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PubMed1993

Anger suppression: its relationship to beta-adrenergic receptor sensitivity and stress-induced changes in blood pressure.

While studies from diverse fields of research suggest a relationship between problems expressing anger and cardiovascular illness, few studies have provided a potential pathophysiological link of such a relationship. Forty-five males were classified according to one of three anger expression categories: those who did not suppress their anger (N = 13), those who partially suppressed their anger (N = 19), and those who definitely suppressed their anger (N = 13). For each, we determined lymphocyte beta-adrenergic receptor function and blood pressure responsiveness to a standardized mathematics stressor. Those subjects who routinely suppressed their expression of anger had increased beta-adrenergic receptor sensitivity (P = 0.01) (isoproterenol-stimulated cyclic AMP production) and a greater systolic blood pressure response to the stressor (P = 0.001). Anger suppression was unrelated to the subject's age, weight, or socioeconomic status. These findings may be germane to prior clinical and epidemiologic observations relating anger expression and cardiovascular illness.

Adaptation, Psychological↗
PubMed1997

Social determinants of experienced anger.

We investigated two social determinants (i.e., availability of social support and status differentials of the provocateur) for the degree of perceived anger in two populations. Because no suitable tool was available, the conceptual and psychometric development and validation of a new vignette-based measure for anger level (STandardized Experience of Anger Measure, STEAM) is described first. Two versions of STEAM were developed: one for students and one for community-living adults. Through a series of four studies, two sets of a 12-item vignette-based questionnaire were developed and validated. The resulting test had excellent test-retest stability and high internal consistency. Using the new STEAM measure, a variety of analyses were conducted to test the hypothesized influence of social determinants of anger. In the student sample, presence of social support was associated with lessened anger, and in both samples decreasing status of the provocateur also led to lessened anger arousal. In addition, findings in both samples revealed that social support reduced anger when the provocateur was of higher status relative to situations of equal and lesser status. In the community sample, the availability of support was associated with greater intensity of the anger experience in the lesser status condition than in the equal or greater status condition. No gender main effects or interactions were noted.

Adolescent↗
PubMed1994

Fuzzy concepts in a fuzzy hierarchy: varieties of anger.

This article argues that the concept of anger is not well characterized from the classical perspective. Instead, its membership is graded, its borders are fuzzy, and its subcategories fail to form a true class-inclusion hierarchy. Ss rated potential anger subcategories (fury, jealousy, annoyance, etc.) and remembered instances of their own anger as varying in degree of membership in anger. Degree of membership (prototypicality) predicted each subcategory's availability from memory given the category name, reaction time to verify its status as a subcategory, and its substitutability within naturally generated sentences about anger. Two predictions of a true class-inclusion hierarchy failed: that Ss would agree in adjudicating the membership of potential subcategories of anger and that all instances of a subcategory of anger would also be instances of anger. As an alternative to the classical view, emotion concepts are hypothesized to vary in their degree of breadth and overlap and to be mentally represented as scripts that allow different instantiations in different contexts.

Anger↗
PubMed1995

Relationship of trait anger to resting blood pressure: a meta-analysis.

A series of meta-analyses were conducted to assess whether anger is related to essential hypertension. The present review also considered the relevance of the distinction between anger experience and anger expression, the effect of participant selection bias, and the white-coat hypertension effect for the anger-blood pressure (BP) association. Anger experience was correlated with elevated BP, but the relationship was small and highly variable. When positive effects emerged, both participant selection and the reliability of BP measurement posed interpretational problems. Persons high in anger are not merely exhibiting elevated BP in response to testing, so a white-coat effect is not evident. Being labeled as hypertensive may contribute to higher anger scores, however. The review suggests lines of future research concerning associations between trait anger and blood pressure.

Anger↗
PubMed1989

Relationship of racial stressors to blood pressure responses and anger expression in black college students.

The physiological effects of racism, as a stressor, were examined as they related to blood pressure (BP) and anger experiences in Black college students. Current research has failed to consider the stressful effects of racism as a factor contributing to the higher incidence of essential hypertension among Blacks. Twenty-seven Black college students viewed three excerpts showing racist situations involving Blacks; anger-provoking, nonracist situations; and neutral situations. After each scene, BP was taken, and a mood checklist was administered. The Framingham Anger Scale and the Anger Expression Scale were administered. Analyses revealed that BP significantly increased during the presentation of racist stimuli but not of anger-provoking or neutral stimuli. Self-reports of state anger, as measured by the mood checklist, were significant for both the anger-provoking and racist stimuli. BP scores were significantly correlated to the two trait anger measures. Exposure to racist stimuli was associated with BP increases among Blacks. Such cumulative exposure to racism may have important implications for the etiology of essential hypertension.

Adaptation, Psychological↗
PubMed1999

Nicotine reduces the frequency of anger reports in smokers and nonsmokers with high but not low hostility: an ambulatory study.

Two studies were conducted to determine the anger-attenuating effects of nicotine as a function of trait hostility. The 1st study examined the effects of nicotine on diary ratings of anger during a 24-hr period in a natural setting in 30 smokers and 30 nonsmokers. Participants took part in 2 monitoring sessions involving the administration of a nicotine patch and a placebo patch. Participants were categorized as high or low on trait hostility on the basis of their scores on the Cook-Medley Hostility scale. Administration of the nicotine patch, compared with the placebo patch, resulted in a significant reduction in diary reports of anger from 24% to 13% in high-hostile participants. In low-hostile participants, nicotine had no effect on reports of anger during the day. The anger-palliative effects of nicotine were greatest among participants more frequently reporting anger on the placebo-patch day. These effects were independent of smoking status and gender. The 2nd study, which was restricted to high-hostile smokers (n = 19) and nonsmokers (n = 23), found that, compared with a placebo patch, administration of nicotine resulted in significant reductions in reports of anger in smokers and nonsmokers. The results of these 2 studies clearly link nicotine to reduced reports of anger in high-hostile individuals.

Administration, Cutaneous↗
PubMed2006

Anger, hostility, and posttraumatic stress disorder in trauma-exposed adults: a meta-analysis.

This meta-analysis synthesizes the available data on the strength of association between anger and posttraumatic stress disorder (PTSD) and between hostility and PTSD, covering 39 studies with trauma-exposed adults. Effect sizes did not differ for anger and hostility, which could therefore be combined; effect sizes for anger expression variables were analyzed separately. The analyses revealed large effects. The weighted mean effect size (r) was .48 for anger-hostility, .29 for anger out, .53 for anger in, and -.44 for anger control. Moderator analyses were conducted for anger-hostility, showing that effect sizes were substantially larger with increasing time since the event and that effect sizes were larger in samples with military war experience than in samples that had experienced other types of traumatic events.

Adult↗
PubMedDate not supplied

Anger and parent-to-child aggression in mood and anxiety disorders.

The relationship between anger and parent-to-child aggression (PTCA) was examined in mothers presenting for treatment of mood and anxiety disorders, because parental anger may have adverse effects on children and anger may decrease with treatment. Anger's role as mediator and moderator of the effects of the following predictors on PTCA was assessed: depression, anxiety, and ecologic variables that can induce or buffer against stress (partner verbal aggression, satisfaction with and perceived availability of social support, socioeconomic status, and number of children). Anger was found to mediate the effects of depression, partner verbal aggression, satisfaction with social support, and number of children on PTCA. Anger also had significant effects on PTCA after controlling for these variables. The other predictors did not have effects on PTCA, and anger did not moderate their effects. If replicated, these findings suggest the importance of examining whether treatment to reduce parental anger will reduce PTCA.

Adult↗
PubMedDate not supplied

Adolescent blood pressure, anger expression and hostility: possible links with body fat.

An uncertain relation between health and angry/hostile behaviour exists in the literature on adolescents. With data from a pilot study, one possible reason for this is explored: health measures such as blood pressure as well as angry/hostile behaviours may change with, or depend upon physical maturity, body size and body fatness. The sample consists of 60 African-, Hispanic-, and Anglo-American adolescents (15 to 16 years of age) drawn from a public school in Houston, TX. Using resting diastolic blood pressure as a model, in a sex stratified analysis, the following conclusions were reached: Physical maturity in girls and body height in boys were related to ethnicity in the sample and were confounders of the blood pressure and anger relationship. In girls secretive anger ('anger-in') and hostility were associated with increased body fat; expressive anger ('anger-out') in boys is associated with increased conicity (central body fat distribution) (p < 0.01). These associations were independent of height and physical maturity. Hostility was not significantly related to diastolic blood pressure in boys after adjusting for height and conicity. 'Anger-in' was significantly and positively related to diastolic blood pressure in girls (p < 0.01). This relationship was strongly mediated by per cent body fat, because the association of 'anger-in' and blood pressure was no longer statistically significant when the model included body fat. The results suggest that measures of physical maturity and more refined measures of body fat and body fat distribution should be considered in studies attempting to link adolescent blood pressure with anger expression.

Adolescent↗
PubMed2004

What's the use in getting mad? Anger and instrumentality in women's relationships.

In two studies, we examined women's anger expression and its instrumental function in relationships by addressing the following questions: What is the relationship between women's self-reports of instrumentality and their perceived styles of anger expression? In what ways and situations do women see their anger expression as instrumental or goal enhancing? In Study I, we expected that women's perceived styles of anger expression would be positively related to instrumentality, as measured with the Personal Attributes Questionnaire (PAQ; Spence, Helmreich, & Stapp, JSAS Catalog of Selected Documents in Psychology, 4, 43, 1974). Although our hypothesis was not supported, a positive relationship did emerge between assertiveness and instrumentality, as predicted. In Study II, we conducted three focus group discussions to elucidate women's experiences of anger and to provide clarification for the results of Study I. We identified group themes related to when women experienced their anger expression as instrumental as well as when women perceived themselves as noninstrumental in anger-arousing situations. In their narratives, women explained how they make decisions about expressing their anger based on relationship concerns.

Adaptation, Psychological↗
PubMed1995

Characteristics of anger expression in depressed children.

OBJECTIVES: To examine anger expression styles in depressed and nondepressed children and to investigate whether the relation between depression and anger expression was mediated by family variables. METHOD: From a sample of 100 psychiatric inpatient children, 11 depressed children and 11 matched nondepressed psychiatric controls were compared on two self-report measures, the Pediatric Anger Expression Style and the Family Adaptability and Cohesion Evaluation Scales-III-K. RESULTS: Depressed children reported significantly more difficulty maintaining cognitive control of their anger than did nondepressed children who were psychiatric inpatients. Family cohesion and adaptability were not found to have an effect on this relationship. No significant differences were found with respect to the tendency to deny or suppress anger or the tendency to express anger aggressively. CONCLUSIONS: Depressed children experienced more difficulties expressing their anger using a controlled/cognitive style than nondepressed (externalizing) children. The lack of a mediating role of family variables suggests that anger expression styles may be more related to the characteristics of depression in children, a finding that has clinical implications for addressing treatment of depressed children.

Anger↗
PubMedDate not supplied

An empirical test of alternate theories of anger in early adolescents.

BACKGROUND: Anger is an especially important phenomenon to understand in early adolescents. While many explanatory theories of state anger can be applied to early adolescents, few, if any, researchers have attempted to test these theories in this age group. OBJECTIVE: To test three theories explaining state anger vis-a-vis each other using hierarchical analysis of sets. METHOD: This was a theory-testing study with a complex correlational design. A total of 141 adolescents aged 12 to 14 years responded to the State Anger Scale and instruments measuring variables linked to stress theory (perceived stress and primary appraisal), differential emotion theory (depression and state anxiety), and trait theory (trait anger and hostility), that were randomly ordered across instrument packets. RESULTS: Using hierarchical analysis of sets, the results indicated that the sets of variables used to test all three theories explained a statistically significant proportion of variance in state anger when entered first in the analysis. Comparatively, the trait theory variables explained more variance in state anger when entered first (41%) in the analysis than did the emotion theory variables when entered first (31%) in the analysis or the stress theory variables when entered first (21%) in the analysis. CONCLUSIONS: The stress theory, the differential emotion theory, and the trait theory all provided theoretically sound and relevant explanations of state anger for early adolescents. However, the trait theory provided the most powerful explanation.

Adolescent↗
PubMedDate not supplied

Anger suppression and adiposity modulate association between ADRB2 haplotype and cardiovascular stress reactivity.

OBJECTIVES: The purpose of this study was to examine how variation in the beta-2 adrenergic receptor gene (ADRB2), in combination with the moderating influences of race, body mass index (BMI), and anger expression style (anger-in, anger-out), affects blood pressure (BP) at rest and in response to acute laboratory stress. METHODS: Four hundred fifty adolescents (mean age = 18.5 +/- 2.7 years; 228 [124 males] whites and 222 [110 males] blacks completed two stressors (video game challenge, forehead cold pressor). Hemodynamic measures were taken before, during, and after each stressor. Stressors were separated by a 20-minute rest period. RESULTS: Frequency of detrimental haplotype (Gly16/Glu27) carrier status was greater among whites than blacks (p < .05). A significant three-way interaction among haplotype, BMI, and race for resting systolic blood pressure (SBP) found the highest BP level to be among high BMI carriers, but only for whites. A separate three-way interaction was found to be significant for haplotype, anger-in and race such that high anger-in carriers showed the highest level of resting SBP (p < .05) and total peripheral resistance (TPR) (p < .05) and the greatest TPR reactivity to the cold pressor task (p < .01). Post hoc analyses revealed these interactions with anger-in were only present among blacks. No significant interactions with anger-out for either ethnic group were observed. CONCLUSIONS: This study demonstrates modulating influences of BMI and anger expression styles on ADRB2 gene associations with hemodynamic function at rest and in response to laboratory stress. These findings support the hypothesis that consideration of gene-environment interactions may better characterize the role of ADRB2 variation in the development of stress-induced essential hypertension.

Adaptation, Psychological↗
PubMed2006

Trait anger and arterial stiffness: results from the Atherosclerosis Risk in Communities (ARIC) study.

The cross-sectional association between trait anger and stiffness of the left common carotid artery was examined in 10,285 black or white men or women, 48-67 years of age, from the Atherosclerosis Risk in Communities (ARIC) study cohort. Trait anger was assessed using the 10-item Spielberger Trait Anger Scale. Arterial stiffness was assessed by pulsatile arterial diameter change (PADC) derived from echo-tracking ultrasound methods; the smaller the PADC, the stiffer the common carotid artery. In men, trait anger was significantly associated with PADC, independent of the established cardiovascular disease risk factors (p=0.04). PADC decreased from the first (lowest anger group) to the second quintile of anger, but there was no progressive decrease thereafter. Also observed was a 13-microm (95% confidence interval [CI], 1-25) difference in the magnitude of PADC from the lowest to the uppermost quintile of anger (PADC [standard error], 421 [4] microm vs. 408 [5] microm). In women, the association was marginally significant (p=0.07). The low-high difference in the magnitude of PADC (PADC [standard error], 397 [3] microm vs. 406 [4] microm) was inverse (-9 microm 95% CI, -19 to 2). Conclusions indicate that very high trait anger is associated with arterial stiffness in men.

Aged↗
PubMedDate not supplied

The concept of anger: universal or culture specific?

I will suggest that the English word 'anger' and its counterparts in diverse languages of the world are based on concepts of anger that have a great deal of complexity. This conceptual complexity derives from several sources: (1) the metaphors and metonymies that apply to the concepts in various languages; (2) the prototypes of anger that people share in these cultures, and (3) the many different senses that the word anger and its counterparts have in different languages. We can ask: Are there any universal aspects of the concept(s) of anger? On the basis of linguistic evidence from English, Chinese, Japanese, Hungarian, Zulu and Wolof, I will suggest that there are, but I will also claim that some of the aspects are culture specific. This raises the further important question of why there is both universality and culture specificity in the conceptualization of this emotion. At stake is the issue of which of the following two contradictory claims is valid: (1) that anger is conceptualized in the same way universally, or (2) that anger is a social construction and thus varies considerably from culture to culture. I will propose a compromise view, which can be called 'body-based social constructionism', that enables us to see anger and its counterparts as both universal and culture specific.

Anger↗
PubMed2004

Anger and hostility predict the development of atrial fibrillation in men in the Framingham Offspring Study.

BACKGROUND: Conflicting findings in the literature with regard to the ability of type A behavior, expressions of anger, or hostility to predict incident coronary heart disease (CHD) have created controversy. In addition, there are no prospective studies relating these characteristics to the development of atrial fibrillation (AF). METHODS AND RESULTS: From 1984 to 1987, 3873 men and women, 18 to 77 years of age, participating in the Framingham Offspring Study, were examined and monitored for 10 years for the incidence of CHD, AF, and total mortality. Measures of type A behavior, anger, hostility, and risk factors for CHD and AF were collected at the baseline examination. After controlling for age, diabetes, hypertension, history of myocardial infarction, history of congestive heart failure, and valvular heart disease in Cox proportional hazards models, trait-anger (RR=1.1; 95% CI, 1.0 to 1.4; P=0.04), symptoms of anger (RR=1.2; 95% CI, 1.0 to 1.4; P=0.008), and hostility (RR=1.3; 95% CI, 1.1 to 1.5; P=0.003) were predictive of 10-year incidence of AF in men. After controlling for risk factors for CHD, none of the measures of anger, type A behavior, or hostility were related to incident CHD; however, trait-anger (RR=1.2; 95% CI, 1.1 to 1.4; P<0.01) was related to total mortality in men. None of the psychosocial variables were related to the 3 outcomes in women. CONCLUSIONS: This is the first study to examine and demonstrate a predictive relation between measures of anger and hostility to the development of AF in men. As opposed to type A behavior, measures of anger and hostility may be more productive avenues for research in studying the risk of arrhythmias and total mortality in men.

Adaptation, Psychological↗
PubMed1996

A prospective study of anger and coronary heart disease. The Normative Aging Study.

BACKGROUND: Recent laboratory and epidemiological studies have suggested that high levels of anger may increase the risk of coronary heart disease (CHD). METHODS AND RESULTS: We examined prospectively the relationship of anger to CHD incidence in the Veterans Administration Normative Aging Study, an ongoing cohort of older (mean age, 61 years) community-dwelling men. A total of 1305 men who were free of diagnosed CHD completed the revised Minnesota Multiphasic Personality Inventory (MMPI-2) in 1986. Subjects were categorized according to their responses to the MMPI-2 Anger Content Scale, which measures the degree to which individuals have problems controlling their anger. During an average of 7 years of follow-up, 110 cases of incident CHD occurred, including 30 cases of nonfatal myocardial infarction hostility. (MI), 20 cases of fatal CHD, and 60 cases of angina pectoris. Compared with men reporting the lowest levels of anger, the multivariate-adjusted relative risks among men reporting the highest levels of anger were 3.15 (95% confidence interval) [CI]: 0.94 to 10.5) for total CHD (nonfatal MI plus fatal CHD) and 2.66 (95% CI: 1.26 to 5.61) for combined incident coronary events including angina pectoris. A dose-response relation was found between level of anger and overall CHD risk (P for trend, .008). CONCLUSIONS: These data suggest that high levels of expressed anger may be a risk factor for CHD among older men.

Adrenergic beta-Antagonists↗
PubMed1995

The relationship between nurses' limit-setting styles and anger in psychiatric inpatients.

OBJECTIVE: Violence by patients in psychiatric settings is frequently associated with the quality of staff-patient interactions. Impulsivity has been identified as a high risk factor for anger and aggression. This study was designed to test the influence of nurses' limit-setting styles on anger among psychiatric inpatients grouped by high or low levels of impulsivity. METHODS: Ninety-seven patients with various diagnoses and either high or low levels of impulsivity participated in role-play scenarios in which nurse actors played out six limit-setting styles, ranging from belittlement to explanations of rules to empathy linked with a presentation of an alternative course of action. Patients' level of anger in response to the acted scenario was assessed using the Spielberger State-Trait Anger Scale. RESULTS: Patients' level of anger was highest in response to unempathic limit-setting styles, moderate for explanations, and lowest for empathic styles. Impulsive subjects were more likely to respond with anger than nonimpulsive patients, regardless of the limit-setting style. CONCLUSIONS: Although many current intervention programs focus on reducing patients' anger after it occurs, the study results suggest that it may be possible to prevent some of patients' anger by improving nurses' limit-setting styles.

Acting Out↗