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PubMedDate not supplied

The angry patient: an intervention for managing anger in substance abuse treatment.

Patients who have problems controlling anger and aggression can pose special problems for substance abuse treatment providers. Levels of anger and violence are higher in substance abusers than in the general population. Although anger management treatments have been studied extensively, few treatments have been developed and studied with substance abusers. In this article, we evaluated an anger management treatment based on Novaco's (1983) cognitive-behavioral stress inoculation procedures. The treatment was delivered as individual sessions and evaluated in a study of six substance abuse patients with a single-subject multiple-baseline design. Preliminary findings suggest that the treatment is effective for substance abuse patients and that this mode of treatment should be explored further.

Adult↗
PubMed2003

Anger behaviour among professionals in a Norwegian hospital: antecedents and consequences for interprofessional cooperation.

The article is an examination of anger behaviour among professionals in a Norwegian hospital, how it develops in the interaction that takes place between the health professionals and the consequences of anger behaviour on work cooperation. The data comes from an ethnographic study of a Norweigian urban hospital and was gathered through interviews, observations and existing documents that were made available. Anger behaviour, in particular from doctors, is a major stress factor in the work day of nurses and has a negative impact on their work environment and professional cooperation and may even reduce the quality of patient care. To a large extent anger behaviour may be understood as an expression of strained interpersonal relationship where contextual factors serve to lower the threshold for keeping such feelings private.

Anger↗
PubMed2004

Impaired recognition of anger following damage to the ventral striatum.

Comparative neuropsychology has identified a role for the ventral striatum (VS) in certain forms of aggression. To address whether the homologous region in humans also contributes to the emotion anger, we studied a case series of four human subjects with focal lesions affecting the VS. All four demonstrated a disproportionate impairment in recognizing human signals of aggression. By contrast, a control group of individuals with damage to more dorsal basal ganglia (BG) regions showed no evidence of an anger impairment. Our findings demonstrate that the VS makes a significant contribution to coding signals of aggression in humans, and emphasize the importance of an approach to human affective neuroscience based on cross-species homologies. The results are discussed in relation to the ventral striatal dopamine system's role in the pursuit of biological resources in general. We propose that the role of the VS in the recognition of human signals of anger may reflect a more general role in the coordination of behaviour relevant to the acquisition and protection of valued resources, including detection of signals of conspecific challenge (anger).

Adult↗
PubMed2002

Anxiety, depression and anger suppression in infertile couples: a controlled study.

BACKGROUND: Although several authors have suggested an important pathogenic role for psychosocial factors in 'functional' infertility, the extent to which depression, anxiety and expressed emotional patterns correlate to infertility is not yet clear. METHODS: This study included 156 infertile couples (recruited at intake) and 80 fertile couples, whose personal characteristics were recorded. They were examined using scales for the evaluation of the degree of psychopathology [Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D)], and anger expression [State-Trait Anger Expression Inventory (STAXI)]. The 156 infertile couples were then subdivided into groups based on the cause of infertility ('organic', 'functional' or 'undetermined'). The psychometric evaluation was double-blind with respect to the causes of infertility. RESULTS: Differences emerged in the degree of psychopathology between 'organic' and 'functional' infertile subjects and fertile controls. In women, logistic regression identified three variables able to predict the diagnosis subtype; these variables are HAM-A, HAM-D, and tendency toward anger suppression. In men, anger did not emerge as a predictor for diagnosis, whereas HAM-A and HAM-D did. CONCLUSIONS: The 'functional' infertile subjects of this sample showed particular psychopathological and psychological features, independent from the stress reaction following the identification of the cause of infertility.

Adult↗
PubMed1998

Negative mood regulation expectancies predict anger among police officers and buffer the effects of job stress.

This study investigated links between occupational stress, negative mood regulation expectancies, coping, anger, and distress. Participants were 56 police officers from two small, urban departments. They filled out the Negative Mood Regulation (NMR) Scale, as well as measures of police stress, coping, anger, and distress. Simultaneous multiple regression analyses revealed that high NMR expectancies predicted subjects' use of adaptive active coping strategies. High NMR Scale scores were also independently associated with lower levels of anger and distress, and anger significantly predicted distress. Results suggest that strong mood regulation expectancies buffer the effects of even high levels of occupational stress. Interventions directed toward raising mood regulation expectancies may help protect officers from the consequences of job stress. Results may also have implications for combat stress.

Adaptation, Psychological↗
PubMedDate not supplied

Women's anger: relationship of suppression to blood pressure.

The relationship of anger suppression to blood pressure was examined in a university sample of 210 female staff, faculty, and students 18 to 71 years of age. Most were White and in good or excellent health. The study replicated that of Goldstein et al. (1988) using their method of assessing anger frequency, intensity, and expression at work (or school) and home. With age, body mass index, family history of hypertension, and exercise controlled, higher systolic blood pressure and diastolic blood pressure were evident when women suppressed anger at home. Women who had grown up in families that readily showed anger were more likely to do so as adults.

Adolescent↗
PubMedDate not supplied

Components of Type A, hostility, and anger-in: relationship to angiographic findings.

Previous research has linked the Type A coronary-prone behavior pattern to angiographically documented severity of coronary atherosclerosis (CAD). The present study sought through component scoring of the Type A Structured Interview (SI) to determine what elements of the multidimensional Type A pattern are related to coronary disease severity in a selected group of patients with minimal or severe CAD. Multivariate analyses controlling for the major risk factors showed no relationship between global Type A and extent of disease. Of all attributes measured, only Potential for Hostility and Anger-In were significantly and positively associated with the disease severity, including angina symptoms and number of myocardial infarctions. Further analysis revealed that Potential for Hostility and Anger-In were interactive in their association, such that Potential for Hostility was associated with disease endpoints only for patients who were high on the Anger-In dimension. These findings support previous research in suggesting that anger and hostility may be the critical aspects of the Type A pattern in predisposing individuals to risk of CAD.

Anger↗
PubMedDate not supplied

The angry voice: its effects on the experience of anger and cardiovascular reactivity.

The results of two studies show that expressive vocal behavior, specifically, speech rate and loudness, influences the experience of anger and cardiovascular reactivity. In both studies, participants spoke about anger-arousing and neutral events using three different voice styles: fast and loud, slow and soft, and normal (personal rate and loudness level). In describing the anger-arousing events, both male and female participants reported feeling significantly more angry and showed significantly greater blood pressure and heart rate reactivity in the fast-loud compared with the normal speaking condition. They also reported feeling significantly less angry and showed significantly lower blood pressure reactivity in the slow-soft compared with the normal voice condition. For males only, the voice manipulation also had significant effects on the participants' anger self-ratings and cardiovascular responses during the neutral communications, but these effects were clearly weaker and less pervasive than those occurring during the angry communications. The results are discussed in terms of their implications for (1) the role of expressive vocal behavior in emotions, and (2) the modification of coronary-prone behavior.

Adult↗
PubMedDate not supplied

Do episodes of anger trigger myocardial infarction? A case-crossover analysis in the Stockholm Heart Epidemiology Program (SHEEP).

OBJECTIVE: Our objectives were to study anger as a trigger of acute myocardial infarction (MI) and to explore potential effect modification by usual behavioral patterns related to hostility. METHODS: This study was a case-crossover study within the Stockholm Heart Epidemiology Program. Exposure in the period immediately preceding MI was compared with exposure during a control period for each case. From April 1993 to December 1994, 699 patients admitted to coronary care units in Stockholm County were interviewed. RESULTS: During a period of 1 hour after an episode of anger, with an intensity of at least "very angry," the relative risk of MI was 9.0 (95% CI, 4.4-18.2). In patients with premonitory symptoms, the time of disease initiation may be misclassified. When restricting the analyses to those without such symptoms, the trigger risk was 15.7 (95% CI, 7.6-32.4). The possibility of examining effect modification was limited by a lack of statistical power (eight exposed cases). Results of the analyses suggested, however, an increased trigger effect among subjects reporting nonhostile usual behavior patterns, nonovert strategies of coping with aggressive situations (not protesting when being treated unfairly), and nonuse of beta-blockers. CONCLUSIONS: The hypothesis that anger may trigger MI is further supported, with an increased risk lasting for approximately 1 hour after an outburst of anger. It is suggested that the trigger risk may be modified by personal behavior patterns.

Adult↗
PubMed2004

Posttraumatic stress disorder, anger and hostility, and physical health status.

Accumulating evidence suggests that posttraumatic stress disorder (PTSD) is linked to both objective and subjective indices of poorer health. Less is known about processes that may explain this association. This study examined anger/hostility as a possible mediator and moderator of PTSD and health status among a sample of 134 medical patients. Participants completed a structured interview of PTSD and questionnaires assessing health perceptions and anger and data on physician-diagnosed illnesses were gathered from computerized databases. Trait anger and anger-in partially explained the association between PTSD and poorer general health perceptions. There was a significant association between anger-in and the presence of a circulatory disorder only in patients with PTSD.

Anger↗
PubMedDate not supplied

Relationships between hostility, anger expression, and blood pressure dipping in an ethnically diverse sample.

OBJECTIVE: The purpose of this study was to examine relationships between hostility, anger expression, and blood pressure (BP) dipping. METHODS: A 24-hour ambulatory BP was obtained from 34 African Americans and 52 white Americans who were enrolled in a study of sleep, stress, and BP. Self-report measures were used to assess anger expression and hostility. RESULTS: After controlling for body mass index and BP status, African Americans were more likely to be classified as nondippers than white Americans. However, when hostility and anger expression were included in the model, there was no longer a significant relationship between ethnicity and BP dipping. Irrespective of race, high levels of hostility and anger were associated with less nocturnal dipping. CONCLUSIONS: These findings suggest that psychological factors may be important in understanding ethnic differences in nocturnal BP decline.

Adult↗
PubMed2003

Self-pity: exploring the links to personality, control beliefs, and anger.

Self-pity is a frequent response to stressful events. So far, however, empirical research has paid only scant attention to this subject. The present article aims at exploring personality characteristics associated with individual differences in feeling sorry for oneself. Two studies with N = 141 and N = 161 university students were conducted, employing multidimensional measures of personality, control beliefs, anger, loneliness, and adult attachment. With respect to personality, results showed strong associations of self-pity with neuroticism, particularly with the depression facet. With respect to control beliefs, individuals high in self-pity showed generalized externality beliefs, seeing themselves as controlled by both chance and powerful others. With respect to anger expression, self-pity was primarily related to anger-in. Strong connections with anger rumination were also found. Furthermore, individuals high in self-pity reported emotional loneliness and ambivalent-worrisome attachments. Finally, in both studies, a strong correlation with gender was found, with women reporting more self-pity reactions to stress than men. Findings are discussed with respect to how they support, extend, and qualify the previous literature on self-pity, and directions for future empirical research are pointed out.

Adaptation, Psychological↗
PubMed2004

Anger and acne: implications for quality of life, patient satisfaction and clinical care.

BACKGROUND: Acne is a common skin disorder with a significant psychological and social impact for some people. Little is known about how personality and emotional traits affect acne and its impact on quality of life and treatment. Trait anger (TA), which is related to heart disease and other morbidities, may also affect acne and patients' adjustment to it. OBJECTIVES: To evaluate the relationship between TA and acne severity, skin-related quality of life, satisfaction with treatment, and adherence to treatment. PARTICIPANTS AND METHODS: A sample of 479 individuals with acne completed a survey instrument to assess acne severity, skin care practices, skin-related quality of life, satisfaction with treatment, adherence, TA and demographic variables. Respondents who reported high TA were compared with individuals with low TA on outcome variables. Regression analyses adjusted for covariates and identified the significant predictors of quality of life, satisfaction and adherence. RESULTS: High TA was unrelated to acne severity (P = 0.2) or frequency of face washing (P = 0.9). Anger was significantly related to both global quality of life (P < 0.001) and skin-related quality of life (P = 0.002) as well as to satisfaction with treatment (P = 0.001) and adherence to treatment advice (P = 0.05) in bivariate analyses. Regression analyses revealed that high TA remained a significant predictor of global (P < 0.001) and skin-related quality of life (P = 0.003) and satisfaction with treatment (P = 0.04), but not adherence to treatment advice (P = 0.8) after controlling for covariates. CONCLUSIONS: Anger is associated with the quality of patients' lives and with their satisfaction with treatment. Care of acne patients should include attention to anger and other chronic emotional states, quality of life, as well as to clinical severity. Simple guidelines are suggested for how clinicians might approach this important aspect of care.

Acne Vulgaris↗
PubMed1992

Anger, depression and self-concept in adults with mental retardation.

Self-report measures of anger, depression and self-concept that were designed for non-retarded children were adapted for adults with mental retardation. The measures were administered to 130 adults with mental retardation who lived in the community. Informants rated the subjects on shortened forms of the three emotional indices. Informant self-concept ratings were negatively correlated with ratings of anger and depression. On the self-report measures, subjects who reported low self-concept also reported high levels of depression. Mildly mentally retarded subjects were more likely to report anger than severe/moderately retarded subjects. Informant and self-report measures were significantly correlated for self-concept and depression, but not for anger. The results provide preliminary normative data on indices of emotional adjustment for community-based adults with mental retardation.

Activities of Daily Living↗
PubMed1995

Young children's understanding of the causes of anger and sadness.

This study investigated kindergarten children's understanding of the causes of anger and sadness. Previous research has shown that before 6 or 7 years of age, children have difficulty distinguishing hypothetical situations designed to evoke anger from those designed to evoke sadness. In this project, 80 kindergarten children (ages 5-1 to 6-5, M = 5-10) predicted and explained protagonists' emotional responses to a variety of hypothetical events. The results showed that intentional harm was not the feature young children used to distinguish anger from sadness. Children predicted anger most often when they believed that protagonists could change undesirable situations and reinstate their goals and when children focused on the person or conditions that brought about undesirable situations. Children predicted sadness most often when they believed that goal reinstatement was impossible and focused on the losses that would ensue as a result.

Affect↗
PubMed1984

Developmental changes in children's reactions to anger in the home.

Developmental trends in children's reactions to anger and affection between others in the home were examined. School-age children evidenced greater emotional self-control and more effective and planful strategies for attempting to alter the course of others' conflicts. Children's responses to anger appeared to be mediated by individual differences in emotionality, which evidenced continuity across settings and between age periods. However, there was evidence that experience could modify reaction patterns to anger. Boys become less likely than girls to react emotionally to affection as they got older, but otherwise there were no developmental changes in responding to affection. Continuity across settings in reacting to affection was also apparent, but there was no relationship between patterns of responding to anger and affection.

Adaptation, Psychological↗
PubMed1985

A test to measure the awareness and expression of anger.

The purpose of this project was to develop a reliable, objective and practical tool with which the awareness and expression of anger could be investigated. This paper gives a description of the Awareness and Expression of Anger Indicator (AEAI). The AEAI is a short and easy to use test. It provides a new objective assessment instrument of value in cases where deficits in affective processes, particularly anger, are suspected. 30 medical patients were tested with the AEAI. The investigators report a high inter-rater reliability in scoring the test. Four distinct response patterns emerged. Also, when confronted with the same anger-provoking stimulus, subjects responded significantly differently with respect to whether or not they felt angry, depending on the type of question. Traditional inducing questions, e.g.: Would you feel angry?, produced significantly more affirmative responses (reports of feeling angry) than non-inducing questions, e.g.: How would you feel? The contribution of the AEAI to chronic pain work is discussed.

Adolescent↗
PubMed1995

Dimensions of anger and hostility in cardiac patients, hypertensive patients, and controls.

Anger and hostility have long been considered important factors in the etiology of essential hypertension (EH) and coronary heart disease (CHD). This case-control study investigates the association of hostility, as measured by the Cook and Medley Hostility Scale (HO), and anger, as measured by the Multidimensional Anger Inventory (MAI), with CHD and EH in 80 CHD patients, 80 EH patients, and a control group of 80 healthy adults from Italy. Cases revealed significantly higher scores than controls in two subsets of HO and in two subscales of MAI. Some of these subscales appeared to be age-dependent. The results indicate that particular components of anger-hostility could be taken into consideration when studying psychological risk factors for CHD and EH.

Adult↗