Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Annals of Behavioral Medicine
Published in: Annals of Behavioral Medicine 3/2008

01-06-2008 | Original Article

Can Hostility Interfere with the Health Benefits of Giving and Receiving Social Support? The Impact of Cynical Hostility on Cardiovascular Reactivity During Social Support Interactions Among Friends

Authors: Julianne Holt-Lunstad, Ph.D., Timothy W. Smith, Ph.D., Bert N. Uchino, Ph.D.

Published in: Annals of Behavioral Medicine | Issue 3/2008

Login to get access

Abstract

Background

Both social support and hostility have been reliably associated with important health outcomes including coronary heart disease (CHD). One potential pathway by which these variables may influence CHD is via their impact on cardiovascular reactivity (CVR). Although social support has been generally associated with beneficial effects on cardiovascular functioning, the cynicism and mistrust among hostile individuals may prevent them from benefiting from the support process during times of stress.

Purpose and Method

The present study examined if level of hostility influenced CVR when discussing positive or negative personal experiences with a friend. To test this, healthy males and females and their same-sex friend were recruited (N = 216) and randomly assigned to discuss either a positive or negative (stressful) personal experience while cardiovascular measures were recorded.

Results and Conclusions

Results revealed the greatest systolic blood pressure and diastolic blood pressure reactivity among individuals high in hostility when discussing a negative experience. These results suggest that hostility may interfere with the benefits from support transactions during stress. Likewise, this association between hostility and reactivity was apparent for both support recipients and support providers, suggesting that hostility could undermine the health benefits of both aspects of support transactions.
Footnotes
1
Further information on this sample was reported in Holt-Lunstad et al. [46].
 
2
We initially included gender in the model to test for any gender and hostility interactions, although there are documented sex differences in cardiovascular functioning, because not much has been done examining hostility among both sexes. However, because there were no significant gender effects (main effects or interactions with hostility), to simplify the model we entered gender in as a covariate in all subsequent analyses.
 
3
A previous report using this data examined the quality of the friends’ relationship (i.e., ambivalent versus positive) as a moderator of the effects of experimentally manipulated social support [46]. When statistically controlling for the quality of the relationship, none of our primary findings were changed. Therefore, the effects of hostility reported here are independent of those reported elsewhere.
 
Literature
1.
Iribarren C, Sidney S, Bild DE, et al. Association of hostility with coronary artery calcification in young adults: The CARDIA study. J Am Med Assoc. 2000; 283: 2546–51.CrossRef
2.
Rutledge T, Hogan BE. A quantitative review of prospective evidence linking psychological factors with hypertension developments. Psychosom Med. 2002; 64: 758–766.PubMedCrossRef
3.
Barefoot JC, Larsen S, Lieth L, Chroll M. Hostility, incidence of acute myocardial infarction and mortality in a sample of older men and women. Am J Epidemiol. 1995; 142: 477–484.PubMed
4.
Kawachi I, Sparrow D, Spiro A, Vokonas PS, Weiss ST. A prospective study of anger and coronary heart disease. The Normative Aging Study. Circulation. 1996; 94: 2090–2095.PubMed
5.
Kop WJ. Chronic and acute psychological risk factors for clinical manifestations of coronary artery disease. Psychosom Med. 1999; 61: 476–487.PubMed
6.
Rozanski A, Blumenthal JA, Kaplan J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation. 1999; 99: 2192–2217.PubMed
7.
Miller TQ, Smith TW, Turner CW, Guijarro ML, Hallet AJ. A meta-analytic review of research on hostility and physical health. Psychol Bull. 1996; 119: 322–348.PubMedCrossRef
8.
Lett HS, Blumenthal JA, Babyak MA. Social support and coronary heart disease: Epidemiologic evidence and implications for treatment. Psychosom Med. 2005; 67: 869–878.PubMedCrossRef
9.
Smith TW, Glazer K, Ruiz JM. Hostility, anger, aggressiveness, and coronary heart disease: An interpersonal perspective on personality, emotion, and health. J Person. 2004; 72: 1217–1270.PubMedCrossRef
10.
Barefoot JC, Dahlstrom GW, Williams RB. Hostility, CHD incidence, and total mortality: A 25-year follow-up study of 255 physicians. Psychosom Med. 1983; 45: 59–63.PubMed
11.
Barefoot JC, Dodge KA, Peterson BL, Dahlstrom GW. The Cook–Medley Hostility scale: Item content and ability to predict survival. Psychosom Med. 1989; 51: 46–57.PubMed
12.
Matthews KA, Gump BB, Harris KF, Haney TL, Barefoot JC. Hostile behaviors predict cardiovascular mortality among men enrolled in the Multiple Risk Factor Intervention Trial. Circulation. 2004; 109: 66–70.PubMedCrossRef
13.
14.
Light KC, Dolan CA, Davis MR, Sherwood A. Cardiovascular responses to an active coping challenge as predictors of blood pressure patterns 10 to 15 years later. Psychosom Med. 1992; 54: 217–230.PubMed
15.
Smith TW, Ruiz JM. Psychosocial influences on the development and course of coronary heart disease: Current status and implications for research and practice. J Consult Clin Psychol. 2002; 70: 548–568.PubMedCrossRef
16.
Matthews KA, Zhu S, Tucker DC, Whooley MA. Blood pressure reactivity to psychological stress and coronary calcification in the Coronary Artery Risk Development in Young Adults Study. Hypertension. 2006; 47: 391–395.PubMedCrossRef
17.
Hardy JD, Smith TW. Cynical hostility and vulnerability to disease: Social support, life stress, and physiological response to conflict. Health Psychol. 1988; 7: 447–459.PubMedCrossRef
18.
Helmers KF, Krantz DS. Defensive hostility, gender and cardiovascular levels and responses to stress. Ann Behav Med. 1996; 18: 246–254.PubMedCrossRef
19.
Smith TW, Allred KD. Blood-pressure responses during social interaction in high- and low-cynically hostile males. J Behav Med. 1989; 12: 135–143.PubMedCrossRef
20.
Smith TW, Brown PC. Cynical hostility, attempts to exert social control, and cardiovascular reactivity in married couples. J Behav Med. 1991; 14: 581–592.PubMedCrossRef
21.
Suarez EC, Kuhn CM, Schanberg SM, Williams RB, Zimmermann EA. Neuroendocrine, cardiovascular, and emotional responses of hostile men. The role of interpersonal challenge. Psychosom. Med. 1998; 60: 78–88.PubMed
22.
Suarez EC, Harlan E, Peoples MC, Williams RB. Cardiovascular and emotional responses in women: The role of hostility and harassment. Health Psychol. 1993; 12: 459–468.PubMedCrossRef
23.
Williams RB Jr, Barefoot JC, Shekelle RB. The health consequences of hostility. In: Chesney MA, Rosenmann RH, eds. Anger and Hostility in Cardiovascular and Behavioral Disorders. New York: Hemisphere; 1985: 173–185.
24.
Gerin W, Pieper C, Levy R, Pickering TG. Social support in social interaction: A moderator of cardiovascular reactivity. Psychosom Med. 1992; 54: 324–336.PubMed
25.
Lepore SJ. Cynicism, social support, and cardiovascular reactivity. Health Psychol. 1995; 14: 210–216.PubMedCrossRef
26.
Uchino BN, Cacioppo JT, Kiecolt-Glaser JK. The relationship between social support and physiological processes: A review with emphasis on underlying mechanisms and implications for health. Psychol Bull. 1996; 119: 488–531.PubMedCrossRef
27.
Uchino BN. Social support and health: A review of physiological processes potentially underlying links to disease outcomes. J Behav Med. 2006; 29: 377–387.PubMedCrossRef
28.
Berkman LF. The role of social relations in health promotion. Psychosom Med. 1995; 57: 245–254.PubMed
29.
Cohen S, Kaplan JR, Manuck SB. Social support and coronary heart disease: Underlying psychological and biological mechanisms. In: Shumaker SA, Czajkowski SM, eds. Social Support and Cardiovascular Disease. New York: Plenum; 1994: 195–221.
30.
Uchino BN, Uno D, Holt -Lunstad J. Social support, physiological processes, and health. Curr Dir Psychol Sci. 1999; 8: 145–148.CrossRef
31.
Christensen AJ, Smith TW. Cynical hostility and cardiovascular reactivity during self-disclosure. Psychosom Med. 1993; 55: 193–202.PubMed
32.
Smith TW, Gallo LC. Hostility and cardiovascular reactivity during marital interaction. Psychosom Med. 1999; 61: 436–445.PubMed
33.
Powch IG, Houston BK. Hostility, anger-in, and cardiovascular reactivity in white women. Health Psychol. 1995; 15: 200–208.CrossRef
34.
Smith TW. Concepts and methods in the study of anger, hostility, and health. In: Siegman AW, Smith TW, eds. Anger, Hostility and the Heart. Hillsdale, NJ: Erlbaum; 1994: 23–42.
35.
Schwarzer R, Knoll N, Rieckmann N. Social support. In: Kaptein A, Weinman J, eds. Health Psychology. Malden, MA, US: Blackwell; 2004: 158–181.
36.
Smith TW, Frohm KD. What’s so unhealthy about hostility? Construct validity and psychosocial correlates of the Cook and Medley Ho scale. Health Psychol. 1985; 4: 503–520.PubMedCrossRef
37.
Gallo LC, Smith TW. Patterns of hostility and social support: Conceptualizing psychosocial risk factors as characteristics of the person and the environment. J Res Pers. 1999; 33: 281–310.CrossRef
38.
Hart KE. Cynical hostility and deficiencies in functional support: The moderating role of gender in psychosocial vulnerability to disease. Pers Individ Differ. 1999; 27: 69–83.CrossRef
39.
O’Neil JN, Emery CF. Psychosocial vulnerability, hostility, and family history of coronary heart disease among male and female college students. Int J Behav Med. 2002; 9: 17–36.PubMedCrossRef
40.
Smith TW, Pope MK, Sanders JD, Allred KD, O’Keefe JL. Cynical hostility at home and work: Psychosocial vulnerability across domains. J Res Pers. 1988; 22: 525–548.CrossRef
41.
Brown NC, Nesse RM, Vinokur AD, Smith DM. Providing social support may be more beneficial than receiving it: Results from a prospective study of mortality. Psychol Sci. 2003; 14: 320–327.PubMedCrossRef
42.
Pincus AL, Ansell EB. Interpersonal theory of personality. In: Millon T, Lerner MJ, eds. Handbook of Psychology: Personality and Social Psychology, Vol. . Hoboken NJ, US: Wiley; 2003; 5: 209–229.
43.
Baron KG, Smith TW, Butner J, Nealey-Moore J, Hawkins MW, Uchino BN. Hostility, anger, and marital adjustment: Concurrent and prospective associations with psychosocial vulnerability. J Behav Med. 2007; 30: 1–10.PubMedCrossRef
44.
Newton TL, Kiecolt-Glaser J. Hostility and erosion of marital quality during early marriage. J Behav Med. 1995; 18: 601–619.PubMedCrossRef
45.
46.
Holt-Lunstad J, Uchino BN, Smith TW, Hicks A. On the importance of relationship quality: The impact of ambivalence in friendships on cardiovascular functioning. Ann Behav Med. 2007; 33: 1–12.CrossRef
47.
Cacioppo JT, Malarkey W, Kiecolt-Glaser JK, et al. Heterogeneity in neuroendocrine and immune responses to brief psychological stressors as a function of autonomic cardiac activation. Psychosom Med. 1995; 57: 154–64.PubMed
48.
Cook W, Medley D. Proposed hostility and pharisaic virtue scales for the MMPI. J Appl Psychol. 1954; 38: 414–418.CrossRef
49.
Gallo LC, Smith TW. Construct validation of health-relevant personality traits: Interpersonal circumplex and five-factor model analyses of the aggression questionnaire. Int J Behav Med. 1998; 5: 129–147.PubMedCrossRef
50.
Gallo LC, Matthews KA. Understanding the association between socioeconomic status and physical health: Do negative emotions play a role? Psychol Bull. 2003; 129: 10–51.PubMedCrossRef
51.
Ruiz JM, Smith TW, Rhodewalt F. Distinguishing narcissism and hostility: Similarities and differences in interpersonal circumplex and five-factor correlates. J Pers Assess. 2001; 76: 537–555.PubMedCrossRef
52.
Kiesler DJ, Anchin JC, Perkins MJ, Cirico BM, Kyle EM, Federman EJ. The Impact Message Inventory: Form II. Palo Alto, CA: Consulting Psychologists; 1985.
53.
Kiesler DJ, Schmidt JA, Wagner CC. A circumplex inventory of impact messages: An operational bridge between emotion and interpersonal behavior. In: Plutchik R, Conte HR, eds. Circumplex Models of Personality and Emotions. Washington, DC, US: American Psychological Association; 1997: 221–244.CrossRef
54.
Nealey JB, Smith TW, Uchino BN. Cardiovascular responses to agency and communion stressors in young women. J Res Pers. 2002; 36: 395–418.CrossRef
55.
Smith TW, Gallo LC, Ruiz JM. Toward a social psychophysiology of cardiovascular reactivity: Interpersonal concepts and methods in the study of stress and coronary disease. In: Suls J, Wallston KA, eds. Social Psychological Foundations of Health and Illness. Malden, MA, US: Blackwell; 2003: 335–366.
56.
Trobst KK. An interpersonal conceptualization and quantification of social support transactions. Pers Soc Psychol Bull. 2000; 26: 971–986.CrossRef
57.
Marteau TM, Bekker H. The development of a six-item short form of the state scale of the Spielberger state-trait anxiety inventory (STAI). Br J Clin Psychol. 1992; 31: 301–306.PubMed
58.
Cohen S, Hoberman HM. Positive events and social supports as buffers of life change stress. J Appl Soc Psychol. 1983; 13: 99–125.CrossRef
59.
Kiesler DJ, Schmidt JA, Wagner CC. A circumplex inventory of impact messages: An operational bridge between emotion and interpersonal behavior. In: Plutchik R, Conte HR, et al. eds. Circumplex Models of Personality and Emotions. Washington, DC: APA; 1991: 221–244.
60.
Newton TL, Bane CMH. Cardiovascular correlates of behavioral dominance and hostility during dyadic interaction. Int J Psychophysiol. 2001; 40: 33–46.PubMedCrossRef
61.
Little RC, Milliken GA, Stroup WW, Wolfinger RD. SAS System for Mixed Models. Cary, NC: SAS Institute Inc; 1996.
62.
Singer JD. Using SAS PROC MIXED to fit multilevel models, hierarchical models, and individual growth models. J Educ Behav Stat. 1998; 23: 323–355.
63.
Kamarck TW, Jennings JR, Debski TT, et al. Reliable measures of behaviorally-evoked cardiovascular reactivity from a PC-based test battery: Results from student and community samples. Psychophysiology. 1992; 29: 17–28.PubMedCrossRef
64.
Llabre MM, Spitzer SB, Saab PG, Ironson GH, Schneiderman N. The reliability and specificity of delta versus residualized change as measures of cardiovascular reactivity to behavioral challenges. Psychophysiology. 1991; 28: 701–711.PubMedCrossRef
65.
Benjamin L. Facts and artifacts in using analysis of covariance to “undo” the law of initial values. Psychophysiology. 1967; 4: 187–206.PubMedCrossRef
66.
Chen YY, Gilligan S, Coups EJ, Contrada RJ. Hostility and perceived social support: Interactive effects on cardiovascular reactivity to laboratory stressors. Ann Behav Med. 2005; 29: 37–43.PubMedCrossRef
67.
Bolger N, Zucherman A, Kessler RC. Invisible support and adjustment to stress. J Pers Soc Psychol. 2000; 79: 953–961.PubMedCrossRef
68.
Christenfeld N, Gerin W, Linden W, et al. Social support effects on cardiovascular reactivity: Is a stranger as effective as a friend? Psychosom Med. 1997; 59: 388–398.PubMed
69.
Smith TW, Spiro A III. Personality, health, and aging: Prolegomenon for the next generation. J Res Pers. 2002; 36: 363–394.CrossRef
Metadata
Title
Can Hostility Interfere with the Health Benefits of Giving and Receiving Social Support? The Impact of Cynical Hostility on Cardiovascular Reactivity During Social Support Interactions Among Friends
Authors
Julianne Holt-Lunstad, Ph.D.
Timothy W. Smith, Ph.D.
Bert N. Uchino, Ph.D.
Publication date
01-06-2008
Publisher
Springer-Verlag
Published in
Annals of Behavioral Medicine / Issue 3/2008
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-008-9041-z

Other articles of this Issue 3/2008

Annals of Behavioral Medicine 3/2008 Go to the issue

Rapid Commuication

Small Changes in Nutrition and Physical Activity Promote Weight Loss and Maintenance: 3-Month Evidence from the ASPIRE Randomized Trial

Rapid Communication

The Use of Theory in Health Behavior Research from 2000 to 2005: A Systematic Review

Original Article

Relation Between Central Adiposity and Cognitive Function in the Maine–Syracuse Study: Attenuation by Physical Activity

Original Article

Exploring Refinements in Targeted Behavioral Medicine Intervention to Advance Public Health

Letter to the Editor

Exercise Preferences and Environmental Contexts: A Response to King and Wilcox

Original Article

Physical Sequelae and Depressive Symptoms in Gynecologic Cancer Survivors: Meaning in Life as a Mediator