Skip to main content
Log in

Depression, anxiety, hostility, and physical health

  • Articles
  • Published:
Current Psychology Aims and scope Submit manuscript

Abstract

This study assessed the relationship of depression, anxiety, and hostility to physical health in a multicultural student population (N=106). When controlling for a variety of demographic and health risk factors (viz., age, sex, body mass, smoking, alcohol, salt, caffeine, and exercise), hostility, depression, and anxiety were related to higher reported incidences of physical symptoms and somatic illness. Depression and hostility had the strongest relationships with physical health, although the most striking single relationship was between depression and illness. Results suggest that it may be premature to focus our attention on hostility in research on the personality-illness relationship. They also suggest that the health behavior model of the relationship between personality and disease does not provide an adequate explanation, since negative affect was significantly associated with illness even when controlling for a variety of health risk factors.

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

  • Ahern, D., Gorkin, L., Anderson, J., Tierney, C., Hallstrom, A., Ewart, C., Capone, R. Schron, E., Kornfeld, D., Herd, J., Richardson, D., & Follick, M. (1990). Biobehavioral variables and mortality or cardiac arrest in the cardiac arrhythmia pilot study (CAPS)American Journal of Cardiology, 66, 59–62.

    Article  PubMed  Google Scholar 

  • Allport, G. W. (1961).Pattern and growth in personality. New York: Holt, Rinehart, & Winston.

    Google Scholar 

  • Altrocchi, J. (1980).Abnormal behavior. New York: Harcourt, Brace, & Jovanovich.

    Google Scholar 

  • American Psychiatric Association. (1994).Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

    Google Scholar 

  • Andrews, G., Schonell, M., & Tennant, C. (1977). The relationship between physical, psychological, and social morbidity in a suburban community.American Journal of Epidemiology, 105, 27–35.

    Google Scholar 

  • Angell, M. (1985). Disease as a reflection of the psyche.New England Journal of Medicine, 312, 1570–1572.

    Article  PubMed  Google Scholar 

  • Barefoot, J. C., Dahlstrom, W. G., & Williams, R. B., Jr. (1983). Hostility, CHD incidence, and total mortality: A 25-year follow-up study of 255 physicians.Psychosomatic Medicine, 45, 59–63.

    PubMed  Google Scholar 

  • Barefoot, J. C., Dodge, K. A., Peterson, B. L., Dahlstrom, W. G., & Williams, R. B., Jr. (1989). The Cook-Medley Hostility Scale: Item content and ability to predict survival.Psychosomatic Medicine, 51, 46–57.

    PubMed  Google Scholar 

  • Belloc, N. B., & Breslow, L. (1972). Relationship of physical health status and health practice.Preventive Medicine, 1, 409–421.

    Article  PubMed  Google Scholar 

  • Bellow, N. B., Breslow, L., & Hochstim, J. R. (1971). Measurement of physical health in a general population survey.American Journal of Epidemiology, 93, 328–336.

    Google Scholar 

  • Booth-Kewley, S., & Friedman, H. S. (1987). Psychological predictors of heart disease: A quantitative review.Psychological Bulletin, 101, 343–362.

    Article  PubMed  Google Scholar 

  • Budman, S. H., & Gurman, A. S. (1988).Theory and practice of brief therapy. New York: Guilford.

    Google Scholar 

  • Chesney, M. A. (1993). Social isolation, depression, and heart disease: Research on women broadens the agenda.Psychosomatic Medicine, 55, 434–435.

    PubMed  Google Scholar 

  • Chesney, M.A., & Rosenman, R. H. (Eds.). (1985).Anger and hostility in cardiovascular and behavioral disorders. New York: Hemisphere.

    Google Scholar 

  • Cook, W. W., & Medley, D. M. (1954). Proposed hostility and pharisaic-virtue scales for the MMPI.Journal of Applied Psychology, 38, 414–418.

    Article  Google Scholar 

  • Costa, P. T., Jr., & McCrae, R. R. (1985). Hypochondriasis, neuroticism, and aging.American Psychologist, 40, 19–28.

    Article  PubMed  Google Scholar 

  • Costa, P. T., Jr., & McCrae, R. R. (1987). Neuroticism, somatic complaints, and disease: Is the bark worse than the bite?Journal of Personality, 55, 299–316.

    Article  PubMed  Google Scholar 

  • Crisp, A. H., Queenan, M., & D’Souza, M.F. (1984). Myocardial infarction and the emotional climate.Lancet, 1, 616–619.

    Article  PubMed  Google Scholar 

  • Dembroski, T. M., & Costa, P. T., Dr. (1987). Coronary-prone behavior: Components of the Type A pattern and hostility.Journal of Personality, 55, 211–235.

    Article  PubMed  Google Scholar 

  • Fielding, R. (1991). Depression and acute myocardial infarction: A review and reinterpretation.Social Science and Medicine, 32, 1017–1028.

    Article  PubMed  Google Scholar 

  • Friedman, H. S. (Ed.). (1990a).Personality and disease. New York: Wiley.

    Google Scholar 

  • Friedman, H. S. (1990b). Where is the disease-prone personality? Conclusion and future directions. In H. S. Friedman (Ed.),Personality and disease (pp. 283–292). New York: Wiley.

    Google Scholar 

  • Friedman, H. S. (1991).The self-healing personality. New York: Henry Holt.

    Google Scholar 

  • Friedman, H. S. (Ed.) (1992).Hostility, coping and health. Washington, D.C.: American Psychological Association.

    Google Scholar 

  • Friedman, H. S., & Booth-Kewley, S. (1987). The “Disease-Prone Personality”: A meta analytic view of the construct.American Psychologist, 42, 539–555.

    Article  PubMed  Google Scholar 

  • Friedman, M., & Ulmer, D. (1984).Treating Type A behavior and your heart. New York: Ballantine.

    Google Scholar 

  • Goldbourt, U., Medalie, J. H., & Neufeld, H. N. (1975). Clinical myocardial infarction over a five-year period-III. A multivariate analysis of incidence, the Israel Ischemic Heart Disease Study.Journal of Chronic Disease, 28, 217–237.

    Article  Google Scholar 

  • Green, A. L., & Austin, C. P. (1993). Psychopathology of pancreatic cancer: A psychobiologic probe.Psychosomatics, 34, 208–221.

    PubMed  Google Scholar 

  • Greer, S. (1991). Psychological response to cancer and survival.Psychological Medicine, 21, 43–49.

    Article  PubMed  Google Scholar 

  • Greer, S., Morris, T., & Pettingale, K. W. (1979). Psychological response to breast cancer: Effect on outcome.Lancet, 2, 785–787.

    Article  PubMed  Google Scholar 

  • Haines, A. P., Imerson, J. D., & Meade, T. W. (1987). Phobic anxiety and ischaemic heart disease.British Medical Journal, 295, 297–299.

    PubMed  Google Scholar 

  • Hallstrom, T., Lapidus, L., Bengtsson, C., & Edstrom, K. (1986). Psychosocial factors and risk of ischaemic heart disease and death in women: A twelve-year follow-up of participants in the population study of women in Gothenburg, Sweden.Journal of Psychosomatic Research, 30, 451–459.

    Article  PubMed  Google Scholar 

  • Havik, O. E., & Maeland, J. G. (1990). Pattern of emotional reactions after a myocardial infarction.Journal of Psychosomatic Research, 32, 145–157.

    Article  Google Scholar 

  • Hearn, M. D., Murray, D. M., & Luepker, R. V. (1989). Hostility, coronary heart disease, and total mortality: A 33-year follow-up study of university students.Journal of Behavioral Medicine, 12, 105–121.

    Article  PubMed  Google Scholar 

  • Herbert, T. B., & Cohen, S. (1993). Depression and immunity: A meta-analytic review.Psychological Bulletin, 113, 472–487.

    Article  PubMed  Google Scholar 

  • Hoehn-Saric, R., & McLeod, D. R. (1987). Cardiac symptoms and anxiety disorders: Contributing factors and pharmacologic treatment.American Journal of Cardiology, 60, 68J-73J.

    Article  PubMed  Google Scholar 

  • Hunt, W. A., Barnett, L. W., & Branch, L. G. (1971). Relapse rates in addiction programs.Journal of Clinical Psychology, 27, 455–456.

    Article  PubMed  Google Scholar 

  • Johnson, E. (1990). The deadly emotions:The role of anger, hostility, and aggression in health and emotional well-being. New York: Praeger.

    Google Scholar 

  • Kaplan, G. (1985). Psychosocial aspects of chronic illness. Direct and indirect associations with ischemic heart disease mortality. In R. Kaplan & M. Crique (Eds.),Behavioral Epidemilogy and Disease Prevention (pp. 237–269). New York: Plenum.

    Google Scholar 

  • Kaplan, H. I. (1980). Treatment of psychosomatic disorders. In H. I. Kaplan, A. M. Freedman, & B. J. Saddock (Eds.),Comprehensive textbook of psychiatry IV: Vol. 2 (3rd ed.) (pp. 1973–1980). New York: Williams & Wilkins.

    Google Scholar 

  • Keehn, R. J., Goldberg, I. D., & Beebe, G. W. (1974). Twenty-four year mortality follow-up of army veterans with disability separations for psychoneurosis in 1994.Psychosomatic Medicine, 36, 27–46.

    PubMed  Google Scholar 

  • Koskenvuo, M., Kapiro, J., Rose, R. J., Kesnaiemi, A., Heikkiloak, K., & Langivanio, H. (1988). Hostility as a risk factor for mortality and ischemic heart disease in men.Psychosomatic Medicine, 50, 330–340.

    PubMed  Google Scholar 

  • Krantz, D. S., Baum, A., & Singer, J. E., (Eds.) (1983).Handbook of psychology and health: Vol. 3. Cardiovascular disorders and behavior. Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Krantz, D. S., & Glass, D. C. (1984). Personality, patterns, & physical illness: Conceptual and methodological issues. In W. D. Gentry (Ed.),Handbook of behavioral medicine (pp. 36–86). New York: Guilford.

    Google Scholar 

  • Lambert, M. J., Shapiro, D. A., & Bergin, A. E. (1986). The effectiveness of psychotherapy. In S. L. Garfield & A. E. Bergin (Eds.),Handbook of psychotherapy and behavior change (pp. 157–212). New York: Wiley.

    Google Scholar 

  • LaRue, A., Bank, L., Jarvik, L., & Hetland, M. (1979). Health in old age: How do physician ratings and self-ratings compare?Journal of Gerontology, 34, 687–691.

    PubMed  Google Scholar 

  • Leigh, H. (1982). Evaluation and management of stress in general medicine: The psychosomatic approach. In L. Goldberger & S. Breznitz (Eds.),Handbook of stress: Theoretical and clinical aspects (pp. 733–744). New York: Free Press.

    Google Scholar 

  • Leiker, M., & Hailey, B. J. (1988). A link between hostility and disease: Poor health habits.Behavioral Medicine, 14, 129–153.

    Article  PubMed  Google Scholar 

  • Maccoby, N. Farquhar, J.W., & Fortmann, S. P. (1985). The community studies of the Stanford heart disease prevention program. In R. M. Kaplan & M. H. Criqi (Eds.). (1985).Behavioral epidemiology and disease prevention (pp. 385–400). New York: Plenum.

    Google Scholar 

  • Maddox, G. L., & Douglas, E. B. (1973). Self-assessment and health: A longitudinal study of elderly subjects.Journal of Health and Social Behavior, 14, 89–93.

    Article  Google Scholar 

  • Matthews, K. A., Weiss, S. M., Detre, T., Dembroski, T. M., Falkner, B., Manuck, S. G., & Williams, R. B., Jr. (Eds.). (1986).Handbook of stress reactivity and cardiovascular disease. New York: Wiley.

    Google Scholar 

  • Matarazzo, J. D., & Leckliter, I. N. (1988). Behavioral health: The role of good and bad habits in health and illness. In S. Maes, C. D. Spielberger, P. B. Defares, & I. G. Sarason (Eds.),Topics in health psychology (pp. 3–18). New York: John Wiley.

    Google Scholar 

  • Meltzer, J., & Hochstim, J. (1970). Reliability and validity of survey data on physical health.Public Health Reports, 85, 1075–1086.

    PubMed  Google Scholar 

  • Meyer, A. J., Nash, J.D., McAlister, A. L., Maccoby, N., & Farquhar, J. W. (1980). Skills training in a cardiovascular health education campaign.Journal of Consulting and Clinical Psychology, 48, 129–142.

    Article  PubMed  Google Scholar 

  • Miller, W. R. (Ed.). (1980).The addictive behaviors: Treatment of alcoholism, drug abuse, smoking, and obesity. New York: Pergamon.

    Google Scholar 

  • Moos, R. H. (1979). Social-ecological perspectives on health. In G. C. Stone, F. Cohen, & N. E. Adler (Eds),Health psychology: A handbook (pp. 523–547). San Francisco: Jossey-Bass.

    Google Scholar 

  • Mossey, J. M., & Shapiro, E. (1982). Self-rated health: A predictor of mortality among the elderly.American Journal of Public Health, 72, 800–808.

    PubMed  Google Scholar 

  • Nunes, E. V., Frank, K. A., & Kornfeld, D. S. (1987). Psychologic treatment for the Type A behavior pattern and for Coronary Heart Disease: A meta-analysis of the literature.Psychosomatic Medicine, 48, 159–173.

    Google Scholar 

  • Ostfeld, A. M., Lebovits, B. Z., Shekelle, R. B., & Paul, O. (1964). A prospective study of the relationship between personality and coronary heart disease.Journal of Chronic Diseases, 17, 265–276.

    Article  Google Scholar 

  • Parikh, R. M., Lipsey, J. R., Robinson, R. G., & Price, T. R. (1988). A two year longitudinal study of poststroke mood disorders: Prognostic factors related to one and two year outcome.International Journal of Psychiatry in Medicine, 18, 45–56.

    Article  PubMed  Google Scholar 

  • Parmelee, P. A., Katz, I. R., Lawton, M. P. (1992). Depression and mortality among institutionalized aged.Journal of Gerontology, 47, 3–11.

    Google Scholar 

  • Peele, S. (1984). The cultural context of psychological approaches to alcoholism: Can we control the effects of alcohol?American Psychologist, 39, 1337–1351.

    Article  PubMed  Google Scholar 

  • Pounds, R. (1992). A review of the medical and social consequences of generalized anxiety disorder and panic disorder.Journal of the Louisiana State Medical Society, 144, 479–483.

    PubMed  Google Scholar 

  • Powell, L. H., & Thoresen, C. E. (1988). Effect of Type A behavioral counseling and severity of prior acute myocardial infarction on survival.American Journal of Cardiology, 62, 1159–1163.

    Article  PubMed  Google Scholar 

  • Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population.Applied Psychological Measurement, 1, 385–401.

    Article  Google Scholar 

  • Rahe, R. H. (1988). Anxiety and physical illness.Journal of Clinical Psychiatry, 49 (Suppl.), 26–29.

    PubMed  Google Scholar 

  • Rahe, R. H. (1989). Anxiety and coronary heart disease in midlife.Journal of Clinical Psychiatry, 50 (Suppl.), 36–39.

    PubMed  Google Scholar 

  • Rovner, B. W. (1993). Depression and increased risk of mortality in the nursing home patient.American Journal of Medicine, 94, 19S-22S.

    PubMed  Google Scholar 

  • Rovner, B. W., German, P. S., Brant, L. J., Clark, R., Burton, L., Folstein, M. F. (1991). Depression and mortality in nursing homes.Journal of the American Medical Association, 265, 993–997.

    Article  PubMed  Google Scholar 

  • Russek, L. G., King, S. H., Russek, S. J., & Russek, H. I. (1990). The Harvard mastery of stress study 35-year follow-up: Prognostic significance of patterns of psychophysiological arousal and adaptation.Psychosomatic Medicine, 52, 271–285.

    PubMed  Google Scholar 

  • Scherwitz, L., & Rugulies, R. (1992). Life-style and hostility. In H. S. Friedman (Ed.),Hostility, coping, and health (pp. 77–98). Washington, D. C.: American Psychological Association.

    Chapter  Google Scholar 

  • Shekelle, R. B., Gale, M., Ostfeld, A. M., & Paul, O. (1983). Hostility, risk of coronary heart disease, and mortality.Psychosomatic Medicine, 45, 109–114.

    PubMed  Google Scholar 

  • Shekelle, R. B., Raynor, W. J., Jr., Ostfield, A. M., Garon, P. C., Bieliauskas, L. A., Shuguey, C. L., Maliza, C., & Oglesby, P. (1981). Psychological depression and 17-year risk of death from cancer.Psychosomatic Medicine, 43, 117–125.

    PubMed  Google Scholar 

  • Siegler, I. C., Zonderman, A. B., Barefoot, J. C., Williams, R. B., Jr., Costa, P. T., Jr., & McCrae, R. R. (1990). Predicting personality in adulthood from college MMPI scores: Implications for follow-up studies in psychosomatic medicine.Psychosomatic Medicine, 52, 644–652.

    PubMed  Google Scholar 

  • Smith, T. W. (1992). Hostility and health: Current status of a psychosomatic hypothesis.Health Psychology, 11, 139–150.

    Article  PubMed  Google Scholar 

  • Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970).Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.

    Google Scholar 

  • Staff. (1993). Anxiety can increase post-surgical complications.Journal of the American Dental Association, 124, 18.

    Google Scholar 

  • Stone, G. C., Cohen, F., & Adler, N. E. (Eds.). (1979).Health psychology: A handbook. San Francisco: Jossey Bass.

    Google Scholar 

  • Stone, S. V., & Costa, P. T., Jr. (1990). Disease-prone personality or distress-prone personality? The role of neuroticism in coronary heart disease. In H. S. Friedman (Ed.),Personality and disease (pp. 178–200). New York: Wiley.

    Google Scholar 

  • Suls, J., & Wan, C. K. (1993). The relationship between trait hostility and cardiovascular activity: A quantitative review and analysis.Psychophysiology, 30, 615–626.

    Article  PubMed  Google Scholar 

  • Talbott, E., Kuller, L., Perper, J., & Murphy, P. (1981). Sudden unexpected death in women.American Journal of Epidemiology, 114, 671–682.

    PubMed  Google Scholar 

  • Taylor, S. E., & Singer, J. E. (Eds.). (1983).Handbook of psychology and health: Vol. 4. Social psychological aspects of health. Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Thomas, C., Kelman, H. R., Kennedy, G. J., Ahn, C., & Yang, C. (1992). Depressive symptoms and mortality in elderly persons.Journal of Gerontology, 47, S80-S88.

    PubMed  Google Scholar 

  • Thomas, C. B., Ross, D. C., & Duszynski, K. R. (1975). Youthful hypercholesteremia: Its associated characteristics and role in premature myocardial infarctions.The Johns Hopkins Medical Journal, 136, 193–208.

    PubMed  Google Scholar 

  • VanderVoort, D. J. (1992). Belief systems and coping styles as mediating variables in the relationship between hostility and illness.Current Psychology, 11, 226–235.

    Google Scholar 

  • VanderVoort, D. J., & Fuhriman, A. (1991). The efficacy of group therapy for depression: A review of the literature.Small Group Research, 22, 320–338.

    Article  Google Scholar 

  • Ware, J. E., Davies-Avery, A., & Donald, C. A. (1978).Conceptualization and measurement of health for adults in the health insurance study: Vol. V. General health perceptions. Santa Monica, CA: Rand.

    Google Scholar 

  • Watson, D., & Pennebaker, J. W. (1989). Health complaints, stress, and distress.Psychological Review, 96, 324–354.

    Article  Google Scholar 

  • Weiner, H., & Fawzy, F. I. (1989). An integrative model of health, disease, and illness. In S. Cheren (Ed.),Psychosomatic medicine: Theory, physiology, and practice (Vol. I, pp. 9–44).

    Google Scholar 

  • Weisse, C. S. (1992). Depression and immunocompetence: A review of the literature.Psychological Bulletin, 11, 475–489.

    Article  Google Scholar 

  • Weissman, M. M., Markowitz, J. S., Ouellette, R., Greenwald, S., & Kahn, J. P. (1990). Panic disorder and cardiovascular/cerebrovascular problems: Results from a community survey.American Journal of Psychiatry, 147, 1504–1508.

    PubMed  Google Scholar 

  • Wells, K. B., Rogers, W., Burnam, M. A., Greenfield, S., & Ware, J. E., Jr., (1991). How the medical comorbidity of depressed patients differs across health care settings: Results from the medical outcomes study.American Journal of Psychiatry, 18, 1688–1697.

    Google Scholar 

  • Whitlock, F. A., & Sisking, M. (1979). Depression and cancer: A follow-up study.Psychological Medicine, 9, 747–752.

    Article  PubMed  Google Scholar 

  • Williams, R. B., Jr. (1990). Do benzodiazepines have a role in the prevention or treatment of coronary heart disease and other major medical disorders?Journal of Psychiatric Research, 24 (Suppl. 2), 51–56.

    Article  PubMed  Google Scholar 

  • Zonderman, A. B., Costa, P. T., Jr., & McCrae, R. R. (1989). Depression as a risk factor for cancer morbidity and mortality in a nationally representative sample.Journal of the American Medical Association, 262, 1191–1195.

    Article  PubMed  Google Scholar 

  • Zyzanski, S. J., Jenkins, C. D., Ryan, T. J., Flessas, A., & Everist, M. (1976). Psychological correlates of coronary angiographic findings.Archives of Internal Medicine, 136, 1234–1237.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

This work was supported, in part, by an intramural grant from the University of Hawaii, #R511.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vandervoort, D. Depression, anxiety, hostility, and physical health. Current Psychology 14, 69–82 (1995). https://doi.org/10.1007/BF02686875

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02686875

Keywords

Navigation