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From the Department of Psychiatry and Behavioral Sciences and Behavioral Medicine Research Center, Duke University Medical Center (I.C.S., J.C.B., B.H.B., M.J.H., R.B.W.), Durham, NC; Department of Psychology, University of North Carolina at Chapel Hill (W.G.D.), Chapel Hill, NC; Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill (B.H.K.), Chapel Hill, NC; Laboratory of Personality and Cognition, Intramural Research Program, Gerontology Research Center, National Institute on Aging (P.T.C.), Baltimore, MD; Department of Psychiatry and Behavioral Sciences, University of Washington (P.P.V.), Seattle, WA; Chevy Chase, MD (M.Z.N.); Human Nutrition Center, University of Texas-Houston School of Public Health (R.S.D.), Houston, TX; Department of Health Behavior and Health Education, School of Public Health and Lineberger Cancer Center, University of North Carolina at Chapel Hill (B.K.R.), Chapel Hill, NC.
Address reprint requests to: Ilene C. Siegler, Department of Psychiatry and Behavioral Sciences and Behavioral Medicine Research Center, Duke University Medical Center, Durham, NC 27710. E-mail: ilene.siegler{at}duke.edu
OBJECTIVE: To examine hostility measured in college and patterns of change in hostility from college to midlife as predictors of high health-related risk later in midlife.
METHODS: Logistic regression models were used to test hostility/risk associations.
RESULTS: College hostility predicted being a current smoker, consuming more than two drinks of alcohol, low social support, achieving less than expected in career and in relationships, risk for depression, and appraisal of life changing for the worse in terms of family events at midlife. Change in hostility did not predict smoking and drinking; however, it did significantly predict social isolation, lower income (only for women), obesity, avoidance of exercise, high-fat diet, and negative changes in economic life, work life, and physical health events-all risk indicators measured during the next decade. Appraisals of social support, lowered expectations, risk for depression, and reports of family life changing for the worse were predicted at both time periods. When change in hostility was modeled with college hostility, all risk indicators were significantly predicted by college hostility.
CONCLUSIONS: High hostility in college and change in hostility from college to midlife predicts a full range of health risk indicators. When compared with the average population decline in hostility, gains in hostility at midlife are related to increased risk while declines in hostility are related to reduced risk. Higher midlife hostility is associated with increased odds of being in the higher risk group. Future research should focus on developing interventions to reduce hostility.
Key Words: hostility, • age, • patterns of change, • health risk, • risk trajectories.
Abbreviations: CHD = coronary heart disease;; HT = hypertension;; MMPI = Minnesota Multiphasic Personality Inventory;; UNCAHS = University of North Carolina Alumni Heart Study;; SES = socioeconomic status;; CESD = Center for Epidemiological Studies of Depression Scale.
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