Defensive hostility and coronary heart disease: A preliminary investigation of male veterans

Objective: Research and theory link an interpersonal conflict model to card iovascular disease. Specifically, persons scoring high on cynical hostility and social defensiveness are thought to manifest a defensive need for appr oval while harboring basic distrust and hostility toward those who could pr ovide such approval. The objective of this study was to assess whether angi ographically determined coronary artery disease (CAD) was associated with t his combination of high cynical hostility and high social defensiveness. Me thods: Fifty-nine male patients of a Veterans Administration Medical Center (86% white, mean age = 59.9 years) participated in the study on the day be fore their angiographic procedure; these men filled out the Cook-Medley Hos tility Scale and the Marlowe-Crowne Social Desirability Scale (social defen siveness). They subsequently were categorized as having defensive hostility (DH), high hostility (HH), high social defensiveness (SD), or low psychoso cial risk (LRisk; low on both scales). Results: The four groups did not dif fer significantly on risk factor status or health status. As predicted, a p replanned contrast showed that the DH group's mean number of arteries with at least 50% blockage (mean = 2.5) differed significantly from the combined means of the other groups. The HH and SD groups did not differ from the LR isk group. Conclusions: When combined with other reports, the approach-avoi dance interpersonal conflict model fields the promise of providing addition al information about the psychosocial factors contributing to CAD developme nt among men with high cynical hostility.