Cognitive hostility predicts all-cause mortality irrespective of behavioural risk at late middle and older age.

BACKGROUND Most but not all evidence supports hostility-related attributes to increase mortality risk. However, studies usually include single attributes, their effects have been studied predominantly in younger populations, and behavioural pathways explaining the mortality effect seem to differ by age. We examined the relationship between all-cause mortality and cognitive hostility, anger, aggression and rebelliousness, and their independence of health behaviours in a late middle-aged and older population. METHODS Data were derived from the longitudinal Dutch Study of Medical Information and Lifestyles in the city of Eindhoven, in the Southeast of the Netherlands study among 2679 late middle-aged and older Dutch people. Psychological characteristics were self-reported in 2004/2005, and mortality was monitored from 2005 to 2010. Cox regression analyses were used to calculate the mortality risk by each unique psychological variable with additional adjustments for the other psychological variables and for health behaviours. Baseline adjustments included age, sex, educational level and prevalent morbidity. RESULTS Cognitive hostility was associated with all-cause mortality, independent of health behaviours (on a scale ranging from 6 to 30, the hazard ratio (HR) was 1.05; 95% confidence interval [95% CI): 1.01-1.09]. Anger, aggression and rebelliousness were not associated with mortality risk. CONCLUSIONS In diminishing excess mortality risks, hostile cognitions might be acknowledged separately and additionally to the risk posed by unhealthy lifestyles.

[1]  S. Mendis The policy agenda for prevention and control of non-communicable diseases. , 2010, British medical bulletin.

[2]  N. Probst-Hensch,et al.  Chronic age-related diseases share risk factors: do they share pathophysiological mechanisms and why does that matter? , 2010, Swiss medical weekly.

[3]  H. Bosma,et al.  Measuring Rebelliousness and Predicting Health Behaviour and Outcomes , 2009, Journal of health psychology.

[4]  Jennifer G. Robinson,et al.  Optimism, Cynical Hostility, and Incident Coronary Heart Disease and Mortality in the Women’s Health Initiative , 2009, Circulation.

[5]  M. Kenward,et al.  Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls , 2009, BMJ : British Medical Journal.

[6]  A. Steptoe,et al.  The association of anger and hostility with future coronary heart disease: a meta-analytic review of prospective evidence. , 2009, Journal of the American College of Cardiology.

[7]  H. de Vries,et al.  The SMILE study: a study of medical information and lifestyles in Eindhoven, the rationale and contents of a large prospective dynamic cohort study , 2008, BMC public health.

[8]  Robert Luben,et al.  Combined Impact of Health Behaviours and Mortality in Men and Women: The EPIC-Norfolk Prospective Population Study , 2008, PLoS medicine.

[9]  S. van Buuren Multiple imputation of discrete and continuous data by fully conditional specification , 2007, Statistical methods in medical research.

[10]  M. Kivimäki,et al.  Does personality predict mortality? Results from the GAZEL French prospective cohort study. , 2007, International journal of epidemiology.

[11]  D. Mark,et al.  Hostility, age, and mortality in a sample of cardiac patients. , 2005, The American journal of cardiology.

[12]  H. Eriksen,et al.  Psychobiological mechanisms of socioeconomic differences in health. , 2004, Social science & medicine.

[13]  E. Eaker,et al.  Anger and Hostility Predict the Development of Atrial Fibrillation in Men in the Framingham Offspring Study , 2004, Circulation.

[14]  W. Saris,et al.  Reproducibility and relative validity of the short questionnaire to assess health-enhancing physical activity. , 2003, Journal of clinical epidemiology.

[15]  David A Bennett,et al.  Negative affect and mortality in older persons. , 2003, American journal of epidemiology.

[16]  Y. Ben-Shlomo,et al.  Life course epidemiology , 2003, Journal of epidemiology and community health.

[17]  P. Costa,et al.  Patterns of Change in Hostility from College to Midlife in the UNC Alumni Heart Study Predict High-Risk Status , 2003, Psychosomatic medicine.

[18]  M. Marmot,et al.  Systematic review of prospective cohort studies of psychosocial factors in the etiology and prognosis of coronary heart disease. , 2002, Seminars in vascular medicine.

[19]  P A Shapiro,et al.  Hostility, Gender, and Cardiac Autonomic Control , 2001, Psychosomatic medicine.

[20]  D. Watson,et al.  A three-factor model of trait anger: dimensions of affect, behavior, and cognition. , 2000, Journal of personality.

[21]  R. Niaura,et al.  Hostility and the Metabolic Syndrome in Older Males: The Normative Aging Study , 2000, Psychosomatic medicine.

[22]  N. Adler,et al.  Socioeconomic Status and Health: What We Know and What We Don't , 1999, Annals of the New York Academy of Sciences.

[23]  J. Blumenthal,et al.  Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. , 1999, Circulation.

[24]  J. Harris,et al.  A further evaluation of the Aggression Questionnaire: issues of validity and reliability. , 1997, Behaviour research and therapy.

[25]  J. Salonen,et al.  Hostility and increased risk of mortality and acute myocardial infarction: the mediating role of behavioral risk factors. , 1997, American journal of epidemiology.

[26]  David S. Krantz,et al.  Defensive hostility, gender and cardiovascular levels and responses to stress , 1996, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[27]  H. Bosma,et al.  Psychometric evaluation of the Dutch version of the Aggression Questionnaire. , 1996, Behaviour research and therapy.

[28]  C. Turner,et al.  A meta-analytic review of research on hostility and physical health. , 1996, Psychological bulletin.

[29]  K. Markides,et al.  A Test of the Psychosocial Vulnerability and Health Behavior Models of Hostility: Results From an 11-Year Follow-Up Study of Mexican Americans , 1995, Psychosomatic medicine.

[30]  M. Schroll,et al.  Hostility, incidence of acute myocardial infarction, and mortality in a sample of older Danish men and women. , 1995, American journal of epidemiology.

[31]  J. Salonen,et al.  Hostility and the progression of carotid atherosclerosis. , 1994, Psychosomatic medicine.

[32]  R. Sugden Multiple Imputation for Nonresponse in Surveys , 1988 .

[33]  B. Roberts,et al.  Patterns of mean-level change in personality traits across the life course: a meta-analysis of longitudinal studies. , 2006, Psychological bulletin.

[34]  M. Apter Motivational styles in everyday life: A guide to reversal theory. , 2001 .

[35]  Timothy W. Smith Concepts and methods in the study of anger, hostility, and health. , 1994 .

[36]  Timothy W. Smith,et al.  Anger, hostility, and the heart , 1994 .

[37]  A. Buss,et al.  The aggression questionnaire. , 1992, Journal of personality and social psychology.

[38]  M. McDermott Rebelliousness in adolescence and young adulthood. , 1987 .

[39]  R. H. Myers Classical and modern regression with applications , 1986 .