Personality and Individual Differences 52 (2012) 444–448

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Personality and Individual Differences

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High hostility among smokers predicts slower recognition of positive facial emotion ⇑ Christopher W. Kahler a, , R. Kathryn McHugh a, Adam M. Leventhal b, Suzanne M. Colby a, Chad J. Gwaltney a, Peter M. Monti a a Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA b University of Southern California Keck School of Medicine, Los Angeles, CA, USA article info abstract

Article history: High levels of trait hostility are associated with wide-ranging interpersonal deficits and heightened phys- Received 8 July 2011 iological response to social stressors. These deficits may be attributable in part to individual differences in Received in revised form 20 September 2011 the perception of social cues. The present study evaluated the ability to recognize facial emotion among Accepted 7 November 2011 48 high hostile (HH) and 48 low hostile (LH) smokers and whether experimentally-manipulated acute Available online 30 November 2011 nicotine deprivation moderated relations between hostility and facial emotion recognition. A computer program presented series of pictures of faces that morphed from a neutral emotion into increasing inten- Keywords: sities of happiness, sadness, fear, or anger, and participants were asked to identify the emotion displayed Hostility as quickly as possible. Results indicated that HH smokers, relative to LH smokers, required a significantly Facial emotion recognition Smoking greater intensity of emotion expression to recognize happiness. No differences were found for other emo- Nicotine tions across HH and LH individuals, nor did nicotine deprivation moderate relations between hostility and emotion recognition. This is the first study to show that HH individuals are slower to recognize happy facial expressions and that this occurs regardless of recent tobacco abstinence. Difficulty recognizing hap- piness in others may impact the degree to which HH individuals are able to identify social approach sig- nals and to receive social reinforcement. Ó 2011 Elsevier Ltd. All rights reserved.

1. Introduction Christensen et al., 1996; Fredrickson et al., 2000; Guerrero & Pal- mero, 2010; Suarez, Kuhn, Schanberg, Williams, & Zimmermann, Hostility is a sociocognitive personality trait characterized by 1998) and are at greater risk for cardiovascular disease and mortal- cynical attitudes and mistrust about others’ behaviors and inten- ity (Aldwin, Spiro, Levenson, & Cupertino, 2001; Barefoot, Dahl- tions (Miller, Smith, Turner, Guijarro, & Hallet, 1996). These cogni- strom, & Williams, 1983; Haukkala, Konttinen, Laatikainen, tive biases may have important implications for social functioning. Kawachi, & Uutela, 2010; Niaura et al., 2002; Smith & Ruiz, 2002). High hostility is associated with greater interpersonal stress (Ben- Greater understanding of the cognitive processes that underlie so- otsch, Christensen, & McKelvey, 1997), expression of hostile emo- cial deficits in HH individuals may be important for elucidating tion during social situations (Brummett et al., 1998), and reports how this important personality trait influences health. of anger and negative interactions (Brondolo et al., 2003; Shapiro, Cognitive theories of psychiatric disorders suggest that emo- Jamner, & Goldstein, 1997). High hostile (HH) individuals report tional processing biases cause people to misinterpret situations lower perceived social support relative to low hostile (LH) individ- and respond in a maladaptive manner that exacerbates psycho- uals (Benotsch et al., 1997; Hardy & Smith, 1988) and may benefit pathologic behavior (Williams, Watts, MacLeod, & Mathews, less from social support (Holt-Lunstad, Smith, & Uchino, 2008; Le- 1990). Accordingly, cognitive biases may cause HH individuals, pore, 1995; Vahtera, Kivimaki, Uutela, & Pentti, 2000; Vella, Ka- compared to LH individuals, to interpret emotional reactions of oth- marck, & Shiffman, 2008). Such interpersonal deficits may affect ers as being more threatening (angry) and less positive (happy), key health outcomes. HH individuals have particularly strong phys- which in turn may lead to greater interpersonal stress, more nega- iological responses to interpersonal stressors (Brondolo et al., 2009; tive emotions, less positive emotions and less perceived social sup- port. Misinterpretation of social cues and corresponding poor mood states may cause further maladaptive interpersonal reactions by ⇑ Corresponding author. Address: Center for Alcohol and Addiction Studies, HH individuals. These reactions may provoke negatives social re- Brown University, Box G-S121-5, Providence, RI 02912, USA. Tel.: +1 401 863 6651; sponses from others, which ultimately confirm interpretive biases. fax: +1 401 863 6697. E-mail address: [email protected] (C.W. Kahler). Indeed, HH individuals tend to perceive others as hostile and

0191-8869/$ - see front matter Ó 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.paid.2011.11.009 C.W. Kahler et al. / Personality and Individual Differences 52 (2012) 444–448 445 controlling (Smith, McGonigle, & Benjamin, 1998), are more likely 2. Method to interpret ambiguous social situations as threatening (Chen & Matthews, 2003), and show information processing schema that 2.1. Participants facilitate processing of negative information about others and inhi- bit processing of positive information (Guyll & Madon, 2003). Participants were LH (n = 48) and HH (n = 48) smokers recruited Whether hostility is associated with distinct deficits in the recogni- from the community. Participants had to: (a) be 18 years of age or tion of emotion in others has rarely been studied, however, and may older, (b) have smoked cigarettes regularly for at least 1 year, (c) offer important insights into mechanisms relating hostility and currently smoke at least 10 cigarettes per day, (d) currently be interpersonal stress. using no other tobacco products or nicotine replacement, and (e) Deficits in the recognition of facial emotion characterize a num- be able to read English, and were excluded if they were currently ber of psychological disorders such as schizophrenia (Feinberg, dependent on alcohol or drugs other than tobacco or met criteria Rifkin, Schaffer, & Walker, 1986; Kohler et al., 2003), depression for a current affective disorder. Participants had to score either a (Demenescu, Kortekaas, den Boer, & Aleman, 2010; Rubinow & 5 or lower (LH) or a 10 or higher (HH) on the 17-item version of Post, 1992), anxiety (Demenescu et al., 2010), autism (Wallace the Cook–Medley Hostility Scale (Strong, Kahler, Greene, & et al., in press), and antisocial personality disorder/psychopathy Schinka, 2005) during a telephone screen, which corresponds clo- (Dolan & Fullam, 2006; Pham & Philippot, 2010). Poor recognition sely with the upper and lower thirds of scores from previous com- of emotion is associated with interpersonal difficulty and other munity samples (Han, Weed, Calhoun, & Butcher, 1995). Groups functional impairment (Kee, Green, Mintz, & Brekke, 2003), were balanced on gender and level of tobacco dependence as as- whereas accurate detection is associated with prosocial behavior sessed by the Fagerström Test for Nicotine Dependence (FTND; (Marsh, Kozak, & Ambady, 2007). Although research has yielded Heatherton, Kozlowski, Frecker, & Fagerstrom, 1991). In total, eight mixed results with respect to the specificity of these deficits to dis- separate blocks were recruited with 12 participants in each block crete emotions, several studies suggest that the type of emotion is of this 2 (high versus low FTND) Â 2 (LH versus HH) by 2 (male ver- relevant to recognition deficits. For example, there is evidence for sus female) design. specific deficits in recognizing negative relative to positive emo- The sample was 50% female, averaged 13.0 (SD = 2.0) years of tional faces in schizophrenia (Bediou et al., 2005; Kohler et al., education, averaged 5.4 (SD = 2.1) on the FTND, and smoked 21.6 2003). Likewise, there is evidence for enhanced recognition of cer- (SD = 8.9) cigarettes per day. Race/ethnicity was 70.3% non-His- tain types of facial emotions, such as recognition of sad faces in panic White, 15.6% African-American, 6.3% of more than one race, depression (Gollan, McCloskey, Hoxha, & Coccaro, 2010). Thus, def- 5.2% Hispanic/Latino, 1.0% Asian, and 1.0% American Indian. HH icits in recognition of specific emotions appear to characterize cer- participants were significantly younger (37.4 years, SD = 12.5) than tain disorders or traits. LH participants (43.0 years, SD = 13.2). Only two studies have examined facial emotion recognition in HH vs. LH individuals; both focused on brain laterality. HH partic- ipants were more likely than LH participants to identify neutral 2.2. Procedure faces as angry, but only when the stimulus was presented in the left visual field (Harrison & Gorelczenko, 1990). HH participants All participants completed an experimental session when they were less accurate than LH participants classifying angry, happy, had been smoking ad lib (non-deprived) and a session when they and neutral faces presented in the left visual field but more accu- abstained from smoking for at least 12 h (deprived) with the order rately classifying angry and happy faces presented in the right vi- counterbalanced across participants. For further description of sual field (Herridge, Harrison, Mollet, & Shenal, 2004). Neither of study design see Kahler, Leventhal, et al. (2009). Following a phone these studies addressed whether HH individuals had deficits recog- screen, eligible participants were invited for a baseline session, and nizing different intensities of specific emotions presented in the if eligible, two additional experimental sessions. At baseline, par- center of the visual field, which is crucial to understanding the po- ticipants completed an informed consent approved by the Brown tential effect of hostility on social–emotional processing. University Institutional Review Board. They then completed an A group for which hostility may be particularly relevant is cig- alcohol breath analysis (those with a positive result were resched- arette smokers. Current smokers have higher levels of hostility uled) and psychiatric interview to confirm eligibility. They also than non-smokers (Bunde & Suls, 2006; Kahler, Daughters, et al., completed baseline measures of mood, smoking characteristics, 2009), and HH smokers have particular difficulties in quitting and recent alcohol and drug use. smoking (Brummett et al., 2002; Iribarren et al., 2000; Lipkus, At the end of the baseline session, participants were informed Barefoot, Williams, & Siegler, 1994; Kahler, Spillane, et al., 2009; whether they were to smoke ad lib prior to the first experimental Kahler, Strong, Niaura, & Brown, 2004). Among HH smokers, com- session or to abstain from smoking for a minimum of 12 h. On the pared to LH smokers, smoking following a social stressor more session in which they were assigned to smoking deprivation, par- strongly buffers against negative affect increases (Kahler, Leven- ticipants were instructed not to smoke cigarettes after midnight thal, et al., 2009), suggesting that HH individuals may smoke, in on the day before that session. All sessions occurred between 12 part, as a means of managing affective reactions to interpersonal and 6 pm. Those who did not complete both sessions successfully stress. Conversely, abstinence from smoking, which reliably in- were replaced so that we achieved our desired sample size of 96. creases negative affect, may exacerbate interpersonal deficits in Overall, 13 out of 109 participants (11.9%) who were eligible fol- HH smokers, heightening their biases in the interpretation of oth- lowing a baseline interview did not complete both experimental ers’ emotions. sessions. Non-completers did not differ significantly from complet- This study examined the effect of hostility in adult smokers on ers on hostility, sex, or level of tobacco dependence. recognition of positive and negative facial emotions. In this sec- At the outset of experimental sessions, a breath carbon monox- ondary analysis of a previous study (Kahler, Leventhal, et al., ide (CO) reading was obtained. In the deprivation condition, indi- 2009), two hypotheses were tested: (1) that HH smokers would viduals were required to have a reading of 10 ppm or less. be slower to recognize positive emotion and quicker to recognize Following the CO reading, participants completed self-report and anger compared to LH smokers and (2) that smoking abstinence computerized cognitive measures. Prior analyses indicated that would accentuate differences in facial emotion recognition related deprivation significantly increased nicotine withdrawal symptoms to hostility. including negative affect (Kahler, Leventhal, et al., 2009). 446 C.W. Kahler et al. / Personality and Individual Differences 52 (2012) 444–448

Additional procedures occurring after the cognitive measures have 3. Results been analyzed and reported elsewhere (Kahler, Leventhal, et al., 2009) and are not described here since they are not the focus of The average speed to recognition of facial emotion was 12.82 s this paper. (SD = 1.72) at Time 1 and 12.75 s (SD = 1.92) at Time 2. There were no main effects of order, nicotine deprivation, or hostility on aver- age speed, nor were there significant interactions among these 2.3. Measures variables. Average intensity at which emotion was recognized at Time 1 was 54.68% (SD = 14.62) for happiness, 73.50% Diagnostic exclusions were determined by the substance use (SD = 11.41) for anger, 70.15% (SD = 11.06) for fear, and 76.72% and affective disorders sections of the Structured Clinical Interview (9.61) for sadness. Results were similar for Time 2 with 54.75% for DSM-IV-Non Patient Version (SCID-NP, First, Spitzer, Gibbon, & (SD = 14.37) for happiness, 73.01% (SD = 11.32) for anger, 77.66% Williams, 2002). (SD = 11.69) for fear, and 75.08% (SD = 10.23) for sadness. Table 1 The intensity threshold at which participants perceived anger, presents the average intensity recognized for each emotion by happiness, sadness, and fear in faces was assessed using a facial group and deprivation condition. emotion change detection task. This task uses facial morphing As intended, higher average intensity at which emotions were technology as implemented in the Morph Man 4.0 software pack- recognized across emotions was associated positively with the age (Stoik Software Inc.). Procedures closely mirrored tasks de- intensity at which each emotion was recognized, ps < .0001, scribed by Blair, Colledge, Murray, and Mitchell (2001) and reflecting general individual differences in recognition speed. Con- Coupland et al. (2004), which have been shown to be sensitive to trolling for that difference, HH participants required greater inten- differences in psychopathology and mood. In this task, images from sity to recognize happy faces relative to LH participants (B = 2.52, the Pictures of Facial Affect (Ekman & Friesen, 1976) series were SE = 1.14, p < .05). The main effect of nicotine deprivation and its morphed to produce a continuum of emotion expression intensity interaction with hostility were nonsignificant. from neutral to the full expression of the emotion. Twelve different The main effect of hostility on recognition of angry faces was models (6 male and 6 female) were used to show each of the four nonsignificant (B = À1.18, SE = 1.29, p = .37). Higher age was associ- emotions for a total of 48 slides, 24 of which were rated in the first ated with significantly slower recognition of anger (B = 0.14, session and 24 of which were rated in the second session counter- SE = 0.05, p < .01). There was no significant effect of hostility group balanced across participants. For each stimulus, the expressions on recognition of fearful (B = À1.15, SE = 1.23, p = .35) or sad were morphed from neutral to 100% in 40 increments of 2.5% at (B = À1.52, SE = 1.34, p = .26) faces. Nicotine deprivation, compared a rate of 5% per second so that the total length of presentation of to ad lib smoking, was associated with significantly quicker recog- each stimulus was 20 s. Participants were instructed to respond nition of fearful faces (B = À2.69, SE = 1.15, p < .05). as soon as they could perceive the emotion being displayed by clicking on one of four different labels on the screen corresponding to the four target emotions and that they could change their re- 4. Discussion sponse at any time during a particular trial by clicking on another label. The dependent variables for this task were the mean affective We hypothesized that cynical beliefs about others’ behaviors intensities (ranging from 2.5% to 100%) at which participants cor- and intentions would bias HH participants towards more quickly rectly perceived the target emotions. If participants did not give recognizing facial anger and less quickly recognizing facial happi- a correct response or changed a correct response to an incorrect re- ness. Results only supported a relative deficit in recognizing happi- sponse and did not correct the error, they were assigned a value of ness. This deficit may have real-world implications as facial 102.5% following the procedure of Coupland et al. (2004). displays of positive emotion have important signaling value for availability of social reward/support and the absence of social threat. HH individuals’ relative deficit in recognizing mild positive 2.4. Data analysis plan emotions in others may contribute to their experiences of social interactions as stressful and unsupportive, which may in turn Repeated-measures mixed-model analyses were run separately maintain hostile attitudes and antagonistic behavior. The mecha- for each type of facial stimulus (happy, angry, fearful, and sad) with nisms for these differences in emotion recognition are not clear, the level of intensity at which the emotion was recognized as the however. Results could reflect differences in attention to facial dependent variable using PROC MIXED in SAS (SAS Institute Inc., indicators of happiness or differences in interpretation of these 2005). The mixed model analyses allowed for random missing data cues. and included all participants in all analyses. The association be- Results from a study conducted in a subsample of the present tween hostility and recognition was evaluated controlling for study indicated that HH smokers, compared to LH smokers, age, sex, and deprivation condition. Hostility  deprivation condi- showed lower attentional interference from angry faces when cod- tion interaction effects were tested to determine whether depriva- ing the gender of a face (Leventhal & Kahler, 2010). The present tion moderated the association between hostility and recognition. study suggests that difficulty recognizing facial anger is unlikely There was strong evidence for individual differences in average speed of response across emotions. At the first session, the correla- Table 1 tions between the mean intensity of emotion recognized for one Average percent intensity (SD) at which facial emotion was recognized by deprivation emotion and the mean intensity for another emotion averaged condition and hostility. r = .45; at the second presentation, these correlations averaged Type of stimulus Deprived Non-deprived .58. To control for these individual differences in speed of respond- ing, we covaried the average intensity of emotion recognized LH HH LH HH across all four stimuli types on that day; thus, analyses reflected Happiness 51.7 (15.2) 58.4 (12.2) 53.6 (14.0) 55.1 (15.9) how emotion recognition differed for a specific emotion controlling Anger 71.9 (11.1) 75.9 (10.7) 75.2 (11.4) 69.8 (11.5) for average intensity recognized across emotions. Average intensity Fear 67.3 (9.7) 69.0 (10.3) 70.6 (14.0) 68.7 (11.3) Sadness 75.1 (10.2) 76.9 (9.3) 77.8 (10.3) 73.8 (9.8) of emotion recognized was not associated with hostility at either session, ps > .70. Note: LH = low hostiles, HH = high hostiles. C.W. Kahler et al. / Personality and Individual Differences 52 (2012) 444–448 447 to explain that result. HH smokers compared to LH smokers recog- enforcement agents: The effects of stressful social interactions. Journal of nize facial anger readily, but facial anger may be less likely to auto- Occupational Health Psychology, 14, 110–121. Brondolo, E., Rieppi, R., Erickson, S. A., Bagiella, E., Shapiro, P. A., McKinley, P., et al. matically grab their attention, suggesting a relative insensitivity to (2003). Hostility, interpersonal interactions, and ambulatory blood pressure. angry social cues rather than a deficit in anger recognition per se. Psychosomatic Medicine, 65, 1003–1011. 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