One study suggests that hostility contributes to heart disease. Another indicates that a hostile personality increases a person's susceptibility to depression
Hostility may be hazardous to your health, judging from the results of two recent studies conducted by Brown-affiliated investigators.
One study suggests that hostility contributes to heart disease. Another indicates that a hostile personality increases a person's susceptibility to depression.
Raymond Niaura, professor of psychiatry and human behavior in the School of Medicine, led the research into heart disease. He and colleagues measured hostility as cynicism, aggressive responses, social avoidance and paranoid alienation. They examined how that hostility influenced metabolic factors that predicted cardiovascular disease, including obesity, upper-body fat distribution, insulin resistance, lipid levels and blood pressure.
The researchers studied 1,081 older men and found that those with high hostility scores were more likely to be overweight, insulin resistant, and with fat distributed in the abdomen and upper body. All of the factors increased the risk for cardiovascular disease. The study also noted a correlation between lower levels of education and higher levels of hostility.
The research was published in the January/February issue of Psychosomatic Medicine.
Niaura hopes the findings will prompt practitioners and patients to consider how psychological and sociological factors are interwoven with cardiovascular disease and other health risks.
The other study, led by Jackie Gollan of Brown's Clinical Psychology Internship Consortium, indicated that people are at a higher risk for recurrent episodes of depression if they are hostile, aggressive and don't rely on others.
For two years, Gollan and colleagues tracked 78 patients who had recovered from major depression. Before entering the study, each patient had received 20 sessions of cognitive behavioral therapy, a structured form of psychotherapy, and was considered symptom free. The researchers measured depression, dysfunctional attitudes, personality styles and involvement in and enjoyment of pleasant activities.
By study's end, 44 percent of participants had relapsed into depression. Post-treatment, individuals who were hostile or very independent were most likely to have suffered another bout of depression. In addition, depression was more likely to recur for people who reported lower levels of enjoyment from self-defined pleasurable activities such as visiting friends.
"These personality styles put people at risk," Gollan said. "They may be isolated and vulnerable, and can't manage on their own. Although they recovered in psychotherapy, they may be reluctant to seek it out again. Plus, they don't have the personality styles that will allow them to rely on others, which may increase their vulnerability to relapse."
The findings suggest that "if you are hostile, irritable, competitive and overly independent, you're behaving and thinking in ways that increase vulnerability to depression," she said. "Although individuals in the study responded to therapy in the short-term, these personality styles significantly increase the likelihood of getting depressed again."
Cognitive behavioral therapy is widely used to treat depression. But the findings suggest the therapy cannot prevent depression for people with hostile and independent personalities.
"As therapists, we need to be more aware of what a person is thinking and to look closer at long-standing behavioral styles."
The study is the first look at how personality dimensions representing hostility, aggression and high independence affect rates of depression relapse.
Gollan presented her findings at the annual meeting of the Association for the Advancement of Behavior Therapy, and will present the work at the annual meeting of the Society for Psychotherapy Research in June. She conducted the study as part of her doctoral research at the University of Washington. Gollan is currently wrapping up a clinical psychology internship at Brown.