Encyclopedia of Behavioral Medicine

Living Edition
| Editors: Marc Gellman


  • Susan A. Everson-Rose
  • Priya Balaji
  • Xiaohui Yu
Living reference work entry
DOI: https://doi.org/10.1007/978-1-4614-6439-6_254-2



Hostility is a multidimensional personality trait with distinct cognitive, affective, and behavioral features. The cognitive component of hostility is evident in the habitual patterns of cynical mistrust and negative, suspicious attitudes and beliefs that hostile individuals have toward their interpersonal network and the community at large. The affective (emotional) component reflects the internal and external expression of anger and contempt, which may vary in degrees from moderate to high. The behavioral component may manifest through mannerisms and actions that perpetuate interpersonal conflicts, such as aggression and irritability. Although distinctions can be made among the cognitive, affective, and behavioral components of hostility, they often are interrelated and co-occur.


The role of hostility and anger in cardiovascular disease (CVD) and more general health...

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References and Further Reading

  1. Adams, S. H. (1994). Role of hostility in women's health during midlife: A longitudinal study. Health Psychology, 13, 488–495.CrossRefPubMedGoogle Scholar
  2. Barefoot, J. C., Beckham, J. C., Haney, T. L., Siegler, I. C., & Lipkus, I. M. (1993). Age difference in hostility among middle-aged and older adults. Psychology and Aging, 8, 3–9.CrossRefPubMedGoogle Scholar
  3. Barnes, L. L., Mendes de Leon, C. F., Bienas, J. L., Wilsons, R. S., Everson-Rose, S. A., & Evans, D. A. (2009). Hostility and change in cognitive function over time in older blacks and whites. Psychosomatic Medicine, 17, 652–658.CrossRefGoogle Scholar
  4. Bernstein, M. H. B., Colby, S. M., Bidwell, L. C., Kahler, C. W., & Leventhal, A. M. (2014). Hostility and Cigarette Use: A comparison between smokers and nonsmokers in a matched sample of adolescents. Nicotine & Tobacco Research, 16, 1085–1093.CrossRefGoogle Scholar
  5. Brydon, L., Lin, J., Butcher, L., Hamer, M., Erusalimsky, J. D., Blackburn, E. H., & Steptoe, A. (2012). Hostility and cellular aging in men from the Whitehall II cohort. Biological Psychiatry, 71(9), 767–773.  https://doi.org/10.1016/j.biopsych.2011.08.020. Epub 2011 Oct 5.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Brydon, L., Lin, J., Butcher, L., Hamer, M., Erusalimsky, J. D., & Blackburn, E. H. (2016). Hostility and cellular aging in men from the Whitehall II cohort. BPS, 71, 767–773.Google Scholar
  7. Bunde, J., & Suls, J. (2006). A qualitative analysis of the relationship between the Cook-Medley Hostility scale and traditional coronary artery disease risk factors. Health Psychology, 25, 493–500.CrossRefPubMedGoogle Scholar
  8. Burns, J. W., Peterson, K. M., Smith, D. A., Keefe, F. J., Porter, L. S., Schuster, E., & Kinner, E. (2013). Temporal associations between spouse criticism/hostility and pain among patients with chronic pain: A within-couple daily diary study. Pain, 154(12), 2715–2721.  https://doi.org/10.1016/j.pain.2013.07.053. Epub 2013 Aug 6.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Cook, W. W., & Medley, D. M. (1954). Proposed hostility and pharisaic-virtue scales for the MMPI. Journal of Applied Psychology, 38, 414–418.CrossRefGoogle Scholar
  10. Cooper, T., Detre, T., & Weiss, S. M. (1981). Coronary-prone behavior and coronary heart disease: A critical review. The review panel on coronary-prone behavior and coronary heart disease. Circulation, 63, 1199–1215.CrossRefGoogle Scholar
  11. Cruz, C., Duarte, J., Nelas, P., Antunes, A., & Almeida, M. (2014). Anxiety and depression in adolescents with hostile behaviour. Atención Primaria, 46, 107–111.CrossRefPubMedGoogle Scholar
  12. Davidson, K., & Hall, P. (1995). What does potential for hostility measure? Gender differences in the expression of hostility. Journal of Behavioral Medicine, 18, 233–247.CrossRefPubMedGoogle Scholar
  13. Demarble, J. B., Moskowitz, D. S., Tardif, J., & Antono, B. D. (2014). The relation between hostility and concurrent levels of inflammation is sex, age, and measure dependent. Journal of Psychosomatic Research, 76, 384–393.CrossRefGoogle Scholar
  14. Everson-Rose, S. A., & Lewis, T. T. (2005). Psychosocial factors and cardiovascular diseases. Annual Review of Public Health, 26, 469–500.CrossRefPubMedGoogle Scholar
  15. Everson-Rose, S. A., Lewis, T. T., Karavolos, K., Matthews, K. A., Sutton-Tyrrell, K., & Powell, L. H. (2006). Cynical hostility and carotid atherosclerosis in African American and white women: The Study of Women’s Health Across the Nation (SWAN) heart study. American Heart Journal, 152, 982.e7–982.e13.CrossRefGoogle Scholar
  16. Everson-Rose, S. A., Roetker, N. S., Lutsey, P. L., Kershaw, K., Longsteth, W. T., Sacco, R. L., Diez Roux, A. V., & Alonso, A. (2014). Chronic stress, depressive symptoms, anger, hostility, and risk of stroke and transient ischemic attack in the MESA Study. Stroke, 45, 2318–2323.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Farmer, C., & Aman, M. (2009). Development of the children’s scale of hostility and aggression: Reactive/proactive (C-SHARP). Research in Developmental Disabilities, 30, 1155–1167.CrossRefPubMedGoogle Scholar
  18. Farmer, C., & Aman, M. (2010). Psychometric properties of the Children’s Scale of Hostility and Aggression (C-SHARP). Research in Developmental Disabilities, 31, 270–280.CrossRefPubMedGoogle Scholar
  19. Ferraz, L., Portella, M. J., Vállez, M., Gutiérrez, F., Martín-Blanco, A., Martín-Santos, R., & Subirà, S. (2013). Hostility and childhood sexual abuse as predictors of suicidal behaviour in Borderline Personality Disorder. Psychiatry Research, 210(3), 980–985.  https://doi.org/10.1016/j.psychres.2013.07.004. Epub 2013 Aug 29.CrossRefPubMedGoogle Scholar
  20. Ferraz, L., Portella, M. J., Vállez, M., Gutiérrez, F., Martín-Blanco, A., Martín-Santos, R., & Subirà, S. (2016). Hostility and childhood sexual abuse as predictors of suicidal behaviour in borderline personality disorder. Psychiatry Research, 210, 980–985.CrossRefGoogle Scholar
  21. Friedman, M., & Rosenman, R. H. (1971). Type A behavior pattern: Its association with coronary heart disease. Annals of Clinical Research, 3, 300–312.PubMedGoogle Scholar
  22. Gallo, L. C., & Matthews, K. A. (2003). Understanding the association between socioeconomic status and physical health: Do negative emotions play a role? Psychological Bulletin, 129, 10–51.CrossRefPubMedGoogle Scholar
  23. Goldbacher, E. M., & Matthews, K. A. (2007). Are psychosocial characteristics related to risk of the metabolic syndrome? A review of the literature. Annals of Behavioral Medicine, 34, 240–252.CrossRefPubMedGoogle Scholar
  24. Graham, J. E., Robles, T. F., Kiecolt-Glaser, J. K., Malarkey, W. B., Bissell, M. G., & Glaser, R. (2006). Hostility and pain are related to inflammation in older adults. Brain, Behavior, and Immunity, 20(4), 389–400. Epub 2006 Jan 11.CrossRefPubMedGoogle Scholar
  25. Hemingway, H., & Marmot, M. (1999). Psychosocial factors in the aetiology and prognosis of coronary heart disease: Systematic review of prospective cohort studies. British Medical Journal, 318, 1460–1467.CrossRefPubMedPubMedCentralGoogle Scholar
  26. Iribarren, C., Sidney, S., Bild, D. E., Lui, K., Markovitz, J. H., Roseman, J. M., & Matthews, K. (2000). Association of hostility with coronary artery calcification in young adults: The CARDIA Study. Journal of the American Medical Association, 283, 2546–2551.CrossRefPubMedGoogle Scholar
  27. Klabbers, G., Bosma, H., van den Akker, M., Kempen, G. I. J. M., & van Eijk, J. T. M. (2012). Cognitive hostility predicts all-cause mortality irrespective of behavioural risk at late middle and older age. European Journal of Public Health, 23(4), 701–705.CrossRefPubMedGoogle Scholar
  28. Kubzansky, L. D., Sparrow, D., Jackson, B., Cohen, S., Weiss, S. T., & Wright, R. J. (2006). Angry breathing: A prospective study of hostility and lung function in the Normative Aging Study. Thorax, 61(10), 863–868. Epub 2006 Sep 1.CrossRefPubMedPubMedCentralGoogle Scholar
  29. Lemogne, C., Levenstein, S., Nabi, H., Ducimetière, P., Goldberg, M., & Zins, M. (2015). Hostility and the risk of peptic ulcer in the GAZEL cohort. Health Psychology, 34(2), 181–185.CrossRefPubMedGoogle Scholar
  30. Lutjen, L. J., Silton, N. R., & Flannelly, K. J. (2012). Religion, forgiveness, hostility and health: A structural equation analysis. Journal of Religion and Health, 51, 468–478.CrossRefPubMedGoogle Scholar
  31. Markovitz, J. H., Matthews, K. A., Kiss, J., & Smitherman, T. C. (1996). Effects of hostility on platelet reactivity to psychological stress in coronary heart disease patients and in healthy controls. Psychosomatic Medicine, 60, 633–638.Google Scholar
  32. Miller, T. Q., Smith, T. W., Turner, C. W., Guijarro, M. L., & Hallet, A. J. (1996). A meta-analytic review of research on hostility and physical health. Psychology Bulletin, 119, 322–348.CrossRefGoogle Scholar
  33. Mwendwa, D. T., Ali, M. K., Sims, R. C., & Madhere, S. (2013). Psychometric properties of the Cook Medley Hostility Scale and its association with inflammatory markers in African Americans. Psychology, Health & Medicine, 18(4), 431–444.CrossRefGoogle Scholar
  34. Niaura, R., Todaro, J. F., Stroud, L., Spiro, A., 3rd, Ward, K. D., & Weiss, S. (2002). Hostility, the metabolic syndrome, and incident coronary heart disease. Health Psychology, 21(6), 588–593.CrossRefPubMedGoogle Scholar
  35. Rosenman, R. H., Brand, R. J., Jenkins, D., Friedman, M., Straus, R., & Wurm, M. (1975). Coronary heart disease in the Western Collaborative Group Study: Final follow-up experience of 8 1/2 years. Journal of the American Medical Association, 233, 872–877.CrossRefPubMedGoogle Scholar
  36. Sahebzamani, F. M., Aoust, R. F. D., Friedrich, D., Aiyer, A. N., Reis, S. E., & Kip, K. E. (2013). Relationship among low cholesterol levels, depressive symptoms, aggression, hostility, and cynicism. Journal of Clinical Lipidology, 7(3), 208–216.CrossRefPubMedGoogle Scholar
  37. Scherwitz, L. L., Perkins, L. L., Chesney, M. A., Hughes, G. H., Sidney, S., & Manolio, T. A. (1992). Hostility and health behaviors in young adults: The CARDIA Study. Coronary artery risk development in young adults study. American Journal of Epidemiology, 136, 136–145.CrossRefPubMedGoogle Scholar
  38. Shen, B. J., Countryman, A. J., Spiro, A., 3rd, & Niaura, R. (2008). The prospective contribution of hostility characteristics to high fasting glucose levels: The moderating role of marital status. Diabetes Care, 31(7), 1293–1298.  https://doi.org/10.2337/dc07-1945. Epub 2008 May 6.CrossRefPubMedPubMedCentralGoogle Scholar
  39. Tindle, H. A., Chang, Y., Kuller, L. H., Manson, J. E., Robinson, J. G., & Rosal, M. C. (2009). Optimism, cynical hostility, and incident coronary heart disease and mortality in the women’s health initiative. Circulation, 120, 656–662.CrossRefPubMedPubMedCentralGoogle Scholar
  40. Tsuchiyama, K., Terao, T., Wang, Y., Hoaki, N., & Goto, S. (2013). Relationship between hostility and subjective sleep quality. Psychiatry Research, 209, 545–548.CrossRefPubMedGoogle Scholar
  41. Williams, R. B., Jr., Haney, T. L., Lee, K. L., Kong, Y. H., Blumenthal, J. A., & Whalen, R. E. (1980). Type A behavior, hostility, and coronary atherosclerosis. Psychosomatic Medicine, 42, 539–549.CrossRefPubMedGoogle Scholar
  42. Zhang, P., Roberts, R. E., Liu, Z., Meng, X., Tang, J., Sun, L., & Yu, Y. (2012). Hostility, physical aggression and trait anger as predictors for suicidal behavior in Chinese adolescents: A school-based study. PLoS Med, 7(2), e31044.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media LLC 2018

Authors and Affiliations

  • Susan A. Everson-Rose
    • 1
  • Priya Balaji
    • 1
  • Xiaohui Yu
    • 1
  1. 1.Department of Medicine and Program in Health Disparities ResearchUniversity of Minnesota Medical SchoolMinneapolisUSA

Section editors and affiliations

  • Mustafa al’Absi
    • 1
  1. 1.University of Minnesota Medical SchoolUniversity of Minnesota, 235 School of MedicineDuluthUSA