Several recent reviews have identified 3 affective dispositions--depression, anxiety, and anger-hostility--as putative risk factors for coronary heart disease. There are, however, mixed and negative results. Following a critical summary of epidemiological findings, the present article discusses the construct and measurement overlap among the 3 negative affects. Recognition of the overlap necessitates the development of more complex affect-disease models and has implications for the interpretation of prior studies, statistical analyses, prevention, and intervention in health psychology and behavioral medicine. The overlap among the 3 negative dispositions also leaves open the possibility that a general disposition toward negative affectivity may be more important for disease risk than any specific negative affect.

One possible explanation for the association between Cook-Medley Hostility Scale (Ho Scale; W. W. Cook & D. M. Medley, 1954) scores and premature coronary artery disease (CAD) morbidity and mortality is that hostile persons also have elevations on CAD risk factors. Meta-analyses with fixed and random-effects models were used to evaluate the relationship between Ho Scale scores and CAD risk factors in the empirical literature. Ho Scale scores were significantly related to body mass index, waist-to-hip ratio, insulin resistance, lipid ratio, triglycerides, glucose, socioeconomic status (SES), alcohol consumption, and smoking. Although there was also heterogeneity among study outcomes, the results of conservative random effects models provide confidence in the obtained relationships. On the basis of available evidence, researchers might give attention to obesity, insulin resistance, damaging health behaviors, and SES as potential contributing factors in understanding the association between Ho Scale scores and CAD.

Depression warrants further attention as a variable that may influence treatment seeking for MI symptoms. Results highlight the need to adequately screen for and treat depression among persons at risk for MI.

Historically, most investigations involving stress have assumed its undesirability, and deleterious effects have been identified across a variety of domains. Recently, however, researchers in management and health have differentiated between types of stress, and revealed a more complicated picture as a result. Specifically, stressors perceived as goal-relevant and manageable (i.e., challenging) are thought to increase motivation, performance, and well-being, while stressors viewed as goal-relevant but unmanageable (i.e., hindering) are believed to hamper performance and occasion maladaptive behaviors. Empirical support for this theoretical framework has accumulated in employment settings, but the model has yet to be adequately extended to higher education. The current study used a longitudinal design and multiple academic outcomes to explore the challenge-hindrance distinction in a large, diverse student sample. Students from 2 Southeastern institutions (N = 853) were assessed for challenge stress (e.g., class difficulty, high expectations), hindrance stress (e.g., ambiguous expectations, favoritism), academic self-efficacy (ASE), grade point average (GPA), hours withdrawn, and transfer intentions. Results were generally theory-consistent, as ratings of challenge and hindrance stress were associated with positive and negative academic outcomes, respectively. ASE did not moderate the challenge–GPA relationship, but emerged as an independent predictor of academic functioning. Implications for stress researchers, educators, and academic decision-makers are discussed.