: Hostility Attitudes & Prevalent or Future Diabetes Among Black Adults: The Jackson Heart Study

Background: Hostility and diabetes mellitus (DM) share common determinants such as obesity, tobacco use and physical inactivity. Thus, we investigated their unstudied relationship at baseline and at 10 yrs after among Black adults in the Jackson Heart Study (JHS), a group with high rates of DM. Hypothesis: Hostility and its subdomains (hostile affect, aggressiveness, and cynicism) correlate with DM at baseline or at 10 yrs after. Methods: From the JHS cohort (n=5301), we studied 3,434 Blacks who completed the Cook-Medley Hostility Scale. Hostility was measured in 3 subdomains: hostile affect, cynicism and aggressiveness; higher scores correlated with higher hostility levels. Participants were stratified into quartiles based on the hostility scale. Frequency of DM at baseline or at 10 yrs after was compared amongst quartiles and tested for trend. Using multivariate logistic regression, we studied the cross-sectional relationship between quartiles of levels of hostility and the combined outcome of presence of diabetes at present or at 10 yrs after, adjusting for known confounders of DM. Subanalyses were conducted at each hostility domain level. Results: Our population was 35% men with a mean age of 54.3 (SD 12.6) yrs. Quartiles were associated with age, BMI, smoking, hA1c, caloric intake, hs-CRP, and alcohol intake (all p<0.05). Overall hostility quartiles and its subscales correlated with DM at baseline but only the subdomains of hostile affect and cynicism correlated with DM at 10 yrs. When prevalent or DM at 10 yrs were assessed as a combined risk, individuals in the last quartile of the hostile affect subdomain was associated with a higher DM risk versus first quartile (Table). Similar link was not found in other subdomains. Conclusions: Hostility attitude was associated with DM risk factors and prevalent DM. Only 2/3 of the hostility subdomains correlated with DM at 10 yrs after. Individuals from the last quartile of hostile affect subdomain was related to a higher risk of prevalent or DM at 10 yrs when compared to the first quartile.

Psychological Profiles in the Prediction of Leukocyte Telomere Length in Healthy Individuals.

BackgroundShorter telomere length (TL) may signal premature cellular aging and increased risk for disease. While depression and psychosocial stress have been associated with shorter telomeres, other psychological risk factors for cardiovascular disease have received less attention.PurposeTo evaluate the association between TL and psychological risk factors (symptoms of anxiety and depression, hostility and defensiveness traits) for heart disease, and to examine whether chronological age and sex moderate the associations observed.Methods132 healthy men and women (Mage = 45.34 years) completed the Marlowe-Crowne Social Desirability Scale, the Beck Depression Inventory II, The Beck Anxiety Inventory and the Cook-Medley Hostility Scale. Relative TL was measured by quantitative polymerase chain reaction (PCR) of total genomic DNA samples. A series of hierarchical linear regressions were performed controlling for pertinent covariates.ResultsShorter TL was observed among individuals high in defensiveness (β = -.221) and depressive symptoms (β = -.213), as well as in those with less hostility (β =.256) and anxiety (β =.220)(all Ps<.05). Psychological variables explained 19% of the variance over and above that explained by covariates (age, sex, exercise, alcohol consumption, systemic inflammation, and 24-hr mean arterial pressure). Age moderated the relation between TL and defensiveness (β =.179, p =.03). Sex did not influence any of the relations.ConclusionsTelomere length is associated with psychological burden though the direction of effect differs depending on the psychological variables under study. Further research is needed to determine the reasons for and implications of these seemingly contradictory findings.

Hostility and quality of life among Hispanics/Latinos in the HCHS/SOL Sociocultural Ancillary Study

Objective: The purpose of this study was to determine if hostility is associated with physical and mental health-related quality of life (QoL) in US. Hispanics/Latinos after accounting for depression and anxiety.Methods: Analyses included 5313 adults (62% women, 18–75 years) who completed the ancillary sociocultural assessment of the Hispanic Community Health Study/Study of Latinos. Participants completed the Center for Epidemiological Studies Depression Scale, Spielberger Trait Anxiety Scale, Spielberger Trait Anger Scale, Cook–Medley Hostility cynicism subscale and Short Form Health Survey. In a structural regression model, associations of hostility with mental and physical QoL were examined.Results: In a model adjusting for age, sex, disease burden, income, education and years in the US., hostility was related to worse mental QoL, and was marginally associated with worse physical QoL. However, when adjusting for the influence of depression and anxiety, greater hostility was associated with better mental QoL, and was not associated with physical QoL.Conclusions: Results indicate observed associations between hostility and QoL are confounded by symptoms of anxiety and depression, and suggest hostility is independently associated with better mental QoL in this population. Findings also highlight the importance of differentiating shared and unique associations of specific emotions with health outcomes.

Hostility, anger, and cardiovascular mortality among blacks and whites

Background: Despite the well-known impact of baseline hostility and anger on subsequent cardiovascular mortality, few studies have tested whether predictive role of hostility and anger on mortality varies as a function of race and gender. Objectives: Current study explored role of race and gender in modifying the effects of baseline hostility and anger on cardiovascular mortality in a nationally representative sample in U.S. Materials and Methods: We used data from the Americans’ changing lives study, a nationally representative longitudinal cohort of U.S. adults. The study followed 1,593 Blacks or Whites for 10 years from 2001 to 2011. Independent variables were baseline hostility and anger (anger-in, and anger-out), measured at 2001, using 4 item Cook-Medley cynical hostility scale and Spielberger Anger Expres- sion scales, respectively. Dependent variable was time to death due to cardiovascular disease since 2001. Covariates were baseline socio-demographics (age and education), behaviors (smoking and drinking), and health (number of chronic medical conditions, self-rated health, and depressive symptoms) measured at 2001. We used Cox proportional hazard models in the pooled sample and specific to race, in the absence and presence of health variables. Results: In the pooled sample, baseline hostility and anger-out predicted cardiovascular mortality in the next 10 years. We found significant interactions between race and baseline hostility and anger-in on cardiovascular mortality, suggesting that these associ- ations are stronger for Whites than Blacks. Race did not interact with baseline anger-out on cardiovascular mortality. Gender also did not have any interactions with baseline hostility, anger-in, or anger-out on cardiovascular mortality. Conclusions: Hostility and anger-in better predict cardiovascular mortality among Blacks than Whites in the United States. Black - White difference in the associations of hostility and anger with cardiovascular mortality suggest these factors may have some role in shaping health disparities across racial groups.

Trait Hostility and Acute Inflammatory Responses to Stress in the Laboratory.

Hostility has been associated with higher basal levels of inflammation. The present study evaluated the association of hostility with acute stress-induced changes in inflammatory activity. One hundred and ninety-nine healthy men and women, aged 19–64 years, were exposed to a stress protocol involving four interpersonal stressors. Participants completed the Cook-Medley Hostility questionnaire and provided two blood samples for the measurement of inflammatory biomarkers (CRP, Il-6, MPO, TNF-α, MCP-1, Il-8, Il-10, and Il-18), prior to and following exposure to a standardized stress protocol. In univariate analyses, hostility was associated with significantly higher TNF-α, but lower Il-8 and Il-18 values post-stress, though only Il-8 remained significant after controlling for baseline differences. In multivariate analyses, a significant Age by Hostility interaction emerged for Il-6, while sex moderated the relation between hostility and Il-10 reactivity. Following stress, hostility was associated with greater pro-inflammatory Il-6 activity among younger individuals and to decreased anti-inflammatory Il-10 activity in women. Future research is needed to replicate these findings and to evaluate their implication for disease.

The Effect of Hostility Reduction on Autonomic Control of the Heart and Vasculature: A Randomized Controlled Trial.

Hostility is associated with coronary artery disease. One candidate mechanism may be autonomic nervous system (ANS) dysregulation. In this study, we report the effect of cognitive behavioral treatment on ANS regulation. Participants were 158 healthy young adults, high in hostility measured by the Cook-Medley Hostility and Spielberger Trait Anger scales. Participants were also interviewed using the Interpersonal Hostility Assessment Technique. They were randomized to a 12-week cognitive behavioral treatment program for reducing hostility or a wait-list control group. The outcome measures were preejection period, low-frequency blood pressure variability, and high-frequency heart rate variability measured at rest and in response to and recovery from cognitive and orthostatic challenge. Linear-mixed models were used to examine group by session and group by session by period interactions while controlling for sex and age. Contrasts of differential group and session effects were used to examine reactivity and recovery from challenge. After Bonferroni correction, two-way and three-way interactions failed to achieve significance for preejection period, low-frequency blood pressure variability, or high-frequency heart rate variability (p > .002), indicating that hostility reduction treatment failed to influence ANS indices. Reduction in anger and hostility failed to alter ANS activity at rest or in response to or recovery from challenge. These findings raise questions about whether autonomic dysregulation represents a pathophysiological link between hostility and heart disease.

Depressive Symptomology and Hostile Affect among Latinos Using Housing Rental Assistance: the AHOME Study.

Studies show that those residing in households subsidized with federal housing vouchers exhibit fewer mental health problems than residents of public housing. The role of housing conditions and neighborhood quality in this relationship is unclear. This study investigated the relationship between rental assistance, housing and neighborhood conditions, and the risk of depressive symptomology and hostile affect among low-income Latino adults living in the Bronx, NY. Latino adults participating in the Affordable Housing as an Obesity Mediating Environment (AHOME) study were used for analysis. All AHOME participants were eligible for federal low-income housing rental assistance (n = 385) and living in the Bronx, New York (2010-2012). Housing (crowding and structural deficiencies) and neighborhood (physical disorder and social cohesion) were measured by questionnaire during in-home interview. Depressive symptomology was measured using the Center for Epidemiologic Studies Depression Scale Short Form, CES-D 10 (score ≥10). Hostile affect was measured using items from the Cook-Medley Hostility Scale (score ≥ 4). Results suggest residents of Section 8 housing have similar levels of depressive symptomology and hostility compared to residents in public housing or those receiving no federal housing assistance. However, depressive symptomology was significantly associated with maintenance deficiencies [OR = 1.17; CI 1.02, 1.35] and social cohesion [OR = 0.71; CI 0.55, 0.93]. Hostility was significantly associated with perceived crowding [OR = 1.18; CI 1.16, 2.85], neighborhood physical disorder [OR = 1.94; CI 1.12, 3.40], and social cohesion [OR = 0.70; CI 0.50, 0.98]. Low-income housing assistance did not have an independent effect on mental health outcomes. However, characteristics of the housing and neighborhood environments were associated with depressive symptomology and hostility.

Associations between central nervous system serotonin, fasting glucose, and hostility in African American females.

Previous research has shown an association between hostility and fasting glucose in African American women. Central nervous system serotonin activity is implicated both in metabolic processes and in hostility related traits. The purpose of this study is to determine whether central nervous system serotonin influences the association between hostility and fasting glucose in African American women. The study consisted of 119 healthy volunteers (36 African American women, 27 White women, 21 White males, and 35 African American males, mean age 34 ± 8.5 years). Serotonin related compounds were measured in cerebrospinal fluid. Hostility was measured by the Cook-Medley Hostility Scale. Hostility was associated with fasting glucose and central nervous system serotonin related compounds in African American women only. Controlling for the serotonin related compounds significantly reduced the association of hostility to glucose. The positive correlation between hostility and fasting glucose in African American women can partly be explained by central nervous system serotonin function.

The relation between hostility and concurrent levels of inflammation is sex, age, and measure dependent

Background and objectiveHostility may be associated with greater systemic inflammation. However, contradictory evidence exists. Certain individuals or dimensions of hostility may be more susceptible to these effects. Main and interactive effects of hostility with sex and/or age were evaluated on markers of inflammation, independently of traditional risk factors for coronary artery disease. Methods199 healthy men (81) and women (118), aged 20–64years (M=41±11years) were recruited. Hostility was assessed using the Cook–Medley Hostility Inventory (CMHo) and ecological momentary assessments (EMA) of quarrelsome behavior and angry affect in daily living. Blood samples were drawn to measure inflammatory activity (Il-6, TNF-α, hsCRP, Il-8, Il-10, Il-18, MCP-1) and lipid oxidation (Myeloperoxidase; MPO). Correlations and hierarchical regression analyses were performed controlling for pertinent behavioral, psychological, medical, and socio-demographic factors. ResultsSignificant univariate associations emerged between CMHo and Il-6, TNF-α, MCP-1 (p<.05). Hierarchical regressions showed interactions of hostility with sex (Il-6, TNF-α; p<.05) and age (hsCRP, Il-6, TNF-α; p<.05). For example, in simple slope analyses, hostility was positively related to TNF-α in women (b=0.009, p=0.006) but not men. Greater hostility was also related to greater Il-6 levels among younger women (b=. 027, p=0.000). ConclusionHostility, particularly cynical hostility, may be detrimental to (younger) women. The TNF-α, Il-6, CRP triad appears vulnerable to psychological and behavioral factors, and may be one mechanism by which cynical hostility (CMHo) contributes to increased cardiovascular risk in women. Prospective research is needed to verify this.

Cognitive behavioral therapy to reduce overt aggression behavior in Chinese young male violent offenders

This 9-week study was designed to determine whether a commercial cognitive-behavioral training program could effectively reduce overt aggression behavior in Chinese young male violent offenders. Sixty-six participants were randomly assigned to receive routine intervention alone (control group) or routine intervention plus Williams LifeSkills Training (WLST group) in a 1:1 ratio. The primary outcome was change scores on the Modified Overt Aggression Scale (MOAS) from baseline to one week following end of training. Secondary outcomes were change scores on the Barratt Impulsiveness Scale-11 (BIS-11) and Cook-Medley Hostility Scale (CMHS). There were significant between-group differences in change of MOAS total score (P < .001) and all sub-scores (Ps < .01) except aggression against property. Between-group differences were also observed in change of BIS-11 and CMHS total score (Ps < 0.05). All results favored the WLST group. These findings suggest WLST has the potential to be an effective intervention to reduce overt aggressive behavior in young male violent offenders.

Relationship between hostility and subjective sleep quality

While hostility and sleep disturbance are the potential risk factors for health problems and disease, few studies have examined the relationship between the two factors. The present study was performed to investigate the relationship between hostility and sleep problems assessed both subjectively and objectively in a nonclinical sample. Sixty-one healthy subjects were enrolled in this study. Hostility was measured according to the Cook–Medley hostility scale. Subjective sleep quality was evaluated according to the global score of the Pittsburgh Sleep Quality Index. Objective sleep was evaluated using actigraphy. A multiple regression analysis revealed that a higher level of hostility was significantly associated with the global score of the Pittsburgh Sleep Quality Index and that a higher level of depression was not associated with the global score of the Pittsburgh Sleep Quality Index. Objective sleep measures were not found to be associated with hostility. Confirming the robust relationship between poor sleep and hostility would have several important treatment implications for preventing health problems.

Relationship among low cholesterol levels, depressive symptoms, aggression, hostility, and cynicism

Treatment guidelines for lipids have become increasingly more aggressive. However, naturally low or therapeutically reduced cholesterol levels may be associated with adverse psychological health symptoms, including depression, aggression, and hostility. To examine relationships between low total cholesterol (TC) and low-density lipoprotein (LDL) cholesterol levels and measures of psychosocial status among middle-aged adults. A total of 1995 subjects enrolled in the Heart Strategies Concentrating on Risk Evaluation study with data on TC, LDL cholesterol, and self-reported ratings of psychological health were evaluated. To quantify ratings of depression, aggression, cynicism, and hostility, psychological measures included the Center for Epidemiologic Studies Depression Scale (CES-D) and Cook-Medley Hostility Inventory. Of 1995 participants, 25.1% were taking a lipid-lowering agent at baseline. Mean CES-D scores were similar between participants with low (<150 mg/dL) versus greater (≥150 mg/dL) TC and low (<100 mg/dL) versus higher (≥100 mg/dL) LDL cholesterol. However, among 22 participants with LDL cholesterol <70 mg/dL, the prevalence of clinically significant depressive symptomatology (CES-D score ≥16) was 31.8% compared with 12.1% in the remaining cohort (P= .005). In multivariable analysis, low LDL cholesterol (<100 mg/dL) was associated with cynicism (partial r=-0.14, P= .02) and hostility (partial r=-0.18, P= .004), but only in the subgroup of white subjects currently taking lipid-lowering medications. Low LDL cholesterol (versus non-low) was associated with greater aggression scores but only among participants currently taking psychiatric medications (3.4±1.7 vs 2.8±1.5, P= .02). Our data indicate mixed evidence for independent relationships between low total and LDL cholesterol levels and impaired psychological health.

Psychometric properties of the Cook Medley Hostility Scale and its association with inflammatory markers in African Americans

Dispositional hostility as measured by the Cook Medley Hostility (Ho) Scale has been associated with inflammation and cardiovascular disease (CVD) risk. There is evidence that suggests that factors of hostility are more useful in predicting poor cardiovascular health outcomes than a single hostility construct. The purpose of this study was to investigate the latent factors of hostility and their association with inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP) in an African-American community sample. This racial/ethnic group has been largely excluded from this line of research despite their disproportionate burden of CVD and its risk factors. Blood samples for plasma IL-6 and CRP were collected on the same day the Ho Scale was administered. Plasma IL-6 and CRP levels were determined using enzymatic-linked immunosorbent assay. Confirmatory factor analysis revealed three latent main factors of hostility: Neuroticism, Manichaeism and Moral Primitiveness, and seven intermediary subfactors. Of the subfactors, hostile affect was significantly associated with greater CRP levels and predatory self interest was significantly associated with greater IL-6 levels. Findings suggest that African Americans have a unique pattern of hostility and two latent subfactors are associated with a marker of CVD. Based on the findings, future studies should aim to further delineate how hostility influences health outcomes in African Americans.

Psychosocial Correlates of Atrial Natriuretic Peptide: A Marker of Vascular Health

Psychosocial factors have been associated with cardiovascular outcomes, but few studies have examined the association between psychosocial function and natriuretic peptides. The purpose of this study is to determine the predictive value of hostility, anger, and social support in relation to atrial natriuretic peptide (ANP), a marker of vascular health, among middle-aged men. One hundred twenty-one men (mean age = 39.8 years, SD = 4.1) underwent assessments of ANP and completed the Cook-Medley Hostility Scale, the Spielberger State-Trait Anger Scale, and the Interview Schedule for Social Interaction. Higher levels of hostility (β = 0.22 [95 % CI 0.04, 0.40], P = 0.032) and trait anger (β = 0.18 [95 % CI 0.01, 0.37], P = 0.044) were associated with greater ANP levels. In contrast, higher perceived social support was also associated with lower ANP levels, (β = -0.19 [95 % CI -0.05, -0.41], P = 0.010). Psychosocial factors, including hostility, anger, and social support, are associated with varying ANP levels among middle-aged men, independent of cardiovascular and behavioral risk factors.

Combining psychosocial data to improve prediction of cardiovascular disease risk factors and events: The National Heart, Lung, and Blood Institute--sponsored Women's Ischemia Syndrome Evaluation study.

There is overlap among psychosocial predictors of cardiovascular disease (CVD). The usefulness of combining psychosocial variables as risk markers for CVD needs investigation. Participants were 493 women in the NHLBI WISE study. Multivariate combination of Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Social Network Index (SNI), and Cook-Medley hostility subscales was evaluated, and principal components analysis also conducted. Relationships of composite psychosocial risk markers to CVD events and risk factors were assessed. The multivariate block of SNI, Cook-Medley Hostile Affect subscale, STAI, and BDI predicted CVD events (χ(2) = 27.8, df = 6, p < .001). Scalewise factor analysis revealed 2 factors: negative affectivity (NA) and hostility (explained variance, 45.6% and 17.1%, respectively). NA was associated with BMI (β [SE] = 0.18 [0.09], p = .04), hostility with metabolic syndrome (exp(β) = 0.60 [0.28], p = .04). Both factors were associated with blood pressure (BP): NA with SBP (β = 2.53 [1.04], p = .02) and DBP (β = 1.66 [0.60], p = .02); hostility with SBP (β = 2.72 [1.13], p = .02) and DBP (β = 1.83 [0.65], p = .005). Neither factor predicted CVD events. Original scales predicted CVD events: lower SNI (HR = 0.74, CI = 0.57-0.96), lower Hostile Affect (HR = 0.80, CI = 0.56-1.03), and higher BDI (HR = 1.33, CI = 1.08-1.74). In women with suspected ischemia, multivariate combination of psychosocial risk markers predicts CVD events; derived psychosocial factors were associated with CVD risk factors but not events. Measuring common variance among psychosocial variables may be a useful research strategy.

Abstract P084: Associations of Anger and Hostility with the Metabolic Syndrome: Cross-sectional Analyses from the Jackson Heart Study

There is evidence that anger and hostility are positively associated with the metabolic syndrome. In turn, the metabolic syndrome mediates the association between anger and hostility and adverse cardiac events. Very little is known about these associations in African-American populations. We assessed the hypothesis that anger and hostility are positively associated with the metabolic syndrome in an African-American cohort. Participants were 2,732 African-American men and women, ages 45 – 95, who were enrolled in the Jackson Heart Study at baseline. Anger was measured using the Spielberger State-Trait Anger Inventory, and hostility was measured using the Cook-Medley Hostility Scale. The metabolic syndrome was defined by the National Cholesterol Education Program, Adult Treatment Panel III criteria. Overall anger, components anger-in and anger-out, and hostility scores were entered into separate logistic regression models as continuous variables. In models adjusted for age, sex, educational level, and physical activity, higher levels of overall anger (β = 0.024, p = 0.006), anger-in (β = 0.028, p = 0.04), anger-out (β = 0.037, p = 0.04), and hostility (β = 0.021, p = 0.04) were associated with an increased prevalence of the metabolic syndrome. The correlation between anger and hostility was statistically significant but not strong (r = 0.38, p &lt;0.0001). In men, 5 of the 16 individual anger items were significantly associated with the metabolic syndrome. The strongest was “I lose my temper” (β = 0.395, p = 0.003) and “I tend to harbor grudges” (β = 0.314, p = 0.008). In women, only 1 anger item, “I make sarcastic remarks” (β = 0.189, p = 0.04) was associated with the metabolic syndrome. In conclusion, higher levels of overall anger, anger-in, anger-out, and hostility were associated with an increased prevalence of the metabolic syndrome in middle- and older-aged African-American men and women. In men, an angry temperament and a tendency to hold grudges were particularly strong correlates of the metabolic syndrome. Increased understanding of the negative emotions anger and hostility among African-Americans may provide greater insights into cardiovascular disease risk in their population.

Do Depressive Traits and Hostility Predict Age-Related Decline in General Intelligence?

Certain personality traits are likely to be associated with stress and distress through the lifespan, and as a consequence these traits may influence the rate of age-related cognitive decline. The present study uses data from the Glostrup 1914 cohort to analyze potential effects of personality on decline in general intelligence over a 30-year period. The Minnesota Multiphasic Personality Inventory was administered at a 50-year baseline exam, and from this inventory the Obvious Depression Scale and an abbreviated version of the Cook-Medley Hostility Scale were derived. At the 50-year baseline and at the 60-, 70-, and 80-year followups the full version of Wechsler's Adult Intelligence Scale (WAIS) was administered to 673, 513, 136, and 184 participants. Mixed effects statistical models were used to evaluate both the effect of the personality scores on level of intelligence and the interaction between the personality scores and the time since followup. Analyses were adjusted for demographic background and a wide range of lifestyle factors. Both obvious depression and hostility were negatively associated with level of intelligence, but personality scores did not influence rate of decline in general intelligence.

A prospective study on personality and the cortisol awakening response to predict posttraumatic stress symptoms in response to military deployment

Few prospective studies on pre-trauma predictors for subsequent development of posttraumatic stress disorder (PTSD) have been conducted. In this study we prospectively investigated whether pre-deployment personality and the cortisol awakening response (CAR) predicted development of PTSD symptoms in response to military deployment. Furthermore, we hypothesized that potential effects of age, childhood trauma and previous deployment on development of PTSD symptoms were mediated via pre-deployment personality, CAR and PTSD symptoms.Path analysis was performed on data from 470 male soldiers collected before and six months after a 4-month deployment to Afghanistan. Before deployment, personality was assessed with the short-form Temperament-Character Inventory and the Cook-Medley Hostility scale. In addition, pre-deployment saliva sampling for assessment of the CAR was performed immediately after awakening and 15, 30 and 60min thereafter.Pre-deployment high hostility and low self-directedness represented intrinsic vulnerabilities for development of PTSD symptoms after deployment. The CAR assessed before deployment did not predict PTSD symptoms after deployment. Pre-deployment low-to-moderate PTSD symptoms were associated with PTSD symptoms after deployment. As hypothesized, the effects of age and childhood trauma on PTSD symptoms after deployment were mediated via personality and pre-deployment PTSD symptoms. However, the number of previous deployments was not related to development of PTSD symptoms. The total model explained 24% of variance in PTSD symptoms after military deployment.

Depressive Symptoms and Subclinical Markers of Cardiovascular Disease in Adolescents

To examine the association between depressive symptoms and subclinical markers of cardiovascular disease (CVD), specifically arterial stiffness, as indexed by pulse wave velocity (PWV), and carotid artery intima media thickening (IMT), in a sample of healthy adolescents, and to explore adolescent hostility as a potential moderator of depression on subclinical markers of CVD. One hundred fifty-seven (n = 157) black and white adolescents between the ages of 16-21 completed a follow-up study of psychosocial stress and cardiovascular risk factors that included measures of PWV and carotid IMT. Psychosocial measures included the Center for Epidemiologic Studies Depression Scale (divided into tertiles), and the Cook-Medley Hostility Inventory subscales. Linear regression models controlled for sociodemographic variables, health behaviors, blood pressure, body mass index, and heart rate. Results show that more severe depressive symptoms were associated with higher levels of PWV (B = .17, R(2) = .30, ΔR(2) = .03, confidence interval = 2.2-47.0, p = .03) but not with higher IMT. Adolescent depression remained a significant predictor of PWV when controlling for adolescent hostility; hostility did not moderate the relationship between adolescent depression and PWV. Depression may be important in the development of arterial stiffness in adolescence. Further research is needed to delineate the relationship in adolescence and young adulthood between depressive symptoms and the pathogenesis of CVD.

Ethnic and Gender Differences in the Relationship Between Hostility and Metabolic and Autonomic Risk Factors for Coronary Heart Disease

To examine the relationship between hostility and biological risk factors for coronary heart disease (CHD) in a population of white European and South Asian men and women living in the United Kingdom. This cross-sectional study involved a community-based sample of 1,757 healthy white and South Asian men and women aged between 35 years and 75 years from West London. Participants completed the Cook-Medley Hostility Scale, together with measures of standard biological risk factors and heart rate variability. Associations between hostility and CHD risk factors were evaluated, controlling for age, education, smoking, physical activity, body mass index, and waist/hip ratio, using regression models. In white men, hostility was associated positively with fasting glucose, glycosylated hemoglobin, and negatively with high-density lipoprotein cholesterol. High levels of hostility were also related to increased prevalence of diabetes and the metabolic syndrome in white men. Hostility in South Asian men was associated with impaired autonomic function. Hostility was not related to any biological CHD risk factors in South Asian or white women. Our results showed that hostility was independently associated with glucose metabolism and dyslipidemia in white men, and with autonomic dysfunction in South Asian men. Hostility was found not to be relevant for measured CHD risk factors in females. Longitudinal data are required to establish whether the impact of hostility on CHD risk in men is mediated through metabolic and autonomic processes.