Cited by 829Psychological Testing and AssessmentPersonality Traits and PsychologyPsychometric Methodologies and Testing

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The Cook-Medley hostility scale: item content and ability to predict survival.

Barefoot, J C, Dodge, K A, Peterson, B L, Dahlstrom, W G, Williams, R B·1989·Psychosomatic Medicine

DOI 10.1097/00006842-198901000-00005

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Abstract

Previous studies have identified the MMPI-based Cook and Medley hostility scale (Ho) as a predictor of health outcomes. To achieve a better understanding of the construct measured by this scale, Ho items were classified on an a priori basis. Six subsets were identified: Cynicism, Hostile Attributions, Hostile Affect, Aggressive Responding, Social Avoidance, and Other. Study 1 examined the correlations of these subsets with scales of the NEO Personality Inventory in two samples of undergraduates. Good convergent and discriminant validity were demonstrated, but there was some evidence that items in the Social Avoidance and Other categories reflect constructs other than hostility. Study 2 examined the ability of the Ho scale and the item subsets to predict the 1985 survival of 118 lawyers who had completed the MMPI in 1956 and 1957. As in previous studies, those with high scores had poorer survival (chi 2 = 6.37, p = 0.012). Unlike previous studies, the relation between Ho scores and survival was linear. Cynicism, Hostile Affect, and Aggressive Responding subsets were related to survival, whereas the other subsets were not. The sum of the three predictive subsets, with a chi 2 of 9.45 (p = 0.002), was a better predictor than the full Ho scale, suggesting that it may be possible to refine the scale and achieve an even more effective measure of those aspects of hostility that are deleterious to health.

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Items 501–600 of 829

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“, 1989), and finally, in several studies, it has been found to predict CHD mortality (e.g., Chesney et al., 1988; Barefoot et al., 1989; Dembroski et al., 1989).”
BackgroundResult
USING AN INTERNET ACTIVITY TO ENHANCE STUDENTS' AWARENESS OF AGE BIAS IN SOCIAL PERCEPTIONS
VonDras, D. D., & Lor-Vang, M. N. (2004) · Educational Gerontology · doi:10.1080/03601270490275572 · Cited by 13
“The pretest survey also included an abbreviated measure of hostility ( Barefoot, 1992 ) that resulted from a rational analysis of item content of the larger Minnesota Multiphasic Personality Inventory (MMPI) based Cook-Medley Hostility Scale ( Barefoot, Dodge, Peterson, Dahlstrom, & Williams, 1989 ).”
Method
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“Five subscales were used, based upon the Barefoot, Dodge, Peterson, Dahlstrom and Williams ( 1989 ) method of scoring: “cynicism”, “hostile affect”, “aggressive responding”, “hostile attribution” and “social avoidance”.”
Method
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“measures an individual’s cynicism, distrust, resentment, and trait anger (Barefoot, 1992; Barefoot et al., 1989).”
Background
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Self-citation
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“The Hostility scale (range 0–50) measures hostile and suspicious attitudes toward others.(22) The JHAC12 scale (range 12–60) measures coping in an effortful manner with chronic and persistent stressors, with high scores representing more effortful coping.”
Background
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“Previously, hostility has been linked to heart disease, cardiovascular disease, hardening of the arteries [51, 86, 87], altered cholesterol levels [88, 12], lipid dysregulation [13], and most notably glucose dysregulation [8, 10, 28].”
Background
Personality and the Self
Robinson, M. D., & Sedikides, C. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108264822.031 · Cited by 18
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“Despite some debate with regard to the validity and the multidimensional nature of the Ho Scale [51, 52], construct validity is supported by several prior studies reporting that the Ho Scale is associated significantly with self-reports of anger and other measures of hostility [50, 53, 54].”
Result
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BackgroundMethodInfluential
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“Psychosocial and behavioral factorswere measured as secondary outcomes and included psychosocial stress, measured by means of the Cohen Perceived Stress Scale (28); hostility, by means of the Cook-Medley Hostility Inventory (29); anger, by using the Spielberger Anger Expression Inventory (30); anxiety, by using the Sp…”
Method
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“Through a rational analysis of the Cook-Medley scale, Barefoot et al. (1989) derived subsets of items that appear to tap distinct cognitive/attitudinal, behavioural and affective components.”
Method
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“The 27-item scale was chosen rather than the 50-item scale because of its documented validity in predicting mortality in a male sample (11) and myocardial ischemia in women (but not men) (17) and because of the need to reduce participant burden in such a large epidemiologic study.”
BackgroundMethodInfluential
Örgütsel Adalet ile Örgütsel Sinizm Arasındaki İlişkide Psikolojik Sermaye ve Çalışan Sesliliğinin Ara Değişken Rolü
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“Consequently, the present study included only 27 of the 39-item abbreviated Cook-Medley Hostility Scale: 11 items on cynicism, 9 on hostile attributions, 4 on aggressive responding, and 3 items on hostile affect [32].”
Self-citation
Ira y hostilidad en los trastornos coronarios
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“The Cook-Medley Hostility Scale (Cook and Medley, 1954) has been widely used in CVD investigations (Barefoot et al., 1989, 1991; Bunde and Suls, 2006; Miller et al., 1996; Niaura et al., 2002; Suls and Bunde, 2005).”
Towards a psychosocial mediator model of hostility and CHD
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“Barefoot [35], which included five dimensions, namely, cynicism, hostile affect, aggressive response, hostile attitude, and social aversion, with a total of 43 items.”
Background
Associations between Central Nervous System Serotonin, Fasting Glucose, and Hostility in African American Females
Boyle, S. H., Georgiades, A., Brummett, B. H., Barefoot, J. C., Siegler, I. C., Matson, W. R., Kuhn, C. M., Grichnik, K. P., Stafford‐Smith, M., Williams, R. B., et al. (2014) · Annals of Behavioral Medicine · doi:10.1007/s12160-014-9626-7 · Cited by 9
“The 27-item version of the Cook-Medley scale comprised of the 3 item subsets ‘Cynicism’, ‘Hostile Affect’ and ‘Aggressive Responding’ has been found to be a better predictor of survival compared to the original 50 item scale (24).”
ResultSelf-citation
Expression and Ambivalence over Expression of Negative Emotion: Cross-Sectional Associations with Psychosocial Factors and Health-Related Quality of Life in Postmenopausal Women
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“The score indicates the total number of items marked in the hostile direction with higher scores reflecting greater levels of hostility or a generally negative view of others [25].”
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Impact of Organization Cynicism on Work Outcomes: Mediating Role of Work Alienation
al., I. S. E. (2018) · NICE Research Journal · doi:10.51239/nrjss.v0i0.8 · Cited by 9
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Evolutionary Personality Psychology
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Self-citation
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“Cynical worldview (founded on negative beliefs about others as untrustworthy, deceitful, and selfish [see Barefoot et al., 1989]) may also serve as a social cognitive mechanism linking emotion regulation problems with mental health outcomes.”
Background
Changes in physical and mental health are associated with cardiovascular disease incidence in postmenopausal women
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Personality and Politics
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“The items measure cynical, mistrustful attitudes toward others and, to a lesser extent, the individual's propensity for aggressive responding and experiencing hostile affects ( Barefoot et al., 1989 ).”
BackgroundMethod
Cynical Hostility: A Risk Factor in HIV‐1 Infection?1
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“We also measured hostility using the Cook–Medley Hostility Inventory (Barefoot et al., 1989) and anger by means of the Spielberger’s Anger Expression Inventory (Spielberger, 1988).”
Method
Conceptual and Historical Perspectives
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“Cynicism is one of the subsets derived from the Cook-Medley Hostility Scale (Barefoot et al., 1989).”
Method
Psychosocial determinants of cardiovascular events among black Americans with chronic kidney disease or associated risk factors in the Jackson heart study
Bhavsar, N. A., Davenport, C. A., Yang, Z., Peskoe, S. B., Scialla, J. J., Hall, R. K., Tyson, C. C., Strigo, T. S., Sims, M., Pendergast, J., et al. (2021) · BMC Nephrology · doi:10.1186/s12882-021-02594-6 · Cited by 6
“Hostility was examined using the sum of 27 true/false items derived from the Cook-Medley Hostility Scale, which included measures of cynicism, hostile affect, and aggressive response [19, 22].”
Method
Associations between mood and specific health composites during U.S. Navy Persian Gulf operations
Burr, R. G., Woodruff, S. I., & Banta, G. R. (1993) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(93)90038-h · Cited by 7
Beyond Type A: Hostility and Coronary Heart Disease—Implications for Research and Practice
Delunas, L. R. (1996) · Rehabilitation Nursing · doi:10.1002/j.2048-7940.1996.tb01705.x · Cited by 7
“Prospective studies, with follow-up for up to 25 years, have demonstrated that hostility scores, as measured by the Ho scale, are associated with later CHD events, including death (Barefoot et al., 1989; Barefoot, Dahlstrom, & Williams, 1983; Shelke, Gale, Ostfeld, & Paul, 1983).”
BackgroundInfluential
Physiological and behavioural indices of hostility: An extension of the capacity model to include exposure to affective stress and right lateralized motor stress
Holland, A. K., Newton, S. E., Hinson, D. W., Hardin, J., Coe, M., & Harrison, D. W. (2014) · Laterality Asymmetries of Body Brain and Cognition · doi:10.1080/1357650x.2014.886586 · Cited by 7
Psychosocial Antecedents of Hostility in Persons with Coronary Heart Disease
Sofhauser, C. D. (2003) · Journal of Holistic Nursing · doi:10.1177/0898010103254918 · Cited by 7
“Construct validity has been examined via principal components factor analyses (Costa, Zonderman, McCrae, & Williams, 1986; Greenglass & Julkunen, 1989, 1991), expert panel review (Barefoot et al., 1989), and empirical studies (Pope, Smith, & Rhodewalt, 1990; Smith, Sanders, & Alexander, 1990).”
Method
The effect of humor coping with interpersonal stress on the relationship between cynical hostility, conscious defensiveness, and depression
Kunugimoto, N., & Yamasaki, K. (2011) · The Japanese journal of psychology · doi:10.4992/jjpsy.82.9 · Cited by 7
The effect of anger expression style on cardiovascular responses to lateralized cognitive stressors
Cox, D. E., DeVore, B. B., Harrison, P. K., & Harrison, D. W. (2017) · Brain Informatics · doi:10.1007/s40708-017-0068-4 · Cited by 9
“General medical and psychiatric health was assessed using a brief inventory designed for use in neuropsychological research [1, 32].”
Method
Psychometric properties of the Cook Medley Hostility Scale and its association with inflammatory markers in African Americans
Mwendwa, D. T., Ali, M. K., Sims, R. C., Madhere, S., Levy, S.-A. T., Callender, C. O., & Campbell, A. L. (2012) · Psychology Health & Medicine · doi:10.1080/13548506.2012.736623 · Cited by 7
Mental stress and the cardiovascular system part I: Cardiovascular response to acute mental stress in normal subjects
Vieweg, W. V. R., Dougherty, L. M., & Nicholson, C. S. (1997) · Medical Update for Psychiatrists · doi:10.1016/s1082-7579(97)00026-5 · Cited by 7
Hostility and cardiovascular reactivity in women during self-disclosure
Kurylo, M. F., & Gallant, S. J. A. (2000) · International Journal of Behavioral Medicine · doi:10.1207/s15327558ijbm0703_06 · Cited by 7
“The shorter version included all the items from the Cynicism, Hostile Affect, Aggressive Responding, and Hostile Attribution subscales but did not include the Social Avoidance and Other subscales, which appear to measure characteristics other than hostility (Barefoot et al., 1989).”
Background
Relationships Among Self-esteem, Psychological and Cognitive Flexibility, and Psychological Symptomatology
Al-Jabari, R. M. (2012) · University of North Texas Digital Library (University of North Texas) · doi:10.12794/metadc177172 · Cited by 7
A cluster analysis of symptom patterns and adjustment in Vietnam combat veterans with chronic posttraumatic stress disorder
Mazzeo, S. E., Beckham, J. C., Witvliet, C. V., Feldman, M. E., & Shivy, V. A. (2002) · Journal of Clinical Psychology · doi:10.1002/jclp.10074 · Cited by 7
Psychosoziale Aspekte und Gesundheitsverhalten bei Herzinsuffizienz
Spaderna, H., & Weidner, G. (2006) · Zeitschrift für Gesundheitspsychologie · doi:10.1026/0943-8149.14.4.145 · Cited by 7
Psychosocial Stressors at Work and Atrial Fibrillation Incidence: An 18‐Year Prospective Study
Diffo, E. T., Lavigne‐Robichaud, M., Milot, A., Brisson, C., Gilbert‐Ouimet, M., Vézina, M., Talbot, D. C., & Trudel, X. (2024) · Journal of the American Heart Association · doi:10.1161/jaha.123.032414 · Cited by 11
“Responses were compiled with a 4-point Likert-type scale and summed to obtain a total score for psychological demands (range, 9–36) and decision latitude (range, 24–96).”
Development of the Japanese version of Type D scale for patients with coronary heart disease
Ishihara, S., Uchibori, T., Imai, A., & Makita, S. (2015) · The Japanese Journal of Health Psychology · doi:10.11560/jahp.27.special_issue_177 · Cited by 6
Racial Differences in Mental Stress–Induced Transient Endothelial Dysfunction and Its Association With Cardiovascular Outcomes
Okoh, A. K., Young, A., Garcia, M. C., Sullivan, S. M., Almuwaqqat, Z., Hu, Y., Liu, C., Moazzami, K., Uphoff, I., Lima, B. B., et al. (2023) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001201 · Cited by 7
“To measure state anger symptoms, we used the 15-item subscale of the Spielberger’s State-Trait Anger Expression Inventory (30); tomeasure hostility, we administered the Cook-MedleyHostility Scale (50 items) (31); and to assess general perceived stress, we used the 10-item Perceived Stress Scale (32).”
Method
Otel İşgörenlerinin Örgütsel Dışlanma Algılarının Örgütsel Sinizm Düzeylerine Etkisi: Beş Yıldızlı Otel İşletmelerinde Bir Araştırma (The Effect of Organizational Ostracism Perceptions of Hotel Employees on Organizational Cynicism Levels: A Study in Five-Star Hotel Enterprises)
SOYBALI, H. H., & Pelit, O. (2019) · Journal of Business Research - Turk · doi:10.20491/isarder.2019.667 · Cited by 7
Test of daily app-based mindfulness meditation preceding a planned smoking quit attempt date on abstinence: Protocol for a randomized controlled trial recruiting across the 58 counties of California
Black, D. S., & Kirkpatrick, M. G. (2022) · Contemporary Clinical Trials · doi:10.1016/j.cct.2022.106855 · Cited by 5
The moderating effects of gender on the associations between multidimensional hostility and psychosomatic symptoms: A Chinese case
Weng, C., Lin, I., & Jiang, D. (2010) · International Journal of Psychology · doi:10.1080/00207591003587697 · Cited by 6
“Barefoot, Dodge, Peterson, Dahlstrom, & Williams, 1989 ; Siegel, Peterson, Barefoot, & Williams, 1992 ).”
The Influence of Job Autonomy on Organizational Cynicism: The Reliability Test
Shaharruddin, S., & Ahmad, F. (2015) · Cited by 6
The MMPI factor scales and risk of death in men during 45 years of follow-up: The Western Electric study.
Weiß, A., Costa, P. T., Deary, I. J., Garside, D. B., & Stamler, J. (2019) · Psychology and Aging · doi:10.1037/pag0000421 · Cited by 7
Hostile personality as a risk factor for hyperglycemia and obesity in adult populations: a systematic review
Vassou, C., D'Cunha, N. M., Naumovski, N., & Panagiotakos, D. B. (2020) · Journal of Diabetes & Metabolic Disorders · doi:10.1007/s40200-020-00551-y · Cited by 6
“The second pathway involves potential neuroendocrine changes associated with the development of hostile emotions [43].”
Background

Authors: Barefoot, J. C., Dodge, K. A., Peterson, B. L., Dahlstrom, W. G., & Williams, R. B.
Affiliations: Duke Medical Center (US)
ORCID: Dodge, K A
Venue: Psychosomatic Medicine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1989-01
Volume: 51
Issue: 1
Pages: 46-57
ISSN: 0033-3174 (ISSN-L)
DOI: 10.1097/00006842-198901000-00005
OpenAlex: W1995645776
Cited by: 825
References: 0
Citations by year: 2026: 7 · 2025: 11 · 2024: 10 · 2023: 10 · 2022: 12 · 2021: 15 · 2020: 63 · 2019: 11 · 2018: 23 · 2017: 12 · 2016: 25 · 2015: 19 · 2014: 24 · 2013: 27 · 2012: 25
FWCI: 25.60
Type: journal article
Language: en
Open access: closed
Locations: Psychosomatic Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5k04hd000806-05)
National Heart, Lung, and Blood Institute (HL 36587, P01HL036587)
National Institute of Mental Health (MH 70482)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (KO4 HD00806)
Topics: Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Keywords: hostility, MMPI, cynicism, hostile attribution, social avoidance, survival prediction, health outcomes, personality traits, lawyers, construct validity
MeSH terms: Adaptation, Psychological, Adult, Coronary Disease, Female, Hostility, Humans, Hypertension, Male, Middle Aged, MMPI, Personality Tests, Prognosis, Risk Factors, Type A Personality

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The Cook-Medley hostility scale: item content and ability to predict survival.

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