Smith, T. W., & Traupman, E. K. (2011). Anger, hostility, and aggressiveness in coronary heart disease: Clinical applications of an interpersonal perspective. In R. Allan & J. Fisher, Heart and mind: The practice of cardiac psychology (pp. 197-217). Washington, DC, US: American Psychological Association.
http://dx.doi.org/10.1037/13086-008
Early descriptions of coronary heart disease (CHD) include observations that negative emotions and related personality traits influence the development and course of the illness. Anger, hostility, and aggressive behavior play a central role in this centuries-old hypothesis. For example, Sir John Hunter (1728–1793), a renowned 18th-century English surgeon, believed that anger could evoke episodes of the angina pectoris he suffered. Hunter’s observation was apparently prescient: He purportedly suffered a fatal coronary event after an argument with colleagues (Carter, 1993). Hunter’s statement describes much about the psychology of these traits. It contains a demeaning view of others (i.e., “any rascal”), an attribution of hostile intent (i.e., “who chooses [italics added] to annoy and tease me”), common precipitants of anger (e.g., intrusion, disrespect), and a tendency to externalize blame rather than accept responsibility for one’s emotions. It is important to note that Hunter’s statement alludes to the inherent embedding of these emotional traits in a pattern of antagonistic social interactions. In this chapter, we review the current literature on anger, hostility, and aggressiveness as coronary risk factors, beginning with the conceptualization of these traits and an interpersonal perspective that considers the compelling figure of the angry person within the antagonistic social contexts that individual typically inhabits (Smith, Glazer, Ruiz, & Gallo, 2004). We then review evidence that these traits confer risk of incident and recurrent CHD and discuss mechanisms underlying these associations. Next, we review evidence that these traits can be modified and the benefits of such interventions for CHD patients. We close by revisiting the interpersonal approach as a guide to clinical practice, suggesting that hostile personality traits, social isolation, and interpersonal conflict are best seen and managed as a single, multifaceted risk process. Overall, this literature suggests that Sir John Hunter—had he enjoyed the benefits of the interventions that evolved from the line of inquiry he foreshadowed—might have escaped the rascal’s grasp. (PsycINFO Database Record (c) 2016 APA, all rights reserved)