Age differences in hostility among middle-aged and older adults.

Multiple measures of hostility were administered to middle-aged and older volunteers. There was a positive association between age and self-report measures reflecting hostile beliefs about others, including cynicism and suspiciousness. There was a weak inverse relationship between age and self-report measures of the overt expression of anger and aggression, but no association between age and measures of covert hostility was found. There was a positive relationship between age and an assessment of hostile behavior that was based on the respondent's interaction style during an interview. The magnitude of these age trends did not differ between men (n?=?50) and women (n?=?75). Findings illustrate the multidimensional nature of hostility. They also have practical implications for older people because hostility is associated with psychological well-being and has been shown to have consequences for health and longevity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Genetic interactions of Hox genes in limb development: learning from compound mutants

Some investigators have noted an increased incidence of suicidal ideation and attempts in individuals with panic attacks. The direct temporal relationship between the panic state and suicidal thoughts and behaviors has not been well elucidated however. Furthermore, although aggressive behavior is often manifested in individuals with suicidal behavior, the relationship between aggression and panic has received little attention. The aim of this study was to assess the frequency and type of reported suicidal and aggressive ideation and behaviors that occur during the panic state in patients with panic disorder. In order to evaluate the contribution of depression, individuals with pure (i.e. uncomplicated) panic disorder were compared with individuals who had comorbid panic and major depression. Nineteen patients with a diagnosis of pure panic disorder and 28 patients with comorbid panic plus major depression were included in the study. All patients were given the Panic, Suicide and Aggression Scale (PSAS), a questionnaire specifically designed to assess reported suicidal and aggressive thoughts and behaviors that occur during panic attacks. Other scales given to all patients included overall measures of impulsivity, suicide risk and violence risk. Patients with pure panic disorder reported high rates of suicidal and aggressive ideation and behavior during panic. The presence of comorbid depression resulted in a doubling of the rate of reported panic-associated suicidal ideation, property destruction and assaults, and a five-fold increase in the rate of homicidal ideation. The rate of reported suicide attempts was equal in the pure panic and comorbid group. There were also high correlations in all panic patients between measures of panic-associated suicide and aggression with the psychometric measures of impulsivity, suicide risk and violence risk.     

Toward a clinical model of suicidal behavior in psychiatric patients

OBJECTIVE: Risk factors for suicide attempts have rarely been studied comprehensively in more than one psychiatric disorder, preventing estimation of the relative importance and the generalizability of different putative risk factors across psychiatric diagnoses. The authors conducted a study of suicide attempts in patients with mood disorders, psychoses, and other diagnoses. Their goal was to determine the generalizability and relative importance of risk factors for suicidal acts across diagnostic boundaries and to develop a hypothetical, explanatory, and predictive model of suicidal behavior that can subsequently be tested in a prospective study. METHOD: Following admission to a university psychiatric hospital, 347 consecutive patients who were 14-72 years old (51% were male and 68% were Caucasian) were recruited for study. Structured clinical interviews generated axis I and axis II diagnoses. Lifetime suicidal acts, traits of aggression and impulsivity, objective and subjective severity of acute psychopathology, developmental and family history, and past substance abuse or alcoholism were assessed. RESULTS: Objective severity of current depression or psychosis did not distinguish the 184 patients who had attempted suicide from those who had never attempted suicide. However, higher scores on subjective depression, higher scores on suicidal ideation, and fewer reasons for living were reported by suicide attempters. Rates of lifetime aggression and impulsivity were also greater in attempters. Comorbid borderline personality disorder, smoking, past substance use disorder or alcoholism, family history of suicidal acts, head injury, and childhood abuse history were more frequent in suicide attempters. CONCLUSIONS: The authors propose a stress-diathesis model in which the risk for suicidal acts is determined not merely by a psychiatric illness (the stressor) but also by a diathesis. This diathesis may be reflected in tendencies to experience more suicidal ideation and to be more impulsive and, therefore, more likely to act on suicidal feelings. Prospective studies are proposed to test this model.     

A longitudinal investigation of depression, hopelessness, social support, and major and minor life events and their relation to suicidal ideation in adolescents

The longitudinal relationship of psychological and social-environmental factors with adolescent suicidal ideation over a 1-year-period was examined in a sample of 374 high school students. Students were assessed twice over a 1-year period with measures of depression, hopelessness, major negative life events, daily hassles, social support, and suicidal ideation. At the initial assessment, daily hassles and negative life events for males and social support and depression for females were significant factors related to suicidal ideation levels 1 year later. Changes in depression and hopelessness were significantly related to changes in suicidal ideation over the 1 year interval for males and females. Differences found between males and females in the relationship of psychological and social-environmental variables with suicidal ideation supports the need to examine gender specific relationships when conducting research on suicidal behavior in adolescents.     

The prediction of suicidal intent in depressed patients

The aim of the present study was to examine the relationships between suicidal ideation or suicidal attempts and severity of depression, presence of personality disorders, and sociodemographic factors in a population of depressed in-patients. A total of 338 adult depressed psychiatric in-patients were examined and classified according to DSM-III criteria as having major depression with or without melancholic or psychotic features, adjustment disorder with depressed mood or dysthymic disorder. Scores on the Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI) and Zung Self-Rating Depression and Anxiety Scales (SDS and SAS) were measured. We found that suicidal ideation was significantly related to severity of depression (according to the HDRS and all self-rating scales), a lower global assessment of functioning the year before hospitalization, and previous psychiatric hospitalizations. The items with the strongest predictive value for suicidal ideation were hopelessness, depressed mood, feelings of guilt, loss of interest and low self-esteem. These symptoms predicted 43% of the variance in suicidal ideation. None of the above predictors of suicidal ideation was related to suicidal attempts. Depressed patients with a personality disorder attempted significantly more suicidal attempts and showed more suicidal ideation than depressed patients without personality disorder. No significant correlations were found between suicidal ideation or suicide attempts and gender, marital status, employment status or psychosocial stressors during the previous 6 months.     

Topical bleomycin for the treatment of dysplastic oral leukoplakia

The objective of this study was to predict suicidality in people with schizophrenia. Ninety-six patients with recent-onset schizophrenia were rated every 2 weeks for 1 year to examine (1) the temporal course of suicidal ideation and suicide attempts and (2) the extent to which anxiety, depression, and mild suicidal ideation were followed by significant suicidal ideation or a suicide attempt. The severity of suicidality changed rapidly. Low levels of suicidal ideation increased the risk for significant suicidal ideation or a suicide attempt during the subsequent 3 months. Depression was moderately correlated with concurrent suicidality, but not independently associated with future suicidality. Therefore, low levels of suicidal ideation may predict future suicidal ideation or behavior better than depressed mood in individuals with schizophrenia.     

Psychological predictors of heart disease: A quantitative review.

A meta-analysis, or quantitative review, was performed to integrate and organize the results of studies that investigated certain personality variables in relation to coronary heart disease (CHD). The personality variables included were anger, hostility, aggression, depression, extroversion, anxiety, Type A, and the major components of Type A. The meta-analytic framework helps focus attention on issues needing clarification. The results indicate that modest but reliable associations exist between some of the personality variables and CHD. The strongest associations were found for Type A and, surprisingly, for depression, but anger/hostility/aggression and anxiety also related reliably to CHD. The Structured Interview diagnosis of Type A was shown to be clearly superior to the Jenkins Activity Survey as a predictor of CHD. The Type A–CHD relation was smaller in prospective than in cross-sectional studies and smaller in recent than in less recent studies. This review also revealed that information about the interrelations of personality predictors of CHD is sorely needed. The picture of coronary-proneness revealed by this review is not one of a hurried, impatient workaholic but instead is one of a person with one or more negative emotions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developmental toxicity of steviol, a metabolite of stevioside, in the hamster

Family history of hypertension (positive and negative) and gender groups were compared on cardiovascular responses at rest, during stressors and during recovery. Two tasks were employed, mental arithmetic and an anger recall interview. Both levels and reactivity measures of blood pressure, heart rate, cardiac output and total peripheral resistance were included. In addition, participants filled out several questionnaires measuring state feelings during the task and recovery periods, trait anger/hostility and emotions. Both men and women with a positive family history of hypertension exhibited higher tonic levels of blood pressure and heart rate at rest, recovery and during both tasks. They also exhibited greater heart rate reactivity during the mental arithmetic task and greater blood pressure reactivity to both tasks when post-math recovery, but not initial rest, was used as a covariate. Positive family history individuals reported less trust and gregariousness, more depression and aggression, less awareness of somatic responses to the tasks and less effort to relax during the post-task rest periods. Finally, significant correlations were found between low anger expression how anger experience and high anger control and task SBP levels in positive family history individuals.     

Depression, PTSD, and suicidal ideation among active duty veterans in an integrated primary care clinic.

Active duty veterans increasingly access primary care for needed mental health services, but the relationship among depression, PTSD, and suicidal ideation in this subpopulation remains unclear. The relationship is explored in 120 active duty members treated in a military integrated primary care behavioral health service. Logistic regression analyses resulted in a significant relationship between PTSD and suicidal ideation, but this relationship was fully explained by depression symptoms. The interaction between depression and PTSD symptoms was likewise unrelated to suicidal ideation, and it did not improve overall model fit, suggesting that depression independently explained increased risk for suicidal ideation in the current sample. The authors discuss the differences between suicidal ideation and suicidal behaviors, and how depression and PTSD symptoms might differentially relate to each. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Type A behavior pattern and emotion expression in younger and older adults.

80 younger (M?=?28 yrs) and 80 older (>50 yrs, M?=?69 yrs) Type A and Type B Ss were evaluated for Type A behavior pattern using the Structured Interview (SI) and given personality tests for anxiety, depression, anger, aggression, hostility, and anger-in–anger-out. Ss also underwent an emotion induction procedure. Videotapes of the emotion induction procedure (N?=?160) and the SI (N?=?80) were coded for facial expression of emotion. Type As did not differ from Bs on anxiety or depression but did on anger and aggression. Type As showed anger inhibition and anger bound to shame, as predicted by emotion socialization theory. The greatest number of differential effects were observed between age groups. Older individuals, in general, were more emotionally expressive than younger Ss across a range of emotions. Women appeared more conflicted about anger expression than men, and Type A women more so than Type A men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Shamed into anger? The relation of shame and guilt to anger and self-reported aggression.

The relation of shame and guilt to anger and aggression has been the focus of considerable theoretical discussion, but empirical findings have been inconsistent. Two recently developed measures of affective style were used to examine whether shame-proneness and guilt-proneness are differentially related to anger, hostility, and aggression. In 2 studies, 243 and 252 undergraduates completed the Self-Conscious Affect and Attribution Inventory, the Symptom Checklist 90, and the Spielberger Trait Anger Scale. Study 2 also included the Test of Self-Conscious Affect and the Buss-Durkee Hostility Inventory. Shame-proneness was consistently correlated with anger arousal, suspiciousness, resentment, irritability, a tendency to blame others for negative events, and indirect (but not direct) expressions of hostility. Proneness to "shame-free" guilt was inversely related to externalization of blame and some indices of anger, hostility, and resentment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lack of relations of hostility, negative affect, and high-risk behavior with low plasma lipid levels in the Coronary Artery Risk Development in Young Adults Study

BACKGROUND: Previous studies have suggested that low plasma cholesterol levels or cholesterol lowering may increase the risk of suicide and violent death. Increased aggression, risk-taking behavior, or depression has been associated with low cholesterol levels in some studies. METHODS: A total of 4240 subjects of the Coronary Artery Risk Development in Young Adults study, aged 23 to 35 years, were included in the study. Analyses were stratified by race (black or white) and sex. Persons in the lowest 10% of plasma total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride levels were compared with the other participants in each race/sex group, using standardized measures of hostility, anger suppression, depressive symptoms, and anxiety. The relations between 5-year change in hostility and 5-year change in lipid levels also were examined. The relations between lipid levels and high-risk behavior (e.g., violent arguments or having a gun at home) were examined in a subset of subjects. All analyses were adjusted for relevant covariates. RESULTS: In cross-sectional analyses, low total cholesterol levels were not related to any of the psychological measures in any race/sex group. Among black women only, low low-density lipoprotein cholesterol was related to greater anxiety, and low triglycerides were related to lower anger suppression (P < or = .002). Among white men only, increases in hostility during the 5-year follow-up were related to increases in triglycerides (P < .01), but changes in hostility were unrelated to changes in cholesterol levels. Among a subset of 371 subjects with initially elevated total cholesterol (> or = 5.17 mmol/L [> or = 200 mg/dL]) and a non-medicated decrease of 0.52 mmol/L (> or = 20 mg/dL) or more during 5 years, hostility decreased in a univariate analysis (P < .001). High-risk behaviors also were not associated with low lipid levels. CONCLUSION: The results do not support a consistent relation between hostility, negative affect, or high-risk behaviors with low lipid levels or lipid-lowering among young adults.     

Effects of delay, attack, and retaliation on state depression and hostility

43 male and 43 female undergraduates were placed in an arbitrary waiting situation, and then the E either verbally attacked or apologized to them. Half of the Ss in each group were given a chance to retaliate by negatively evaluating the E on a written form. State and trait hostility and depression measures (e.g., Costello and Comrey's Depression scale, Buss-Durkee Hostility Inventory, and the Depression Adjective Check List) were given before the anger manipulation and again after the manipulation and retaliation. Both males and females became angry and depressed following the attack, and females tended to become more depressed than males (though not more angry). Although males reported more outward hostility than did females after attack, females retaliated more. Retaliation did not, however, reduce either anger or depression, as had been expected. Implications for clinical depression are discussed. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parents' marital functioning and adolescent psychotherapy.

Parents' marital functioning and adolescent psychopathology were investigated in 2 studies. The first study compared parents' marital satisfaction, conflict over childrearing, affective communication, and traditional role orientation in matched samples of psychiatric inpatient and control-group adolescents. The second study examined associations between specific dimensions of marital functioning and adolescent depression severity, suicidal ideation, and social adjustment in a larger sample of adolescent inpatients. In Study 1, parents of inpatients reported less marital satisfaction and more conflicts over childrearing than parents of control-group adolescents. In Study 2, marital conflicts over childrearing were associated with a less active or involved father–adolescent relationship and more severe school behavior and spare time problems. Marital functioning was not associated with depression severity or suicidal ideation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A test of the reactive aggression-suicidal behavior hypothesis: Is there a case for proactive aggression?

A large body of literature suggests that aggressive behavior can be classified into two subtypes--reactive aggression (RA) and proactive aggression (PA)--which differ on dimensions of emotional arousal, control, and impulsivity. A longstanding hypothesis posits that RA underlies the association between aggression and suicidal behavior, with the implicit assumption that PA is unrelated to suicidal behavior. However, no empirical study to date has specifically investigated this question. The authors examined associations of RA and PA with suicide attempts and suicidal ideation among 878 male and female patients in substance-dependence treatment programs. They also examined the moderating effects of sex. Contrary to hypotheses, PA was associated with both suicide attempts and suicidal ideation. RA was also associated with both outcomes in unadjusted analyses but became nonsignificant for suicide attempts in multivariate analyses. Moreover, sex served as a moderator, with PA showing an association with suicide attempt among men but not women. Results indicate the need for additional studies of PA and suicidal behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hopelessness as a measure of suicidal intent in the depressed elderly.

Suicidal ideation in the elderly has been related to depression, changes in health, and anticipation of a limited future. The present study examined the Hopelessness Scale (HS) and its relation to these factors in a depressed geriatric population. A total of 120 elderly outpatients, who had applied to receive psychotherapy for depression, completed the HS, Beck Depression Inventory (BDI), health ratings, and the Schedule for Affective Disorder and Schizophrenia (SADS) at intake. The HS was found to be internally consistent, and a principal components analysis revealed three distinct factors that were related to hope, feelings of giving up, and future planning. The HS, BDI, and health ratings were predictive of suicidal ideation as measured by specific items in the SADS. The relation among suicidal ideation hopelessness, depression, and health perceptions for the depressed aged are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

étude des composantes dépressives chez des adolescents à tendances suicidaires.

Studied symptoms of depression in adolescents with suicidal tendencies. Ss were 2,850 secondary school students (aged 12–18 yrs). Ss completed a questionnaire assessing sociodemographic variables, symptoms of depression, and suicidality. Results from the following subsamples were compared: (1) 105 Ss with suicidal ideation; (2) 206 Ss with suicidal ideation who had contemplated specific means of suicide; (3) 94 Ss who had attempted suicide; (4) 62 Ss with depression but without suicidal ideation; and (5) 336 age-, gender-, and grade-matched comparison Ss without suicidal ideation. The Dysphoria Scale by L. S. Radloff (1977) was used. (English abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child–Adolescent Suicidal Potential Index (CASPI): A screen for risk for early onset suicidal behavior.

This study's purpose was to develop a reliable and valid self-report questionnaire, the Child–Adolescent Suicidal Potential Index (CASPI), to screen for risk for suicidal behavior in children and adolescents. Four hundred twenty-five child and adolescent psychiatric patients and nonpatients completed the CASPI and other research instruments to rate suicidal and assaultive behavior and symptoms of depression, anxiety, and hopelessness. The 30-item CASPI involves 3 factors (anxious–impulsive depression, suicidal ideation or acts, family distress) that contributed to a unidimensional 2nd-order factor accounting for 59% of the total variance. Internal consistency (alpha) for the total score was .90, and test-retest reliability (ICC) for the total score was .76. Total score distinguished between children and adolescents with different severity of psychopathology and different levels of suicidal and assaultive behavior. Each of the 3 factors had different contributions to discriminating between levels of suicidal status. CASPI total score of 11 distinguished suicidal ideation or acts from nonsuicidal behavior, with sensitivity 70% and specificity 65%. CASPI total score positively correlated with symptom severity of depression, anxiety, and hopelessness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aggression and hostility in substance abusers: the relationship to abuse patterns, coping style, and relapse triggers

A cohort of 3,367 substance abusers seeking treatment were administered measures of aggression and hostility including the Buss-Durkee Hostility Inventory and the NEO Personality Inventory Hostility Scale. Polysubstance abusers scored significantly higher on all measures of hostility and aggression, regardless of whether they abused cocaine or not. Subjects scoring higher on aggression and hostility utilized escape-avoidance, distancing, and confrontational coping styles more regularly. Subjects scoring higher on measures of aggression and hostility reported more situations that triggered their use of substances and less confidence that they could resist using when faced with such situations in the future. This was especially true for situations involving unpleasant internal states, situations involving rejection, and situations involving conflict with family and friends. The implications of these findings for clinical assessment and treatment planning are discussed.