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PubMed2005

Domain-specific anger expression and blood pressure in an occupational setting.

OBJECTIVE: The purpose of the present study was to extend a previous work in a sample of American undergraduates demonstrating the effects of situational factors on reported anger expression behavior and blood pressure. METHOD: General and domain-specific anger expression behavior and subjective work stress were assessed in 218 nurses from the Frankfurt am Main metropolitan area using the original and three altered versions of the State Trait Anger Expression Inventory (STAXI) and the Job Stress Survey (JSS). The altered versions of the STAXI asked for individuals' anger expression at home, during free time, and at work. Blood pressure and heart rate (HR) were measured in the field during working breaks. RESULTS: Women had higher scores on anger-out and lower on anger-control in the original and in the home version of the STAXI, but no sex difference was found in the work version. Participants scoring high on anger-out at work displayed elevated blood pressures and HR compared with those scoring low on this scale. High job stress was associated with greater reports of anger-in and anger-out behavior. CONCLUSION: The results suggest that the way people express stress at their work place might be an important factor in determining the impact of experienced stress on cardiovascular health.

Adaptation, Psychological↗
PubMed2006

Basal testosterone moderates responses to anger faces in humans.

Prior research [van Honk J, Tuiten A, Verbaten R, van den Hout M, Koppeschaar H, Thijssen J, de Haan E. Correlations among salivary testosterone, mood, and selective attention to threat in humans. Horm Behav 1999;36(1):17-24; van Honk J, Tuiten A, Hermans E, Putman P, Koppeschaar H, Thijssen J, Verbaten R, van Doornen L. A single administration of testosterone induces cardiac accelerative responses to angry faces in healthy young women. Behav Neurosci 2001;115(1):238-42.] showed relationships in humans between testosterone (T) and vigilance to facial expressions of anger, which are considered signals of an impending dominance challenge. In Study 1, we used a differential implicit learning task (DILT) (see [Schultheiss OC, Pang JS, Torges CM, Wirth MM, Treynor W. Perceived facial expressions of emotion as motivational incentives: evidence from a differential implicit learning paradigm. Emotion 2005;5(1):41-54.]) to investigate the degree to which subjects find anger faces reinforcing. In the DILT, separate sequences of actions were paired with presentations of anger faces, neutral faces or a blank screen. After training, performance on the three sequences was measured in the absence of face stimuli. Saliva was collected for T measurement. Higher T predicted better learning on sequences paired with sub-threshold (i.e., presented too fast for conscious awareness) anger faces, suggesting that T is related to reinforcing qualities of these faces. In Study 2, we examined whether morning or afternoon T better predicted attention and vigilance to anger faces. Participants were tested at 9:00 and 15:00. At each session, saliva was collected for T measurement, and participants completed a Stroop task and a dot-probe task [Mogg K, Bradley BP, Hallowell N. Attentional bias to threat: roles of trait anxiety, stressful events, and awareness. Q J Exp Psychol A 1994;47(4):841-64.] with facial expression stimuli. Morning (peak) T was a better predictor of responses to anger faces than afternoon T. Morning T predicted greater Stroop-like interference to sub-threshold anger faces, as well as attentional orienting away from sub-threshold anger faces. These effects were not present for joy faces or for supraliminal anger faces. T may generally decrease aversion to threatening stimuli, and/or may specifically facilitate approach towards signals of dominance challenge.

Adolescent↗
PubMed1999

Aggression Questionnaire hostility scale predicts anger in response to mistreatment.

We tested the hypotheses that the hostility and anger scales of the Buss and Perry (1992) [Buss, A. H. & Perry, M. (1992). The Aggression Questionnaire. Journal of Personality and Social Psychology, 63, 452-459.] Aggression Questionnaire would predict anger in college students in response to mistreatment. We found low and high hostility groups did not differ in anger at baseline or after completing a task without provocation, but the high hostility group reported greater anger than the low group after the onset of provocation, which required all students to redo completed tasks because some students (confederates) were observed cheating. Hostility also influenced anxiety and depression, but only anger was greater as a result of the provocation in the high than in the low hostility group. The anger scale did not predict anger in response to provocation, but anger was higher in the high than the low anger group before the provocation. These findings support the construct validity of the Aggression Questionnaire hostility scale as a measure of suspicion, resentment and sensitivity to mistreatment.

Adolescent↗
PubMed2001

Anger, negative emotions, and cardiovascular reactivity during interpersonal conflict in women.

OBJECTIVE: In order to evaluate the relationship between women's subjective emotional discomfort with anger and cardiovascular responses to stress, cardiovascular and affective responses were examined during two anger-provoking conditions: one in which anger would be in self-defense, and one in which anger would be in defense of a significant other. METHODS: A total of 42 healthy, normotensive women aged 18-35 years recruited a close female friend to participate in the study with them, and were randomly assigned to one of two harassment conditions: (i) Self-Harass, where women were harassed while performing a math task; (ii) Friend-Harass, where women witnessed a close female friend being harassed while their friend performed a math task. RESULTS: Self-Harass and Friend-Harass women reported feeling equally angry, annoyed, and irritated (all P's<.01) during their respective anger-provocation conditions. However, Self-Harass women reported experiencing significantly greater increases in feelings of depression and guilt during anger provocation (P's<.05) relative to Friend-Harass women. Interestingly, it was also the Self-Harass women who exhibited significantly greater elevations in heart rate (HR), cardiac output (CO), systolic blood pressure (SBP), forearm blood flow (FBF), and significant reductions in forearm vascular resistance (FVR; P's<.001) relative to Friend-Harass women during anger provocation. CONCLUSIONS: Results suggest that women may experience other negative emotions (e.g., guilt, depression) when anger is in self-defense relative to when it is in defense of others, and that these emotions may play a more important role than anger in moderating cardiovascular reactivity (CVR) during interpersonal conflict.

Adult↗
PubMedDate not supplied

Axis I and Axis II disorder comorbidity in unipolar depression with anger attacks.

OBJECTIVE: We evaluated whether anger attacks in patients with major depressive disorder (MDD) are associated with higher rates of panic or other Axis I or II comorbid disorders. METHODS: 306 out-patients (163 women, mean age 39.5+/-10.5) with MDD were administered the Structured Clinical Interviews for Axis I and II Disorders, and the Anger Attacks Questionnaire. RESULTS: Patients with anger attacks showed only a trend toward a significantly higher rate of current panic disorder (P = 0.06) but no other difference in Axis I comorbidity. In addition patients with anger attacks had a slightly but significantly greater degree of depression severity. Consistent with previous studies, we have also found that depressed patients with anger attacks had significantly higher rates of dependent, avoidant, narcissistic, borderline, and antisocial personality disorders than those without anger attacks. CONCLUSION: Anger attacks do not appear to be associated with any specific pattern of Axis I comorbidity, but they are certainly linked with certain personality disorders. It is possible that the acute depressive state may have confounded the assessment of personality disorder rates, as well as the presence of anger attacks. On the other hand, both depressed patient groups (with or without anger attacks) were subject to the same confounding effect as their depression severity was rather comparable, thereby limiting the impact of this potential bias.

Adolescent↗
PubMed2000

Fenfluramine challenge in unipolar depression with and without anger attacks.

We have previously hypothesized that patients with major depression and anger attacks may have a greater central serotonergic dysregulation than depressed patients without such attacks. We wanted to compare the prolactin response to fenfluramine challenge, as an indirect measure of central serotonergic function, in depressed patients with and without anger attacks. We recruited 37 outpatients (22 men and 15 women; mean age: 39.5+/-10.5) with DSM-III-R major depressive disorder, diagnosed with the SCID-P. Their initial 17-item Hamilton Rating Scale for Depression score was >/=16. Patients were classified as either having or not having anger attacks with the Anger Attacks Questionnaire. All patients received a single-blind placebo challenge followed by a fenfluramine challenge (60 mg orally) the next day. Plasma prolactin measurements were obtained with double antibody radioimmunoassay before and after both placebo and fenfluramine challenges, and fenfluramine and norfenfluramine blood levels after each challenge were determined by gas chromatography. Of the 37 study participants, 17 (46%) were classified as having anger attacks. There were no significant differences in age, gender, fenfluramine, or norfenfluramine blood levels between depressed patients with and without anger attacks. Depressed patients with anger attacks showed a significantly blunted prolactin response to fenfluramine challenge compared to patients without anger attacks. As previous studies have shown blunted prolactin responses to fenfluramine in impulsive aggression among patients with personality disorders, our results support our hypothesis that depressed patients with anger attacks may have a relatively greater serotonergic dysregulation than depressed patients without these attacks.

Adult↗
PubMed1997

Cognitive-behavioral treatment for severe anger in posttraumatic stress disorder.

With a randomized group design, a 12-session anger treatment was evaluated with severely angry Vietnam War veterans suffering combat-related posttraumatic stress disorder (PTSD). Eight participants in anger treatment and 7 in a routine clinical care control condition completed multiple measures of anger control, anger reaction, and anger disposition, as well as measures of anxiety, depression, and PTSD at pre- and posttreatment. Controlling for pretreatment scores, significant effects were found on anger reaction and anger control measures but not on anger disposition or physiological measures. Eighteen-months follow-up (for both completers and dropouts) supported the posttreatment anger control findings. The challenges of treatment research with this refractory population are discussed.

Analysis of Variance↗
PubMed2003

There is more to anger coping than "in" or "out".

There is growing dissatisfaction with a dichotomized "anger-in" versus "anger-out" view of anger coping. Three studies using student and community adultsamples revealed a broader understanding of the nature of anger coping styles and led to the development of the new Behavioral Anger Response Questionnaire (BARQ). The BARQ is empirically derived and factorially validated and has good psychometrics. Results suggest that dichotomizing anger responses as "in" versus "out" is too coarse and that a 6-factor model may be more appropriate. The 6 factors identified here are Direct Anger-Out, Assertion, Support-Seeking, Diffusion, Avoidance, and Rumination. Women reported use of a wider range of anger coping styles, especially more social support-seeking and more use of anger diffusion strategies than men.

Adaptation, Psychological↗
PubMed2001

Understanding women's anger: a description of relational patterns.

Sixty women's narratives about their anger were coded for elements of anger expression. Their decisions regarding how and where to express anger are most strongly influenced by the anticipated reactions of others. Six patterns of bringing anger into relationships or keeping it out were identified. Women bring anger into relationship: (1) positively and directly, with the goal of removing barriers to relationship; (2) aggressively, with the goal of hurting another; and (3) indirectly, through disguising anger with the goal of remaining safe from interpersonal consequences, using strategies of (a) quiet sabotage, (b) hostile distance, (c) deflection, and (d) loss of control. Women keep anger out of relationship (1) consciously and constructively, choosing to express it in positive ways; (2) explosively expressing anger, but not in the presence of another; and (3) through self-silencing, which ranges from conscious to less-conscious awareness of anger and its suppression. Implications of differing patterns for women's health are discussed.

Adaptation, Psychological↗
PubMed2000

Anger management group treatment for cocaine dependence: preliminary outcomes.

Cocaine abusers who fail to manage anger appropriately may have greater difficulty achieving and maintaining abstinence. We conducted a pilot study to examine an anger management group treatment in a sample of 59 men and 32 women with a diagnosis of cocaine dependence. Participants attended a 12-week anger management group treatment and background substance abuse treatment. Levels of anger, negative affect, and anger control were measured at baseline, weekly during treatment, and at 3-month posttreatment follow-up. Levels of anger decreased and anger control increased between baseline and the end of treatment. End-of-treatment changes were maintained at follow-up. These findings were not moderated by gender, age, or psychiatric medication use. In the absence of a randomized control group, we cannot make conclusive statements regarding the effectiveness of the anger management group treatment. However, these preliminary findings demonstrate the need for a randomized clinical trial to test the efficacy of the anger management group treatment.

Adult↗
PubMed1995

Depression and the experience and expression of anger in marital and other relationships.

In prior research using trait self-report measures, depression has been linked to elevated anger experience and anger suppression, whereas observational studies of marital interactions reveal high rates of overt anger expression by depressed people. This study tested whether the key distinction between these contradictory lines of research is a) target of anger expression (people in general versus spouse) or b) method of measurement (self-report versus behavioral observation). Depressed patients (N = 33) scored significantly higher than did nondepressed controls (N = 41) on self-report measures of anger and anger suppression regardless of whether the target of anger was the spouse or others. Group differences were nonsignificant on anger expression. Thus, it appears that the critical feature of studies linking depression with heightened anger expression may be their use of behavioral observations rather than their specific focus on the marital relationship.

Adult↗
PubMed2003

The effects of affective, behavioral, and cognitive components of trait anger on the alcohol-aggression relation.

OBJECTIVE: The purpose of this study was to investigate the effects of affective, behavioral, and cognitive components of trait anger on alcohol-related aggression in men and women. METHODS: Subjects were 300 (150 men and 150 women) healthy social drinkers between 21 and 35 years of age. Trait anger was measured using the ABC Anger Inventory. Following 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: Results indicated that alcohol increased aggression only for men with higher behavioral and cognitive anger scores and only for women with higher behavioral anger scores. Results also showed that when all anger components were taken into account, behavioral anger was the only factor that put one at risk for intoxicated aggression. CONCLUSIONS: Two recent studies demonstrated that the trait of "general" anger is a risk factor for intoxicated aggression (Giancola, 2002a; Parrott and Zeichner, 2002). The present investigation confirmed and extended these findings by examining the role of three different components of anger. The results highlight the fact that alcohol consumption does not increase aggression in all persons and in all situations. An important goal for future research is to identify which individual difference and contextual factors are most important in determining who will, and will not, behave in an aggressive manner when intoxicated.

Adult↗
PubMedDate not supplied

Expressive/suppressive anger-coping responses, gender, and types of mortality: a 17-year follow-up (Tecumseh, Michigan, 1971-1988).

OBJECTIVES: This study examined prospectively (1971-1988) the relationship between anger-coping responses, gender, and mortality (N = 91) in a representative sample of men (N = 324) and women (N = 372), aged 30 to 69, from the Tecumseh Community Health Study. METHODS: Anger-coping was measured by responses to hypothetical unfair anger-provoking situations. Cox proportional hazard regressions were used adjusted for seven health risk factors (age, smoking, relative weight, systolic blood pressure (SBP), bronchial problems, FEV1, and cardiovascular (CV) risk). RESULTS: Men's suppressed anger interacted significantly with SBP and also with bronchial problems to predict both all-cause and CV mortality. Women showed direct relationships between suppressed anger and early mortality (all-cause, CV, and cancer). Women also showed an interaction of spouse-suppressed anger and SBP for all-cause and CV mortality. Data suggest men who expressed their anger died earlier of cancer (N = 16) deaths. CONCLUSIONS: Suppressed anger at the time of an unjust attack may become chronic resentment (intermittent rage or hatred) about which little is known and requires research. The design for future research should experimentally measure both suppressed anger-coping responses (after an unfair attack) and morbidity (eg, blood pressure, bronchitis, immune disorder, etc.) to predict prospectively to earlier mortality.

Adaptation, Psychological↗
PubMed2006

Anger, hostility and aggression in the first days of acute stroke.

In acute stroke patients, anger can disturb management and rehabilitation and creates a stressful situation for family, health-care providers and other patients. We aim to describe the presence of anger and its association with demographic, clinical, psychiatric, lesion variables and functional outcome in acute stroke patients. We screened anger prospectively in 202 consecutive acute stroke patients (< or =4 days) using eight items from three psychiatric scales (Catastrophic Reaction Scale, Mania Rating Scale and Comprehensive Psychopathological Rating Scale). Anger was present if the patient scored in at least one item. Anger was detected in 71 (35%) patients and 26 of these were severely angry (> or =4 points). There was no association between anger and the considered variables. Analysis of the items extracted two factors: (i) the emotional-cognitive and (ii) the behavioural components of anger. These components were independent of each other in 26 patients. In 38 patients we found a dissociation between clinical observation and patients' subjective expression. Anger was frequent in acute stroke patients. Anger was probably triggered by the brain lesion, which interfered with the emotional control. The lack of an association with clinical and imaging variables suggests a contribution of psychological/psychosocial dimensions.

Aged↗
PubMed1992

The relationship of anger, depression, and perceived disability among headache patients.

Depression is a common concomitant of headache. Conflict with regard to anger or the expression of anger has also been discussed in terms of its relationships to headache. The direction of the relationship between headaches and depression and/or anger is not clear from available research literature. Thus, the present study proposed to examine the interrelationships among measures of anger expression, depression and self-reported disability in a sample of chronic headache patients. It was predicted that there would be significant correlations between depression and perceived disability, and anger held in and perceived disability. Finally, it was predicted that anger held in would be shown to impact perceived disability by way of its relationship to depression. Path analysis was employed to investigate the relationships among the variables. Results showed a significant and positive relationship between depression and perceived disability, which supported the first hypothesis. Anger expression was not significantly related to perceived disability. Therefore, the second hypothesis was not supported. Anger-in, however, was strongly and positively related to depression. Although the causal direction of the relationships cannot be stated with certainty, the suppression of anger appears to be a moderating variable that amplifies the experience of depression among chronic headache patients.

Adult↗
PubMed2000

Anger proneness predicts coronary heart disease risk: prospective analysis from the atherosclerosis risk in communities (ARIC) study.

BACKGROUND: Increased research attention is being paid to the negative impact of anger on coronary heart disease (CHD). METHODS AND RESULTS: This study examined prospectively the association between trait anger and the risk of combined CHD (acute myocardial infarction [MI]/fatal CHD, silent MI, or cardiac revascularization procedures) and of "hard" events (acute MI/fatal CHD). Participants were 12 986 black and white men and women enrolled in the Atherosclerosis Risk In Communities study. In the entire cohort, individuals with high trait anger, compared with their low anger counterparts, were at increased risk of CHD in both event categories. The multivariate-adjusted hazard ratio (HR) (95% CI) was 1.54 (95% CI 1.10 to 2.16) for combined CHD and 1.75 (95% CI 1.17 to 2.64) for "hard" events. Heterogeneity of effect was observed by hypertensive status. Among normotensive individuals, the risk of combined CHD and of "hard" events increased monotonically with increasing levels of trait anger. The multivariate-adjusted HR of CHD for high versus low anger was 2.20 (95% CI 1.36 to 3.55) and for moderate versus low anger was 1.32 (95% CI 0.94 to 1.84). For "hard" events, the multivariate-adjusted HRs were 2.69 (95% CI 1.48 to 4.90) and 1.35 (95% CI 0.87 to 2.10), respectively. No statistically significant association between trait anger and incident CHD risk was observed among hypertensive individuals. CONCLUSIONS: Proneness to anger places normotensive middle-aged men and women at significant risk for CHD morbidity and death independent of the established biological risk factors.

Aged↗
PubMed2003

Anger assessment in rural high school students.

Anger and aggression in school children are a major concern in American society today. Students with high anger levels and poor cognitive processing skills are at risk for poor relationships, underachievement in school, and health problems. This article describes characteristics of children who are at risk for high anger levels and aggression as well as those who are able to modulate their anger. Results of a survey are reported which describe levels of anger in 624 rural high school students. This sample reported lower levels of anger, compared to the normative group. Differences among the sample include higher internal anger expression in girls, higher trait anger in boys ages 15-16, and higher trait anger in girls ages 16-17. Recommendations are made for future research and specific steps that school nurses can take.

Adolescent↗
PubMed2005

Interactive effects of anger expression and ET-1 Lys198Asn polymorphism on vasoconstriction reactivity to behavioral stress.

BACKGROUND: Ineffective anger expression has been associated with essential hypertension (EH) and with blood pressure (BP) reactivity to stress. The ET-1/Lys198Asn polymorphism has been associated with increased resting BP and exaggerated vasoconstrictive mediated BP reactivity. African Americans (AAs) are at particular risk for development of EH, report greater anger difficulties, and exhibit greater vasoconstrictive reactivity than their European American (EA) counterparts. PURPOSE: The objective is to investigate a gene-environment model of stress reactivity in which anger expression, particularly in combination with ET-1 T allele carrier status and AA ethnicity, would be associated with the greatest vasoconstrictive reactivity in response to a behavioral stressor. METHODS: One hundred ninety-one AA and 197 EA normotensive young adults (M age=18.8+/-2.5 years) participated in the study. Total peripheral resistance index (TPRI) reactivity was assessed during a 10-min video game challenge. Anger expression was measured using Spielberger's Anger Expression Scale. RESULTS: A multiple regression model with TPRI reactivity as the dependent variable revealed a three-way interaction effect for anger management (i.e., AM=anger control minus anger out scores), ethnicity, and ET-1 polymorphism. Specifically, AA carriers of the ET-1 polymorphism with poor AM skills exhibited the greatest TPRI reactivity. CONCLUSIONS: Individuals with a genetic predisposition for exaggerated vasoconstriction who also display low AM skills may be at particular risk for development of stress-induced EH. Such individuals may particularly benefit from anger management training.

Adolescent↗