1. Purpose and Hypothesis Results Implications Discussion Acknowledgment Background Empirically Derived Components of the Cook Medley Scale and Inflammation in African Americans Mana K. Ali, MS¹, Denee T. Mwendwa, PhD¹, Regina C. Sims, PhD¹, Serge Madhere, PhD¹, Shellie-Anne T. Levy, MS¹, Georica K. Gholson, MS¹, Shannon E. Chiles¹, Clive O. Callender, MD², Alfonso Campbell Jr., PhD¹ Howard University 1 and Howard University Hospital 2 Washington, DC 20059 Methodology Purpose: The purpose of this cross-sectional research is to understand the makeup of hostility in an African- American sample. Additionally, a goal was to establish whether emerged (if any) dimensions of hostility are associated with the inflammatory markers IL-6 and CRP. Hypothesis: This study contends that hostility as measured by the Cook Medley Hostility (Ho) Scale is a multidimensional personality construct. The dimensions of hostility will be associated with higher levels of IL-6 and CRP.  This research is part of a larger study entitled “Stress and Psychoneuroimmunological Factors in Renal Health and Disease” that is funded by The National Center on Minority Health and Health Disparities under grant #1P20MD000512-04, “A Research Center to Reduce Ethnic Disparities in ESRD.” This poster was made possible by Howard University's General Clinical Research Center grant #2MO1-RR010284 from the National Center for Research Resources (NCRR) a component of the National Institutes of Health (NIH) and its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH.  Health Promotion and Risk Reduction Research Center (HealthPARC)  This study offers insight into the biopsychosocial correlates of cardiovascular disease risk in African Americans.  The pattern of hostility identified involved elements of suspicion of others’ intentions, resentment about the success of others, cynicism, and irritability. This pattern was unique from other studies that had not looked at African Americans and suggests that they may display a different type of hostility than other groups.  BMI was most helpful in explaining levels of IL-6 and CRP. The mean BMI for the sample is considered obese. Previous research has found an association between BMI and inflammation ( Cossrow & Falkner, 2004 ).  A biobehavioral pathway including hostility and BMI may lead to CVD risk. Hostility has been associated with maladaptive coping behaviors such as increased food intake and physical inactivity ( Allen, Markovitz, Jacobs, & Knox, 2001; Carmody et al., 1999 ).  Being suspicious about others’ intentions was related to CRP. Being vigilant and interpreting the environment negatively may lead to more intense and longer bodily responses (i.e. cardiovascular, neuroendocrine), putting African Americans at greater risk for CVD (Smith, 1992).  It may be important for health professionals to assess and understand how hostility looks in African Americans for a more complete picture of their patients’ health.  Interventions that reduce levels of hostility in African Americans may reduce CVD risk.  Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the United States and disproportionately affects African-American men and women (American Heart Association 2009; Yancy, 2005).  Interleukin-6 (IL-6) and C-Reactive protein (CRP) are markers of inflammation that have been identified as biological correlates of CVD and poor health outcomes ( Browning, Krebs, & Jebb, 2004; Harris et al., 1999 ).  Hostility has been associated with IL-6 and CRP ( Miller, Freedland, Carney, Stetler & Banks, 2003; Graham et al., 2006 ). African Americans have higher hostility scores compared to Whites ( Allen, et al., 2001; Hughes, Sherwood, Blumenthal, Suarez, & Hinderliter, 2003 )  Hostility has been conceptualized as a multidimensional construct ( Barefoot et al., 1989; Houston, Smith & Cates, 1989 ). Dimensions of hostility have been found to be more useful predictors of health outcomes compared to the global score of hostility ( Barefoot, et al., 1989; Boyle, Williams, Mark, Brummett, Siegler & Barefoot, 2005 ). Hierarchical Regression Analyses Principal Component Analysis ItemSuspicious Attributions Resentment Toward Others’ Success CynicismIrritability I am sure that I am being talked about..674 Someone has it in for me..655 I feel like I have often been punished without a cause..531 I have frequently worked under people who seem to have things arranged so that they get credit for good work but are able to pass off mistakes onto those under them..682 I have often had to take orders from someone who did not know as much as I did..640 I have often met people who were supposed to be experts who were no better than me..587 I tend to be on guard with people who are somewhat friendlier than I had expected..744 I commonly wonder what hidden reason another person may have for doing something nice for me..492 Most people make friends because friends are likely to be useful to them..447 At times I feel like swearing..780 Sometimes when I’m not feeling well I am cross..500 I have at times had to be rough with people who were rude or annoying..434 Cook Medley Hostility Scale Factor Loadings (abbreviated ) n=198 Step 1Step 2 PredictorsΒSE ΒβΒ β Suspicious Attributions.015.025.045.020.023.060 Resentment Towards Success.053*.025.158.042.023.125 Cynicism.065*.025.189.039.023.113 Irritability.010.025.029.015.023.043 BMI.174**.033.391 Age.005**.002.190 SBP.000.001.020 Gender.010.048.016 Diabetes.015.068.014 F2.952*6.530** R2R2.063.257 Adj R 2.042.218 R2R2.194** Step 1Step 2 PredictorsΒSE ΒβΒ β Suspicious Attributions.069.041.125.076*.034.137 Resentment Towards Success.044.040.081.022.033.040 Cynicism.094*.040.173.033.060 Irritability.008.039.015.020.033.037 BMI.419**.048.587 Age.005.003.116 SBP.001.002.021 Gender.039.069.037 Diabetes-.026.098-.017 F2.35812.374** R2R2.051.396 Adj R 2.029.364 R2R2.345** Transformed IL-6 n=180Transformed CRP n=180 Note. * p<.05; **p<.01 Variable MSD Age (years)45.611.56 Cook Medley Scale23.277.82 BMI (kg/m 2 )30.647.90 Systolic BP (mm/Hg)133.3418.54 Diastolic BP (mm/Hg)79.5813.56 Years of Education (years)13.812.39 IL-6 (pg/mL)2.76 3.08 CRP (pg/mL)4.01 6.25 Income (yearly)% Less than $10,0025.1% $10,001 - 30,00034.1% $30,001 - 50,00024.6% $50,001 - 80,00012.3% More than $80,0003.8% Self-reported hypertension29.9% Self-reported diabetes11.8% Participants: The participants were a community- based sample of African Americans, 18 to 73 years of age, who reside in the Washington, DC metropolitan area. The sample was 48% male. Setting: The study site was Howard University Hospital’s General Clinical Research Center (GCRC) located in Washington, DC. Tests and Measures: Informed consent was obtained. Participants were administered the Cook Medley Hostility scale (Cook & Medley, 1954). Participants also underwent a medical examination, which included measurements of body mass index (BMI) and blood pressure. Weight and height measurements were used to calculate BMI. Blood pressure was measured via a sphygmomanometer. Plasma CRP and IL-6 were measured by enzyme- linked immunosorbent assay (ELISA). Sample Characteristics N=214