The Cook-Medley hostility scale: item content and ability to predict survival
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J C Barefoot1, K A Dodge, B L Peterson
1Department of Psychiatry, Duke University Medical Center, Durham, NC 27710.
Insights
The Cook and Medley hostility scale (Ho) predicts health outcomes. Specific hostility facets like Cynicism, Hostile Affect, and Aggressive Responding better predict survival than the full scale.
Area of Science:
- Psychology
- Health Psychology
- Personality Assessment
Background:
- The Cook and Medley hostility scale (Ho) from the MMPI is a known predictor of health outcomes.
- Understanding the specific components of hostility measured by the Ho scale is crucial for refining its predictive power.
Purpose of the Study:
- To deconstruct the Ho scale into meaningful subsets and examine their validity and predictive utility for health outcomes.
- To determine which facets of hostility are most strongly associated with mortality risk.
Main Methods:
- Ho items were a priori classified into six subsets: Cynicism, Hostile Attributions, Hostile Affect, Aggressive Responding, Social Avoidance, and Other.
- Study 1: Correlated Ho subsets with NEO Personality Inventory scales in undergraduates to assess convergent and discriminant validity.
- Study 2: Examined the predictive relationship between Ho scale/subsets and 1985 survival in a cohort of lawyers (MMPI completed 1956-1957).
Main Results:
- Study 1 demonstrated good validity for most subsets, though Social Avoidance and Other showed some overlap with non-hostility constructs.
- High Ho scores predicted poorer survival in Study 2, with a linear relationship observed.
- Cynicism, Hostile Affect, and Aggressive Responding subsets significantly predicted survival, outperforming the full Ho scale when summed.
Conclusions:
- The Ho scale measures multiple facets of hostility, not all equally relevant to health outcomes.
- Refining the Ho scale by focusing on predictive subsets (Cynicism, Hostile Affect, Aggressive Responding) could enhance its accuracy in predicting mortality.
- Targeting specific hostility components may lead to more effective interventions for improving health outcomes.
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.