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PubMed1998

Anger attacks in depression.

Anger, hostility and irritability are frequently observed among patients with unipolar depressive disorders. Approximately one-third of depressed outpatients present with "anger attacks," sudden spells of anger accompanied by symptoms of autonomic activation such as tachycardia, sweating, hot flashes, and tightness of the chest. Depressed patients with anger attacks are significantly more anxious and hostile and they are more likely to meet criteria for avoidant, dependent, borderline, narcissistic, and antisocial personality disorders than depressed patients without anger attacks. Several studies suggest that antidepressant treatment of anger attacks in depression is safe and effective. Anger attacks disappear in 53-71% of depressed outpatients treated with antidepressants such as fluoxetine, sertraline, and imipramine. In addition, the rate of emergence of anger attacks after treatment with fluoxetine (6-7%) is no different from the rates observed after treatment with sertraline (8%) and imipramine (10%), and lower than the rate with placebo (20%). Finally, since the central serotonergic neurotransmitter system is known to be involved in the modulation of aggressive behavior in animals and humans, one can hypothesize that antidepressants which affect this system may be particularly effective in depressed patients with anger attacks.

Anger↗
PubMed2003

[Correlational study among anger, perceived stress and mental health status in middle aged women].

PURPOSE: This study was to identify the relationships of trait anger, mode of anger expression, and perceived stress to mental health status in middle aged women. METHOD: The subjects were 157 middle aged women from 40s to 60s who lived in Seoul. Data was collected by questionnaire surveys using the convenience sampling. The instruments used for this study were Spielberger's trait anger scale and anger expression scale, Cohen, Kamarck, and Mermelstein's perceived stress and Derogatis's SCL-90-R. The collected data was analyzed using descriptive statistics, Pearson correlation coefficient, and Stepwise multiple regression with SAS/PC. RESULT: The trait anger of middle aged women indicated a significantly positive correlation to perceived stress(r=.180, p=.023) and mental health status(r.=021, p=.014). Anger-in(r=.237, p<.05), and perceived stress(p=.461, p<.01) showed significantly positive correlation to mental health status. The most significant predictor influencing health status of middle aged women was perceived stress, and anger-in and the variance explained was 27%. CONCLUSION: These results suggested that middle aged women with high degree of trait anger is likely to be high in stress perception. Perceived stress and anger-in are major factors influencing mental health status.

English Abstract↗
PubMed2001

Anger on and off the road.

Participants reported on two recent experiences of anger, of which one had occurred while they were driving and the other in a non-driving situation. Anger while driving was described as less mixed with other emotions, involving purer appraisals of other-blame, more likely to be caused by communication difficulties, and slower to be noticed by the person who was its target. Levels of negative affect preceding anger were rated as significantly lower in driving than non-driving situations, and mood and unrelated pressure were considered to be less influential causes of the subsequent emotional reaction. Frequency estimates supported the popular notion that anger is relatively more likely while driving than during other activities. Individual difference measures relating to ambivalence over emotional expression, self-consciousness, and empathy showed no reliable correlations with frequency of anger while driving, but previously developed self-report indices of driving anger and aggression made a significant contribution to its prediction even after controlling for anger frequency in other situations. These results support everyday intuitions that certain features of the road situation differentially predispose drivers to become angry and that the resulting anger tends to take a different form from anger experienced off the road.

Journal Article↗
PubMed2005

Anger and bulimic psychopathology: gender differences in a nonclinical group.

OBJECTIVE: The current study addressed the link between anger and bulimic psychopathology between young adult men and women. METHOD: Volunteers (125 males and 125 females) completed two self-report questionnaires measuring anger (State Trait Anger Inventory [STAXI]) and bulimic attitudes and behaviors (Bulimic Investigatory Test, Edinburgh [BITE]). RESULTS: Although overall levels of anger did not differ broadly across genders, bulimic attitudes were associated with state anger in men but with anger suppression in women. DISCUSSION: Men appear to engage in bulimic behaviors to reduce anger states, whereas women appear to use such behaviors to reduce the likelihood of anger states from arising. Further experimental validation of these findings is required in both clinical and nonclinical groups.

Adolescent↗
PubMed2005

Anger as a moderator of safer sex motivation among low-income urban women.

Theoretical models suggest that both HIV knowledge and HIV risk perception inform rational decision making and, thus, predict safer sex motivation and behavior. However, the amount of variance explained by knowledge and risk perception is typically small. In this cross-sectional study, we investigated whether the predictive power of HIV knowledge and HIV risk perception on safer sex motivation is affected by trait anger. We hypothesized that anger may disrupt rational decision making, distorting the effects of both HIV knowledge and risk perception on safer sex intentions. Data from 232 low-income, urban women at risk for HIV infection were used to test a path model with past sexual risk behavior, HIV knowledge, and HIV risk perception as predictors of safer sex intentions. Moderator effects of anger on safer sex intentions were tested by simultaneous group comparisons between high-anger and low-anger women (median split). The theoretically expected "rational pattern" was found among low-anger women only, including (a) a positive effect of knowledge on safer sex intentions, and (b) buffer (inhibitor) effects of HIV knowledge and HIV risk perception on the negative path leading from past risk behavior to safer sex intentions. Among high-anger women, an "irrational pattern" emerged, with no effects of HIV knowledge and negative effects of both past risk behavior and HIV risk perception on safer sex intentions. In sum, the results suggest that rational knowledge- and risk-based decisions regarding safer sex may be limited to low-anger women.

Adolescent↗
PubMed1996

Cynical hostility, anger, and resting blood pressure.

Research on associations of anger and hostility with resting blood pressure (BP) has generally ignored their interrelationships. The present study examined the individual and joint relationships of cynical hostility, anger-in, anger-out, and anger frequency with resting BP using the Cook-Medley Hostility Scale and the Spielberger anger scales. Multiple regressions were conducted on data from a community sample of 105 men and women to examine the main and interactive effects of anger and hostility on BP, controlling for established physical covariates. Diastolic BP was inversely related to anger-in scores in men and women. Systolic and diastolic BP were positively associated with Ho (hostility) score only in women. No confounding or interactive effects of hostility and anger on BP were found. It is suggested that the sex-specific link between cynical hostility and BP may reflect a chronic mismatch between the social cognitions of cynically hostile women and some of the cultural norms that govern women's social lives.

Adult↗
PubMed1995

Anger attacks in eating disorders.

As central nervous system serotonergic dysregulation has been postulated to exist in both eating and aggression disorders, we hypothesized that anger attacks would be more common among patients with eating disorders than among control subjects. In addition, we wanted to examine possible relationships between the presence of anger attacks and the type or severity of the eating disorder. Subjects were 39 normal female volunteers and 132 female outpatients with anorexia nervosa, bulimia nervosa, or both. Forty-one (31%) of the patients met criteria for anger attacks compared with four (10%) of the control subjects. Bulimic patients reported the highest prevalence of anger attacks to be associated with greater severity of illness. In addition, patients with eating disorders who have anger attacks had significantly more depressive symptoms than patients without these attacks. Central serotonergic function is involved in such diverse processes as feeding behavior, mood regulation, and anger and aggression. The higher prevalence of anger attacks among patients than among control subjects may reflect central hyposerotonergic function, found in previous studies to be present in both eating disorders and pathologic aggression. Supporting this interpretation is the finding that the prevalence of anger attacks increased, although nonsignificantly, with the severity of bulimia, which has previously been shown to be inversely correlated with central serotonergic activity.

Adolescent↗
PubMed1987

Hostility, anger expression, cardiovascular responsivity, and social support.

Sixty male subjects completed the Cook-Medley Hostility Scale (Ho), the anger-in, anger-out, and anger-discuss measures of anger expression from the Framingham Heart Study, and a measure of social support. Subjects also performed two challenging tasks while systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate (PR) were monitored. Neither SBP, DBP, nor PR responses to the tasks were found to be related to the Ho or anger expression scales. Quality of social support was not found to be related to the Ho scale but was related negatively to the anger-discuss scale. The more subjects reported discussing their anger with others, the less social support they reported having. A negative correlation was found between the Ho and anger-out scales. The possibility is discussed that the relation between either of these two measures and coronary heart disease may be mediated or moderated by the other variable.

Adolescent↗
PubMed1995

The relationship between habitual anger coping style and serum lipid and lipoprotein concentrations.

The relationship between habitual anger coping styles, especially anger expression in a socially assertive manner and serum lipid concentrations was examined in 86 healthy subjects. Habitual anger expression was measured by the Müller Anger Coping Questionnaire (MAQ) on four scales: Aggression, Controlled Affect, Guilt, and Social Inhibition. A positive correlation between serum cholesterol and Aggression was found, as was a negative correlation between LDL/HDL ratio and Controlled Affect. These correlations remained significant after adjustments for age, Body Mass Index (BMI), athletic activity, alcohol, nicotine and coffee consumption. After these adjustments, significant negative partial correlations between Controlled Affect and both total cholesterol and LDL were also found. We found no significant gender differences on any lipid measure. This study demonstrated that unfavourable lipid profiles are linked to a predominantly aggressive anger coping style, whereas favourable lipid profiles are associated with more socially assertive anger coping (Controlled Affect). Thus the expression of anger in a socially assertive manner can be seen as health promoting. The MAQ scales were better predictors of total serum cholesterol concentrations than the health related behaviors and characteristics. Results are discussed in terms of a psychophysiological risk model of inadequate anger coping.

Adaptation, Psychological↗
PubMed2005

Anger attacks in major depressive disorder and serum levels of homocysteine.

BACKGROUND: Increased levels of homocysteine have been associated with anger and depression separately. We investigated the association of anger attacks in major depressive disorder (MDD) with serum levels of homocysteine. METHODS: Homocysteine serum levels were measured in 192 outpatients with nonpsychotic MDD, mean age 39.9 +/- 10.7 (range 19-65), 53% women, at baseline of an open-trial antidepressant treatment. We used the Massachusetts General Hospital Anger Attacks Questionnaire to evaluate anger attacks, the Structured Clinical Interview for DSM-III-R Axis I Disorders-Patient Edition (SCID-I/P) to diagnose MDD and the 17-item Hamilton Rating Scale for Depression to measure depression severity. RESULTS: In the multiple regression analysis split by anger attacks adjusted for parameters of depression, creatinine, vitamin B(12), folate, age, smoking, and alcohol consumption, serum levels of homocysteine were positively correlated with length of current major depressive episode (t value, 3.01; 95% confidence interval [CI], .09 to .43; p = .004) and HAM-D-17 scores (t value, 2.48; 95% CI, .07 to 0.64; p = .016) in patients with anger attacks but not in those without anger attacks. CONCLUSIONS: Anger attacks in MDD may moderate the relationship of homocysteine serum levels with the severity and length of the depressive episode. Future studies are warranted to confirm and clarify the nature of this moderating effect.

Adult↗
PubMed2004

Anger, hostility, and male perpetrators of intimate partner violence: a meta-analytic review.

There has been significant interest in, and controversy about, whether anger and hostility problems are meaningfully related to male-to-female intimate partner violence (IPV). In this meta-analytic review, we empirically evaluated whether the constructs of anger and hostility discriminated between IPV perpetrators and nonviolent comparison males. Thirty-three studies reporting data from 28 independent samples were included for analysis. IPV perpetrators consistently reported moderately higher levels of anger and hostility than nonviolent men across assessment methods (i.e., self-report, observational, and spouse-specific). In prior reviews, relationship distress has been proposed as a moderating variable between relationship distress and IPV. In this review, IPV perpetrators also consistently reported moderately higher levels of anger and hostility than relationship-discordant nonviolent men. Additionally, comparisons of subtypes of IPV perpetrators found that men in moderate-high severity IPV subtypes reported higher levels of anger and hostility than low-moderate IPV subtypes. While the pattern of results in this review suggests that elevated anger and hostility are distinguishing characteristics of IPV perpetrators, empirically based conclusions regarding the functional and contextual relationship between anger, hostility, and IPV remain elusive. The implications and limitations suggested by this review are discussed in the context of emerging models of anger and IPV and treatment programs for abusive men.

Affect↗
PubMed2004

A cross-sectional study on expression of anger and factors associated with criminal recidivism in prisoners with prior offences.

OBJECTIVE: The purpose of this study is to determine demographical characteristics leading to crime recidivism and define anger levels and anger expression manners for those who re-commit crime. METHOD: All the literate inmates in Izmit Closed Penitentiary were included in this cross-sectional study. The prisoners were asked to respond to State-Trait Anger Expression Inventory. Their socio-demographic data were collected and a questionnaire was given to them to determine their state of imprisonment, sentence, nature of the crime in which they were involved, their criminal history, their relationship with inmates and prison staff and substance and alcohol use. RESULTS: Of the 438 prisoners, 302 (68.9%) responded to the questionnaires. Crime recidivism among the study cohort was observed to be 37.4%. Mean trait anger, anger out and anger in scores were significantly higher in prisoners with criminal recidivism in comparison with those who did not have prior criminal records. However, mean anger control scores for prisoners with or without criminal recidivism were similar. Unemployment, education level completed at secondary school or below, having committed a crime under the influence of alcohol or narcotics, having been involved in prison fights, having resisted police officers, caused damage in their vicinity when angry and violent crimes were all found to be possible causes of criminal recidivism. Educational level completed at secondary school or below, getting into fights with other prisoners, unemployment and resisting police officers were determined to be the strongest indicators to predict criminal recidivism when all variables were considered according to a logistic regression model. CONCLUSION: It can be proposed that those who have problems with officials or hostile towards others constitute a risk group for criminal recidivism. If prisoners with criminal recidivism can be helped to identify and control their anger, their risk of committing a new crime can be minimised.

Adolescent↗
PubMed2005

Relationship between trait-anger and sleep disturbances in middle-aged men and women.

OBJECTIVE: The present study was performed to determine whether high levels of trait-anger (T-Anger) are independently associated with sleep disturbances and quantitative and qualitative measurements of sleep in middle-aged adults. METHODS: Enrolled in the study were 2404 men and 2291 women derived from the Korean Health and Genome Study (KHGS), which is an ongoing population-based prospective study. The Spielberger Trait Anger Scale was used to measure T-Anger. RESULTS: Sleep disturbances, including difficulty in initiating and maintaining sleep (DIS and DMS, respectively) and early morning awakening (EMA), significantly increased with increasing levels of T-Anger (P<.05 by test for trend). Nonrestorative feelings in the morning and excessive daytime sleepiness were also strongly associated with higher levels of T-Anger. After adjusting for other potential risk factors, the high and/or moderate T-Anger showed 40% to 70% increases in the odds for sleep disturbances. CONCLUSION: The present study provides evidence that high levels of T-Anger are independently associated with symptoms of disturbed sleep in middle-aged adult population.

Anger↗
PubMed2006

Anger suppression mediates the relationship between optimism and natural killer cell cytotoxicity in men treated for localized prostate cancer.

OBJECTIVE: This study evaluated relations among optimism, depression, anger suppression and natural killer cell cytotoxicity (NKCC) in 61 men treated for localized prostate cancer (PC). METHOD: All participants were assessed at a single time point where demographics, optimism, depression and anger suppression were measured. We also collected peripheral venous blood to assess NKCC. RESULTS: Results showed that greater optimism was associated with greater NKCC (beta=.27, P<.05), less depression (beta=-.63, P<.001) and less anger suppression (beta=-.29, P<.05). Furthermore, less anger suppression (beta=-.35, P<.01) was associated with greater NKCC. In a hierarchical regression model controlling for depression and then anger suppression, the relationship between optimism and NKCC became nonsignificant [beta=.18, t(56)=1.51, P=.14], while anger suppression remained significantly correlated with NKCC [beta=-.29, t(56)=-2.40, P<.05]. CONCLUSIONS: Results suggest that optimism is associated with NKCC and a greater ability to adaptively express anger. Furthermore, it appears that less anger suppression partially mediates the relationship between optimism and NKCC.

Aged↗
PubMed2000

Anger, depression, and coping interactions in headache activity and adjustment: a controlled study.

OBJECTIVE: To determine if individuals in the general community with chronic headache or migraine differ in terms of anger, depression, and coping strategies and from headache-free individuals in terms of anger and depression. METHOD: A community sample comprising 16 chronic tension-type headache (CTH), 28 migraine headache (MH), and 38 headache-free control subjects (CNT) were compared on measures of anger, depression, and use of various coping strategies. Affective and coping measures, recorded during a headache-free period, were regressed on headache activity measured in a daily diary over the following 2 weeks. Relationships between anger, depression, and coping were also examined in each of the headache groups. RESULTS: The MH subjects were found to use less effective coping strategies than controls and CTH, while the CTH group had higher levels on depression and various anger scales compared to controls and MH. Direct positive relationships were observed between suppressed anger and depression in the MH group, and between trait anger and depression in the CTH group. Anger and coping were predictive of headache activity in the following 2 weeks for both MH and CTH groups, while depression and coping, compared to coping only, were predictive of lifestyle interference from head pain in MH and CTH, respectively. CONCLUSION: The results support a relationship between affective and coping factors in headache activity and adjustment.

Adaptation, Psychological↗
PubMed2004

Life events, entrapments and arrested anger in depression.

OBJECTIVES: A recent, evolution derived theory of depression has suggested that aroused but arrested defences of fight (arrested anger) and flight (entrapments) may be important components of depression. This study therefore set out to explore unexpressed anger and entrapment in depression. The focus was on the nature of severe life events and difficulties, the time course of arrested defences, fantasies of escaping, fantasies of expressing anger, and reasons for not acting on emotions/behaviours. METHODS: Fifty diagnosed depressed people, being treated for depression, were interviewed using the Life Event and Difficulties Schedule (LEDS). They then completed five further questionnaires: the escape inhibition questionnaire; the reasons for not escaping questionnaire; the anger inhibition questionnaire; the reasons for not expressing anger questionnaire, and the Beck Depression Inventory. RESULTS: In regard to arrested flight, 88% of the group acknowledged strong desires to escape difficulties in their life but many felt unable to. Transcript analysis from the LEDS also indicated strong themes of entrapment. 38.7% felt trapped before becoming depressed. Fantasies of escaping were common, but making actual plans to get away less common. A variety of reasons were given for not escaping: In regard to arrested anger, 82% felt they suppressed their anger and 56% felt this problem predated their depression. A number of different reasons were given for not expressing anger. Despite self-blame often being seen as important to depression, we found that for many severe life events and difficulties patients did not blame themselves. Rather they blamed external circumstances or other people and saw these as the source of their entrapment. CONCLUSIONS: Disturbances in fight/flight mechanisms are common in depression. For some these may predate a depression and may play a causal role, whilst for others these experiences emerge with the depression. Depression is related to chronic stress states and clinical attention to disturbances in flight/flight may throw light on these states and offer novel approaches to intervention.

Adult↗
PubMed1998

Interactive effects of trait hostility and anger expression on cardiovascular reactivity in young men.

Hostility and anger-expression style are personality traits often associated with elevated cardiovascular reactivity and potential heightened risk for cardiovascular disease. In the present study a sample of 50 young, healthy men were divided into groups low or high on the Cook-Medley Hostility scale and on anger-out from Spielberger's Anger Expression scale. Subjects worked on mental arithmetic and public speaking tasks in counterbalanced order. Heart rate, systolic and diastolic blood pressure and hemodynamic indices were measured at baseline and during the tasks. Hostility and anger-out interacted in their effects on cardiovascular responses. The High Anger-Out/Low-Hostile group displayed the greatest increases in heart rate and blood pressures, while the High Anger-Out/High-Hostile group was least reactive. Furthermore, the High Anger-Out/Low-Hostile group showed a distinct fight/flight response pattern during public speaking, indicated by increases in stroke volume and cardiac output and a decrease in systemic vascular resistance. These results suggest that a mismatch between hostile cognitions and habitual anger expression leads to greater cardiovascular reactivity to challenging tasks, potentially enhancing risk for development of cardiovascular diseases.

Adult↗
PubMed2003

The association between anger expression and chronic pain intensity: evidence for partial mediation by endogenous opioid dysfunction.

Recent work suggests that an expressive anger management style (anger-out) is associated with elevated acute pain sensitivity due to endogenous opioid antinociceptive dysfunction. We tested the hypothesis that this opioid dysfunction mediates the previously reported positive association between anger-out and chronic pain intensity. To assess endogenous opioid antinociception in the laboratory, 71 subjects with chronic low back pain received opioid blockade (8 mg naloxone i.v.) or placebo in counterbalanced order in separate sessions. During each, subjects participated in a 1-min finger pressure pain task followed by an ischemic forearm pain task, providing acute pain ratings on the McGill Pain Questionnaire-Short Form (MPQ) immediately following each task. Subjects also completed a 7-day chronic pain diary based on the MPQ between laboratory sessions. To index opioid antinociceptive function, blockade effects were derived, subtracting placebo from blockade condition pain ratings. Greater anger-out was associated with both smaller blockade effects (suggesting impaired opioid antinociception) and greater chronic pain intensity, and blockade effects were inversely associated with chronic pain intensity. Sequential hierarchical regressions suggested that opioid dysfunction partially mediates the positive association between anger-out and total MPQ chronic pain intensity. Inclusion of blockade effects in the first step of the regression resulted in a decrease from 7 to 3% in chronic pain variance accounted for by anger-out. Opioid dysfunction did not mediate the positive association between anger-in and chronic pain. These results provide preliminary support for the hypothesis that the positive association between anger expression and chronic pain intensity is mediated by opioid antinociceptive system dysfunction.

Adult↗