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PubMed1982

Habitual anger-coping styles: I. Effect on mean blood pressure and risk for essential hypertension.

In this study we examined the effect(s) of race, sex socioecological stress, and habitual anger-coping systolic/diastolic blood pressure levels and risk for being classified hypotensive. A total of 495 black/white males and 511 black/white females, residing in high/low stress areas of Detroit, were classified in terms of high, medium, and low levels of anger expression to various provocative interpersonal situations. Results indicated that: 1) race and anger expression were major determinants of diastolic pressure; 2) race and sex influence systolic pressure; 3) anger expression was related to systolic pressure, but only for female respondents; 4) all four behavioral factors were independently related to one's relative risk of being labeled hypertensive; and 5) the odds of being hypertensive by a multiple 1.56 with the addition of each behavioral risk factor. These findings extended our understanding of both the important role played by sociodemographic factors and socioecological niche in predisposing humans to vascular disease and the magnitude of difference in mean blood pressure and risk for hypertension attributable to chronic suppressed anger. The present finding also provide a basis for identifying subgroups of individuals who are especially at risk for hypertension and, similarly, a basis on which to calculate the amount of potential therapeutic benefit resulting from attempts at modifying one or more risk factors.

Adaptation, Psychological↗
PubMedDate not supplied

Occupational stress, suppressed anger, and hypertension.

The present study examined the modifying effect of suppressed anger on the relationship between job stress and hypertension. The study population consisted of a random sample of male hourly workers, aged 40-63 years, employed at one of two plants in the metropolitan Pittsburgh, Pennsylvania area. Those men currently taking antihypertensive medication were excluded from the analyses. With both plants combined, stratified analyses indicated that, compared to men who do not habitually suppress their anger, hypertension was more strongly associated with self-reports of an uncertain job future and dissatisfaction with coworkers and promotions among men who suppress their anger. Using logistic regression procedures, these interactions between suppressed anger and job stress significantly predicted hypertension status, controlling for age, body mass index, smoking, alcohol consumption, and family history of hypertension. These findings suggest that a coping-related characteristic such as anger expression may be an important modifier of the relationship between job stress and hypertension.

Adaptation, Psychological↗
PubMedDate not supplied

Suppressed anger and blood pressure: the effects of race, sex, social class, obesity, and age.

We studied 572 men and women who participated in a blood pressure screening program at a government unemployment office. Before having their blood pressures taken, the subjects completed a brief questionnaire that included two items measuring conflict over anger expression. Information was also obtained on obesity, race, sex, social class, and age. Across all subjects, systolic blood pressure was found to be significantly related to suppressed anger (p less than 0.016). Normotensive were twice as likely as hypertensives to be free of suppressed anger. This relationship remained after controlling for the covariates of age, social class, and obesity. The relationship between suppressed anger and systolic blood pressure was significant for white men, exhibited a trend in black men, and was not significant for women. In contrast to the systolic findings, suppressed anger was unrelated to diastolic pressure in all the analyses.

Adult↗
PubMedDate not supplied

Job strain and anger expression predict early morning elevations in salivary cortisol.

OBJECTIVE: The objectives of this study were to test the hypothesis that high job demands and low job control (job strain) are associated with elevated free cortisol levels early in the working day and with reduced variability across the day and to evaluate the contribution of anger expression to this pattern. METHODS: One hundred five school teachers (41 men and 64 women) classified 12 months earlier as high (N = 48) or low (N = 57) in job strain according to the demand/control model sampled saliva at 2-hour intervals from 8:00 to 8:30 hours to 22:00 to 22:30 hours on a working day. Anger expression was assessed with the Speilberger State-Trait Anger Expression Inventory, and negative affect was also measured. RESULTS: Free cortisol was significantly elevated at 8:00 to 8:30 hours in the high job strain group but not at later times of the day or evening. After adjustment for age and negative affect, cortisol was an average of 21.7% higher early in the working day in the high job strain group. This effect was significantly greater in high job strain teachers, who also reported high anger-out. The cortisol decline from morning to evening was greater in the high than low job strain individuals. Independently of job strain, women had a higher cortisol concentration at 8:00 to 8:30 hours than men, whereas cortisol concentration was greater in men than women in the middle of the working day between 12:00 and 16:30 hours. CONCLUSIONS: Job strain is associated with elevated free cortisol concentrations early in the working day but not with reduced cortisol variability. The interaction with outward anger expression suggests that individual characteristics modulate the impact of chronic work stress on the hypothalamic-pituitary-adrenocortical system.

Adult↗
PubMed2002

The influence of trait anger on the alcohol-aggression relation in men and women.

BACKGROUND: The purpose of this study was to investigate the influence of trait anger on alcohol-related aggression in men and women. METHODS: Subjects were 204 healthy social drinkers (111 men and 93 women) between 21 and 35 years of age. Trait anger was measured using the Spielberger Trait Anger Scale. After the consumption of either an alcohol or a placebo beverage, subjects were tested on a modified version of the Taylor Aggression Paradigm in which mild electric shocks were received from and administered to a fictitious opponent during a competitive task. Aggressive behavior was operationalized as the shock intensities administered to the fictitious opponent under conditions of low and high provocation. RESULTS: Of all of the variables, provocation was the strongest elicitor of aggression. Overall, anger was positively related to aggression for all subjects. However, the central finding of this study was that alcohol was more likely to increase aggression for persons, particularly men, with higher, as opposed to lower, levels of trait anger. CONCLUSIONS: The results show that alcohol consumption does not increase aggression for all persons and in all situations. A continuing goal for future research in this area is to identify which individual difference and which contextual factors are most important in determining who will and who will not behave in an aggressive manner when intoxicated.

Adult↗
PubMed2007

Anger in palliative care: a clinical approach.

Anger in patients and families is a common problem in the care of persons with advanced disease. Whereas it is widely accepted that anger may be a justifiable reaction to significant illness and loss, it frequently creates difficulties for the doctors involved in care. In particular, there is often a personal impact on the doctor at whom anger is directed. This paper examines results of qualitative research with palliative care workers in the context of the broader published literature and the authors' clinical experiences. The ability to interact effectively with angry patients is a skill that is often learned with experience and is extremely useful in both transforming the patients' reaction into a more creative emotion and in developing a therapeutic relationship. Despite conscientious efforts, however, a few patients continue to be angry. A practical approach to anger, useful for the clinician directly involved in care, is outlined along with some strategies to adopt in the face of persistent anger.

Adaptation, Psychological↗
PubMed1995

Anger, depression, and disability: a path analysis of relationships in a sample of chronic posttraumatic headache patients.

Anger and depression are common affective concomitants of chronic headache. Previous research suggests that the affective component of headache may contribute to the patient's perceptions of the degree to which the headache is disabling. The present study examined the relationship between anger expression, anger suppression, depression, and headache-related disability (interference with function) in a sample of chronic posttraumatic headache patients. A path analytic model indicated a direct relationship between depression and perceived disability. Anger suppression and anger expression each had a direct influence on depression, but their effects on disability were mediated through depression. The results partially replicate a previous path analytic study of the relationships among these variables in a chronic headache sample.

Adolescent↗
PubMedDate not supplied

Teaching healthy anger management.

TOPIC: Teaching anger management in the community. PURPOSE: To describe anger management and offer guidelines for assessing potential participants and teaching healthy behaviors. SOURCES: Drawing from the literature, more than 10 years of quantitative and qualitative studies by our research team, and 5 years of experience in conducting anger management groups, the author presents basic principles of teaching anger management. A model is described for a 4-week group for women. CONCLUSIONS: Anger management has wide applicability to a variety of constituencies for both primary and secondary prevention. Advanced practice psychiatric nurses are well-qualified to provide this psychoeducational intervention.

Anger↗
PubMedDate not supplied

Channeling nurses' anger into positive interventions.

Nurses are angry, and with good reason, but few seem to be proficient in anger management. Work-related experiences of anger were vividly described by female registered nurses (Smith, Droppleman, & Thomas, 1996) and male registered nurses (Brooks, Thomas, & Droppleman, 1996) in phenomenological interviews. The roots of the anger were found in the system and the interpersonal and intrapsychic elements of nursing. In this article the authors outline strategies to address system and interpersonal sources of anger provocations, and describe positive interventions that can reduce the intrapsychic characteristics that fuel personal anger.

Adaptation, Psychological↗
PubMedDate not supplied

Behavioral and emotional disturbances in the offspring of depressed parents with anger attacks.

BACKGROUND: To examine the emotional and behavioral characteristics of the offspring of depressed parents with and without anger attacks. METHODS: Forty-three parents who met criteria for major depressive disorder (MDD) completed the Achenbach Child Behavior Checklist - Parent Report Version (CBCL) for each of their birth children (n = 58, age range 6-17 years). Unpaired t tests were used to evaluate the CBCL scale score differences between children of parents with and children of parents without anger attacks. Baseline demographics and clinical differences between the two groups of parents were also evaluated. RESULTS: Parents with anger attacks had a significantly younger age of onset of MDD. Offspring of depressed parents with anger attacks were found to have significantly lower social and school competency scale scores and higher scores for delinquency, attention problems, and aggressive behavior. In addition, this group was found to have a significantly higher total T score (a global measure of psychopathology). CONCLUSIONS: There are some important differences between offspring of depressed parents with and without anger attacks. This finding may be important in identifying and formulating intervention strategies for childhood problems in the offspring of depressed parents.

Achievement↗
PubMed2004

Relevance of anger and irritability in outpatients with major depressive disorder.

INTRODUCTION: Current psychiatric classification systems underestimate the part played by anger and aggressiveness in unipolar depression. This study was designed to assess the relevance of anger, irritability, aggressiveness, hostility, and psychomotor activation in major depressive disorder. METHODS: A total of 222 newly admitted consecutive outpatients with major depressive disorder (mean age 48.9 years, 64.4% females) were enrolled in the study. They had no comorbid axis I or II DSM-IV disorder, and they received no treatment with antidepressants in the preceding 2 months. They were assessed with the SVARAD, a validated scale for the rapid assessment of the main psychopathological dimensions. Principal component analysis was performed on SVARAD items. RESULTS: We obtained a three-factor solution accounting for 47.4% of total variance. The factors were interpreted as 'anger/irritability', 'depression', and 'anxiety', respectively. The anger/irritability dimension was clinically relevant in 23% of patients. Anger/aggressiveness was especially frequent (21.6%), whereas psychomotor activation was infrequent (0.9%). DISCUSSION: In depressive disorders, there are psychopathological dimensions other than depressed mood and anxiety that deserve greater clinical recognition and research. Our study suggests that one of these symptom clusters includes anger, irritability, aggressiveness, and hostility. The relevance of this dimension was not related to concurrent pharmacological treatment. Misdiagnosis of bipolar II disorder is also unlikely to explain our findings. Possibly, personality factors might at least partly explain the occurrence of anger and aggressiveness in several depressed patients. Attachment theory suggests that anger might also be conceived as part of the protest-despair-detachment reaction to a loss, either actual or symbolic.

Adult↗
PubMed1992

Self-rated inhibited anger, somatization and depression.

In order to examine the relationship of self-rated inhibited anger to somatization, the authors administered several self-rating scales, including the SCL-90 and a Likert scale pertaining to inhibited anger, to psychiatric patients and family practice patients of both sexes. In a linear stepwise regression, depression predicted inhibited anger in all four groups. Previous studies have reported an association of inhibited anger and somatization; the present study suggests that depression is the link between the two in the majority of patients. The relationship of inhibited anger to depression may have implications for psychotherapy.

Adolescent↗
PubMed1996

Alexithymia, anger, and interpersonal behavior.

BACKGROUND: We explored the relationship between alexithymia and interpersonal behavior, particularly the expression of anger. METHODS: Ninety-eight college students completed the Toronto Alexithymia Scale. A median split was used to divide participants into a low-alexithymia and a high-alexithymia group. The experimenter intentionally engaged in a series of anger-provoking behaviors. RESULTS: Compared to individuals in the low-alexithymia group, individuals in the high-alexithymia group were more interpersonally avoidant and exhibited more nonverbal anger, yet there was a trend for them to describe their lab experience as more pleasant. Among individuals in the high-alexithymia group, the different measures of anger and interpersonal behavior were less strongly associated than they were among individuals in the low-alexithymia group. CONCLUSIONS: The results provide evidence of a complex association between alexithymia and anger, and of the lack of coherence in the communication of individuals with high levels of alexithymia.

Adolescent↗
PubMed1993

Do anger and aggression affect carotid atherosclerosis?

BACKGROUND AND PURPOSE: Although a number of metabolic and psychosocial factors have been identified as coronary risk factors, no studies have evaluated the relation between personality and cerebrovascular disease. The purpose of the present study was to elucidate the relation between the characteristics of anger or aggression and the severity of carotid atherosclerosis on the basis of the findings of B-mode ultrasonography. METHODS: The Cornell Medical Index was used to measure anger in 34 patients with signs of atherosclerosis or at least one of four recognized risk factors for atherosclerosis (hypertension, hypercholesterolemia, diabetes mellitus, and cigarette smoking). The Rosenzweig Picture Frustration Study and Yatabe-Guilford Personality Test were used to evaluate aggression. High-resolution B-mode ultrasonography was performed, and the severity of carotid atherosclerosis was determined by plaque score. The occurrence of risk factors for carotid atherosclerosis was compared among the patients. RESULTS: The correlation of plaque score with one item that endorses anger was r = .65 (P < .01) and with "extrapersistive" in aggression was r = .50 (P < .01). Multivariate analysis identified significant correlations between plaque score and age, hypercholesterolemia, and anger. CONCLUSIONS: Our results suggest that anger and, perhaps, aggression may be risk factors for cerebrovascular disease.

Aggression↗
PubMed1977

Anger provocation as a crisis intervention technique.

The author describes the use of anger provocation, a technique that encourages patients to express their repressed anger to a therapist who makes himself the target for their anger. He presents five case examples to illustrate the positive effects of the technique in crisis and emergency situations. Three of the patients were depressed and withdrawn, one was suffering from conversion hysteria, and one was a paranoid schizophrenic. The author cautions that the technique must be used with discretion only in those cases where the repression of anger is producing major incapacitating symptomatology, but where the anger is not the major source of disorganization.

Abreaction↗
PubMed2005

Why do fear and anger look the way they do? Form and social function in facial expressions.

The origins of the appearances of anger and fear facial expressions are not well understood. The authors tested the hypothesis that such origins might lie in the expressions' resemblance to, respectively, mature and babyish faces in three studies. In Study 1, faces expressing anger and fear were judged to physically resemble mature and babyish faces. Study 2 indicated that characteristics associated specifically with babyishness are attributed to persons showing fear, whereas characteristics associated with maturity are attributed to persons showing anger. In Study 3, composite faces were used to minimize the possibility that the attributions were based on associations to the anger and fear emotions alone rather than to the physical resemblance of the expressions to static facial appearance cues. These results suggest that fear and anger expressions may serve socially adaptive purposes for those who show them, similar to the social adaptations associated with a babyish or mature facial appearance.

Adaptation, Psychological↗
PubMed2006

Anger and guilt about ingroup advantage explain the willingness for political action.

Three studies examined non-Aboriginal Australians' guilt and anger about their ingroup's advantage over structurally disadvantaged Aborigines. Study 1 showed that participants who perceived their ingroup as relatively advantaged perceived this inequality as unfair and felt guilt and anger about it. Anger, and to a lesser degree guilt, predicted the willingness to engage in political action regarding ingroup advantage. Study 2 showed both guilt and anger to be relatively self-focused because both were associated with appraising the ingroup's (rather than the government's) discrimination as responsible for ingroup advantage. Study 3 examined on participants especially willing to engage in political action to bring about systemic compensation to Aborigines. Anger about ingroup advantage was a potent predictor. Although guilt was associated with the abstract goal of systemic compensation, guilt did not explain willingness for political action. Results underline the importance of examining specific group-based emotions in intergroup relations.

Adolescent↗
PubMed2006

The meaning of anger for Australian Indigenous offenders: the significance of context.

The problem of overrepresentation of Indigenous offenders in Australian prisons highlights the need for effective tertiary intervention programs within correctional settings as a way of reducing Indigenous reincarceration. This study seeks to explore meanings of anger within an Indigenous context that might inform the development of more acceptable and potentially more effective rehabilitation programs. A methodology that acknowledges the importance of narrative, context, and culture was devised to explore how anger as an emotion is understood and experienced by a group of Indigenous men in a South Australian prison. Although some of the major themes reflected experiences of anger common to many offenders, it was evident that for these Indigenous men, anger was experienced within a broad social and political context that imbued the experience of anger with layers of culturally specific meaning. It is suggested that these layers of meaning constitute sufficient difference to warrant further exploration.

Adult↗