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Anger, anxiety, guilt and increased basal and stress-induced neurogenic tone: causes or effects in primary hypertension?

1. Basal plasma and spinal fluid noradrenaline were increased in patients with primary hypertension and phaeochromocytoma compared with normotensive patients (P less than 0.01). 2. Patients with primary hypertension had more anger (P less than 0.01), anxiety (P less than 0.01) and guilt (P less than 0.05) than normotensive patients or patients with phaeochromocytoma. 3. The responses of noradrenaline and adrenaline concentrations were similar after mental and isometric stress in primary hypertensive and normotensive subjects. 4. However, after mental stress and isometric exercise there were increased responses of plasma noradrenaline and systolic blood pressure respectively, in patients with high anxiety and anger compared with those below the 50th percentile (P less than 0.05). 5. Increased central and peripheral neurogenic tone at rest and after stress in association with increased anxiety and suppressed anger appear to be pathogenic factors in some patients with primary hypertension and may not be a result of the blood pressure elevation.

Adrenal Gland Neoplasms↗

Nurses' responses to patient anger: from disconnecting to connecting.

Caring for angry patients can be a threatening experience. Grounded theory research was used to explore female nurses' reactions and feelings as the recipients of patient anger. The data were collected by interviewing nine female registered nurses in two hospitals in south-western Nova Scotia. The participants were asked to discuss their feelings and responses to an intense encounter with an angry patient. Anger was defined as a multi-dimensional concept with negative cogitations. The concept of self-efficacy emerged as the major area of concern for the participants. The findings suggest that when the threat to self was high, nurses managed anger situations by disconnecting from the angry patient. Low or controllable threats were generally managed by connecting with the angry patient.

Adaptation, Psychological↗

Perception of genuine and masking smiles in children and adults: sensitivity to traces of anger.

The authors examined children's and adults' sensitivity to traces of anger in masking smiles by presenting participants with short video excerpts of smiles that differed by the intensity of an anger component. Fifty-two children, aged 6 to 12 years, and 26 adults were asked to judge whether a stimulus person was really happy or pretending to be happy. Six- and 7-year-old children were found to be sensitive to traces of anger, but less so than older children and adults. Researchers found evidence of explicit knowledge of the emotion hidden in masking smiles only in adult participants.

Adult↗

It's not because I'm fat: perceived overweight and anger avoidance in marriage.

Employed married Israeli women responded to questions about their perceived weight, their husbands' evaluation of their appearance, and their expression of anger in marriage. Our data, based on 125 questionnaires and five in-depth interviews, supports the possibility that women who perceive themselves as overweight, that is, "fail" to live up to the standards of female beauty in society, often suppress their anger and express it in limited areas. Our findings suggest that women who have not been able to resist the appearance-directed normative imperative in the constitution of their feminine self have to work harder to meet gender norms that require "emotion work" in the form of anger avoidance.

Adult↗

Women's anger and its meanings: a phenomenological perspective.

This study focused on the interactions of somatizations, thoughts, and social processes evolving from unrecognized, unexpressed, or repressed anger in women. Material from patients' clinical narratives was phenomenologically described and interpreted. The most critical finding was the transformation of anger as lived by women into socially acceptable pathology. Anger was left in silence, and the possibilities for its expression were found in physiological disorders, substance abuse, self-deprecation, and affiliation problems, among other conditions.

Adaptation, Psychological↗

Comparison of movement-to-music, rhythm activities, and competitive games on depression, stress, anxiety, and anger of females in substance abuse rehabilitation.

Over the past several decades the number of females using addictive substances has continuously increased. Females have different reasons for initiating substance abuse and specific treatment needs that differ from males. Researchers suggested gender specific drug rehabilitation treatment, in which female clients developed or improved functional behaviors. The purpose of this study was to investigate the effects of 3 different types of music therapy interventions on levels of depression, stress, anxiety, and anger of female clients in substance abuse rehabilitation. Ten females in an outpatient substance abuse rehabilitation program participated twice a week for 6 weeks in a music therapy program, participating in movement-to-music activities, rhythm activities, and competitive games for 2 weeks, 4 sessions each. After each intervention state-trait anxiety and levels of anger were measured. A repeated-measures ANOVA indicated no significant differences for the three types of music therapy interventions; however, data collected on daily scores, immediately before and after each session, indicated that individuals reported a decrease in depression, stress, anxiety, and anger immediately following the music therapy sessions.

Adult↗

Effect of fluoxetine on anger in symptomatic volunteers with borderline personality disorder.

Clinical data and uncontrolled observations have suggested that fluoxetine is helpful in some patients with borderline personality disorder. This article describes the results of a 13-week double-blind study of volunteer subjects with mild to moderately severe borderline personality disorder. Thirteen fluoxetine recipients and nine placebo recipients received treatment. Pretreatment and posttreatment measures were obtained for global mood and functioning, anger, and depression. The most striking finding from this study was a clinically and statistically significant decrease in anger among the fluoxetine recipients. This decrease was independent of changes in depression. These data support previous observations that fluoxetine may reduce anger in patients with borderline personality disorder. The number of subjects in this study was small, the placebo responsiveness was high, and the clinical characteristics of the patients were in the mild to moderate range of severity. The data cannot be extrapolated to more severely ill borderline patients, but further study of fluoxetine and other selective serotonin reuptake inhibitors is indicated in this population.

Adult↗

Self-ratings of anger and hostility in borderline personality disorder.

Forty-six patients with borderline personality disorder with and without major depression and 27 normal volunteers completed the Buss-Durkee Hostility Inventory, a self-rating scale of anger and hostility. The patients with borderline personality had significantly higher scores than the normal volunteers. The scores of the patients with borderline personality disorders were not related to gender, treatment or research setting, the degree of acute distress, or the presence of major depression. These findings suggest that a proneness to anger and hostility are enduring characteristics of borderline personality disorder and that anger and depression may represent independent clinical conditions with independent biological mechanisms regulating these two affective states.

Adult↗

Cardiovascular differentiation of happiness, sadness, anger, and fear following imagery and exercise.

This study examined cardiovascular patterns following happiness, sadness, anger, fear, relaxation, and control imagery in 32 subjects while they were seated and while they exercised. Affective imagery was an effective strategy for inducing reliable patterns of systolic and diastolic blood pressure and heart rate associated with particular emotional states. Anger, rather than fear, produced the greatest overall increases in cardiovascular measures and was distinctly opposite from relaxation. Anger differed from fear and all other conditions in terms of greater increases in diastolic pressure following imagery and greater increases in heart rate and slower recovery of systolic pressure following exercise. Sadness was unique in that systolic pressure and heart rate were virtually as high when subjects were still as when they were actually moving. Furthermore, sadness was the one emotional state that seemed to interfere with the cardiovascular adjustments normally associated with exercise. Implications of these findings for current biobehavioral models of emotion, including the role that specific emotions may play in the pathogenesis and treatment of cardiovascular disease, are considered.

Anger↗

Under the volcano: varieties of anger and their transformation.

This paper seeks to illustrate the ambiguity of the affect of 'anger' which masks a number of subtly different emotions observable in clinical work. The author differentiates between anger, rage and hatred in terms of the dialectical relationship between ego and self and pays particular attention to why it is that for some patients, experiences of anger may be harnessed creatively into development, whereas for others, they remain self destructive. Using illustrations from work with two patients in analysis, the author describes how a persistent grievance originating in the earliest stages of life is linked with hatred and can lead to a defensive self structure. It is suggested that the clues to the presence of a grievance and to its potential transformation are likely to be observable first in the analyst's countertransference in the form of an all-embracing emotional strait jacket. Analysts' capacity to tolerate their own hatred is crucial to the transformation of a patient's grievance.

Aggression↗

A three-factor model of trait anger: dimensions of affect, behavior, and cognition.

The structure of trait anger was tested in a study of 24 self-report scales. Exploratory factor analyses in an undergraduate sample (N = 457) yielded a two-factor model (comprising cynicism and aggression) and a three-factor model (representing angry emotions, aggressive behaviors, and cynicism). Subsequent evaluations, including confirmatory factor analyses, indicated that the three-factor model provided the best characterization of the trait anger domain. The three-factor solution was consistent with an "ABC" conceptualization of trait anger, consisting of the dimensions of affect, behavior, and cognition. The three factors showed strikingly different associations with the Big Five personality traits. Angry Affect was most strongly related to Neuroticism, whereas Behavioral Aggression was associated with low Agreeableness. Cynical Cognition represented a blend of neurotic and disagreeable characteristics. Modest mean-level differences were observed between the genders for each factor.

Adolescent↗

Observational, physiological, and self-report measures of children's anger: relations to reactive versus proactive aggression.

The goal of this study was to examine the relations of reactive versus proactive aggression to children's anger, as assessed using observational, physiological, and self-report measures. Anger was hypothesized to be related to reactive aggression, but not to proactive aggression. Children (N = 272 second-grade boys and girls) participated in a procedure in which they lost a board game and prize to a confederate who cheated. Skin conductance reactivity and heart rate reactivity were measured throughout the procedure. Following the interaction, children viewed a videotape of the game and self-reported on their level of anger after each turn of the game. Observational coding of children's angry facial expressions and angry nonverbal behaviors was conducted. Reactive aggression, but not proactive aggression, was positively related to skin conductance reactivity and angry nonverbal behaviors, both at an aggregated level and in terms of rate of increase over the time span of the game.

Aggression↗

Comparison of hemodynamic responses to social and nonsocial stress: evaluation of an anger interview.

Hemodynamic responses to an anger interview and cognitive and physical stressors were compared, and the stability of associated hemodynamic reactions examined. Participants experienced control, handgrip, counting, and mental arithmetic tests and an anger interview on two occasions. Systolic and diastolic blood pressure, heart rate, stroke volume, and cardiac output were measured. Total peripheral resistance was also derived. The anger interview produced larger, more sustained changes in blood pressure in both sessions than the other stressors. These changes were largely a consequence of increased peripheral resistance. Consistent with previous findings, handgrip was associated with a resistance-type reaction whereas arithmetic was associated with a cardiac output-type reaction. There was low-to-modest stability of hemodynamic reactions to the interview. Further research is necessary to optimize its utility in studies of cardiovascular function. Nevertheless, the findings underscore the ability of ecologically relevant stressors to provoke unique configurations of cardiovascular activity.

Adult↗

Feelings of anger among caregivers of patients with Alzheimer's disease.

The purpose of this article is to examine the caregiver's feelings of anger, the causes of these feelings as described by the caregivers and their reactions. Twenty female caregivers of Alzheimer's disease patients participated in a support group at a psychogeriatric centre for 3 years. The group was directed by a registered nurse and a social worker. Frequently, anger was raised as a major issue in the caregiving. The group directors constructed two models that emerged from the support group's meetings. The first model showed the sources of the anger felt by the caregivers and the second model showed coping strategies. The caregivers said that the most infuriating behaviours of patients Alzheimer's disease were: aggressive behaviour, sleeplessness and verbal or behavioural repetition. The caregiver's reactions to the two models are discussed in this paper together with their feelings, which expressed by the women in their own words.

Adaptation, Psychological↗

Children's beliefs about strategies to reduce parental anger.

Age and sex differences in beliefs about strategies for reducing parental anger were assessed. The central question was whether direct intervention strategies are the most effective for, and reflect more advanced understanding of, anger reduction. In Study 1, 120 children ages 4-9 years generated strategies they believed would lessen a parent's anger elicited by 3 situations of increasing complexity. Across ages children proposed direct intervention strategies for the simplest situation, and there was an age increase in suggesting direct intervention strategies for the more complex situations. In Study 2, 180 children, ages 4-12 years, and their parents rated the effectiveness of the strategies generated for the most complex situation (interparental argument). There was no longer a unilinear age increase in believing direct intervention strategies effective. Unlike with older and younger children, there was no agreement between 7-9-year-olds and their parents on the efficacy of direct intervention strategies.

Age Factors↗

Background verbal and physical anger: a comparison of children's responses to adult-adult and adult-child arguments.

Children's responses to adult-child conflict were examined and compared to their responses to adult-adult conflict. These responses were further analyzed in relation to 2 forms of anger expression: verbal and physical. 6-7- and 9-10-year-olds were interviewed after viewing videotaped segments of angry arguments. Although children were distressed by both adult-child and adult-adult conflict, the participants in conflict and form of anger expression moderated some of their responses. In adult-child conflict, children were more scared in response to physical versus verbal arguments. For verbal arguments, some children felt both more scared and mad during adult-adult conflict in comparison to adult-child conflict; however, the percentage of children reporting fear and anger was small. Intervention in conflict through siding with one party occurred more frequently in adult-child conflict versus adult-adult conflict. Responses were further moderated by the age and gender of the subject.

Adult↗

Anger, perceived control and school behavior among students with learning problems.

With regard to students with learning problems, findings indicate that the more severe the learning problem, the greater the tendency toward anger in response to conflicts at school. The relationship between learning problem severity and perceptions of control at school was not significant, but anger was negatively correlated to perceived control. None of the variables were significantly related to misbehavior. A stepwise regression analysis indicated perceived control as the most potent single variable accounting for the variance in anger scores. Overall, findings highlight implications for work focused on reactions to learning problems and factors associated with their cause and correction.

Adolescent↗

Aggression, social cognitions, anger and sadness in bullies and victims.

BACKGROUND: The present study aimed to investigate children's social information processing (SIP) and emotions in the bullying situation, taking into account reactive and proactive aggression. More specifically, we investigated the way in which children interpret social information, which goals they select, how they evaluate their responses and which emotions they express in hypothetical situations. METHOD: The participants comprised 242 Dutch children (120 girls and 122 boys; mean age: 117.2 months), who were assigned by means of peer nominations (Salmivalli, Lagerspetz, et al., 1996) to one of the following roles: bully (n=21), follower of the bully (n=38), victim (n=35), defender of the victim (n=48), outsider (n=52) and not involved (n=32). Sixteen children (including 3 bully/victims) were not given any role. The reactive and proactive aggression scale (Dodge, & Coie, 1987) was filled out by teachers in order to test the association between these types of aggression and involvement in bullying. Children were presented with ambiguous scenarios and responded to questions about attribution of intent, goal selection and emotions (anger and sadness). In addition, two questionnaires were administered to children: one assessed perceived self-efficacy in performing aggression, inhibiting aggression and using verbal persuasion skills, and the other assessed expected outcomes from behaving aggressively or prosocially. RESULTS: Results showed that while reactive aggression was common in bullies and victims, proactive aggression was only characteristic of bullies. Both bullies and victims, compared to the other children, scored higher on hostile interpretation, anger, retaliation and ease of aggression. Bullies and followers claimed that it was easy for them to use verbal persuasion, while victims turned out to be the saddest group. All children, irrespective of their role in the peer group, thought that aggressive as well as prosocial behavior was more likely to produce desired results from a friendly peer than from an aggressive one. CONCLUSIONS: Bullies and victims seem to be similar in reactive aggression, SIP, and in the expression of anger, but the motivations which lead to their behavior may be different, as well as the final outcomes of their acts.

Aggression↗