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Cynical Hostility, Socioeconomic Position, Health Behaviors, and Symptom Load: A Cross-Sectional Analysis in a Danish Population-Based Study

From the Department of Social Medicine, Institute of Public Health, University of Copenhagen, Denmark (U.C., R.L., M.T.D., B.E.H., F.D., P.D., J.L.); Department of Biostatistics, Institute of Public Health, University of Copenhagen, Denmark (S.D.); Department of Health, County of Ribe, Denmark (L.I.); Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan (J.L.).

Address correspondence and reprint requests to Ulla Christensen, MA, PhD, Department of Social Medicine, Institute of Public Health, University of Copenhagen, Panum Institute, Blegdamsvej 3, DK 2200 Copenhagen N, Denmark. E-mail: U.Christensen{at}socmed.ku.dk

OBJECTIVE: To analyze the cross-sectional association between cynical hostility and high symptom load in a Danish population-based study. Furthermore, the aim was to investigate to what extent health risk behaviors mediated this association.

METHODS: Data were based on a postal questionnaire in a Danish random sample of 3426 men and 3699 women aged 40 or 50 years. Cynical hostility was measured by the 8-item Cynical Distrust Scale. High symptom load was assessed by physiological and mental symptoms experienced within the last 4 weeks. Confounders were age and socioeconomic position, while potential mediators were alcohol consumption, smoking, physical activity, and BMI.

RESULTS: Higher cynical hostility was associated with self-reported symptom load. Health behaviors did not seem to mediate this effect. Socioeconomic position was a strong confounder for the effect on both health and health behaviors. After adjustment the effects of hostility on health remained with odds ratios of 2.1 (1.7–2.6) for women and 2.3 (1.8–2.8) for men.

CONCLUSION: After adjustment for socioeconomic position, cynical hostility has an effect on self-reported high symptom load, and this effect is not mediated by health behaviors.

Key Words: cynical hostility, • symptom load, • social class, • health risk behaviors.

Abbreviations: BMI = body mass index.

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