HYPERTENSION AND PERSONALITY: A comment on Thomas and Kirkcaldy
J. J. RAY
University of New South Wales, Kensington, N.S. W 2033, Australia
(Received 14 October 1988)
Summary -- Thomas and Kirkcaldy found that hypertensives score low on dominance and aggression. It is pointed out that previous findings tend toward the conclusion that hypertensives should score high on such attributes.
The finding by Thomas and Kirkcaldy (1988) that hypertensives tend to be low on dominance and aggression is more disturbing than Thomas and Kirkcaldy appear to realize. Although it is true that the findings can be fitted to various theories, they do not fit in well with other findings in the literature on circulatory disorders generally. As hypertension is a major precursor of coronary heart disease (for instance) one would expect that personality factors predisposing to both hypertension and CHD would be similar. The Thomas and Kirkcaldy findings, however, are almost the opposite of what is found in the literature on CHD. What is generally found has recently been reviewed at some length by Diamond (1982). Diamond found that anger, aggression and hostility were the recurring personality features of both CHD sufferers and hypertensives. Other papers published since Diamond did his review support this conclusion. To take just a few instances, Ray and Simons (1982) found that CHD sufferers scored high on scales of dominance and aggression while Smith, Follick and Korr (1984) found that the severity of anginal symptoms was greater in people prone to anger. Van Dijl (1982) found that male myocardial infarction patients scored high on a factor identified by him as measuring 'aggression/hostility'. The large body of work done over the years by the Jenkins group (see Jenkins, Zyzanski and Rosenman, 1979) also deserves separate mention. These workers showed an association between their 'A-B' personality and CHD. When this A-B concept is demystified it turns out to be little more than a combination of dominance and aggression (Ray and Bozek, 1980). Ray (1986) has in fact presented evidence leading to the view that 'A-B' predicts CHD only insofar as it constitutes an index of dominance and aggression. It might also be noted that Heaven (1986) has shown that, at least in some populations, dominance and aggression themselves seem to be ineluctibly associated. The finding by Thomas and Kirkcaldy that hypertensives are low on dominance and aggression does then sit very oddly with what has gone before. It raises the possibility that the causes of mild hypertension among adolescents (which Thomas and Kirkcaldy studied) might be quite different to the causes of serious hypertension in older populations (the type of person most studied heretofore). This may be yet another complication we have to accept in an already complex field. Some re-checking of their findings by Thomas and Kirkcaldy might be called for before we do this, however. Their sampling procedures, for instance, do appear to be quite careful but we are not in fact given any detail of them.
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