Claudia Trudel-Fitzgerald1, Laetitia R Reduron, Ichiro Kawachi, Laura D Kubzansky. 1. From the Department of Social and Behavioral Sciences (Trudel-Fitzgerald, Kawachi, Kubzansky), Harvard T.H. Chan School of Public Health, Boston, Massachusetts; and School of Psychology (Reduron), Laval University, Quebec City, Quebec, Canada.
Abstract
OBJECTIVE: Although evidence has linked anger and hostility with all-cause mortality risk, less research has examined whether anger frequency and expression (outwardly expressing angry feelings) are linked to all-cause and cause-specific mortality. METHODS: In 1996, men (n = 17,352) free of medical conditions from the Health Professionals Follow-Up Study reported anger frequency and aggressive expression levels. Deaths were ascertained from participants' families, postal authorities, and death registries. Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality risk until 2016 with a 2-year lag, adjusting for a range of relevant covariates. RESULTS: There were 4881 deaths throughout follow-up. After adjustment for sociodemographics and health status, moderate and higher (versus lower) levels of anger frequency and aggressive expression were generally unrelated to the risk of death from all-cause, neurological, or respiratory diseases. However, cardiovascular mortality risk was greater with higher anger frequency (HR = 1.17, 95% CI = 1.01-1.34), whereas cancer mortality risk was greater with higher anger expression (HR = 1.14, 95% CI = 0.98-1.33). Results were similar after including all covariates and stronger when considering anger expression's interaction with frequency. CONCLUSIONS: In this cohort of men, experiencing angry feelings and expressing them aggressively were related to an increased risk of dying from cardiovascular disease and cancer but not from other specific causes, over two decades. These results suggest that not only the experience of negative emotions but also how they are managed may be critical for some but not all health outcomes, highlighting the importance of considering causes of death separately when investigating psychosocial determinants of mortality.
OBJECTIVE: Although evidence has linked anger and hostility with all-cause mortality risk, less research has examined whether anger frequency and expression (outwardly expressing angry feelings) are linked to all-cause and cause-specific mortality. METHODS: In 1996, men (n = 17,352) free of medical conditions from the Health Professionals Follow-Up Study reported anger frequency and aggressive expression levels. Deaths were ascertained from participants' families, postal authorities, and death registries. Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality risk until 2016 with a 2-year lag, adjusting for a range of relevant covariates. RESULTS: There were 4881 deaths throughout follow-up. After adjustment for sociodemographics and health status, moderate and higher (versus lower) levels of anger frequency and aggressive expression were generally unrelated to the risk of death from all-cause, neurological, or respiratory diseases. However, cardiovascular mortality risk was greater with higher anger frequency (HR = 1.17, 95% CI = 1.01-1.34), whereas cancer mortality risk was greater with higher anger expression (HR = 1.14, 95% CI = 0.98-1.33). Results were similar after including all covariates and stronger when considering anger expression's interaction with frequency. CONCLUSIONS: In this cohort of men, experiencing angry feelings and expressing them aggressively were related to an increased risk of dying from cardiovascular disease and cancer but not from other specific causes, over two decades. These results suggest that not only the experience of negative emotions but also how they are managed may be critical for some but not all health outcomes, highlighting the importance of considering causes of death separately when investigating psychosocial determinants of mortality.
Authors: Shinobu Kitayama; Jiyoung Park; Jennifer Morozink Boylan; Yuri Miyamoto; Cynthia S Levine; Hazel Rose Markus; Mayumi Karasawa; Christopher L Coe; Norito Kawakami; Gayle D Love; Carol D Ryff Journal: Psychol Sci Date: 2015-01-06
Authors: Marjorie L McCullough; Diane Feskanich; Meir J Stampfer; Edward L Giovannucci; Eric B Rimm; Frank B Hu; Donna Spiegelman; David J Hunter; Graham A Colditz; Walter C Willett Journal: Am J Clin Nutr Date: 2002-12 Impact factor: 7.045
Authors: Patricia Mona Eng; Garrett Fitzmaurice; Laura D Kubzansky; Eric B Rimm; Ichiro Kawachi Journal: Psychosom Med Date: 2003 Jan-Feb Impact factor: 4.312