title: Expression of anger and ill health in two cultures: an examination of inflammation and cardiovascular risk.
abstract: Expression of anger is associated with biological health risk (BHR) in Western cultures. However, recent evidence documenting culturally divergent functions of the expression of anger suggests that its link with BHR may be moderated by culture. To test this prediction, we examined large probability samples of both Japanese and Americans using multiple measures of BHR, including pro-inflammatory markers (interleukin-6 and C-reactive protein) and indices of cardiovascular malfunction (systolic blood pressure and ratio of total to HDL cholesterol). We found that the link between greater expression of anger and increased BHR was robust for Americans. As predicted, however, this association was diametrically reversed for Japanese, among whom greater expression of anger predicted reduced BHR. These patterns were unique to the expressive facet of anger and remained after we controlled for age, gender, health status, health behaviors, social status, and reported experience of negative emotions. Implications for sociocultural modulation of bio-physiological responses are discussed.
authors.affiliation: University of Michigan, Ann Arbor kitayama@umich.edu.
authors.forename: Shinobu
authors.initials: S
authors.lastname: Kitayama
authors.affiliation: University of California, San Francisco.
authors.forename: Jiyoung
authors.initials: J
authors.lastname: Park
authors.affiliation: University of Pittsburgh.
authors.forename: Jennifer Morozink
authors.initials: JM
authors.lastname: Boylan
authors.affiliation: University of Wisconsin-Madison.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Miyamoto
authors.affiliation: Northwestern University.
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Levine
authors.affiliation: Stanford University.
authors.forename: Hazel Rose
authors.initials: HR
authors.lastname: Markus
authors.affiliation: Tokyo Woman's Christian University.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Karasawa
authors.affiliation: University of Wisconsin-Madison.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Coe
authors.affiliation: University of Tokyo.
authors.forename: Norito
authors.initials: N
authors.lastname: Kawakami
authors.affiliation: University of Wisconsin-Madison.
authors.forename: Gayle D
authors.initials: GD
authors.lastname: Love
authors.affiliation: University of Wisconsin-Madison.
authors.forename: Carol D
authors.initials: CD
authors.lastname: Ryff
mesh_terms: D000368:Aged; D000786:Anger / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology*; D003466:Cultural Characteristics; D005260:Female; D006801:Humans; D007249:Inflammation / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012931:Social Environment; D014481:United States / Q000453:epidemiology
keywords: anger expression; cardiovascular malfunctioning; culture; inflammation