International Journal of Behavioral Medicine

, Volume 18, Issue 1, pp 52–64

Cardiovascular and Psychological Reactivity and Recovery from Harassment in a Biracial Sample of High and Low Hostile Men and Women

  • Serina A. Neumann
  • Karl J. Maier
  • Jessica P. Brown
  • Paul P. Giggey
  • Denise C. Cooper
  • Stephen J. Synowski
  • Layne A. Goble
  • Edward C. Suarez
  • Shari R. Waldstein



This study emphasizes the importance of studying the emotional, motivational, and cognitive characteristics accompanying and the potential hemodynamic mechanisms underlying cardiovascular reactivity to and recovery from interpersonal conflict.


The relation of dispositional hostility to cardiovascular reactivity during a frustrating anagram task and post-task recovery was investigated.


The sample was composed of 99 healthy participants (age, 18–30 years; 53% women; 51% Caucasian; 49% African American)—half randomly assigned to a harassment condition. High and low hostility groups were created by a median split specific to sex and race subgroup score distributions on the Cook–Medley Hostility Scale. It was hypothesized that hostility would interact with harassment such that harassed, high hostile individuals would display the greatest cardiovascular and emotional reactivity and slowest recovery of the four groups. Participants completed a 10-min baseline, a 6-min anagram task, and a 5-min recovery period with blood pressure, heart rate, pre-ejection period, stroke index, cardiac index, and total peripheral resistance index measured.


Harassed participants displayed significantly greater cardiovascular responses and lower positive affect to the task and slower systolic blood pressure (SBP) recovery than did nonharassed participants. The high hostile group, irrespective of harassment, showed blunted cardiovascular responses during the task and delayed SBP recovery than the low hostile group.


Although the predicted interaction between hostility and harassment was not supported in the context of cardiovascular responses, such an interaction was observed in the context of blame attributions, whereby harassed hostile participants were found to blame others for their task performance than the other subgroups.


Hostility Harassment Cardiovascular reactivity Post-stress recovery Impedance cardiography 


  1. 1.
    Adams SH. Role of hostility in women's health during mid-life: a longitudinal study. Health Psychol. 1994;13:488–95.CrossRefPubMedGoogle Scholar
  2. 2.
    Barefoot JC, Larsen S, Vonderlieth L, Schroll M. Hostility, incidence of acute myocardial-infarction, and mortality in a sample of older Danish men and women. Am J Epidemiol. 1995;142(5):477–84.PubMedGoogle Scholar
  3. 3.
    Dembroski TM, MacDougall JM, Costa PT, Grandits GA. Components of hostility as predictors of sudden death and myocardial infarction in multiple risk factor intervention trial. Psychosom Med. 1989;51:514–22.PubMedGoogle Scholar
  4. 4.
    Hecker HL, Chesney MA, Black GW, Frautschi N. Coronary-prone behaviors in the Western Collaborative Group Study. Psychosom Med. 1988;50:153–64.PubMedGoogle Scholar
  5. 5.
    Iribarren C, Sidney S, Bild DE, Liu K, Markovitz JH, Roseman JM, et al. Association of hostility with coronary artery calcification in young adults: the CARDIA study. J Am Med Assoc. 2000;283:2546–51.CrossRefGoogle Scholar
  6. 6.
    Matthews KA, Glass DC, Rosenman RH, Bortner RW. Competitive drive, pattern A, and coronary heart disease: a further analysis of some data from the Western Collaborative Group Study. J Chron Dis. 1977;30:489–98.CrossRefPubMedGoogle Scholar
  7. 7.
    Matthews KA, Owens JF, Kuller LH, Sutton-Tyrrell K, Jansen-McWilliams L. Are hostility and anxiety associated with carotid atherosclerosis in healthy postmenopausal women? Psychosom Med. 1998;60(5):633–8.PubMedGoogle Scholar
  8. 8.
    Scherwitz LW, Perkins LL, Chesney MA, Hughes GH, Sidney S, Manolio TA. Hostility and health behaviors in young adults: the CARDIA study. Coronary Artery Risk Development in Young Adults Study. Am J Epidemiol. 1992;136:136–45.PubMedGoogle Scholar
  9. 9.
    Sykes DH, Arveiler D, Salters CP, Ferrieres J, McCrum E, Amouyel P, et al. Psychosocial risk factors for heart disease in France and Northern Ireland: the prospective epidemiological study of myocardial infarction (PRIME). Int J Epidemiol. 2002;31:1227–34.CrossRefPubMedGoogle Scholar
  10. 10.
    Everson SA, Kauhanen J, Kaplan GA, Goldberg DE, Julkunen J, Tuomilehto J, et al. Hostility and increased risk of mortality and acute myocardial infarction: the mediating role of behavioral risk factors. Am J Epidemiol. 1997;146(2):142–52.PubMedGoogle Scholar
  11. 11.
    Rozanski A, Blumenthal JA, Kaplan J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation. 1999;99(16):2192–217.PubMedGoogle Scholar
  12. 12.
    Miller TQ, Smith TW, Turner CW, Guijarro ML, Hallet AJ. A meta-analytic review of research on hostility and physical health. Psychol Bull. 1996;119(2):322–48.CrossRefPubMedGoogle Scholar
  13. 13.
    Manuck SB. Cardiovascular reactivity in cardiovascular disease: “Once More Unto Breach”. Int J Behav Med. 1994;1:4–31.CrossRefPubMedGoogle Scholar
  14. 14.
    Matthews KA. Summary, conclusions, and implications. In: Matthews KA, Weiss SM, Detre T, Dembroski TM, Falkner B, Manuck SB, et al., editors. Handbook of stress reactivity and cardiovascular disease. New York: Wiley; 1986. p. 461–73.Google Scholar
  15. 15.
    Smith TW. Hostility and health—current status of a psychosomatic hypothesis. Health Psychol. 1992;11(3):139–50.CrossRefPubMedGoogle Scholar
  16. 16.
    Mc Ewen BS. Protective and damaging effects of stress mediators. N Engl J Med. 1998;338(3):171–9.CrossRefGoogle Scholar
  17. 17.
    Barnett PA, Spence JD, Manuck SB, Jennings JR. Psychological stress and the progression of carotid artery disease. J Hypertens. 1997;15(1):49–55.CrossRefPubMedGoogle Scholar
  18. 18.
    Kamarck TW, Eranen J, Jennings JR, Manuck SB, Everson SA, Kaplan GA, et al. Anticipatory blood pressure responses to exercise are associated with left ventricular mass in Finnish men—Kuopio Ischemic Heart Disease Risk Factor Study. Circulation. 2000;102(12):1394–9.PubMedGoogle Scholar
  19. 19.
    Krantz DS, Manuck SB. Acute psychophysiological reactivity and risk of cardiovascular disease: a review and methodologic critique. Psychol Bull. 1984;9:435–64.CrossRefGoogle Scholar
  20. 20.
    Everson SA, Mckey BS, Lovallo WR. Effect of trait hostility on cardiovascular-responses to harassment in young men. Int J Behav Med. 1995;2(2):172–91.CrossRefPubMedGoogle Scholar
  21. 21.
    Smith TW, Allred KD. Blood pressure responses during social interaction in high and low cynically hostile males. J Behav Med. 1989;12:135–43.CrossRefPubMedGoogle Scholar
  22. 22.
    Suarez EC, Harlen E, Peoples MC, Williams RB. Cardiovascular and emotional responses in women: the role of hostility and harassment. Health Psychol. 1993;12:459–68.CrossRefPubMedGoogle Scholar
  23. 23.
    Suarez EC, Williams RB. Situational determinants of cardiovascular and emotional reactivity in high and low hostile men. Psychosom Med. 1989;51:404–18.PubMedGoogle Scholar
  24. 24.
    Anderson JC, Linden W, Habra ME. The importance of examining blood pressure reactivity and recovery in anger provocation research. Int J Psychophysiol. 2005;57:159–63.CrossRefPubMedGoogle Scholar
  25. 25.
    Brosschot JF, Thayer JF. Anger inhibition, cardiovascular recovery, and vagal function: a model of the link between hostility and cardiovascular disease. Ann Behav Med. 1998;20:326–32.CrossRefPubMedGoogle Scholar
  26. 26.
    Gerin W, Pickering TG. Association between delayed recovery of blood-pressure after acute mental stress and parental history of hypertension. J Hypertens. 1995;13(6):603–10.CrossRefPubMedGoogle Scholar
  27. 27.
    Linden W, Earle TL, Gerin W, Christenfeld N. Physiological stress reactivity and recovery: conceptual siblings separated at birth? J Psychosom Res. 1997;42(2):117–35.CrossRefPubMedGoogle Scholar
  28. 28.
    Neumann SA, Waldstein SR, Sollers JJ, Thayer JF, Sorkin JD. Hostility and distraction have differential influences on cardiovascular recovery responses to anger recall in women. Health Psychol 2004;23(6).Google Scholar
  29. 29.
    Pieper S, Brosschot JF. Prolonged stress related cardiovascular activation: is there any? Ann Behav Med. 2005;30(2):91–103.CrossRefPubMedGoogle Scholar
  30. 30.
    Davis MC, Matthews KA, McGrath CE. Hostile attitudes predict elevated vascular resistance during interpersonal stress in men and women. Psychosom Med. 2000;62(1):17–25.PubMedGoogle Scholar
  31. 31.
    Prkachin KM, Mills DE, Zwaal C, Husted J. Comparison of hemodynamic responses, to social and nonsocial stress: evaluation of an anger interview. Psychophysiology. 2001;38(6):879–85.CrossRefPubMedGoogle Scholar
  32. 32.
    Neumann SA, Waldstein SR. Similar patterns of cardiovascular response during emotional activation as a function of affective valence and arousal and gender. J Psychosom Res. 2001;50(5):245–53.CrossRefPubMedGoogle Scholar
  33. 33.
    Sinha R, Lovallo WR, Parsons OA. Cardiovascular differentiation of emotions. Psychosom Med. 1992;54(4):422–35.PubMedGoogle Scholar
  34. 34.
    Smith TW, Gallo LC. Hostility and cardiovascular reactivity during marital interaction. Psychosom Med. 1999;61:436–45.PubMedGoogle Scholar
  35. 35.
    Enkelmann HC, Bishop GD, Tong EM, Diong SM, Why YP, Khader M, et al. The relationship of hostility, negative affect and ethnicity to cardiovascular responses: an ambulatory study in Singapore. Int J Psychophysiol. 2005;56(2):185–97.CrossRefPubMedGoogle Scholar
  36. 36.
    Houston BK. Personality characteristics, reactivity, and cardiovascular disease. In: Turner JR, Sherwood A, Light K, editors. Individual differences in cardiovascular response to stress. New York: Plenum; 1992. p. 103–23.Google Scholar
  37. 37.
    Blascovich J, Brennan K, Tomaka J, Kelsey RM, Hughes P, Coad ML, et al. Affect intensity and cardiac arousal. J Pers Soc Psychol. 1992;63(1):164–74.CrossRefPubMedGoogle Scholar
  38. 38.
    Tomaka J, Blascovich J, Kibler J, Ernst JM. Cognitive and physiological antecedents of threat and challenge appraisal. J Pers Soc Psychol. 1997;73(1):63–72.CrossRefPubMedGoogle Scholar
  39. 39.
    Maier KJ, Waldstein SR, Synowski SJ. Relation of cognitive appraisal to cardiovascular reactivity, affect, and task engagement. Ann Behav Med. 2003;26(1):32–41.CrossRefPubMedGoogle Scholar
  40. 40.
    Durel LA, Carver CS, Spitzer SB, Llabre MM, Weintraub JK, Saab PG, et al. Associations of blood pressure with self-report measures of anger and hostility among black and white men and women. Health Psychol. 1989;8(5):557–75.CrossRefPubMedGoogle Scholar
  41. 41.
    Scherwitz L, Perkins L, Chesney M, Hughes G. Cook–Medley Hostility Scale and subsets: relationship to demographic and psychosocial characteristics in young adults in the CARDIA study. Psychosom Med. 1991;53(1):36–49.PubMedGoogle Scholar
  42. 42.
    Barefoot JC, Peterson BL, Dahlstrom WG, Siegler IC, Anderson NB, Williams Jr RB. Hostility patterns and health implications: correlates of Cook–Medley Hostility Scale scores in a national survey. Health Psychol. 1991;10(1):18–24.CrossRefPubMedGoogle Scholar
  43. 43.
    Maier KJ, Goble LA, Neumann SA, Giggey P, Suarez EC, Waldstein SR. Dimensions across measures of dispositional hostility, expressive style, and depression show some variation by race/ethnicity and gender in young adults. J Soc Clin Psychol. 2009;28(10):1199–225.CrossRefGoogle Scholar
  44. 44.
    Stoney CM, Davis MC, Matthews KA. Sex differences in physiological responses to stress and in coronary heart disease: a causal link? Psychophysiology. 1987;24(2):127–31.CrossRefPubMedGoogle Scholar
  45. 45.
    Stoney CM, Matthews KA, McDonald RH, Johnson CA. Sex differences in lipid, lipoprotein, cardiovascular, and neuroendocrine responses to acute stress. Psychophysiology. 1988;25(6):645–56.CrossRefPubMedGoogle Scholar
  46. 46.
    Lawler KA, Wilcox ZC, Anderson SF. Gender differences in patterns of dynamic cardiovascular regulation. Psychosom Med. 1995;57(4):357–65.PubMedGoogle Scholar
  47. 47.
    Allen MT, Stoney CM, Owens JF, Matthews KA. Hemodynamic adjustments to laboratory stress: the influence of gender and personality. Psychosom Med. 1993;55(6):505–17.PubMedGoogle Scholar
  48. 48.
    Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. J Am Med Assoc. 2003;289:2560–72.CrossRefGoogle Scholar
  49. 49.
    Cook WW, Medley DM. Proposed hostility and pharisaic-virtue scales for the MMPI. J Appl Psychol. 1954;38:414–8.CrossRefGoogle Scholar
  50. 50.
    Smith TW, Frohm KD. What's so unhealthy about hostility? Construct validity and psychosocial correlaters of the Cook and Medley Ho scale. Health Psychol. 1985;4:503–20.CrossRefPubMedGoogle Scholar
  51. 51.
    Barefoot JC, Dodge KA, Peterson BL, Dohlstrom WG, Williams RB. The Cook–Medley Hostility Scale: item content and ability to predict survival. Psychosom Med. 1989;51:46–57.PubMedGoogle Scholar
  52. 52.
    Costa PT, Zonderman AB, McCrae RR, Williams RB. Cynicism and paranoid alienation in the Cook and Medley Ho Scale. Psychosom Med. 1986;48:283–5.PubMedGoogle Scholar
  53. 53.
    Smith TW, Pope MK, Sanders JD, Allred KD, O'Keefe JL. Cynical hostility at home and work: psychosocial vulnerability across domains. J Res Pers. 1988;22:525–48.CrossRefGoogle Scholar
  54. 54.
    Woodall K, Matthews KA. Familial environment associated with type A behaviors and psychophysiological responses to stress in children. Health Psychol. 1989;8:403–26.CrossRefPubMedGoogle Scholar
  55. 55.
    Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988;54(6):1063–70.CrossRefPubMedGoogle Scholar
  56. 56.
    Waldstein SR, Bachen EA, Manuck SB. Active coping and cardiovascular reactivity: a multiplicity of influences. Psychosom Med. 1997;59(6):620–5.PubMedGoogle Scholar
  57. 57.
    Feldman PJ, Cohen S, Lepore SJ, Matthews KA, Kamarck TW, Marsland AL. Negative emotions and acute physiological responses to stress. Ann Behav Med. 1999;21(3):216–22.CrossRefPubMedGoogle Scholar
  58. 58.
    Warner RM, Strowman SR. Cardiovascular reactivity and positive/negative affect during conversations. J Behav Med. 1995;18(2):141–59.CrossRefPubMedGoogle Scholar
  59. 59.
    Light KC, Obrist PA. Cardiovascular response to stress: effects of opportunity to avoid, shock experience, and performance feedback. Psychophysiology. 1980;17(3):243–52.CrossRefPubMedGoogle Scholar
  60. 60.
    Cohen S, Hamrick N, Rodriguez MS, Feldman PJ, Rabin BS, Manuck SB. The stability of and intercorrelations among cardiovascular, immune, endocrine, and psychological reactivity. Ann Behav Med. 2000;22(3):171–9.CrossRefPubMedGoogle Scholar
  61. 61.
    Piferi RL, Lawler KA. Hostility and the cardiovascular reactivity of women during interpersonal confrontation. Women Health. 2000;30(3):111–29.CrossRefPubMedGoogle Scholar
  62. 62.
    Smith CA, Haynes KN, Lazarus RS, Pope LK. In search of the “hot” cognitions: attributions, appraisals, and their relation to emotion. J Pers Soc Psychol. 1993;65(5):916–29.CrossRefPubMedGoogle Scholar
  63. 63.
    Sherwood A, Allen MT, Fahrenberg J, Kelsey RM, Lovallo WR, van Doornen LJP. Methodological guidelines for impedance cardiography. Psychophysiology. 1990;27:1–23.CrossRefPubMedGoogle Scholar
  64. 64.
    Debski TT, Kamarck TW, Jennings JR, Young LW, Eddy MJ, Zhang Y. A computerized test battery for the assessment of cardiovascular reactivity. Int J Biomed Comput. 1991;27:277–89.CrossRefPubMedGoogle Scholar
  65. 65.
    Kamarck TW, Jennings JR, Manuck SB. Psychometric applications in the assessment of cardiovascular reactivity. Homeostasis. 1993;34:5–6.Google Scholar
  66. 66.
    Kubicek WG, Karnegis JN, Patterson PP, Witsoe DA, Mattson RH. Developmental and evaluation of an impedance cardiograph system. Aerosp Med. 1966;37:1208–12.PubMedGoogle Scholar
  67. 67.
    Protter MH, CBJr M. College calculus with analytical geometry. Reading: Addison-Wesley; 1964.Google Scholar
  68. 68.
    Le Floch JP, Escuyer P, Baudin E, Baudon D, Perlemuter L. Blood glucose area under the curve. Methodological aspects. Diab Care. 1990;13(2):172–5.CrossRefGoogle Scholar
  69. 69.
    Earle TL, Linden W, Wenberg J. Differential effects of harassment on cardiovascular and salivary cortisol stress reactivity and recovery in women and men. J Psychosom Res. 1999;46(2):125–41.CrossRefPubMedGoogle Scholar
  70. 70.
    Suarez EC, Williams RB. The relationships between dimensions of hostility and cardiovascular reactivity as a function of task characteristics. Psychosom Med. 1989;52:558–70.Google Scholar
  71. 71.
    Powch IG, Houston BK. Hostility, anger-in, and cardiovascular reactivity in white women. Health Psychol. 1996;15(3):200–8.CrossRefPubMedGoogle Scholar
  72. 72.
    Smith CA, Lazarus RS. Appraisal components, core relational themes, and the emotions. Cogn Emot. 1993;7(3/4):233–69.CrossRefGoogle Scholar
  73. 73.
    Peters ML, Godaert GL, Ballieux RE, Heijnen CJ. Moderation of physiological stress responses by personality traits and daily hassles: less flexibility of immune system responses. Biol Psychol. 2003;65(1):21–48.CrossRefPubMedGoogle Scholar
  74. 74.
    Sterling P, Ever J. Allostasis: a new paradigm to explain arousal pathology. Handbook of life stress, cognition, and health. New York: Wiley; 1988. p. 629–49.Google Scholar
  75. 75.
    McEwen B. Allostasis and allostatic load: implications for neuropsychopharmacology. Neuropsychopharmacology. 2000;22(2):108–24.CrossRefPubMedGoogle Scholar
  76. 76.
    Brosschot JF, Pieper S, Thayer JF. Expanding stress theory: prolonged activation and perseverative cognition. Psychoneuroendocrinology. 2005;30(10):1043–9.CrossRefPubMedGoogle Scholar
  77. 77.
    Williams R. Basic biological mechanisms. In: Seigman AW, Smith TW, editors. Anger, hostility, and the heart. Hillsdale: Erlbaum; 1994. p. 119–25.Google Scholar
  78. 78.
    Kubzansky LD, Kawachi I, Sparrow D. Socioeconomic status, hostility, and risk factor clustering in the Normative Aging Study: any help from the concept of allostatic load? Ann Behav Med. 1999;21(4):330–8.CrossRefPubMedGoogle Scholar
  79. 79.
    Hogan BE, Linden W. Anger response styles and blood pressure: at least don't ruminate about it! Ann Behav Med. 2004;27(1):38–49.CrossRefPubMedGoogle Scholar
  80. 80.
    Key BL, Campbell TS, Bacon SL, Gerin W. The influence of trait and state rumination on cardiovascular recovery from a negative emotional stressor. J Behav Med. 2008;31(3):237–48.CrossRefPubMedGoogle Scholar
  81. 81.
    Anderson NB, Myers HF, Pickering T, Jackson JS. Hypertension in blacks: psychosocial and biological perspectives. J Hypertens. 1989;7(3):161–72.CrossRefPubMedGoogle Scholar
  82. 82.
    Barnes VA, Treiber FA, Musante L, Turner JR, Davis H, Strong WB. Ethnicity and socioeconomic status: impact on cardiovascular activity at rest and during stress in youth with a family history of hypertension. Ethn Dis. 2000;10(1):4–16.PubMedGoogle Scholar
  83. 83.
    Abel JL, Larkin KT, Edens JL. Women, anger, and cardiovascular responses to stress. J Psychosom Res. 1995;39(3):251–9.CrossRefPubMedGoogle Scholar
  84. 84.
    Hughes BM. Self-esteem, performance feedback, and cardiovascular stress reactivity. Anxiety Stress Coping. 2007;20(3):239–52.CrossRefPubMedGoogle Scholar
  85. 85.
    Lai JY, Linden W. Gender, anger expression style, and opportunity for anger release determine cardiovascular reaction to and recovery from anger provocation. Psychosom Med. 1992;54(3):297–310.PubMedGoogle Scholar

Copyright information

© International Society of Behavioral Medicine 2010

Authors and Affiliations

  • Serina A. Neumann
    • 1
    • 2
  • Karl J. Maier
    • 2
    • 3
  • Jessica P. Brown
    • 2
    • 6
  • Paul P. Giggey
    • 2
  • Denise C. Cooper
    • 2
    • 4
  • Stephen J. Synowski
    • 2
  • Layne A. Goble
    • 2
  • Edward C. Suarez
    • 5
  • Shari R. Waldstein
    • 2
    • 6
    • 7
  1. 1.Department of Psychiatry and Behavioral SciencesEastern Virginia Medical SchoolNorfolkUSA
  2. 2.University of Maryland, Baltimore CountyBaltimoreUSA
  3. 3.Salisbury State UniversitySalisburyUSA
  4. 4.University of California, San DiegoSan DiegoUSA
  5. 5.Duke University Medical CenterDurhamUSA
  6. 6.University of Maryland School of MedicineBaltimoreUSA
  7. 7.Baltimore Veterans Affairs Medical CenterBaltimoreUSA

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