Journal of Behavioral Medicine

, Volume 26, Issue 6, pp 501–515

Cynical Hostility, Depressive Symptoms, and the Expression of Inflammatory Risk Markers for Coronary Heart Disease


    • Department of PsychologyWashington University
  • Kenneth E. Freedland
    • Department of PsychiatryWashington University School of Medicine
  • Robert M. Carney
    • Department of PsychiatryWashington University School of Medicine
  • Cinnamon A. Stetler
    • Department of PsychologyWashington University
  • William A. Banks
    • Department of Internal Medicine, GRECC–Veterans Affairs Medical Center and Division of GeriatricsSaint Louis University School of Medicine

DOI: 10.1023/A:1026273817984

Cite this article as:
Miller, G.E., Freedland, K.E., Carney, R.M. et al. J Behav Med (2003) 26: 501. doi:10.1023/A:1026273817984


Although the prognostic significance of depression and hostility has been established, little is known about how they operate together to influence disease processes. This study explored the independent and interactive relationships between these constructs and the expression of inflammatory markers implicated in the pathogenesis of coronary heart disease. One hundred adults completed measures of cynical hostility and depressive symptoms, and had blood drawn to assess serum levels of interleukin-1β, interleukin-6, and tumor necrosis factor-α. Depression was directly related to inflammatory markers, but hostility was not. A significant interaction between hostility and depression emerged. Among participants scoring low in depressive symptoms, hostility was positively associated with interleukin-6 and tumor necrosis factor-α concentrations. Hostility's association with these inflammatory markers was much weaker among participants with moderate depressive symptoms, however, and virtually nil among participants with severe depressive symptoms. Neither depression nor hostility was associated with interleukin-1β concentrations. These findings highlight the importance of considering both the independent and interactive relationships among psychosocial characteristics involved in disease.


Copyright information

© Plenum Publishing Corporation 2003