Anger, hostility, and hospitalizations in patients with heart failure.

Abstract

Objective Heart failure patients have a high hospitalization rate, and anger and hostility are associated with coronary heart disease morbidity and mortality. Using structural equation modeling, this prospective study assessed the predictive validity of anger and hostility traits for cardiovascular and all-cause re-hospitalizations in patients with heart failure. Methods 146 heart failure patients were administered the STAXI and Cook-Medley Hostility Inventory to measure anger, hostility, and their component traits. Hospitalizations were recorded for up to 3 years following baseline. Causes of hospitalizations were categorized as heart failure, total cardiac, non-cardiac, and all-cause (sum of cardiac and non-cardiac). Results Measurement models were separately fit for Anger and Hostility, followed by a Confirmatory Factor Analysis to estimate the relationship between the Anger and Hostility constructs. An Anger model consisted of State Anger, Trait Anger, Anger Expression Out, and Anger Expression In, and a Hostility model included Cynicism, Hostile Affect, Aggressive Responding, and Hostile Attribution. The latent construct of Anger did not predict any of the hospitalization outcomes, but Hostility significantly predicted all-cause hospitalizations. Analyses of individual trait components of each of the two models indicated that Anger Expression Out predicted all-cause and non-cardiac hospitalizations, and Trait Anger predicted non-cardiac hospitalizations. None of the individual components of Hostility were related to re-hospitalizations or death. Conclusion The construct of Hostility and several components of Anger are predictive of hospitalizations that were not specific to cardiac causes. Mechanisms common to a variety of health problems, such as self-care and risky health behaviors, may be involved in these associations.

Broken Bodies, Broken Spirits: How Poor Health Contributes to A Cynical Worldview

“…Cynicism has been associated with an elevated level of inflammatory biomarkers (Boyle, Jackson, & Suarez, 2007), metabolic syndrome (D'Antono, Moskowitz, & Nigam, 2013;Gremigni, 2006;Nelson, Palmer, & Pedersen, 2004), incidence of a large number of diseases, including cardiovascular and coronary heart disease (Chida & Steptoe, 2009), atherosclerosis (Pollitt et al, 2005), ulcer (Lemogne et al, 2015), diabetes (Wylie-Rosett et al, 2010) and dementia (Neuvonen et al, 2014) and consequently even increased mortality risks (Everson et al, 1997;Klabbers, Bosma, van den Akker, Kempen, & van Eijk, 2013;Smigelskas, Joffe, Jonyniene, Julkunen, & Kauhanen, 2017;Wong, Sin, & Whooley, 2014). Importantly, longitudinal studies have shown cynicism to predict health deterioration and disease onset years later, supporting the frequently held assumption of a causal effect of cynicism on poor health (Adams, Cartwright, Ostrove, Stewart, & Wink, 1998;Boyle et al, 2007;Keith et al, 2017;Lemogne et al, 2015;Vahtera, Kivimäki, Koskenvuo, & Pentti, 1997). Yet, none of the existing studies examined the reverse causal pathway: does poor health contribute to cynicism development as well?…”

They’re (not) playing our song: (Ir)religious identity moderates the effects of listening to religious music on memory, self‐esteem, and mood

“…This was evidenced by responses analogous to those observed following threats which target other group identities (e.g., gender; Kaiser & Hagiwara, 2011). Similarly, when listening to a Christian hymn, Atheists’ performance self‐esteem was impeded (relative to listening to Buddhist chants or no music), and their hostility increased (which itself is associated with a variety of negative health impacts; e.g., coronary heart disease, telomere shortening; Keith et al., 2017; Watkins et al., 2016). Interestingly, parallel effects were not observed among Atheists who listened to a Buddhist chant, despite its religious roots.…”

Long-term Effects of Perceived Stress, Anxiety, and Anger on Hospitalizations or Death and Health Status in Heart Failure Patients

“…HF patients (n=147) with reduced ejection fraction (HFrEF) participated in the Behavioral Triggers of Heart Failure (BETRHEART) study (23, 28) at the University of Maryland Medical Center. Inclusion criteria were: prior HFrEF diagnosis, age >21 years, NYHA Class II-IV, and LVEF<40%.…”