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Vassou C, Georgousopoulou EN, Chrysohoou C, Yannakoulia M, Pitsavos C, Cropley M, Panagiotakos DB. Psychological factors in relation to the 10-year incidence of metabolic syndrome: The ATTICA epidemiological study (2002-2012). Nutr Metab Cardiovasc Dis 2022; 32:2195-2203. [PMID: 35843796 DOI: 10.1016/j.numecd.2022.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS Various bio-psychological mechanisms underlying the association between mental health problems and metabolic syndrome remain unknown. We investigated the role of irrational beliefs in conjunction with anxiety, depression and hostility in the 10-year metabolic syndrome (MetS) incidence, and the effect of biochemical and socio-behavioral factors on the aforementioned associations. METHODS AND RESULTS ATTICA is a prospective, cohort study (2002-2012). The sample included 591 participants [51.3% men (aged 41.5 ± 10 years) and 48.7% women (aged 37.5 ± 11.5 years)], free of MetS at baseline. Detailed biochemical, clinical, and lifestyle evaluations were performed, while participants' irrational beliefs, anxiety, depression and hostility were assessed using the Irrational Beliefs Inventory, the Spielberger State-Trait Anxiety Inventory, the Zung Self-Rating Depression Scale and the Hostility and Direction of Hostility Questionnaire, respectively. Multiple logistic regression was applied to estimate the odds ratio (OR) of developing MetS and to control for confounders, as well as stratified logistic regression to detect moderator effects. High irrational beliefs were associated with 1.5-times higher odds of developing MetS than low irrational beliefs. Especially, participants with high irrational beliefs and high anxiety were 96% more likely to develop MetS, compared with those with low irrational beliefs and low or high anxiety (OR = 1.96; 95% CI = 1.01, 3.80). CONCLUSION The findings of the study underline the important role of irrational beliefs and anxiety in the development of MetS and the need to build new holistic approaches focused on the primary prevention of both mental health and MetS.
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Affiliation(s)
- Christina Vassou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | | | - Christina Chrysohoou
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Mark Cropley
- School of Psychology, University of Surrey, Guildford, UK
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece; Faculty of Health, University of Canberra, Canberra, Australia.
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Vassou C, D'Cunha NM, Naumovski N, Panagiotakos DB. Hostile personality as a risk factor for hyperglycemia and obesity in adult populations: a systematic review. J Diabetes Metab Disord 2021; 19:1659-1669. [PMID: 33520858 DOI: 10.1007/s40200-020-00551-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 05/14/2020] [Accepted: 05/21/2020] [Indexed: 12/12/2022]
Abstract
Purpose Several studies have already provided valuable insights into the physiological and genetic causes of hyperglycemia and obesity. Concurrently, personality traits, such as hostility, have been suggested to have an impact on health and illness (i.e., self-reported general health, coronary artery disease, and overall mortality). The present systematic review investigated possible effects of hostility upon metabolic markers, such as high plasma glucose level and obesity among adults. We also attempted to reveal current gaps in knowledge and provide insights for future directions. Methods This systematic review was performed following the PRISMA 2009 guidelines to examine current evidence arising from observational studies regarding the potential impact of hostile behavior on hyperglycemia and obesity among adults. Of the initial 139 articles, 13 studies were included. Results The evidence supports an association between pre-diabetes and obesity with a hostile temperament in certain populations. The relationship between hostility and hyperglycemia was most common in African American women, in women with a family history of diabetes, in unmarried individuals, in White men, as well as in middle-aged and older people. Regarding obesity, high body mass index (BMI) was associated with a hostile personality, particularly among men. However, the paths by which hostile temperament affects glucose levels and BMI, as well as potential mediating and moderating mechanisms, are not entirely understood. Conclusions There is a need for research to enhance the understanding of biological, psychological and social factors related to hostility with a view to prevention and effective intervention.
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Affiliation(s)
- Christina Vassou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Ave, Athens, 176 71 Greece
| | - Nathan M D'Cunha
- Faculty of Health, University of Canberra, Canberra, 2601 Australia
| | - Nenad Naumovski
- Faculty of Health, University of Canberra, Canberra, 2601 Australia
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Ave, Athens, 176 71 Greece.,Faculty of Health, University of Canberra, Canberra, 2601 Australia
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Starnino L, Dupuis G, Busque L, Bourgoin V, Dubé MP, Busseuil D, D'Antono B. The associations of hostility and defensiveness with telomere length are influenced by sex and health status. Biol Sex Differ 2021; 12:2. [PMID: 33397445 PMCID: PMC7783995 DOI: 10.1186/s13293-020-00349-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/10/2020] [Indexed: 12/16/2022] Open
Abstract
Background Shorter telomere length (TL) may indicate premature cellular aging and increased risk for disease. While there is substantial evidence for shorter TL in individuals suffering from psychiatric disorders, data is scarce on maladaptive personality traits related to coronary artery disease (CAD). The purpose of this study was to evaluate the association of TL with hostility and defensiveness in individuals with CAD or other non-cardiovascular illnesses and whether associations were moderated by CAD status and sex. Methods One thousand thirty-six individuals (Mage = 65.40 ± 6.73 years) with and without CAD completed the Marlowe-Crowne Social Desirability Scale and the Cook–Medley Hostility Scale. Relative TL was measured via quantitative polymerase chain reaction of total genomic DNA samples. Analyses involved hierarchical regressions on TL, performed separately for hostility and defensiveness, controlling for pertinent sociodemographic, behavioural, and medical risk factors. Separate analyses were performed on 25 healthy participants. Results A hostility by sex interaction emerged (β = − .08, p = .006) in the patient groups, where greater hostility was associated with shorter TL in women only (p < .01). A Defensiveness by CAD status interaction (β = − .06, p = .049) revealed longer TL in more defensive CAD patients only (p = .06). In healthy men, shorter TL was observed in those with greater defensiveness (β = .52, p = .006) but lower hostility (β = − .43, p = .049). Conclusion Hostility and defensiveness are differentially associated with TL as a function of sex and health status. The implication of these results for health remains to be determined, but propose an additional pathway through which the effect of maladaptive personality traits may contribute to CV and other disease.
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Affiliation(s)
- Louisia Starnino
- Research Center, Montreal Heart Institute, 5000 Rue Bélanger, Montréal, QC, H1T 1C8, Canada.,Department of Psychology, Université du Québec à Montréal, Montreal, Canada
| | - Gilles Dupuis
- Department of Psychology, Université du Québec à Montréal, Montreal, Canada
| | - Lambert Busque
- Research Center, Hematology Division, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Canada
| | - Vincent Bourgoin
- Research Center, Hematology Division, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Canada
| | - Marie-Pierre Dubé
- Research Center, Montreal Heart Institute, 5000 Rue Bélanger, Montréal, QC, H1T 1C8, Canada
| | - David Busseuil
- Research Center, Montreal Heart Institute, 5000 Rue Bélanger, Montréal, QC, H1T 1C8, Canada
| | - Bianca D'Antono
- Research Center, Montreal Heart Institute, 5000 Rue Bélanger, Montréal, QC, H1T 1C8, Canada. .,Department of Psychology, Université du Québec à Montréal, Montreal, Canada. .,Department of Psychology, Université de Montréal Pavillon Marie-Victorin, Montreal, Canada.
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Effect of Work Environment on Presenteeism among Aging American Workers: The Moderated Mediating Effect of Cynical Hostility. SUSTAINABILITY 2020. [DOI: 10.3390/su12135314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cynical hostility in the workplace has been studied. However, there is still no complete study examining how cynical hostility affects work performance. We examined how work environment impacts presenteeism through the mediation of cynical hostility and how chronic work discrimination moderates the relationship between work environment and cynical hostility among ageing workforces. The psychosocial vulnerability model supplies theoretical support for our model. We analyzed data from a sample of 2926 aging workforces from the Health and Retirement Study. Structural equation modeling (SEM) was used to examine the relationships with a moderated mediation model. In the final SEM model, our results showed that work environment was directly negatively associated with presenteeism. Moreover, cynical hostility was significantly inversely correlated with work environment and positively correlated with presenteeism. We found that the significant indirect effect between work environment and presenteeism can be significantly mediated by cynical hostility. In addition, cynical hostility is more likely to be affected by work environment among ageing workforces with lower levels of chronic work discrimination than those with higher levels. Enterprise, government, and employees themselves should be aware of the impact of presenteeism on ageing workforces with high levels of cynical hostility.
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Thomas MC, Kamarck TW, Wright AGC, Matthews KA, Muldoon MF, Manuck SB. Hostility Dimensions and Metabolic Syndrome in a Healthy, Midlife Sample. Int J Behav Med 2020; 27:475-480. [PMID: 32030598 DOI: 10.1007/s12529-020-09855-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Evidence links trait hostility with components of the metabolic syndrome (MetS), a clustering of cardiometabolic risk factors, but which hostility dimensions (e.g., expressive or cognitive hostility) relate to MetS are not well known. Further, there may be age and sex differences in the extent to which hostility dimensions relate to MetS. The present study evaluated associations between dimensions of hostility and the metabolic syndrome and its individual components as well as the moderating effects of sex and age. METHODS In a cross-sectional sample of 478 employed adults, a principal component analysis from common trait hostility questionnaires yielded a two-factor solution: expressive hostility (anger and aggression) and cognitive hostility (cynicism). Each of these two components of hostility was examined as predictors of each of two aggregated MetS outcomes: a dichotomous measure of MetS, based upon the NCEP-ATP III definition, and a continuous measure based upon the average of standardized scores for each component; and they were examined as predictors of individual MetS components as well. RESULTS Expressive hostility was associated with MetS severity (b = 0.110, p = 0.04) and waist circumference (b = 2.75, p = 0.01). Moderation analyses revealed that elevated expressive hostility was associated with elevated waist circumference in women but not men. Cognitive hostility was not related to any metabolic syndrome component or aggregated outcome, and no moderation was observed. CONCLUSIONS Among multiple individual components and two aggregated scores, only trait dispositions to expressed hostile affect and behavior were associated with MetS severity and waist circumference. The effects were small but statistically significant. The association between cognitive hostility and metabolic syndrome measures may not be robust in a large sample of healthy, midlife adults.
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Affiliation(s)
- Mark C Thomas
- University of Pittsburgh, Pittsburgh, PA, 15260, USA
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Starnino L, Busque L, Tardif JC, D’Antono B. Psychological Profiles in the Prediction of Leukocyte Telomere Length in Healthy Individuals. PLoS One 2016; 11:e0165482. [PMID: 27788238 PMCID: PMC5082938 DOI: 10.1371/journal.pone.0165482] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 10/12/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Shorter telomere length (TL) may signal premature cellular aging and increased risk for disease. While depression and psychosocial stress have been associated with shorter telomeres, other psychological risk factors for cardiovascular disease have received less attention. PURPOSE To evaluate the association between TL and psychological risk factors (symptoms of anxiety and depression, hostility and defensiveness traits) for heart disease, and to examine whether chronological age and sex moderate the associations observed. METHODS 132 healthy men and women (Mage = 45.34 years) completed the Marlowe-Crowne Social Desirability Scale, the Beck Depression Inventory II, The Beck Anxiety Inventory and the Cook-Medley Hostility Scale. Relative TL was measured by quantitative polymerase chain reaction (PCR) of total genomic DNA samples. A series of hierarchical linear regressions were performed controlling for pertinent covariates. RESULTS Shorter TL was observed among individuals high in defensiveness (β = -.221) and depressive symptoms (β = -.213), as well as in those with less hostility (β =.256) and anxiety (β =.220)(all Ps<.05). Psychological variables explained 19% of the variance over and above that explained by covariates (age, sex, exercise, alcohol consumption, systemic inflammation, and 24-hr mean arterial pressure). Age moderated the relation between TL and defensiveness (β =.179, p =.03). Sex did not influence any of the relations. CONCLUSIONS Telomere length is associated with psychological burden though the direction of effect differs depending on the psychological variables under study. Further research is needed to determine the reasons for and implications of these seemingly contradictory findings.
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Affiliation(s)
- Louisia Starnino
- Research Center, Montreal Heart Institute, Montreal, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, Canada
| | - Lambert Busque
- Research Center, Hematology Division, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Canada
| | - Jean-Claude Tardif
- Research Center, Montreal Heart Institute, Montreal, Canada
- Department of Medicine, Montreal Heart Institute and Université de Montréal, Montreal, Canada
| | - Bianca D’Antono
- Research Center, Montreal Heart Institute, Montreal, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, Canada
- Department of Psychology, Université de Montréal, Montreal, Canada
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Girard D, Tardif JC, Boisclair Demarble J, D’Antono B. Trait Hostility and Acute Inflammatory Responses to Stress in the Laboratory. PLoS One 2016; 11:e0156329. [PMID: 27270459 PMCID: PMC4894569 DOI: 10.1371/journal.pone.0156329] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 05/12/2016] [Indexed: 11/18/2022] Open
Abstract
Hostility has been associated with higher basal levels of inflammation. The present study evaluated the association of hostility with acute stress-induced changes in inflammatory activity. One hundred and ninety-nine healthy men and women, aged 19–64 years, were exposed to a stress protocol involving four interpersonal stressors. Participants completed the Cook-Medley Hostility questionnaire and provided two blood samples for the measurement of inflammatory biomarkers (CRP, Il-6, MPO, TNF-α, MCP-1, Il-8, Il-10, and Il-18), prior to and following exposure to a standardized stress protocol. In univariate analyses, hostility was associated with significantly higher TNF-α, but lower Il-8 and Il-18 values post-stress, though only Il-8 remained significant after controlling for baseline differences. In multivariate analyses, a significant Age by Hostility interaction emerged for Il-6, while sex moderated the relation between hostility and Il-10 reactivity. Following stress, hostility was associated with greater pro-inflammatory Il-6 activity among younger individuals and to decreased anti-inflammatory Il-10 activity in women. Future research is needed to replicate these findings and to evaluate their implication for disease.
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Affiliation(s)
- Dominique Girard
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Jean-Claude Tardif
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada
- Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Julie Boisclair Demarble
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Bianca D’Antono
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
- * E-mail:
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Abstract
A growing body of research demonstrates that psychosocial factors play an important role in the development of hypertension. Previous reviews have identified several key factors (i.e., occupational stress) that contribute to the onset of hypertension; however, they are now outdated. In this review, we provide an updated synthesis of the literature from 2010 to April 2014. We identified 21 articles for inclusion in the review, of which there were six categories of psychosocial stressors: occupational stress, personality, mental health, housing instability, social support/isolation, and sleep quality. Sixteen of the studies reported an association between the psychosocial stressor and blood pressure. While several findings were consistent with previous literature, new findings regarding mediating and moderating factors underlying the psychosocial-hypertension association help to untangle inconsistencies reported in the literature. Moreover, sleep quality is a novel additional factor that should undergo further exploration. Areas for future research based on these findings are discussed.
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Gentile C, Dragomir AI, Solomon C, Nigam A, D’Antono B. Sex Differences in the Prediction of Metabolic Burden from Physiological Responses to Stress. Ann Behav Med 2014; 49:112-27. [DOI: 10.1007/s12160-014-9639-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Dragomir AI, Gentile C, Nolan RP, D'Antono B. Three-year stability of cardiovascular and autonomic nervous system responses to psychological stress. Psychophysiology 2014; 51:921-31. [DOI: 10.1111/psyp.12231] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 04/09/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Anda I. Dragomir
- Research Center; Montreal Heart Institute; Montreal Quebec Canada
- Psychology Department; Université de Montréal; Montreal Quebec Canada
| | - Christina Gentile
- Research Center; Montreal Heart Institute; Montreal Quebec Canada
- Psychology Department; Université de Montréal; Montreal Quebec Canada
| | - Robert P. Nolan
- Behavioural Cardiology Research Unit; University Health Network; Toronto Ontario Canada
- Faculty of Medicine; University of Toronto; Toronto Ontario Canada
| | - Bianca D'Antono
- Research Center; Montreal Heart Institute; Montreal Quebec Canada
- Psychology Department; Université de Montréal; Montreal Quebec Canada
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Boisclair Demarble J, Moskowitz DS, Tardif JC, D'Antono B. The relation between hostility and concurrent levels of inflammation is sex, age, and measure dependent. J Psychosom Res 2014; 76:384-93. [PMID: 24745780 DOI: 10.1016/j.jpsychores.2014.02.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 02/20/2014] [Accepted: 02/23/2014] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Hostility may be associated with greater systemic inflammation. However, contradictory evidence exists. Certain individuals or dimensions of hostility may be more susceptible to these effects. Main and interactive effects of hostility with sex and/or age were evaluated on markers of inflammation, independently of traditional risk factors for coronary artery disease. METHODS 199 healthy men (81) and women (118), aged 20-64 years (M=41 ± 11 years) were recruited. Hostility was assessed using the Cook-Medley Hostility Inventory (CMHo) and ecological momentary assessments (EMA) of quarrelsome behavior and angry affect in daily living. Blood samples were drawn to measure inflammatory activity (Il-6, TNF-α, hsCRP, Il-8, Il-10, Il-18, MCP-1) and lipid oxidation (Myeloperoxidase; MPO). Correlations and hierarchical regression analyses were performed controlling for pertinent behavioral, psychological, medical, and socio-demographic factors. RESULTS Significant univariate associations emerged between CMHo and Il-6, TNF-α, MCP-1 (p<.05). Hierarchical regressions showed interactions of hostility with sex (Il-6, TNF-α; p<.05) and age (hsCRP, Il-6, TNF-α; p<.05). For example, in simple slope analyses, hostility was positively related to TNF-α in women (b=0.009, p=0.006) but not men. Greater hostility was also related to greater Il-6 levels among younger women (b=. 027, p=0.000). CONCLUSION Hostility, particularly cynical hostility, may be detrimental to (younger) women. The TNF-α, Il-6, CRP triad appears vulnerable to psychological and behavioral factors, and may be one mechanism by which cynical hostility (CMHo) contributes to increased cardiovascular risk in women. Prospective research is needed to verify this.
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Affiliation(s)
- Julie Boisclair Demarble
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada; Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - D S Moskowitz
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Jean-Claude Tardif
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada; Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Bianca D'Antono
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada; Department of Psychology, Université de Montréal, Montreal, Quebec, Canada.
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