What's so unhealthy about hostility? Construct validity and psychosocial correlates of the Cook and Medley Ho scale

The Cook and Medley (1954) Hostility (Ho) scale, a measure of hostility derived from the Minnesota Multiphasic Personality Inventory (MMPI), was recently found in one cross-sectional study to be related to the severity of coronary artery disease and in two prospective studies to predict the development of coronary heart disease. Unfortunately, little information is available to clarify the meaning of the scale, and little is known about the psychosocial characteristics of individuals with high Ho scores. As a result, interpretation of the previous studies is difficult. Our two studies attempted to address these concerns. In Study 1, the Ho scale demonstrated convergent and discriminant validity. Data indicated that the scale primarily assesses suspiciousness, resentment, frequent anger, and cynical distrust of others rather than overtly aggressive behavior or general emotional distress. In Study 2, individuals with high scores displayed comparatively more anger, less hardiness, more frequent and severe hassles, and fewer and less satisfactory social supports. Thus, we propose that the Ho scale assesses cynical hostility and conclude that high scores are associated with a particularly unhealthy psychosocial risk profile. These findings refine our understanding of the Ho scale and assist in the interpretation of previous studies using this measure.