Helmers K F, Krantz D S, Merz C N, Klein J, Kop W J, Gottdiener J S, Rozanski A
Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
Health Psychol. 1995 May;14(3):202-9. doi: 10.1037//0278-6133.14.3.202.
Three studies assessed whether the combined traits of hostility and defensiveness identify a group of hostile individuals with functionally severe coronary artery disease (CAD). CAD patients completed the Cook-Medley Hostility Inventory (Ho) and the Marlowe-Crowne Social Desirability Scale (MC). Patients were classified into 4 groups: defensive hostile (DH: high Ho, high MC), low hostile (LH: low Ho, low MC), high hostile (HH: high Ho, low MC), and defensive (Def: low Ho, high MC). DH in comparison to HH, LH, and Def CAD patients demonstrate the greatest perfusion defects as measured by exercise thallium scintigraphy; DH patients exhibit the most frequent ischemic episodes during ambulatory electrocardiographic monitoring; and in a laboratory study, DH patients exhibit the most severe mental stress-induced ischemia assessed by echocardiography. Thus, the combination of high hostility and high defensiveness are associated with more functionally severe CAD and may predispose CAD patients to a more adverse prognosis.
三项研究评估了敌意和防御性的综合特征是否能识别出一组患有功能性严重冠状动脉疾病（CAD）的敌意个体。CAD患者完成了库克-梅德利敌意量表（Ho）和马洛-克劳恩社会赞许性量表（MC）。患者被分为四组：防御性敌意组（DH：高Ho，高MC）、低敌意组（LH：低Ho，低MC）、高敌意组（HH：高Ho，低MC）和防御组（Def：低Ho，高MC）。与HH、LH和Def CAD患者相比，DH患者在运动铊闪烁扫描中显示出最大的灌注缺损；DH患者在动态心电图监测期间出现缺血发作的频率最高；在一项实验室研究中，通过超声心动图评估，DH患者表现出最严重的精神应激性缺血。因此，高敌意和高防御性的结合与功能性更严重的CAD相关，并且可能使CAD患者预后更差。
