An extension of the functional cerebral systems approach to hostility: a capacity model utilizing a dual concurrent task paradigm

Hostility and prevalent diabetes among black adults: The Jackson Heart Study

BACKGROUND AND AIMS

The relationship between hostility and the prevalence of diabetes mellitus (DM) among black adults was investigated using the Jackson Heart Study (JHS) cohort. We hypothesized that Cook-Medley Hostility scores will be positively related with the prevalence of DM.

METHODS AND RESULTS

A total of 3232 black adults who completed at least one question for each of the three subscales of the Cook-Medley Hostility Scale and had data available regarding DM status were included. Using multivariate logistic regression, we studied the cross-sectional relationship between the overall Total Cook-Medley Hostility scores and individual subscales, hostile affect (n = 3232), aggression (n = 3119) and cynical distrust (n = 3085), with prevalent DM, adjusting for known DM confounders. Our population was 36% male with a mean age of 53.5 ± 0.9 years. In risk-factor adjusted models, each point higher in the overall Total Cook-Medley Hostility scores was associated with increased odds of having DM [Adjusted OR 1.02, 95%CI 1.00-1.04, P = 0.03]. Higher scores of cynicism were independently associated with prevalent DM [Adjusted OR 1.04, 95%CI 1.01-1.07, p = 0.021].

CONCLUSIONS

There was a positive relationship between overall hostility levels and prevalent DM. Future studies should investigate the extent to which additional social determinants may impact the relationship between hostile affect and prevalent DM.

Hostility and cognitive control: Evidence of increased cardiovascular reactivity as a function of exposure to affective stress using a dichotic listening paradigm

Indices of cognitive control were examined in men with high and low levels of trait hostility as a function of exposure to affective and cognitive stress. A dual concurrent task paradigm was used whereby participants intentionally directed focus to the left or right ear under dichotic listening conditions before and after exposure to angry infant vocalizations. Analysis of the behavioral data supports the prediction of reduced right frontal regulatory control in men with high levels of hostility as indicated by diminished capacity to suppress report of phonemes presented to the language dominant left hemisphere (right ear) in the Focus Left condition. This diminishment in the capacity to suppress report of phonemes presented to the right ear in the Focus Left condition is suggestive of reduced cognitive control. With respect to the neurophysiological data, heart rate increased for only men with high levels of hostility in the Focus Left condition, and this was especially evident in the post-affective stress condition. This increase in right hemisphere arousal provides additional evidence of reduced cognitive control and support for the capacity model of hostility by implicating poor right frontal regulatory control over right posterior cerebral regions under dual task conditions. The results are discussed in terms of integrating the construct of cognitive control into the capacity model as well as providing implications regarding reductions in the capacity to suppress predominant aggressive responses in domestic settings.

Frontal lobe regulation of blood glucose levels: support for the limited capacity model in hostile violence-prone men

Hostile men have reliably displayed an exaggerated sympathetic stress response across multiple experimental settings, with cardiovascular reactivity for blood pressure and heart rate concurrent with lateralized right frontal lobe stress (Trajanoski et al., in Diabetes Care 19(12):1412-1415, 1996; see Heilman et al., in J Neurol Neurosurg Psychiatry 38(1):69-72, 1975). The current experiment examined frontal lobe regulatory control of glucose in high and low hostile men with concurrent left frontal lobe (Control Oral Word Association Test [verbal]) or right frontal lobe (Ruff Figural Fluency Test [nonverbal]) stress. A significant interaction was found for Group × Condition, F (1,22) = 4.16, p ≤ .05 with glucose levels (mg/dl) of high hostile men significantly elevated as a function of the right frontal stressor (M = 101.37, SD = 13.75) when compared to the verbal stressor (M = 95.79, SD = 11.20). Glucose levels in the low hostile group remained stable for both types of stress. High hostile men made significantly more errors on the right frontal but not the left frontal stressor (M = 17.18, SD = 19.88) when compared to the low hostile men (M = 5.81, SD = 4.33). These findings support our existing frontal capacity model of hostility (Iribarren et al., in J Am Med Assoc 17(19):2546-2551, 2000; McCrimmon et al., in Physiol Behav 67(1):35-39, 1999; Brunner et al., in Diabetes Care 21(4):585-590, 1998), extending the role of the right frontal lobe to regulatory control over glucose mobilization.

The dynamic opponent relativity model: an integration and extension of capacity theory and existing theoretical perspectives on the neuropsychology of arousal and emotion

Arousal theory as discussed within the present paper refers to those mechanisms and neural systems involved in central nervous system activation and more specifically the systems involved in cortical activation. Historical progress in the evolution of arousal theory has led to a better understanding of the functional neural systems involved in arousal or activation processes and ultimately contributed much to our current theories of emotion. Despite evidence for the dynamic interplay between the left and right cerebral hemispheres, the concepts of cerebral balance and dynamic activation have been emphasized in the neuropsychological literature. A conceptual model is proposed herein that incorporates the unique contributions from multiple neuropsychological theories of arousal and emotion. It is argued that the cerebral hemispheres may play oppositional roles in emotion partially due to the differences in their functional specializations and in their persistence upon activation. In the presence of a threat or provocation, the right hemisphere may activate survival relevant responses partially derived from hemispheric specializations in arousal and emotional processing, including the mobilization of sympathetic drive to promote heightened blood pressure, heart rate, glucose mobilization and respiratory support necessary for the challenge. Oppositional processes and mechanisms are discussed, which may be relevant to the regulatory control over the survival response; however, the capacity of these systems is necessarily limited. A limited capacity mechanism is proposed, which is familiar within other physiological systems, including that providing for the prevention of muscular damage under exceptional demand. This capacity theory is proposed, wherein a link may be expected between exceptional stress within a neural system and damage to the neural system. These mechanisms are proposed to be relevant to emotion and emotional disorders. Discussion is provided on the possible role of currently applied therapeutic interventions for emotional disorders.

Group administration influences design but not written word fluency testing

Quicker assessments of right and left frontal lobe function, such as the examination of performance on design and language fluency tasks, respectively, lend themselves to a group administration setting. However, the influence of social facilitation factors on a dissociation model in these group settings is not well understood. One hundred college students (71 women) completed design and written word fluency tasks while sitting beside a faster or slower working confederate. Questionnaires related to trait worry, emotion regulation, state depression, anxiety and stress were completed following these tasks. Students in the fast condition produced significantly more unique designs, but there was no condition difference on written word fluency. This finding indicated that performance on a design task, which requires relative right frontal activation, may decrease if the subject is paired with a slow working confederate. High trait worriers demonstrated reduced performance on the design task (as indicated by higher design error ratios) but preserved performance on the word task. This supported a single dissociation in that performance on these tasks indicates compromised right hemisphere function and preserved left hemisphere function, respectively, in high trait worriers.

Physiological and behavioural indices of hostility: an extension of the capacity model to include exposure to affective stress and right lateralized motor stress

Right hemisphere functional cerebral systems have reliably been associated with sympathetic nervous system arousal and the perception of negative affective events. The goal of the current research was to provide additional support for the capacity model of hostility by examining changes attributable to functional cerebral systems within the right hemisphere using a dual concurrent task paradigm. To incorporate exposure to negative affective and right-lateralized motor stress using this approach, high and low hostile individuals completed a series of grip-strength tasks before and after hearing a recording of angry infant vocalizations. Results supported the capacity model in that high hostile individuals were unable to maintain regulatory control over right hemisphere activation as indicated through increased motor perseveration in the pre- and post-affective stress conditions, heightened systolic blood pressure (SBP) upon exposure to negative emotional sounds, and increased heart rate (HR) following stress. Conversely, low hostile individuals showed improved regulatory control over these regions as evidenced by reduced motor perseveration in the pre- and post-affective stress conditions, maintenance of SBP and reductions in HR following stress. The current data support the capacity model and extend its scope to include exposure to affective and right-lateralized motor stress.