Trait anger but not anxiety predicts incident type 2 diabetes: The Multi-Ethnic Study of Atherosclerosis (MESA)

Sherley Abraham, Nina G. Shah, Ana Diez Roux, Felicia Hill-Briggs, Teresa Seeman, Moyses Szklo, Pamela J. Schreiner, Sherita Hill Golden

Research output: Contribution to journalArticle

Abstract

Objective: Prior studies have shown a bidirectional association between depression and type 2 diabetes mellitus (T2DM); however, the prospective associations of anger and anxiety with T2DM have not been established. We hypothesized that trait anger and anxiety would predict incident T2DM, independently of depressive symptoms. Research design and methods: In the Multi-ethnic Study of Atherosclerosis (MESA), we prospectively examined the association of trait anger and trait anxiety (assessed via the Spielberger Trait Anger and Anxiety Scales, respectively) with incident T2DM over 11.4 years in 5598 White, Black, Hispanic, and Chinese participants (53.2% women, mean age 61.6 years) at baseline without prevalent T2DM or cardiovascular disease. We used Cox proportional hazards models to calculate the hazard ratios (HR) of incident T2DM by previously defined anger category (low, moderate, high), and anxiety quartile, as there were no previously defined categories. Results: High total trait anger was associated with incident T2DM (HR 1.50; 95% CI 1.08-2.07) relative to low total trait anger. The association was attenuated following adjustment for waist circumference (HR 1.32; 95% CI 0.94-1.86). Higher anger reaction was also associated with incident T2DM (HR. = 1.07; 95% CI 1.03-1.11) that remained significant after adjusting for potential confounders/explanatory factors. In contrast, trait anxiety did not predict incident T2DM. Conclusions: High total trait anger and anger reaction are potential modifiable risk factors for T2DM. Further research is needed to explore the mechanisms of the anger-diabetes relationship and to develop preventive interventions.

Original languageEnglish (US)
Pages (from-to)105-113
Number of pages9
JournalPsychoneuroendocrinology
Volume60
DOIs
StatePublished - Oct 1 2015

Fingerprint

Anger
Type 2 Diabetes Mellitus
Atherosclerosis
Anxiety
Depression
Waist Circumference
Hispanic Americans
Proportional Hazards Models
Research Design
Cardiovascular Diseases

Keywords

  • Anger
  • Anxiety
  • Diabetes

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health
  • Biological Psychiatry
  • Endocrine and Autonomic Systems

Cite this

Trait anger but not anxiety predicts incident type 2 diabetes : The Multi-Ethnic Study of Atherosclerosis (MESA). / Abraham, Sherley; Shah, Nina G.; Roux, Ana Diez; Hill-Briggs, Felicia; Seeman, Teresa; Szklo, Moyses; Schreiner, Pamela J.; Golden, Sherita Hill.

In: Psychoneuroendocrinology, Vol. 60, 01.10.2015, p. 105-113.

Research output: Contribution to journalArticle

@article{279f089bba074d7aa52c811ef28298f6,
title = "Trait anger but not anxiety predicts incident type 2 diabetes: The Multi-Ethnic Study of Atherosclerosis (MESA)",
abstract = "Objective: Prior studies have shown a bidirectional association between depression and type 2 diabetes mellitus (T2DM); however, the prospective associations of anger and anxiety with T2DM have not been established. We hypothesized that trait anger and anxiety would predict incident T2DM, independently of depressive symptoms. Research design and methods: In the Multi-ethnic Study of Atherosclerosis (MESA), we prospectively examined the association of trait anger and trait anxiety (assessed via the Spielberger Trait Anger and Anxiety Scales, respectively) with incident T2DM over 11.4 years in 5598 White, Black, Hispanic, and Chinese participants (53.2{\%} women, mean age 61.6 years) at baseline without prevalent T2DM or cardiovascular disease. We used Cox proportional hazards models to calculate the hazard ratios (HR) of incident T2DM by previously defined anger category (low, moderate, high), and anxiety quartile, as there were no previously defined categories. Results: High total trait anger was associated with incident T2DM (HR 1.50; 95{\%} CI 1.08-2.07) relative to low total trait anger. The association was attenuated following adjustment for waist circumference (HR 1.32; 95{\%} CI 0.94-1.86). Higher anger reaction was also associated with incident T2DM (HR. = 1.07; 95{\%} CI 1.03-1.11) that remained significant after adjusting for potential confounders/explanatory factors. In contrast, trait anxiety did not predict incident T2DM. Conclusions: High total trait anger and anger reaction are potential modifiable risk factors for T2DM. Further research is needed to explore the mechanisms of the anger-diabetes relationship and to develop preventive interventions.",
keywords = "Anger, Anxiety, Diabetes",
author = "Sherley Abraham and Shah, {Nina G.} and Roux, {Ana Diez} and Felicia Hill-Briggs and Teresa Seeman and Moyses Szklo and Schreiner, {Pamela J.} and Golden, {Sherita Hill}",
year = "2015",
month = "10",
day = "1",
doi = "10.1016/j.psyneuen.2015.06.007",
language = "English (US)",
volume = "60",
pages = "105--113",
journal = "Psychoneuroendocrinology",
issn = "0306-4530",
publisher = "Elsevier Limited",

}

TY - JOUR

T1 - Trait anger but not anxiety predicts incident type 2 diabetes

T2 - The Multi-Ethnic Study of Atherosclerosis (MESA)

AU - Abraham, Sherley

AU - Shah, Nina G.

AU - Roux, Ana Diez

AU - Hill-Briggs, Felicia

AU - Seeman, Teresa

AU - Szklo, Moyses

AU - Schreiner, Pamela J.

AU - Golden, Sherita Hill

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Objective: Prior studies have shown a bidirectional association between depression and type 2 diabetes mellitus (T2DM); however, the prospective associations of anger and anxiety with T2DM have not been established. We hypothesized that trait anger and anxiety would predict incident T2DM, independently of depressive symptoms. Research design and methods: In the Multi-ethnic Study of Atherosclerosis (MESA), we prospectively examined the association of trait anger and trait anxiety (assessed via the Spielberger Trait Anger and Anxiety Scales, respectively) with incident T2DM over 11.4 years in 5598 White, Black, Hispanic, and Chinese participants (53.2% women, mean age 61.6 years) at baseline without prevalent T2DM or cardiovascular disease. We used Cox proportional hazards models to calculate the hazard ratios (HR) of incident T2DM by previously defined anger category (low, moderate, high), and anxiety quartile, as there were no previously defined categories. Results: High total trait anger was associated with incident T2DM (HR 1.50; 95% CI 1.08-2.07) relative to low total trait anger. The association was attenuated following adjustment for waist circumference (HR 1.32; 95% CI 0.94-1.86). Higher anger reaction was also associated with incident T2DM (HR. = 1.07; 95% CI 1.03-1.11) that remained significant after adjusting for potential confounders/explanatory factors. In contrast, trait anxiety did not predict incident T2DM. Conclusions: High total trait anger and anger reaction are potential modifiable risk factors for T2DM. Further research is needed to explore the mechanisms of the anger-diabetes relationship and to develop preventive interventions.

AB - Objective: Prior studies have shown a bidirectional association between depression and type 2 diabetes mellitus (T2DM); however, the prospective associations of anger and anxiety with T2DM have not been established. We hypothesized that trait anger and anxiety would predict incident T2DM, independently of depressive symptoms. Research design and methods: In the Multi-ethnic Study of Atherosclerosis (MESA), we prospectively examined the association of trait anger and trait anxiety (assessed via the Spielberger Trait Anger and Anxiety Scales, respectively) with incident T2DM over 11.4 years in 5598 White, Black, Hispanic, and Chinese participants (53.2% women, mean age 61.6 years) at baseline without prevalent T2DM or cardiovascular disease. We used Cox proportional hazards models to calculate the hazard ratios (HR) of incident T2DM by previously defined anger category (low, moderate, high), and anxiety quartile, as there were no previously defined categories. Results: High total trait anger was associated with incident T2DM (HR 1.50; 95% CI 1.08-2.07) relative to low total trait anger. The association was attenuated following adjustment for waist circumference (HR 1.32; 95% CI 0.94-1.86). Higher anger reaction was also associated with incident T2DM (HR. = 1.07; 95% CI 1.03-1.11) that remained significant after adjusting for potential confounders/explanatory factors. In contrast, trait anxiety did not predict incident T2DM. Conclusions: High total trait anger and anger reaction are potential modifiable risk factors for T2DM. Further research is needed to explore the mechanisms of the anger-diabetes relationship and to develop preventive interventions.

KW - Anger

KW - Anxiety

KW - Diabetes

UR - http://www.scopus.com/inward/record.url?scp=84938255495&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84938255495&partnerID=8YFLogxK

U2 - 10.1016/j.psyneuen.2015.06.007

DO - 10.1016/j.psyneuen.2015.06.007

M3 - Article

C2 - 26142567

AN - SCOPUS:84938255495

VL - 60

SP - 105

EP - 113

JO - Psychoneuroendocrinology

JF - Psychoneuroendocrinology

SN - 0306-4530

ER -