Assessing Personality Factors in Essential Hypertension with a Brief Self-Report Instrument*

Abstract

A 16-item self-report instrument was designed and cross-validated, comparing essential hypertensives with normotensives. After item selection using two sets of standardization groups, scores obtained from three additional sets of hypertensive and normotensive groups were significantly different. The scores were not significantly related to variables such as age, sex, socioeconomic status, hypochondriasis, social desirability or target organ involvement. The instrument's factorial structure for hypertensives consisted of factors labeled anger arousal, resentment, anxiety, and attention seeking. Hypertensives reported higher levels of hostility and anxiety than normotensives. High and low scoring subgroups on the instrument were examined on the 16 PF, with hypertensive high scorers demonstrating a different profile than low scoring hypertensives. The existence of two psychological types of essential hypertensives was suggested.

Anger and denial as predictors of cardiovascular reactivity in women

“…Across the studies of cardiovascular disease and negative health outcomes, the common denominators which have Correlational studies have found a positive association between self-reported reluctance to express anger openly, and higher resting blood pressure (Diamond, 1982;Harrell, 1980;Harburg, Blakelock, & Roeper, 1979; Heiner, 1977;Baer, Collins, Bourianoff, & Ketchel, 1979), as well as elevations in baseline blood pressure under stress (Harburg et al, 1979; Gentry, Chesney, Gary, Hall, & Harburg, 1982). .…”

“…Likewise, Asendorpf and Scherer (1983) utilized a stressful phrase association task with male subjects and found that individuals who scored highest Cardiovascular Reactivity 11 in denial also reported the lowest anxiety levels and displayed reliably greater physiological reactivity (in terms of heart rate and pulse volume amplitude) than subjects who reported both low anxiety and low denial. Baer, Collins, Bourianoff, and Ketchel (1979) hypertensives prefer not to disclose information about personal life concerns. When social pressure to do so was increased in their study, however, accuracy of response improved.…”

“…This finding is supported by other researchers as well (Kahn, Medalie, Neufeld, Riss, & Goldbourt, 1972; McClelland, 1979; Falkner et al, 1979 Equally as important as the frequency and amount of anger experienced is the expression of the feelings, often described as "anger-in," and "anger-out." Anger-in is defined as "an unwillingness in a variety of oircumstances to express frustration-induced hostility and/or anger overtly, especially if the potential for interpersonal conflict would be heightened by such behavior" (Dembrosxi, MacDougall, Williams, Haney, & Blumenthal, 1985, p. 230)._ Conversely, anger-out is openly directed towards the source.Across the studies of cardiovascular disease and negative health outcomes, the common denominators which have Correlational studies have found a positive association between self-reported reluctance to express anger openly, and higher resting blood pressure (Diamond, 1982;Harrell, 1980;Harburg, Blakelock, & Roeper, 1979; Heiner, 1977;Baer, Collins, Bourianoff, & Ketchel, 1979), as well as elevations in baseline blood pressure under stress (Harburg et al, 1979; Gentry, Chesney, Gary, Hall, & Harburg, 1982). .…”

Psychological aspects of high and low blood pressure

“…Only in males aged 41-50 was there a significant correlation, though the authors concede that this result may be due to chance, given that the number of correlations was large and the number of subjects in this sample was small (N = 14). Baer et al (1979), using their own instrument, reported higher levels of anxiety in 332 essential hypertensives referred by a physician than in 335 normal population controls. A rather different approach (Rabkin et al, 1983) involved a sample of 452 consecutively admitted psychiatric patients, of whom 66 identified themselves as having high blood pressure.…”

Specificity Revisited: Personality Profiles and Behavioral Issues

“…In fact, a review of articles pub lished in 'Psychosomatic Medicine' for the past 2 years revealed at least eight to be related to type A behavior. The only other articles which could be interpreted as relating personality to physical disease were one connecting cancer and dependency and one examining personality factors in hypertension [3]. Personality research in psychosomatic medicine is not being very actively pursued except in the area of type A behavior.…”