Hostility
Summary prepared by Karen A. Matthews in
collaboration with the Psychosocial Working Group. Last revised November, 1997.
Table of Contents
a. Definition
b. Measurement
c. Relation to disease
d. Relation to SES
e. Limitations
f. Readings
Definition
Hostility is a multidimensional construct that is thought to have cognitive, affective,
and behavioral components. The cognitive component is defined as negative beliefs about
and attitudes toward others, including cynicism and mistrust. The affective component
typically labeled as anger refers to an unpleasant emotion ranging from irritation to rage
and can be assessed with regard to frequency, intensity, and target. The behavioral
component is thought to result from the attitudinal and affective component and is an
action intending to harm others, either verbally or physically.
Measurement 
There are at least 26 measures of hostility and these are reviewed in Matthews et al.
1984. Here we highlight a few frequently used measures. The cognitive component is usually
assessed by the 50-item Cook-Medley Hostility Inventory. This scale was derived
empirically from the MWI originally to identifv teachers who get along with pupils and has
been subject to numerous validity studies documenting its ability to predict negative
attitudes toward others. The affective component is often assessed by the 20 item
Spielberger Trait Anger, which asks about frequency of feeling quick tempered, hot-headed,
and flying off the handle. The intensity of angry feelings is assessed by the 90-item
Novaco Anger Inventory; this scale asks for the intensity of reactions to hypothetical
situations. The Buss-Durkee hostility scale is a self-rating scale with 76 true-false
items, yielding 7 subscale scores that assess the cognitive, affective, and behavioral
components. There are several interview ratings methods for assessing hostility from the
Type A Structured Interview or Videotaped Structured Interview. These methods require
extensive training in recognizing overt signs of annoyance and argumentativeness as well
as more subtle signs of sullenness, uncooperativeness. There has been considerable
interest in the expression of anger outwardly vs. holding it in because of psychosomatic
hypotheses regarding the development of hypertension. Spielberger Anger Expression Scale
allows the assessment of anger in vs. out independently,
Relation to disease
There have been two recent reviews of hostility and
physical health. Miller et al. (1996) showed that cognitive aspects of hostility predicted
all cause mortality and to a lesser extent CHD, whereas the interview measures of
hostility predicted CHD. Jorgensen et al.(1996) reported that lower affect expression and
more negative affectivity and defensiveness were associated with the development of
hypertension. Hostility is also associated with a variety of health behaviors, including
smoking, alcohol consumption, and weight. It may also be related to sympathetic arousal
during interpersonal circumstances.
Relation to SES
High Cook-Medley Hostility scores are apparent in low SES
individuals, men, and Blacks.
Limitations
The concept is messy. Although the distinction between affective, cognitive, and
behavioral dimensions has been useful theoretically, it is difficult to separately them
operationally. The ratings of hostility made from interviews is time consuming and not
easily transportable to different cultural groups, other than white upper middle class
men. The cognitive and affective components of hostility correlate rather highly with
other negative emotions, including anxiety and depressive symptoms.
Network usage
Given the hypothesized role of reactive responding in the Network's thinking, it is
important to measure hostile attitudes, feelings, and behavior in understanding how SES
make get under the skin, especially in the context of the lower end of the distribution of
SES.
Readings
Barefoot JC, Peterson BL, Dahlstrom WG, Siegler IC, Anderson NB, Williams RB (I 991).
Hostility patterns and health implications. Correlates of Cook-Medley Hostility Scale
scores in a national survey. Health Psychology, 10, 18-24.
Jorgensen RS, Johnson BT, Kolodziej ME, Schreer GE (I 996). Elevated blood pressure and
personality: A meta-analytic review. Psychological Bulletin 120:293-320
Matthews KA, Jamison JW, Cottington EM Assessment of Type A, anger, and hostility: A
review of scales through 1982. Measuring Psychosocial Variables in Epidemiologic Studies
of Cardiovascular Disease. NIH Pub No. 85-2270 1985; also in Psychological Documents,
1984.
Miller TQ, Smith TW, Turner CW, Guijarro ML, Hallet AJ (1996) A meta-analytic review of
research on hostility and physical health. Psychological Bulletin 119:322-48
Siegler IC, Peterson BL, Barefoot JC, Williams RB Jr. (1992) Hostility during late
adolescence predicts coronary risk factors at mid-life. American Journal of Epidemiology.
136:146-54.
Suls J, Wan CK (I 993) The relationship between trait hostility and
cardiovascular reactivity: A quantitative review and analysis. Psychophysiology 30:615-26.
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