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The Incremental Validity of Self-Report and Performance-Based Methods for Assessing Hostility to Predict
Gregory J Meyer1, Nicholas J Katko2, Joni L Mihura1
1a Department of Psychology , University of Toledo.
Insights
Assessing hostility using multiple methods can predict premature cardiovascular disease (CVD) and coronary heart disease (CHD). High aggressive imagery combined with self-reported hostility significantly increased CVD and CHD risk in a long-term study.
Area of Science:
- Psychology
- Preventive Medicine
- Cardiology
Background:
- Cardiovascular disease (CVD) and coronary heart disease (CHD) pose significant health risks.
- Identifying early risk factors for CVD and CHD is crucial for preventive medicine.
- Hostility and anger have been implicated as potential contributors to cardiovascular risk.
Purpose of the Study:
- To evaluate an integrative, multimethod approach for assessing hostility-related constructs.
- To determine if hostility assessment predicts premature cardiovascular disease (CVD) and coronary heart disease (CHD).
- To explore the utility of multimethod assessment in health psychology and preventive medicine.
Main Methods:
- Utilized participants from the Johns Hopkins Precursors Study (N = 416), assessed during medical school (1946-1962).
- Employed individually administered Rorschach protocols scored for aggressive imagery (Aggressive Content, Aggressive Past).
- Included self-report measures of anger responses to stress; analyzed using Cox regression analyses.
Main Results:
- A significant interaction effect was found: high Aggressive Content and high self-reported hostility predicted increased rates of premature CVD and CHD.
- This predictive relationship remained significant after controlling for smoking and cholesterol levels.
- Hostility and anger measures at baseline did not predict CVD risk factors assessed at midlife.
Conclusions:
- An integrative, multimethod assessment of hostility can effectively predict premature cardiovascular and coronary heart disease.
- This approach highlights the value of combining projective tests and self-reports for understanding health risks.
- Findings support the integration of psychological assessments into preventive cardiology strategies.
Abstract:
We evaluated the utility of an integrative, multimethod approach for assessing hostility-related constructs to predict premature cardiovascular disease (CVD) and premature coronary heart disease (CHD) using participants from the Johns Hopkins Precursors Study, which was designed to identify risk factors for heart disease. Participants were assessed at baseline while in medical school from 1946 to 1962 (M age = 24.6) and have been followed annually since then. Baseline assessment included individually administered Rorschach protocols (N = 416) scored for aggressive imagery (i.e., Aggressive Content, Aggressive Past) and self-reports of 3 possible anger responses to stress. Cox regression analyses predicting morbidity or mortality by age 55 revealed a significant interaction effect; high levels of Aggressive Content with high self-reported hostility predicted an increased rate of premature CVD and CHD, and incrementally predicted the rate of these events after controlling for the significant covariates of smoking (CVD and CHD) and cholesterol (CHD) that were also assessed at baseline. The hostility and anger measures, as well as other baseline covariates, were not predictors of CVD risk factors assessed at midlife during follow-up. Overall, this integrative model of hostility illustrates the potential value of multimethod assessment to areas of health psychology and preventive medicine.