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Cardiovascular reactivity in anger-defensive individuals: the influence of task demands.

This study examined whether the elevated cardiovascular response to stressful stimuli previously suggested for individuals who are defensive in their reporting of anger might be moderated by the demands of the stressor task. Forty male undergraduates were exposed to four tasks: shock avoidance video game, handgrip, film, and cold pressor. Employing cluster analysis, defensive/low anger subjects were identified by high scores on the Marlowe-Crowne Social Desirability scale and low scores on the Spielberger Anger Expression and Trait Anger questionnaires. These individuals exhibited elevated heart rate and systolic blood pressure responses as compared with other subjects, but only to the shock avoidance task. Defensive/low anger subjects also reported less state anger to all tasks. It is proposed that an anger defensive style results in elevated cardiovascular activity only in interaction with stressors that elicit a sympathetic nervous system response and/or involve evaluation threat.

Adult↗

Anger inhibition potentiates the association of high end-tidal CO2 with blood pressure in women.

OBJECTIVE: High resting end-tidal CO2 (PetCO2) has been shown to be an independent predictor of systolic blood pressure (SBP) in women, particularly older women. The study reported in this article investigated whether the tendency to experience, express, and/or suppress anger contributes to the association of PetCO2 and SBP in women and in men. METHODS: The Spielberger Anger Expression Inventory was administered to 403 healthy male and female participants in the Baltimore Longitudinal Study on Aging. Resting PetCO2 was obtained by means of a respiratory gas monitor, and resting blood pressure was obtained with an oscillometric device. The associations of resting PetCO2 and the anger scales with SBP and diastolic blood pressure (DBP) were investigated using multivariate regression analyses. RESULTS: PetCO2, as well as age and body mass index, was an independent predictor of SBP in women with low, but not high, trait anger and in women with low, but not high, anger-out. PetCO2 was not an independent predictor of SBP in men with either high or low anger. In addition, PetCO2 was not an independent predictor of DBP in either men or women. CONCLUSIONS: The results of this study indicate that inhibition of anger potentiates the relationship of high PetCO2 with SBP in women but not men. Additional studies are needed to determine the origins of the observed gender differences and the psychophysiological pathways by which high resting PetCO2 contributes to elevated resting blood pressure in women.

Adult↗

Effects of perceived racism and anger inhibition on ambulatory blood pressure in African Americans.

OBJECTIVE: Hypertension is more prevalent in African Americans compared with Americans of European descent. Preliminary evidence indicates that perceived racism may play a role in elevated blood pressure in African Americans. The present study examined whether perceived racism was associated with higher ambulatory blood pressure measured during daily life. A potential contributing role for anger inhibition was also evaluated. METHODS: Twenty-four-hour ABP was obtained from 69 African American men and women with normal or mildly elevated blood pressure. ABP was averaged over waking and sleep periods, and clinic BP was also assessed. Perceived racism and anger expression were measured using self-report questionnaires. RESULTS: Greater perceived racism was related to higher ABP during waking hours for SBP (p <.01) and DBP (p <.05). Perceived racism was positively correlated with anger inhibition (r =.29, p <.05) but was not related to outwardly expressed anger (r =.01, NS). Anger inhibition was related to higher sleep DBP (p =.05) and a smaller drop in DBP from day to night (p <.05). Anger inhibition did not account for the relationship between perceived racism and blood pressure. CONCLUSIONS: Perceived racism and anger inhibition are independently related to higher ABP. Both may contribute to the incidence of hypertension and hypertensive-related diseases observed in African Americans.

Adult↗

Coping with background anger in early childhood.

Normative patterns, individual styles, and developmental changes in coping with background anger (anger between others) were examined in preschoolers. Live models expressed verbalized anger toward each other while pairs of same-sex friends played in an adjacent room. 85 4- and 5-year-olds participated, playing took place in the presence of mothers, and a 7-episode sequence of background conditions (no emotion, positive, no emotion, anger, no emotion, positive, no emotion) described the experimental situation. Children were also interviewed concerning their feelings during others' anger. Preschoolers evidenced heightened arousal, that is, greater distress, social sharing, preoccupation, and positive affect, concurrent with exposure to background anger. Increased verbal aggressiveness in play occurred in the period following exposure. Coping styles initially identified from behavioral emotional responses to the adults' quarrel were further delineated by contrasts on other aspects of functioning. Concerned emotional responders (46%) showed negative emotions concurrent with exposure, and later reported that they had felt sad during the fight and wanted to intervene. Unresponsive children (15%) showed no evidence of emotion, but later reported that they were angry. Ambivalent responders (35%) showed high emotional arousal during exposure, typified by both positive and negative emotions. Later they reported feeling happy but disregulated and were most likely to become physically and verbally aggressive in play with a friend. Analyses on a subsample (N = 43) also seen as toddlers showed that responses to background anger changed markedly, but precursors of preschoolers' coping styles were evident in toddlers' behavioral responses.

Adaptation, Psychological↗

Adolescent anger: a developmental study.

This research examined adolescent anger in a cohort of adolescents measured twice, once during the freshman year and again in the senior year of high school. Anger was measured by the Anger Index, a questionnaire developed by Siegel (1984). The purpose of the research was to determine if adolescent anger changed over time and if there were gender differences. Results of the study indicated that anger scores appeared to be stable over time for both boys and girls. There were gender and time differences on individual responses for several items, indicating that certain dimensions of anger may differ over time and by gender. It also appeared possible that the interpretation of certain questions on the anger index was different for the adolescents at the two time intervals.

Adolescent↗

Childhood anger: so common, yet so misunderstood.

PURPOSE: To review findings of recent research studies on anger in children and adolescents, the outcomes of mishandled anger and interventions to promote appropriate anger management. SOURCE: Published literature. CONCLUSIONS: Anger may be a healthy or unhealthy response in children experiencing small frustrations or great injustices. Research findings vary and there is a need to clearly define anger and the correlates of anger in children and adolescents. In addition, there are limited studies on anger management strategies and their effectiveness that would assist healthcare professionals.

Adaptation, Psychological↗

The association between trait anger and incident stroke risk: the Atherosclerosis Risk in Communities (ARIC) Study.

BACKGROUND AND PURPOSE: This study examined the relation between trait anger and incident stroke risk among participants without a history of stroke at the first follow-up examination of the Atherosclerosis Risk in Communities (ARIC) study. METHODS: The study sample included 13 851 black and white men and women, aged 48 to 67 years, who completed the Spielberger Trait Anger Scale. Median follow-up time was 77.3 months. RESULTS: In the full cohort, Cox proportional hazards regression analyses showed a modest increase in the risk for stroke among individuals with high trait anger, though the association did not remain statistically significant after multivariate adjustment. Participants < or =60 years of age who reported having high trait anger had a 2.82 (95% CI, 1.65 to 4.80) times greater risk for hemorrhagic and ischemic strokes combined (any) and a 2.93 (95% CI, 1.64 to 5.22) times greater risk for ischemic strokes alone than their counterparts who reported having low trait anger (hazard rate ratios adjusted for sex and race/ethnicity). Similarly, among participants with HDL cholesterol levels >47, the risk for any stroke was 2.86 (95% CI, 1.56 to 5.25) times greater for those who reported having high trait anger, whereas the risk for ischemic strokes alone was 2.98 (95% CI, 1.58 to 5.61) times greater (hazard rate ratios adjusted for age, sex, and race/ethnicity). These associations remained strong and statistically significant after further adjustment for several established biological and sociodemographic risk factors for stroke and were absent among older participants and those with lower HDL cholesterol values. CONCLUSIONS: Trait anger was associated with an increased risk for incident stroke in the ARIC study among younger participants and those with higher HDL cholesterol levels.

Age Factors↗

Influence of family therapy on bullying behaviour, cortisol secretion, anger, and quality of life in bullying male adolescents: A randomized, prospective, controlled study.

OBJECTIVE: To determine the influence of brief strategic family therapy (BSFT) on salivary cortisol, anger, and health-related quality of life (QoL) in adolescent boys with bullying behaviour. METHOD: We selected a sample of 72 boys demonstrating bullying behaviour from the general population and treated 36 with BSFT for 12 weeks. The other 36 boys formed the control group. Primary outcome measures were salivary cortisol concentration 15 to 30 minutes after awakening and changes on the subscales of the State-Trait Anger Expression Inventory (STAXI) and the Health Survey (SF-36). RESULTS: After 12 weeks' treatment, we observed a significant reduction in bullying behaviour in the BSFT group (P = 0.017) and in the mean values (according to the intent-to-treat principle) for salivary cortisol concentration (P < 0.001). The BSFT group also showed significantly greater change on the STAXI subscales State-Anger (P < 0.001), Trait-Anger (P < 0.001), Anger-Out (P < 0.001), and Anger-Control (P < 0.001). Treatment with BSFT also resulted in significant improvement on the SF-36 subscales for Vitality (P < 0.001), Social Functioning (P < 0.001), Role-Emotional (P < 0.001), and Mental Health (P < 0.001). CONCLUSIONS: BSFT effectively influenced bullying behaviour, salivary cortisol concentration, anger, and health-related QoL in adolescent bullying boys.

Adolescent↗

The relationship of anger and social skills to psychological symptoms.

The link between anger, social skills, and psychological symptoms was investigated in a college population. Seven hundred and nine individuals were administered the State Trait Anger Expression Inventory, the Anger Inventory, the Social Problem Solving Inventory, the Social Skills Inventory, and a series of questions about the degree to which anger affected their lives. Symptomatology was measured by the Brief Symptom Inventory and served as the criterion measure for a series of multiple regression analyses. Results indicated that both anger and social factors related to measures of psychological distress. Implications of the relationship between anger, social skills, and psychological symptoms are discussed in terms of research and assessment of individuals who may suffer from anger problems.

Adult↗

Driving anger and other driving-related behaviors in high and low ADHD symptom college students.

This study examined differences between college students with high and low symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD). Fifty-nine introductory psychology students completed ADHD diagnostic measures and were compared on measures of driving anger and driving anger expression; accident-related, aggressive, and risky driving behaviors; general anger; and general anger expression. Results indicated high ADHD symptom college students experience more driving anger, display such anger in more hostile/aggressive ways, are more aggressive and risky on the road, experience more crash-related outcomes, are more generally angry, and tend to display anger in socially unacceptable ways. Results are discussed in regard to the understanding and treatment of ADHD.

Adolescent↗

Association of anger proneness, depression and low social support with peripheral arterial disease: the Atherosclerosis Risk in Communities Study.

There is mounting evidence to suggest that psychosocial factors, including anger proneness, depression and social isolation, are risk factors for cardiovascular disease. Nevertheless, evidence relating these factors to peripheral arterial disease (PAD) and intermittent claudication remains sparse. Using data from the Atherosclerosis Risk in Communities Study, we analyzed the relationship of psychosocial variables (Spielberger anger score, depression score from the Maastricht questionnaire, and a perceived social support scale) at study visit 2 with incident PAD (ankle-brachial index < or = 0.9; a hospital discharge diagnosis of PAD, leg amputation, or leg revascularization procedures; or intermittent claudication). In 12,965 middle-aged adults with no prior history of PAD, 854 developed PAD over a mean follow-up time of 9.7 years, yielding an incidence rate of 6.8 per 1000 person years. A modest, monotonic dose-response, positive association between anger proneness and incident PAD was observed in a multivariable model: relative risk (RR) = 1.15 (95% confidence interval (CI) 0.99-1.38) in the moderate anger group and RR = 1.38 (95% CI 1.08-1.76) in the high anger group, compared with the low anger group. When compared with a low level of depressive symptoms, moderate and high levels of depressive symptoms were also associated with greater incident PAD, with multi-variable RRs of 1.20 (95% CI 0.99-1.45) and 1.44 (95% CI 1.19-1.74) respectively. There was no association of perceived level of social support with the occurrence of PAD. Anger proneness and depressive symptoms may be associated with the occurrence of PAD, as for other atherosclerotic syndromes. These findings may warrant confirmation in further studies and, if causal, could serve as a unique target for a PAD prevention trial.

Anger↗

Individual cognitive-behavioural anger treatment for people with mild-borderline intellectual disabilities and histories of aggression: a controlled trial.

OBJECTIVES: Anger is a significant predictor and activator of violent behaviour in patients living in institutional settings. There is some evidence for the value of cognitive-behavioural treatments for anger problems with people with intellectual disabilities. In this study, a newly designed treatment targeted at anger disposition, reactivity, and control was provided to intellectually disabled offenders with aggression histories living in secure settings. DESIGN: About forty detained patients with mild-borderline intellectual disabilities and histories of serious aggression were allocated to specially modified cognitive-behavioural anger treatment (AT group) or to routine care waiting-list control (RC group) conditions. METHODS: AT group participants received 18 sessions of individual treatment. The AT and RC groups were assessed simultaneously at 4 time points: screen, pre- and post-treatment, and at 4-month follow-up using a range of self- and staff-rated anger measures. The effectiveness of the treatment was evaluated using ANCOVA linear trend analyses of group differences on the main outcome measures. RESULTS: The AT group's self-reported anger scores on a number of measures were significantly lower following treatment, compared with the RC wait-list condition, and these improvements were maintained at follow-up. Limited evidence for the effectiveness of treatment was provided by staffs' ratings of patient behaviour post-treatment. CONCLUSIONS: Detained men with mild-moderate intellectual disabilities and histories of severe aggression can successfully engage in, and benefit from, an intensive individual cognitive-behavioural anger treatment that also appears to have beneficial systemic effects.

Adult↗

Anger and sports participation.

This study investigated differences between 19 varsity and 20 intramural male football players in trait anger, anger expression, and sports orientation. While varsity athletes reported comparable levels of trait anger, they described significantly less internalized (anger in) and externalized anger (anger out) than intramural athletes. Also, the varsity athletes reported significantly less anger control. Significant differences were also found for competitiveness and goal orientation, but not win orientation, such that the varsity athletes were more competitive and goal-oriented than the intramural athletes. The implications of these findings are discussed in terms of several alternative hypotheses.

Adolescent↗

Development of a driving anger scale.

A cluster analysis of responses from more than 1500 college students to 53 potentially angering driving-related situations yielded a 33-item driving anger scale (alpha reliability = .90) with six reliable subscales involving hostile gestures, illegal driving, police presence, slow driving, discourtesy, and traffic obstructions. Subscales all correlated positively, suggesting a general dimension of driving anger as well as anger related to specific driving-related situations. Men were more angered by police presence and slow driving whereas women were more angered by illegal behavior and traffic obstructions, but differences compensated so there were no gender differences on total score. A 14-item short form (alpha reliability = .80) was developed from scores more highly correlated (r = .95) with scores on the long form. Driving anger may have potential value for research on accident prevention and health psychology.

Accidents, Traffic↗

Anger and drug addiction.

Differences in the experience, expression, and control of anger were evaluated for young-adult drug addicts and a control group (matched in age, residence, and education) of nondrug users from Southern Italy. The Italian adaptation of Spielberger's State- Trait Anger Expression Inventory (STAXI) was administered with standard instructions to both groups. Drug abusers had significantly higher scores on the STAXI State and Trait scales, the Trait-Angry Temperament and Reaction sub-scales, and the Anger-Out and Total Anger Expression scales, and significantly lower scores on Anger-Control. These findings indicate that the drug abusers experienced anger more often than the nonusers, were more likely to express anger toward other persons or objects in the environment, and had less control of their angry feelings.

Adult↗

Vocal expression of anger and cardiovascular reactivity within dyadic interactions.

This experiment was conducted to examine whether the vocal expression of anger correlated with cardiovascular reactivity within dyadic interactions. Participants selected three social issues on which they had a strong opinion and, with a confederate who opposed their views, debated these opinions in each of the three vocal styles. The three vocal styles were (1) Anger-out during which they described their view in a loud, fast voice, (2) Mood-incongruent during which they described their view in a soft, slow voice, and (3) Anger-in during which they listened to the confederate oppose their view and only responded from a list of neutral phrases given to them. Cardiovascular reactivity measures (heart rate and blood pressure) were taken during the initial baseline and the three expression of anger conditions. Both the anger-out and mood-incongruent vocal styles significantly correlated with systolic blood pressure and heart-rate reactivity measures. The disparity between the results of this experiment and previous ones on anger and cardiovascular response may be related to differences in the method of anger-arousal (memory-evoked versus dyadic interactions). Results are discussed in terms of similarities to active and passive coping and defensiveness.

Adult↗

Relation of the tendency to feel anger and postanger reappraisals.

The present study was designed to identify defensive reappraisals by analyzing their relations to changes in an interpersonal situation following expression of anger and reappraisals as well as to identify the characteristics of people who use defensive reappraisals. Japanese undergraduate students (N= 229) responded to a questionnaire on how they express anger in daily life. Analysis indicated the group who reported a lower tendency to feel anger (the Low group) reported reappraisals such that Damage to Self was less severe, and Instigator's Responsibility was smaller than that for the group who reported a higher tendency (the High group), which suggested that people who tend to feel less anger use reappraisals to reduce their anger after expression more than those who tend to feel more anger. Moreover, the amount of variance in Reappraisals accounted for by Changes in Interpersonal Situation was small in the Low group (R2=.06) compared to that for the High group (R2=.48), so people who tend to feel less anger seem to use defensive reappraisals.

Anger↗

The relationship of anger expression and alexithymia with coronary artery stenosis in patients with coronary artery diseases.

This study examined the relationship between anger expression or alexithymia and coronary artery stenosis in patients with coronary artery diseases. 143 patients with coronary artery diseases (104 males and 39 females) were enrolled in this study. The severity of their coronary artery stenosis was measured by angiography. The Anger Expression Scale and the Toronto Alexithymia Scale were used to assess the level of anger expression and alexithymia. The more stenotic group (occluded by 75% or more) exhibited a significantly higher level of alexithymia than the less stenotic group (occluded by less than 25%). Multiple regression analysis on the extent of stenosis also revealed that regardless of gender and age, the coronary artery disease patients with higher alexithymia were likely to show a greater level of stenosis. However, no significant differences were found on either the anger-in or anger-out subscale scores between the two groups. These results suggest that alexithymia is associated with the severity of coronary artery stenosis in patients with coronary artery disease. However, both anger expression and anger suppression were not shown to be associated with the severity of coronary artery stenosis.

Adult↗