Personality and Health Psychology Laboratory
Reverend Michael Wm. MacGregor, Ph.D., R.D.Psych.

Anger, Hostility, and Health Research

Anger, Hostility, and Health
Although my main area of research is the relation between defense mechanisms and health (both physical and psychological), I have also been involved in investigating more specifically the relation between anger/hostility and blood pressure.

Although they are not yet listed in the Diagnostic and Statistical Manual of Mental Disorders, I believe that anger disorders are highly prevalent in our society.  Anger and anger disorders cause considerable psychological, social, and health problems and I believe they constitute a form of psychopathology.  As such, it is important to understand the assessment, presentation, and implications of anger.  My past research has focused on sex differences in the assessment or rating of anger as well as sex differences in the presentation or manifestation of anger.  I have also investigated the relation between anger and hostility and blood pressure.  More recently I have been involved in the assessment of constructive anger behaviour and have investigated the relation between constructive anger and blood pressure.  As I hope will become obvious below, not only do I believe that there are sex differences in the assessment and presentation of anger, but I also believe that there are different types of anger, some of which may be less pathological or damaging than others.  

Sex Differences in the Rating and Presentation of Anger
I have been interested in sex differences in the assessment and the expression of anger/hostility.  In a previous study we examined the effects of coder sex on Potential for Hostility ratings (a standardized clinical rating of hostility).  Six trained coders who were unaware of the sex coding hypothesis rated 60 (30 men and 30 women) video-recorded interviews for Potential for Hostility.  There was a significant sex effect with women rating participants significantly lower than men on Potential for Hostility.  Most studies, however, fail to consider the sex of the coder when assessing the relation between Potential for Hostility and health outcomes such as Coronary Heart Disease.  Future Potential for Hostility investigations need to consider coder sex as a factor that may significantly and substantially influence reported Potential for Hostility ratings. 

More recently we have investigated the relation between sex and anger/hostility expression.  Popular belief holds that women talk and men act when experiencing a negative emotion.  We examined whether this belief influences hostility perceptions even when men and women express hostility in identical ways.  We found that when women display non-verbal hostility (i.e., acting) and men display verbal hostility (i.e., talking) they are perceived as violating social expectancies and that these deviations from sex-specific expectancies result in a perception of increased hostility.  

Anger and Hostility Related to Blood Pressure
As mentioned above, anger/hostility has been proposed to predict health outcomes and has been identified as a risk factor for some health outcomes (e.g., blood pressure).  I have been involved in investigations to better understand the relation between anger/hostility and blood pressure.  For example, taking sex differences into consideration, we have examined the relation between interview-derived hostility scores and resting blood pressure.  Higher Structured Interview-derived hostility scores were related to higher resting blood pressure in men.  However, in women Structured Interview-derived hostility scores were related to lower resting blood pressure and higher neuroticism.  Controlling for standard risk factors Structured Interview-derived hostility predicted resting systolic blood pressure and hypertensive status in both men and women though in different directions.  Thus, it may be that Structured Interview-derived hostility scores assesses different constructs in women than in men.  

Constructive Anger and Blood Pressure
According to a recent model anger can be broken down into constructive and destructive components.  As well, each of these components can subsequently be broken down into three subcomponents (verbal, behavioural, and cognitive).  Recently, I have been involved in determining the relation between Constructive Verbal Anger Behaviour and blood pressure.  For example, using a population-based sample of community adults we demonstrated that those persons with high Constructive Verbal Anger Behaviour had significantly lower resting blood pressure.  This relation also remained significant after controlling for hypertension risk factors.  As well, this relation remained after removing all those persons with hypertension, those persons on anti-hypertension medication, and those persons with other known incidence of cardiovascular disease.  The results from our studies suggest that Constructive Verbal Anger Behaviour may have independent beneficial relations with resting blood pressure.   

Future Research
My future research will continue to investigate sex differences in the rating and expression of anger and will consider how these potential sex differences may influence our understanding of the relation between anger and health outcomes such as blood pressure.  As well, I will continue to investigate both self-reported and observer-reported constructive anger and its relation to blood pressure.  Lastly, I plan to begin investigating the other subcomponents of anger and their relation to blood pressure (e.g., constructive behavioural anger behaviour, constructive cognitive anger behaviour etc.).   
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