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A study of 37 depressed patients explored the association among depression, hostility, and the direction in which hostility is expressed. A spectrum of hostile behaviors was found, defined by four factors, with an approximately equal number of patients turning hostility inward and outward. In those patients who tended to turn hostility in, there was a relationship between the degree of turning hostility inward and higher scores on several measures of the severity of depression. Several indicators of outward hostility were related to presence of hysterical features and resentment. These tentative findings are in keeping with a theory which considers depression to be primarily an emotional signal and hostility to serve as a defense. There is evidence from responses on the Buss-Durkee Inventory that the defense may be failing as depression becomes more severe since the highly depressed patients we observed see their anger as being weak. As they also see other people's anger as more potent and on-the-surface, they may fear retaliation, and therefore express their hostility in the form of resentment.
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