Skip to main content
Log in

Anger and impatience/irritability in patients of low socioeconomic status with acute coronary heart disease

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

This case-control study examines the relationship between anger and impatience/irritability and acute coronary heart disease (CHD) in middle-aged men of low socioeconomic status (SES). Subjects included patients with myocardial infarction (MI) (N=31) or unstable angina (AP) (N=26), who were compared with hospital controls (N=26). In separate multi-variate analyses for each anger scale, MI was associated with Anger-Out and Impatience/Irritability, particularly in the subgroup of patients who did not have a previous MI. The same factors were associated with AP, but only when this acute ischemic event was not preceded by a ML No relationship was found between Trait-Anger and Anger-In and either acute ischemic outcome. The results indicate that particularly overt behavioral expression of anger is related to CHD in lower SES patients and that there is similarity in the behavioral factors associated with acute CHD between low- and high-SES men.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Costa, P. T., McCrae, R. R., and Dembroski, T. M. (1989). Agreeableness versus antagonism: Explication of a potential risk factor for CHD. In Siegman, A. W., and Dembroski, T. M. (eds.),In Search of Coronary Prone Behavior: Beyond Type A, Lawrence Erlbaum, Hillsdale, NJ, pp. 41–63.

    Google Scholar 

  • Dembroski, T. M., and Costa, P. T. (1987). Coronary prone behavior: components of the type A pattern and hostility.J. Personal. 55: 211–235.

    Google Scholar 

  • Dembroski, T. M., MacDougall, J. M., Williams, R. B., Haney, T. L., and Blumenthal, J. A. (1985). Components of Type A, hostility, and anger-in: Relationship to angiographic findings.Psychosom. Med. 47: 219–233.

    PubMed  Google Scholar 

  • Dembroski, T. M., MacDougall, J. M., Costa, P. T., and Grandits, G. A. (1989). Components of hostility as predictors of sudden death and myocardial infarction in the Multiple Risk Factor Intervention Trial.Psychosom. Med. 51: 514–522.

    PubMed  Google Scholar 

  • Diamond, E. L. (1982). The role of anger and hostility in essential hypertension and coronary heart disease.Psychol. Bull. 92: 410–433.

    PubMed  Google Scholar 

  • Dixon, W. J. (1988).BMDP Statistical Software Manual, University of California Press, Los Angeles.

    Google Scholar 

  • Haynes, S. G., Feinleib, M., and Kannel, W. B. (1980). The relationship of psychosocial factors to coronary heart disease in the Framingham Study. III. Eight-year incidence of coronary heart disease.Am. J. Epidemiol. 111: 37–58.

    PubMed  Google Scholar 

  • Jenkins, C. D., and Zyzanski, S. J. (1980). Behavioral risk factors and coronary heart disease.Psychother. Psychosom. 34: 149–177.

    PubMed  Google Scholar 

  • Jenkins, C. D., Zyzanski, S. J., and Rosenman, R. H. (1978). Coronary prone behavior. One pattern or several?Psychosom. Med. 40: 25–43.

    PubMed  Google Scholar 

  • Koskenvuo, M., Kaprio, J., Rose, R. J., Kesäniemi, A., Sarna, S., Haikkilä, K., and Langin-vainio, H. (1988). Hostility as a risk factor for mortality and ischaemia heart disease in men.Psychosom. Med. 50: 330–340.

    PubMed  Google Scholar 

  • MacDougall, J. M., Dembroski, T. M., Dimsdale, J. E., and Hackett, T. P. (1985). Components of Type A, hostility, and anger-in: Further relationships to angiographic findings.Health Psychol. 4: 137–152.

    PubMed  Google Scholar 

  • Matthews, K. A., Feinleib, M., and Kannel, W. B. (1977). The relationship of psychosocial factors to coronary heart disease: A further analysis of some data from the Western Collaborative Group Study.J. Chron. Dis. 30: 489–498.

    PubMed  Google Scholar 

  • Musante, L., MacDougall, J. M., Dembroski, T. M., and Costa, P. T. (1989). Potential for hostility and dimensions of anger.Health Psychol. 8: 343–354.

    PubMed  Google Scholar 

  • Ostfeld, A. M., Lebovits, B. S., Shekelle, R. B., and Paul, O. (1964). A prospective study of the relationship between personality and coronary heart disease.J. Chron. Dis. 17: 265–276.

    Google Scholar 

  • Pell, S., and Fayerweather, W. E. (1985). Trends in the incidence of myocardial infarction and in associated mortality and morbidity in a large employed population, 1957–1983.N. Engl. J. Med. 312: 1005–1011.

    PubMed  Google Scholar 

  • Powell, L. H., and Thoresen, C. E. (1988). Effects of Type A behavior counseling and severity of prior acute myocardial infarction on survival.Am. J. Cardiol. 62: 1159–1163.

    PubMed  Google Scholar 

  • Rogot, E., and Hrubec, Z. (1989). Trends from mortality from coronary heart disease and stroke from U.S. Veterans: 1954–1979.J. Clin. Epidemiol. 42: 245–256.

    PubMed  Google Scholar 

  • SAS Institute Inc. (1988).SAS/STAT User's Guide, Release 6.03 Edition. SAS Institute Inc., Cary, NC.

    Google Scholar 

  • Shocken, D. D., Worden, T., Greene, A. F., Harrison, E. F., and Spielberger, C. D. (1985). Age differences in the relationship between coronary artery disease, anxiety, and anger.Gerontologist 25: 36.

    Google Scholar 

  • Siegman, A. W., Dembroski, T. M., and Ringel, N. (1987a). Components of hostility and the severity of coronary artery disease.Psychosom. Med. 49: 127–135.

    PubMed  Google Scholar 

  • Siegman, A. W., Feldstein, S., Tommaso, C. T., Ringel, N., and Lating, J. (1987b). Expressive vocal behavior and the severity of coronary atherosclerosis.Psychosom. Med. 49: 545–561.

    PubMed  Google Scholar 

  • Siegman, A. W., Anderson, R. A., and Berger, T. (1990). The angry voice: Its effects on the experience of anger and cardiovascular reactivity.Psychosom. Med. 52: 631–643.

    PubMed  Google Scholar 

  • Smith, T. W., and Frohm, K. D. (1985). What's so unhealthy about hostility? Construct validity and psychosocial correlates of the Cook and Medley Ho scale.Health Psychol. 4: 503–520.

    PubMed  Google Scholar 

  • Spence, J. T., Helmreich, R. L., and Pred, R. S. (1987). Impatience versus achievement striving in the Type A pattern: differential effects on students' health and academic achievement.J. Appl Psychol. 72: 522–528.

    PubMed  Google Scholar 

  • Spielberger, C. D., Jacobs, G. A., Russell, S., and Crane, R. S. (1983). Assessement of anger: The State-Trait Anger Scale. In Butcher, J. N., and Spielberger, C. D. (eds.),Advances in Personality Assessment, Vol. 2, Erlbaum, Hillsdale, NJ.

    Google Scholar 

  • Spielberger, C. D., Johnson, E. H., Russell, S. F., Crane, R. J., Jacobs, G. A., and Worden, T. J. (1985). The experience and expression of anger. In Chesney, M. A., and Rosenman, R. H. (eds.),Anger and Hostility in Cardiovascular and Behavioral Disorders, McGraw-Hill, New York, pp. 5–30.

    Google Scholar 

  • Suarez, E. C., and Williams, R. B. (1990). The relationships between dimensions of hostility and cardiovascular reactivity as a function of task characteristics.Psychosom. Med. 52: 558–570.

    PubMed  Google Scholar 

  • Tennant, C. C., Langeluddecke, P. M., Fulcher, G., and Wilby, J. (1987). Anger and other psychological factors in coronary atherosclerosis.Psychol. Med. 17: 425–431.

    PubMed  Google Scholar 

  • Williams, R. B. (1988). Coronary-prone behavior. In Houston, B. K., and Snyder, C. R. (eds.),Type A Behavior Pattern: Current Trends and Future Directions, Wiley, New York.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

de Leon, C.F.M. Anger and impatience/irritability in patients of low socioeconomic status with acute coronary heart disease. J Behav Med 15, 273–284 (1992). https://doi.org/10.1007/BF00845356

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00845356

Key words

Navigation