Defensive hostility: relationship to multiple markers of cardiac ischemia in patients with coronary disease.
Three studies assessed whether the combined traits of hostility and defensiveness identify a group of hostile individuals with functionally severe coronary artery disease (CAD). CAD patients completed the Cook-Medley Hostility Inventory (Ho) and the Marlowe-Crowne Social Desirability Scale (MC). Patients were classified into 4 groups: defensive hostile (DH: high Ho, high MC), low hostile (LH: low Ho, low MC), high hostile (HH: high Ho, low MC), and defensive (Def: low Ho, high MC). DH in comparison to HH, LH, and Def CAD patients demonstrate the greatest perfusion defects as measured by exercise thallium scintigraphy; DH patients exhibit the most frequent ischemic episodes during ambulatory electrocardiographic monitoring; and in a laboratory study, DH patients exhibit the most severe mental stress-induced ischemia assessed by echocardiography. Thus, the combination of high hostility and high defensiveness are associated with more functionally severe CAD and may predispose CAD patients to a more adverse prognosis.
Helmers
K F
KF
Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
Krantz
D S
DS
Merz
C N
CN
Klein
J
J
Kop
W J
WJ
Gottdiener
J S
JS
Rozanski
A
A
D000368:Aged; D001143:Arousal / Q000502:physiology; D003326:Coronary Circulation / Q000502:physiology; D003327:Coronary Disease / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D003674:Defense Mechanisms; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006791:Hostility; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011379:Prognosis; D011594:Psychometrics; D014434:Type A Personality