Hostility as a Predictor of Survival in Patients With Coronary Artery Disease

Boyle, Stephen H.; Williams, Redford B.; Mark, Daniel B.; Brummett, Beverly H.; Siegler, Ilene C.; Helms, Michael J.; Barefoot, John C.

doi:10.1097/01.psy.0000138122.93942.4a

Cited by 125Cardiac Health and Mental HealthPsychosomatic Disorders and Their TreatmentsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Hostility as a Predictor of Survival in Patients With Coronary Artery Disease

Boyle, Stephen H., Williams, Redford B., Mark, Daniel B., Brummett, Beverly H., Siegler, Ilene C., Helms, Michael J., Barefoot, John C.·2004·Psychosomatic Medicine

DOI 10.1097/01.psy.0000138122.93942.4a

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Abstract

OBJECTIVE: This article presents a reanalysis of an earlier study that reported a nonsignificant relation between the 50-item Cook-Medley Hostility Scale (CMHS) and survival in a sample of coronary patients. Since publication of those results, there have been significant developments in the measurement of hostility that suggest that an abbreviated scale may be a better predictor of health outcomes. This study examined the ability of the total CMHS and an abbreviated form of the CMHS (ACM) to predict survival in a sample of patients with documented coronary artery disease (CAD) with increased statistical power. METHODS: Nine hundred thirty-six patients (83% were male; mean age = 51.48) with CAD who were followed for an average of 14.9 years. The ACM consisted of the combination of the cynicism, hostile attribution, hostile affect, and aggressive responding subscales that were identified in an earlier study (Barefoot et al. [1989]) by a rational analysis of the item content. The relation between hostility and survival was examined with Cox proportional hazard models (hazard ratios [HRs] based on a two standard deviation difference). RESULTS: Controlling for disease severity, the ACM was a significant predictor for both CHD mortality (HR = 1.33, p <.009) and total mortality (HR = 1.28, p <.02). The total CMHS was only a marginally significant predictor of either outcome (p values < 0.06). CONCLUSION: The results of this study suggest that hostility is associated with poorer survival in CAD patients, and it may be possible to refine measures of hostility in order to improve prediction of health outcomes.

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Hostility as a predictor of survival in patients with coronary artery disease, Psychosomatic medicine
Boyle, S. H., Williams, R. B., Mark, D. B., Brummett, B. H., Siegler, I. C., Helms, M. J., John, & Barefoot, C. (2004)
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Hostility predicts mortality but not recurrent acute coronary syndrome
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Authors: Boyle, S. H., Williams, R. B., Mark, D. B., Brummett, B. H., Siegler, I. C., Helms, M. J., & Barefoot, J. C.
Affiliations: Duke Medical Center (US)
Duke University (US)
Corresponding author: Boyle, Stephen H.
ORCID: Boyle, Stephen H.
Williams, Redford B.
Mark, Daniel B.
Venue: Psychosomatic Medicine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2004-09
Volume: 66
Issue: 5
Pages: 629-632
ISSN: 0033-3174 (ISSN-L)
DOI: 10.1097/01.psy.0000138122.93942.4a
OpenAlex: W2002180930
Cited by: 125
References: 27
Citations by year: 2023: 1 · 2022: 1 · 2021: 1 · 2020: 40 · 2018: 4 · 2017: 1 · 2016: 3 · 2015: 5 · 2014: 5 · 2013: 1 · 2012: 12
FWCI: 4.58
Type: journal article
Language: en
Open access: closed
Locations: Psychosomatic Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: National Heart, Lung, and Blood Institute (P01 HL36587, P01HL036587, R01HL054780, R01 HL55356, R01HL055356, R01-HL54780)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: hostility, coronary artery disease, survival, mortality prediction, cynicism, hostile attribution, psychosocial risk factors
MeSH terms: Cause of Death, Coronary Disease, Female, Follow-Up Studies, Hostility, Humans, Male, Middle Aged, MMPI, Personality Assessment, Prognosis, Psychometrics, Severity of Illness Index, Proportional Hazards Models, Survival Analysis

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Hostility as a Predictor of Survival in Patients With Coronary Artery Disease

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