Quantifying the density of Friedman's pathogenic emotions (AIAI)

Abstract

Because of both psychoneuroendocrine and psychobehavioral mechanisms, the chronicity of negative emotional arousal is probably the final common pathway mediating the relationship of psychosocial factors (cognitions, environments and behaviors) on one side of the mind-brain chasm, and ischemic heart disease (IHD) on the other. But the problem of "denial" remains a potential source of measurement error in studies of the association of such factors and IHD endpoints. The present study examined the association of patient-reported and spouse/friend-reported AIAI (aggravation, irritation, anger and impatience) with four measures of Type A Behavior or hostility (the Framingham Type A Scale, Cook-Medley Hostility Scale, Type A Structured Interview and a Hostility rating from the Structured Interview) in two samples: 175 men undergoing coronary angiography; and 56 age and SES-matched males with no manifest history of occlusive atherosclerotic disease. Chronic AIAI was underreported by the sample as a whole relative to spouse/friend perception, while the opposite was true of Depression and Anxiety/Worry (p < .001). All four measures were significantly associated with both patient and spouse/friend reported chronicity of AIAI, but the FTAS was the most reliable correlate according to both sources. The FTAS was also negatively associated with denial of AIAI, while the other three measures were not.