Patterns of change in hostility from college to midlife in the UNC alumni heart study predict high-risk status

Ilene C. Siegler, Paul T. Costa, Beverly H. Brummett, Michael J. Helms, John C. Barefoot, Redford B. Williams, W. Grant Dahlstrom, Berton H. Kaplan, Peter P. Vitaliano, Milton Z. Nichaman, R. Sue Day, Barbara K. Rimer

Research output: Contribution to journalArticlepeer-review

66 Scopus citations


Objective: To examine hostility measured in college and patterns of change in hostility from college to midlife as predictors of high health-related risk later in midlife. Methods: Logistic regression models were used to test hostility/risk associations. Results: College hostility predicted being a current smoker, consuming more than two drinks of alcohol, low social support, achieving less than expected in career and in relationships, risk for depression, and appraisal of life changing for the worse in terms of family events at midlife. Change in hostility did not predict smoking and drinking; however, it did significantly predict social isolation, lower income (only for women), obesity, avoidance of exercise, high-fat diet, and negative changes in economic life, work life, and physical health events-all risk indicators measured during the next decade. Appraisals of social support, lowered expectations, risk for depression, and reports of family life changing for the worse were predicted at both time periods. When change in hostility was modeled with college hostility, all risk indicators were significantly predicted by college hostility. Conclusions: High hostility in college and change in hostility from college to midlife predicts a full range of health risk indicators. When compared with the average population decline in hostility, gains in hostility at midlife are related to increased risk while declines in hostility are related to reduced risk. Higher midlife hostility is associated with increased odds of being in the higher risk group. Future research should focus on developing interventions to reduce hostility.

Original languageEnglish (US)
Pages (from-to)738-745
Number of pages8
JournalPsychosomatic medicine
Issue number5
StatePublished - 2003
Externally publishedYes


  • Age
  • Health risk
  • Hostility
  • Patterns of change
  • Risk trajectories

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health


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