A group comparison of those with hypertension and other chronic illness: Afactor and item level analysis of anger and hostility

A considerable body of research has suggested that essential hypertension i s related to both expressed anger and suppressed hostility. This study sugg ests and provides some evidence that these reported results may simply have arisen as the result of a lack of proper statistical control and different ial item functioning across the items on which the measures were based. Thr ee groups of respondents were selected (a) those diagnosed as having hypert ension (b) a group who admitted to having a chronic medical condition unrel ated to hypertension and (c) individuals who did not have a chronic medical condition. A confirmatory factor model was used to test the structure of a measure of expressed anger and suppressed hostility. Differences were then examined across the three conditions at both the factor and item levels wi thin a MIMIC structure and controlling for age and gender. Differential eff ects were found between females and males on two observed measures of expre ssed anger. Age had a direct effect on both the measure of expressed anger and suppressed hostility. After the effects of age and gender were controll ed, no statistically significant group differences were found. Previous res ults indicating a difference on expressed anger and suppressed hostility ma y, as in the present analysis, be put down to a combination of lack of appr opriate statistical control, and to ignoring the differential pattern of re sponding across the observed measures.