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PubMed2002

Effects of alcohol and trait anger on physical aggression in men.

OBJECTIVE: According to recent theoretical models, the alcohol-aggression link is predicated on the interaction among many variables, including the drinker's personality. The few studies that investigated effects of personal dispositions on alcohol-related aggression have been inconclusive, possibly because the role of dispositions related to affect were largely ignored. As such, the purpose of this study was to investigate the interactive effect of alcohol and trait anger on physical aggression. METHOD: Participants were 136 male social drinkers who reported high, moderate, and low levels of trait anger and were nonrandomly assigned to an "alcohol" or "no-alcohol" control beverage group. Participants competed in an aggression paradigm in which electric shocks were received from and administered at will to a fictitious opponent during a competitive task. Shock intensity, duration, and proportion of highest shock served as indexes of aggression. RESULTS: Intoxicated participants with moderate trait anger selected higher shock intensity and had a greater proportion of highest shock, compared with their sober counterparts. Within the alcohol group, high- and moderate-anger participants were more aggressive than low-anger participants. Intoxicated participants selected longer shock durations following both low and high provocation, and they evinced a greater increase in shock duration from low to high provocation than their sober counterparts. Independent of beverage group, men who reported a high or moderate level of trait anger displayed more aggression on all measures, compared with those who reported low anger disposition. CONCLUSIONS: The present findings suggest that individuals who report low levels of trait anger may be more resistant to the potentiating effects of alcohol on aggression and that the effects of alcohol on aggression may be most pronounced in men who have a moderate level of trait anger. Furthermore, independent of intoxication, trait anger appears to be a risk factor for physical aggression in men.

Adolescent↗
PubMed1990

Correlates of the MMPI-2 anger content scale.

Scores on the MMPI-2 anger-content scale were correlated with those on Spielberger's anger expression scale, Zelin, et al.'s anger self-report scale, and the Cook and Medley hostility scale. Subjects were 32 men and 33 women in college. As expected, the anger-content scale correlated significantly with measures of anger awareness, anger expression (anger out versus anger in), and negatively with anger control. There was also a significant correlation with measures of hostility (projection of anger) for men.

Adult↗
PubMedDate not supplied

Anger expression and cardiovascular reactivity to mental stress: a spectral analysis approach.

The cardiovascular reactivation to a recently described videogame task i.e. a maze test was evaluated in the time and frequency-domain using finger blood pressure (BP) measurement in 25 subjects on no medication, including 6 subjects with mild hypertension. Prior to BP measures subjects completed the items of the State-Trait Anger Expression Inventory questionnaire corresponding to the trait anger and anger expression scales. The BP recording session was divided into resting, test and recovery periods. A detrending procedure was applied to each recording prior to the fast Fourier transform. Systolic BP (SBP) and heart rate (HR) were increased during the test. The mid-frequency (MF, 0.1 Hz) components of SBP and HR variability were also elevated during the stressful period. In resting conditions SBP levels of subjects with low trait anger was lower than in subjects with high trait anger (128 +/- 4 mmHg, n = 14 versus 148 +/- 4 mmHg, n = 11, P < 0.01, Student t test). Nevertheless the average SBP increase due to the stress was of similar magnitude in these two subgroups (14 mmHg). A significant negative relationship was observed between anger-out expression score and the MF SBP variation (r = 0.46, P < 0.05). A significant negative relation was found between anger-in mode of expression and the HR peak during the test (r = 0.43, P < 0.05). In conclusion, our data suggest that individuals who are often in anger-provoking situations (high trait anger) should have heightened BP. Two different patterns of cardiovascular responses (SBP variability and HR levels) were observed for the outward and inward mode of expression of anger. This may reflect a different psychological control of HR levels and BP variability.

Adult↗
PubMed2003

[Anger experience and the process of calming down].

This study investigated the affects and behaviors that accompany and follow anger episodes, and examined the relationship among them, in hope of developing self-regulated and effective methods of controlling anger. With an open-ended questionnaire, 42 anger episodes were collected and categorized. Results suggested that typical anger episodes were instigated by selfishness, insult, coercion, and trouble and a close person such as friends was often the cause and target of anger. Surprise and depression frequently accompanied it, and eight forms of response followed: rationalization, cause searching, aggression, social sharing, displacement to object, mood change, forgetfulness, and rumination. Another questionnaire examined the relationship among these variables, as well as trait anger, perception of malice, and sense of injury, with a sample of 118 undergraduates. Results indicated, first, that sense of injury was heightened by trait anger and malice perception. Second, anger and depression were evoked only by a sense of injury. Finally, while anger without depression evoked aggression, anger with depression led to mood change and forgetfulness.

Adult↗
PubMed1992

Anger management training for brain injured patients and their family members.

Anger dyscontrol is a common occurrence after brain injury. The anger problems of brain injured persons create a burden for their caretakers who most frequently are their family members. Two single-case design studies are presented that demonstrate the efficacy of behavioral interventions for the control of anger problems in brain injured adults. Anger control was accomplished by training the patients in skills to control their own anger, and teaching family members behavior modification principles. In each case, the patient was taught to implement a self-talk method to decrease tension during the escalation period of an anger episode and to execute a time-out when aware of increased anger. Family members were trained in ways to monitor such problems and to identify antecedents to an outburst. They were given feedback and suggestions to modify their communication style with the patient so as to reduce patient irritability, and were taught ways to use a verbal cue to remind the patient to use pretrained self-control methods. Patients and family members were also asked to increase the number of pleasant events in which they engaged as a general means to decrease the patients' anger outbursts. These cases showed evidence that the treatment program reduced the frequency of anger outbursts and, in one case, increased the social participation by the patient immediately after treatment and at one-month and three-month follow-up assessments. The importance of having key family members involved in anger management training for brain injured patients is underscored, particularly when cognitive impairment limits patients' ability to benefit from and to retain the content of psychotherapy.

Adult↗
PubMed1998

Anger in an inpatient treatment sample of chronic alcoholics.

Four measures of anger were investigated in sober male and female alcoholics and nonalcoholic peers. The relationships among anger variables, past drinking behavior, and substance abuse consequences in alcoholics were explored. Additionally, the interrelationships among anger, depression, and anxiety in the groups were examined, and the relationships between an overall dysphoria index and drinking behavior and substance abuse consequences were determined. 104 alcoholics (sober 21 to 45 days) and 70 community controls, aged 21 to 56, were given the Spielberger Anger Expression Inventory, the Beck Depression Inventory, and the Spielberger State Anxiety Inventory. Alcoholics scored higher than controls on Trait Anger, Anger-In, and Anger-Out, but not on State Anger. There were no main effects of sex. Anger-In was significantly negatively correlated with the Quantity-Frequency Index in alcoholic males. Anger-In was significantly positively correlated with depression in male and female alcoholics and with substance abuse consequences in the latter group. The depression measure was significantly correlated with consequences in female, but not in male alcoholics. These data have treatment implications, especially for female alcoholics.

Adult↗
PubMed2002

Anger in young men and subsequent premature cardiovascular disease: the precursors study.

BACKGROUND: Anger can trigger myocardial ischemia and may be an independent risk factor for coronary heart disease, but its effect on early compared with late onset of disease is unclear. METHODS: We performed a prospective study of 1055 men followed up for 32 to 48 years to examine the risk of premature and total cardiovascular disease (CVD) associated with anger responses to stress during early adult life. Highest level of anger was defined as a self-report of all 3 possible anger reactions to stress (expressed or concealed anger, gripe sessions, and irritability) on a checklist questionnaire administered in medical school. Premature disease was defined as events before age 55 years. RESULTS: During a median follow-up period of 36 years, 205 men developed CVD (cumulative incidence at 76 years, 34.5%), of whom 77 men developed premature disease (cumulative incidence before 55 years, 7.9%). The highest level of anger was associated with an increased risk of premature CVD (adjusted relative risk, 3.1; 95% confidence interval, 1.1-8.6), including premature coronary heart disease (relative risk, 3.5; 95% confidence interval, 1.1-11.8) and premature myocardial infarction (relative risk, 6.4; 95% confidence interval, 1.8-22.3), compared with lower levels of anger. When CVD events after age 55 years were included, there was no longer a statistically significant association between anger and CVD. CONCLUSION: High level of anger in response to stress in young men is associated with an increased risk of subsequent premature CVD, particularly myocardial infarction.

Adult↗
PubMed2000

Positive and negative outcomes of anger in early adolescents.

The purposes of this study were to examine symptom patterns and diminished general well-being as negative outcomes and vigor and change as positive outcomes of trait and state anger via two structural equation models. In a school auditorium, a convenience sample of 141 boys and girls, ages 12-14 years, responded to the Trait Anger Scale and the State Anger Scale and to instruments measuring general well-being, symptom patterns, vigor, and change. In the negative outcome model, results indicated that diminished general well-being and increased symptom patterns were outcomes of trait anger and state anger in early adolescents. In the positive outcome model, contrary to expectation, less vigor and less inclination to change were outcomes of trait anger in early adolescents, while state anger had no appreciable influence on the same variables. The findings suggest that anger, particularly trait anger, had a negative influence on the outcome variables studied.

Adolescent↗
PubMed2000

Anger and bulimic psychopathology among nonclinical women.

OBJECTIVE: Although there are well-established links between bulimic psychopathology and some affective states, the role of anger is not clearly understood. This is likely to be a product of the diverse nature of anger. The present study examines the association of different components of anger with bulimic attitudes and behaviors among a nonclinical group of women. METHODS: Eighty-three nonclinical women completed standardized measures of anger and bulimic attitudes/behaviors. RESULTS: Bulimic attitudes and behaviors were correlated specifically with state anger and anger suppression, rather than with trait anger. The pattern of results suggests that binging and vomiting behaviors may serve different functions with regard to anger. CONCLUSIONS: Bulimic attitudes and behaviors appear to reduce immediate anger states, particularly when the individual has a strong tendency to avoid expressing that emotion. Potential therapeutic implications are considered.

Adolescent↗
PubMed1998

Anger inhibition, cardiovascular recovery, and vagal function: a model of the link between hostility and cardiovascular disease.

A model of the association between hostility and cardiovascular disease (CVD) is proposed based upon anger inhibition, slow cardiovascular recovery, and low parasympathetic activity (vagal tone). This model is opposed to the more conventional model that emphasizes anger expression, cardiovascular reactivity, and high sympathetic tone. We argue that in social reality, incidences of anger inhibition outnumber incidences of anger expression to a great extent, irrespective of preferred expression style. Moreover, slow cardiovascular recovery, rather than high reactivity, may be the mechanism underlying the CVD risk associated with anger inhibition. Both anger inhibition and slow cardiovascular recovery are associated with a persistently low vagal tone. Thus, the anger inhibition/vagal inhibition model seems more consistent with the actual nature of anger in daily life and with the known cardiovascular control mechanisms. The model may better account for the chronic pathophysiological state that is believed to lead to CVD. Importantly, an experimental inhibition/recovery paradigm might also allow to test potential behavioral and cognitive accelerators of cardiovascular recovery. As an example of an important socially-mediated health risk that may be elucidated using the anger inhibition/vagal inhibition model, we discuss Black-White differences that have been found in CVD.

Adaptation, Psychological↗
PubMed2004

Alexithymia and anger in patients with fibromyalgia.

Our objective was to delineate the relevance of the personality construct alexithymia and anger-in in patients with fibromyalgia syndrome. Fifty subjects with fibromyalgia syndrome were compared to 20 subjects with rheumatoid arthritis and 42 healthy controls on the measures of anxiety, depression, anger, alexithymia, pain intensity and disability. There was a significant difference on the measures of anxiety and anger between FMS and RA groups, and also between FMS patients and healthy controls. There was a significant difference between FMS patients and healthy controls on the measures of depression, difficulty in identifying feelings subscale of TAS (TAS-dif), and total alexithymia scores. When the severity of pain was controlled for, there was a significant difference on the measures of anger and alexithymia between the FMS and the RA groups. Fibromyalgia patients were more alexithymic than rheumatoid arthritis patients even when the level of depression was controlled for. Anger towards oneself, which is anger-in, was higher in patients with fibromyalgia patients than in the rheumatoid arthritis sample. A stepwise regression model showed that the anger-out scores and the anxiety scores predicted the level of pain severity, and this explained 32% of the variance in the fibromyalgia syndrome group. Although anger-in is consistently higher in fibromyalgia patients, it is the behavioral expression of anger, together with anxiety, that predicts the severity of the pain. The difficulty of identifying feelings, rather than other dimensions of alexithymia, seems to be associated with fibromyalgia.

Adult↗
PubMed2006

Anger regulation style, postoperative pain, and relationship to the A118G mu opioid receptor gene polymorphism: a preliminary study.

Greater trait anger-out is associated with elevated pain responsiveness. Previous work suggests this effect may be mediated by deficient endogenous opioid analgesia, possibly reflecting diminished opioid receptor sensitivity. The A118G single nucleotide polymorphism (SNP) of the mu opioid receptor gene influences both opioid receptor sensitivity and clinical responsiveness to opioid analgesics. Therefore, this study tested whether this SNP either mediated or moderated the effects of anger-out on postsurgical pain outcomes. Forty-eight patients undergoing coronary artery bypass graft surgery provided genetic samples, and completed measures of anger-out and postsurgical pain. Postsurgical opioid analgesic use was also recorded. Anger-out was positively associated with postsurgical pain ratings (p < 0.05). Anger-out was not associated with A118G SNP status (p > 0.10), suggesting the latter is unlikely to mediate anger-out's pain-related effects. A significant anger-out x A118G interaction was observed on analgesic use (p < 0.05), due to a much stronger positive relationship between anger-out and analgesic demands in patient with the A118G SNP (b = 0.53) than those with the wild-type receptor (b = 0.07). These results suggest that the A118G SNP may moderate but not mediate the effects of anger-out on postoperative pain responses.

Adult↗
PubMed2006

Anger expression and pain: an overview of findings and possible mechanisms.

A tendency to manage anger via direct expression (anger-out) is increasingly recognized as influencing responses to pain. Elevated trait anger-out is associated with increased responsiveness to acute experimental and clinical pain stimuli, and is generally related to elevated chronic pain intensity in individuals with diverse pain conditions. Possible mechanisms for these links are explored, including negative affect, psychodynamics, central adipose tissue, symptom specific muscle reactivity, endogenous opioid dysfunction, and genetics. The opioid dysfunction hypothesis has some experimental support, and simultaneously can account for anger-out's effects on both acute and chronic pain. Factors which may moderate the anger-out/pain link are described, including narcotic use, gender, and genetic polymorphisms. Pain exacerbating effects of trait anger-out are contrasted with the apparent pain inhibitory effects of behavioral anger expression exhibited in anger-provoking contexts. Conceptual issues related to the state versus trait effects of expressive anger regulation are discussed.

Acute Disease↗
PubMed1996

The expression of anger and its consequences.

Cluster analysis, using TRYSYS key cluster variable analyses, on 59 anger expression items replicated Spielberger's Anger-In and Anger-Control dimensions and revealed seven additional forms of anger expression: Noisy Arguing, Verbal Assault, Physical Assault-People, Physical Assault-Objects, Reciprocal Communication, Time Out, and Direct Expression. Aggressive dimensions (Noisy Arguing, Verbal Assault, Physical Assault-People and -Objects) correlated positively with each other and with trait anger and negatively with non-aggressive forms of expression (Control, Reciprocal Communication, and Time Out). The latter were positively correlated with each other and negatively with trait anger. Forms of expression correlated logically with the frequency of eight types of anger consequences, and there was evidence of distinct relationships between anger expression and anger consequences; e.g. Physical Assault-People correlated most with frequency of physical altercations, and Noisy Arguing and Verbal Assault with the frequency of verbal fights. Males were more likely to utilize aggressive forms of expression and to suffer consequences involving physical and verbal fights and property damage. Results are discussed in terms of convergent and discriminant validity, and in terms of their implications for assessment, treatment, and future research.

Adaptation, Psychological↗
PubMed1989

Anger assessment and reactivity to stress.

This study compared a questionnaire method to an interview method of anger assessment in predicting reactivity to a stressor and explored possible associations between anger expression and reactivity to a stressor. Blood pressure, heart rate and plasma catecholamines were measured in 40 normotensive subjects before and after a 5 min mental arithmetic task. The questionnaire and interview anger scores were related (p = 0.03). Anger expressed outward was associated with lower heart rate (p = 0.005) and norepinephrine (p = 0.01) reactivity to the stressor. The results suggest that self report questionnaires may be a reliable and inexpensive way to evaluate anger in the context of reactivity to stressors and that anger expression, particularly anger expressed outward, may be related to decreased heart rate and norepinephrine reactivity. The relationship between anger expression and reactivity to stressors may provide insight into the mechanisms linking anger, blood pressure and incidence of cardiovascular disease.

Adult↗
PubMed1995

Women, anger, and cardiovascular responses to stress.

Cardiovascular reactivity (CVR) to stressful stimuli is predictive of future development of cardiovascular disease (CVD). Anger appears to be an important mediator of this relationship. Unfortunately, the majority of research in this area has utilized predominantly male subjects, leaving the relationship between CVD and anger in females largely unexplored. To address the dearth of research among females, the present study examined the relationship between Anger-In, as well as Anger-Out, and CVR to stressors among women. Females reporting moderate levels of Anger-Out exhibited lower blood pressure reactions to a mental arithmetic stressor than females reporting high and low levels of Anger-Out. Females reporting moderate levels of Anger-Out also exhibited lower heart rate reactions than individuals reporting high levels of Anger-Out. Anger-In was not related to CVR in the present study.

Adolescent↗
PubMed1996

Anger management style, hostility and spouse responses: gender differences in predictors of adjustment among chronic pain patients.

This study examined whether relationships between anger management style (anger suppression; anger expression) and adjustment variables for patients with chronic pain depend on patient hostility, and/or depend on a patient's gender. A 'spouse response model' was also evaluated to test whether patient expression of hostile anger is linked to infrequent positive and frequent negative responses from spouses, and hence to poor adjustment. The sample of 127 married chronic pain patients was assessed prior to entry into a multidisciplinary pain treatment program. Hierarchical multiple regressions revealed significant 'Anger Expression x Hostility x Gender' interactions for pain severity, activity interference and activity level: High Anger Expressor/Low Hostile women reported the lowest pain and highest activity; Low Anger Expressor/High Hostile men reported the highest pain and highest interference. Among men, support was also found for a spouse response model: pain severity and activity interference for High Anger Expressors was partly accounted for by negative spouse responses. Results suggest that discriminations among patients may be made based on anger management style in interaction with level of hostile attitude and the patient's gender, and that these distinctions may have implications for understanding mechanisms of pain and disability, and for designing appropriate treatment.

Adaptation, Psychological↗
PubMed2004

Sex differences in childhood anger and aggression.

There are few differences in the frequency or intensity of men's and women's self-reported or observed anger. Women are more likely to be angered by relationship conflicts than men. Men are more frequently the targets of anger than women. Typically, men see the expression of anger as exerting dominance, where as women view it as a loss of control. There are also sex differences in the mode of anger expression. At ages 8 and older, girls are more likely to engage in "relational" aggression (eg, deliberate social ostracism). The most consistent and salient difference in anger expression is women's tendency to cry when angry, whereas men are more likely to throw things or hit. The difference in physical aggression appears in children who are as young as 1 to 2 years of age. Despite an overall reduction in physical aggression after 2 to 3 years of age, the sex difference remains consistent into adulthood. In contrast to differences in physical aggression, differences in anger are few and inconsistent up to 4 or 5 years of age. By this age, girls tend to suppress the expression of anger consciously. By about 7 to 8 years of age, adult like differences become more consistent, with boys expressing more anger.

Adolescent↗