Anger Expression Styles, Cynical Hostility, and the Risk for the Development of Type 2 Diabetes or Diabetes-Related Heart Complications

Secondary Analysis of the Health and Retirement Study

Bibliographic Data

ID19307342
AuthorsR Ward (University of Southern Denmark), Richard Andrew Ward, Geneviève Forget (0000-0001-8977-5248, Carleton University), Nanna Lindekilde (0000-0002-4212-6838), Sonya S Deschêne (0000-0002-9258-0895, University College Dublin), Frans Pouwer (0000-0002-8172-9818), François Pouwer, Norbert Schmitz (0000-0001-7777-6323), Miranda T Schram (0000-0001-8113-7604, Maastricht University Medical Centre), Rita J Burns (0000-0002-5337-7878, Carleton University, corresponding author)
Year2024
Volume86
Issue9
Pages758-767
Publication date2024-11-01
Open AccessNo
TypeARTICLE
VenuePsychosomatic Medicine (JOURNAL)
Journal identifiersISSN: 0033-3174 • E-ISSN: 1534-7796
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/psy.0000000000001344
PMID39258890
OpenAlexW4402441487
LanguageEN
References cited46

OBJECTIVE: Limited research has examined associations between trait anger and hostility and incident type 2 diabetes (T2D) and diabetes-related heart complications. However, anger expression styles (i.e., anger-in, anger-out) have not been examined. The present study used secondary data to examine the associations between anger expression styles, cynical hostility, and the risk of developing T2D (objective 1) or diabetes-related heart complications (objective 2). METHODS: Self-report data came from participants aged 50 to 75 years in the Health and Retirement Study. Anger-in (anger that is suppressed and directed toward oneself, anger-out (anger directed toward other people or the environment), and cynical hostility were measured at baseline (2006 or 2008). Follow-up data (i.e., diabetes status or diabetes-related heart complications status) were collected every 2 years thereafter until 2020. The objective 1 sample included 7898 participants without T2D at baseline, whereas the objective 2 sample included 1340 participants with T2D but without heart complications at baseline. RESULTS: Only anger-in was significantly associated with incident T2D after controlling for sociodemographic characteristics (hazard ratio = 1.08, 95% confidence interval = 1.01-1.16), but the association did not hold after further adjustment for depressive symptoms. Only anger-out was significantly associated with incident diabetes-related heart complications after adjusting for sociodemographic characteristics, health-related covariates, and depressive symptoms (hazard ratio = 1.21, 95% confidence interval = 1.02-1.39). CONCLUSIONS: Anger expression styles were differentially related to diabetes outcomes. These findings demonstrate the value of expanding the operationalization of anger beyond trait anger in this literature and encourage further investigation of anger expression styles

Anger · Diabetes mellitus · Hostility · Type 2 diabetes · Bullying, Victimization, and Aggression · Cardiac Health and Mental Health · Clinical Psychology · Endocrinology · Medicine · Mindfulness and Compassion Interventions · Psychology

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