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Hostility Dimensions and Metabolic Syndrome in a Healthy, Midlife Sample



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.


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.


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.


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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I would like to acknowledge and thank Dr. Barbara Anderson and the AHAB staff for their roles in data collection and preparation.


This research was supported by the National Heart, Lung, and Blood Institute (HL040962, 4T32HL007560).

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Correspondence to Thomas W. Kamarck.

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Thomas, M.C., Kamarck, T.W., Wright, A.G.C. et al. Hostility Dimensions and Metabolic Syndrome in a Healthy, Midlife Sample. Int.J. Behav. Med. (2020).

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  • Hostility
  • Cynicism
  • Anger
  • Aggression
  • Metabolic syndrome
  • Sex differences