The Pattern of Hostility in Affective Illness

Many theoretical accounts of the affective disorders, in particular those by writers of the psychodynamic schools, have emphasized the central role of hostility and aggression. However, there have been very few objective studies of the expression of aggression in patients with affective disorders. Of these, two have used the Hostility and Direction of Hostility Questionnaire (HDHQ,) of Foulds (Foulds et al., 1960; Foulds, 1965). Mayo (1967) tested 24 depressed patients before and after treatment and found a significant decrease after recovery, both in their level of general punitiveness and in their level of intropunitiveness. The psychotically depressed patients scored significantly higher than the neurotic depressives. Philip (1971) tested depressed women, and found that extra-punitiveness did not change over time, but that improved patients were less intropunitive than those who showed no improvement. No studies have reported the hostility pattern of manic patients.