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PubMed2006

Anger, hostility, and cardiac symptoms in women with suspected coronary artery disease: the Women's Ischemia Syndrome Evaluation (WISE) Study.

OBJECTIVE: To determine the relationship of anger and hostility to angiographic coronary artery disease (CAD), symptoms, and functional status among women with suspected CAD. METHODS: Data were collected from 636 women with suspected CAD referred for diagnostic angiography in the Women's Ischemia Syndrome Evaluation (WISE) Study. CAD was assessed as angiographic presence/absence of disease (> or =50% stenosis in any epicardial coronary artery). Hostility/anger, angina, symptoms, and functional status were assessed by the Cook-Medley Hostility Inventory, Spielberger Anger Expression Scale, cardiovascular symptom history, and the Duke Activity Status Index. RESULTS: Logistic regression revealed that anger-out (i.e., aggressive behavior in response to angry feelings) was independently associated with the presence/absence of angiographic CAD (OR = 1.09, CI 1.01-1.17). Anger and hostility were higher among women reporting increased cardiovascular symptoms. In women without angiographic CAD, those with nonanginal cardiac symptoms had the highest anger-out, anger expression, hostile affect, and aggressive responding scores, and those with typical angina reported the lowest functional status. Among women with CAD, functional status was lowest in women with atypical angina. CONCLUSIONS: Among women with suspected CAD, anger-out scores were associated with the presence of angiographic CAD. Anger/hostility traits were associated with increased symptoms, particularly with nonanginal chest pain in women without angiographic CAD. Relationships among psychosocial factors, cardiac symptoms, and angiographic CAD are potentially important in the management of women with suspected CAD.

Aged↗

PubMed2005

Driving anger, sensation seeking, impulsiveness, and boredom proneness in the prediction of unsafe driving.

The present study investigated the potential contribution of sensation seeking, impulsiveness, and boredom proneness to driving anger in the prediction of aggressive and risky driving. Two hundred and twenty-four college student participants completed measures of trait driving anger, aggressive and risky driving, driving anger expression, sensation seeking, impulsiveness, and boredom proneness. Findings provided additional support for the utility of the Driving Anger Scale (DAS; Deffenbacher, J.L., Oetting, E.R., Lynch, R.S., Development of a driving anger scale, Psychological Reports, 74, 1994, 83-91.) in predicting unsafe driving. In addition, hierarchical multiple regression analyses demonstrated that sensation seeking, impulsiveness, and boredom proneness provided incremental improvements beyond the DAS in the prediction of crash-related conditions, aggressive driving, risky driving, and driving anger expression. Results support the use of multiple predictors in understanding unsafe driving behavior.

Adult↗

PubMed1994

Psychopathology and anger in interpersonal violence offenders.

The current literature on psychopathology and anger suggests that both contribute to interpersonal violence. The present study examined psychopathology and anger expression with two objectives: to confirm previous distinctions of personality type among abusive individuals and to examine the relation between these types and anger. Cluster analysis was conducted with data gathered from 40 subjects. Results suggested confirmation of four clusters of interpersonal violence offenders. Furthermore, the most pathological cluster type reported the highest level of total anger experience, while the histrionic cluster type reported the lowest anger expression. These results provide tentative support for a positive relationship between psychopathology and anger, as well as for the distinction between overcontrolled and under-controlled anger as subtypes of interpersonal violence offenders.

Adolescent↗

PubMed2001

The role of anger and depression in recurrent headache.

Individuals with tension-type headache report significant anger, depression, anxiety, and stressors. However, it is not clear to what extent these variables are interrelated. The objective of the present study was to explore the role of anger in headaches, and to examine its relationship to anxiety, depression, and daily life stressors. Participants were 65 young adult women who suffered from recurrent headaches. The sample was obtained in a large-scale screening of young adult women using the Headache Symptoms List to identify those with recurrent headache. Those individuals reporting headaches completed a battery of assessment measures that included the State-Trait Anger Expression Inventory, the Mood and Anxiety Symptoms Questionnaire, and the Hassles Scale. Results revealed a significant relationship between anger suppression and depression (r = 0.40, P<.01), as well as anger expression and anxiety (r = 0.41, P<.01) for those with headache. The use of the Mood and Anxiety Symptoms Questionnaire allowed for the separate analysis of general distress symptoms and symptoms more specific to anxiety and depression. Results indicated that those with headache experience more general, nonspecific distress rather than symptoms indicative of anxiety and depression (P<.01). In addition, the mixed headache group scored high on both general (mean, 28.96) and specific measures of depression (mean, 65.76) and on anger suppression (mean, 20.12), suggesting that they might experience more psychological distress than those with tension-type headache. The present results indicate the need to distinguish the unique dimensions of anxiety and depression that should be assessed in the population with recurrent headache.

Adult↗

PubMedDate not supplied

Psychological characteristics and responses to antihypertensive drug therapy.

The objective of this study was to explore the relationship between psychological characteristics and responses to antihypertensive drug therapy. Twenty-two hypertensive subjects underwent psychological evaluation and treatment with 1) a diuretic, hydrochlorothiazide (HCTZ); 2) an angiotensin-converting enzyme (ACE) inhibitor, quinapril; and 3) combined alpha + beta blockade (doxazosin + betaxolol). Anger-Out scores on the State-Trait Anger Expression Inventory were positively correlated with the HCTZ-induced fall in systolic blood pressure (p<0.01); Anger-In was negatively correlated with the quinapril-induced fall in systolic pressure (p<0.05). The target systolic blood pressure (130 mm Hg) was achieved with either HCTZ or quinapril in 79% of subjects without, vs. 25% of subjects with, childhood trauma (p=0.03). Responses to doxazosin + betaxolol were not correlated with psychological characteristics. The authors conclude that both inhibited anger expression and childhood trauma are associated with reduced response to a diuretic or ACE inhibitor. Combined alpha/beta blockade may be preferable to an ACE inhibitor or diuretic in treating selected hypertensive patients. Further studies should include examination of psychological factors in terms of the response to combined ACE inhibitor + diuretic therapy.

Adult↗

PubMedDate not supplied

Effects of perceived racism and anger inhibition on ambulatory blood pressure in African Americans.

OBJECTIVE: Hypertension is more prevalent in African Americans compared with Americans of European descent. Preliminary evidence indicates that perceived racism may play a role in elevated blood pressure in African Americans. The present study examined whether perceived racism was associated with higher ambulatory blood pressure measured during daily life. A potential contributing role for anger inhibition was also evaluated. METHODS: Twenty-four-hour ABP was obtained from 69 African American men and women with normal or mildly elevated blood pressure. ABP was averaged over waking and sleep periods, and clinic BP was also assessed. Perceived racism and anger expression were measured using self-report questionnaires. RESULTS: Greater perceived racism was related to higher ABP during waking hours for SBP (p <.01) and DBP (p <.05). Perceived racism was positively correlated with anger inhibition (r =.29, p <.05) but was not related to outwardly expressed anger (r =.01, NS). Anger inhibition was related to higher sleep DBP (p =.05) and a smaller drop in DBP from day to night (p <.05). Anger inhibition did not account for the relationship between perceived racism and blood pressure. CONCLUSIONS: Perceived racism and anger inhibition are independently related to higher ABP. Both may contribute to the incidence of hypertension and hypertensive-related diseases observed in African Americans.

Adult↗

PubMed1993

Role of emotional factors in adults with atopic dermatitis.

BACKGROUND: The role of anger in the onset or perpetuation of episodes of atopic dermatitis in adults has long been considered an important factor. The objective was to investigate whether atopic patients feel ineffective in dealing with anger and assertiveness when compared with psoriasis patients and control patients. METHODS: Thirty-four adult patients with atopic dermatitis were compared to 28 patients with psoriasis and 32 controls, dental patients without major skin disease. Standard measures of anxiety, anger, assertion, depression, and locus of control as well as a measure of anger effectiveness, designed for this study, were used. RESULTS: There were significant differences between atopic dermatitis patients and controls in that atopics felt angry more readily but were less likely to express it, were more anxious and less assertive, and felt less effective in expressing anger. The only difference between psoriasis patients and controls was less ability to express anger. Atopic patients were more chronically anxious than those with psoriasis. CONCLUSIONS: Adult atopic dermatitis patients are often chronically anxious and feel ineffective in handling anger which suggests that psychological interventions may prove helpful.

Adolescent↗

PubMed2005

Attachment style and symptom reporting: examining the mediating effects of anger and social support.

OBJECTIVE: Attachment style has been related to symptom reporting. The aim of this research was to examine whether social support and anger expression or experience mediate this relationship. DESIGN AND METHODS: 141 women and 50 men from a Midlands university completed questionnaires examining attachment style, anger expression and experience, perceived social support, and symptom reporting. RESULTS: Significant differences were found between attachment groups on somatic, anxiety, social dysfunction, and depressive symptoms. Post hoc analysis showed differences were present between secure and preoccupied attachment styles on social dysfunction and depressed symptoms, and secure and fearful attachment styles on somatic, social dysfunction, and depressed symptoms (p < . 05). ANCOVA revealed that there were no differences between attachment styles and any of the symptom scales when perceived social support, anger-in, and trait anger were entered as covariates. CONCLUSION: Results indicate that insecure attachment styles of preoccupied and fearful were associated with increased symptom reporting. Social support and anger mediated the relationship between attachment style and symptom reporting.

Adolescent↗

PubMed1995

Working with anger in groups: a modern analytic approach.

The development of Modern Psychoanalytic psychotherapy with schizophrenic and borderline patients is briefly traced, and the major themes of the treatment approach that derived from that early work are discussed with attention to their application in group therapy. These themes include the concepts of the narcissistic defense, narcissistic transference, joining or reinforcing defenses, emotional communication, and a shift away from the classical psychoanalytic emphasis on interpretation and insight to a strategy of helping the patient put all his or her thoughts and feelings into language in a constructive manner. These principles are discussed in connection with three kinds of problems involving anger in therapy groups: members' anger destructively turned against their own egos, anger expressed toward the leader within a negative transference, and anger destructively expressed toward others in the group. Lastly, consideration is given to the group leader's anger and its expression within the group. Some contrasts are made between the Modern Analytic approach and the classical Freudian position as well as Kohut's self psychology.

Anger↗

PubMed1996

Five-factor analysis of Buss-Durkee hostility inventory neurotic hostility and expressive hostility factors: implications for health psychology.

Neurotic and expressive hostility from the perspective of the five-factor model of personality. Sixty-five male and 105 female students (mean age = 25.0 years) at a public university completed the Buss-Durkee Hostility Inventory, the revised NEO Personality Inventory, and measures of stress and depression. Correlations were computed between the hostility measures and all personality domains and facets. Profiles of participants classified into neurotic and expressive hostility groups were also produced using T scores based on normative samples. The results suggest that neurotically hostile individuals view others as distrustful, the world as threatening, and themselves as unable to cope. They experience frequent negative affect, including unexpressed anger. Expressive hostility predicts direct and positive engagement of the environment and others, but also a readiness to express anger in response to conflict. The lack of association between neurotic hostility and objective health problems may be due, in part, to an absence of exaggerated behavioral and physiological responses to stressors, whereas the positive association between expressive hostility and heart disease may result partly from frequent and intense behavioral engagement and accompanying physiological arousal.

Adult↗

PubMed2001

Anger and personality in eating disorders.

OBJECTIVE: This study was designed to examine how anger, temperament and character profiles differ across subtypes of eating disorders (EDs) in comparison to healthy controls and to analyze the relationship between anger expression, eating attitudes and personality dimensions. METHOD: One hundred and thirty-five outpatients (50 of whom suffered from anorexia nervosa restrictor type [AN-R], 40 from anorexia nervosa binge/purging [AN-BP] and 45 from bulimia nervosa [BN]) and 50 control subjects were recruited and administered State-Trait Anger Expression Inventory (STAXI), Temperament and Character Inventory (TCI) and Eating Disorder Inventory II (EDI-II). RESULTS: STAXI showed greater levels of anger in patients with BN than in those with AN. TCI showed different personality profiles, in accordance with previous studies. Correlations were found between the management of anger feelings and psychological and personality traits typical of patients with EDs. CONCLUSIONS: Clinically, impulsivity seems to be the psychopathologic element most strongly correlated to anger. Moreover, it appears clear that anger is better managed by individuals with greater character strength.

Adolescent↗

PubMed1995

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↗

PubMed2003

[Correlational study among anger, perceived stress and mental health status in middle aged women].

PURPOSE: This study was to identify the relationships of trait anger, mode of anger expression, and perceived stress to mental health status in middle aged women. METHOD: The subjects were 157 middle aged women from 40s to 60s who lived in Seoul. Data was collected by questionnaire surveys using the convenience sampling. The instruments used for this study were Spielberger's trait anger scale and anger expression scale, Cohen, Kamarck, and Mermelstein's perceived stress and Derogatis's SCL-90-R. The collected data was analyzed using descriptive statistics, Pearson correlation coefficient, and Stepwise multiple regression with SAS/PC. RESULT: The trait anger of middle aged women indicated a significantly positive correlation to perceived stress(r=.180, p=.023) and mental health status(r.=021, p=.014). Anger-in(r=.237, p<.05), and perceived stress(p=.461, p<.01) showed significantly positive correlation to mental health status. The most significant predictor influencing health status of middle aged women was perceived stress, and anger-in and the variance explained was 27%. CONCLUSION: These results suggested that middle aged women with high degree of trait anger is likely to be high in stress perception. Perceived stress and anger-in are major factors influencing mental health status.

English Abstract↗

PubMed1987

Identifying coronary-prone behavior in adolescents using the Bortner Self-Rating Scale.

Brief measures to identify coronary-prone (Type-A) behavior in young persons are greatly needed for longitudinal epidemiologic study of cardiovascular diseases. We examined the suitability of a modified 14-item Bortner Self-rating Scale (ABS) for use in an adolescent population. Responses of 549 racially mixed, low to middle income urban high school students were analyzed to see if ABS measurement properties matched those of the parent version. Construct validity was explored by correlating ABS scores with measures of anger expression, social support, life satisfaction, academic achievement and blood pressure. Results disclosed that the distribution and factor structure of adolescent ABS responses closely resembled findings obtained with adults. Scale validity was supported by significant associations of ABS scores with degree of overt anger expression, lack of social support, and dissatisfaction with school and life in and life in general. Academic achievement and blood pressure were found not to correlate with adolescent ABS scores. Possible race and sex differences are considered.

Adolescent↗

PubMed2005

[Prediction model on mental health status in middle-aged women of an urban area].

PURPOSE: This study was designed to construct a structural model for explaining mental health status in middle-aged women. METHODS: The data was collected by self-reported questionnaires from 206 middle-aged women in Seoul. Data analysis was done with the SAS pc program for descriptive statistics and a PC-LISREL Program for finding the best fit model which assumes causal relationships among variables. RESULTS: The overall fit of the hypothetical model to the data was good, but paths and variables of the model were modified by considering theoretical implications and statistical significances of parameter estimates. Thus it was modified by excluding 3 paths. The modified model showed was good fit to the data(chi(2)=177.55, p=.00), GFI=0.908, AGFI=0.860, RMR=0.013, NFI=0.972, NNFI=0.982). Perceived stress, anger expression method, and self-esteem were found to have direct effects on mental health status in middle-aged women. These predictive variables of mental health status explained 66.6% of the model. CONCLUSION: Programs to enhance mental health status in middle-aged women should include stress management skill, anger expression skill, and self-esteem enhancement skills to be effective.

Adult↗

PubMed1997

Enhancing physical and psychological functioning in older family caregivers: the role of regular physical activity.

Although informal caregiving among older adults creates a range of physical and psychological burdens for the caregiver, little research has been directed at evaluating strategies for preserving caregivers physical functioning in addition to their psychological well-being. The purpose of the current research was to examine, through population-based survey sampling procedures, levels of physical activity and related health practices and preferences among a random sample of older family caregivers; evaluate, using an experimental design, the feasibility of initiating a four-month supervised home-based moderate-intensity physical activity regimen among older family caregivers; and explore the potential effects of physical activity on anger expression, caregiver burden, and related psychological outcomes in this population. The results suggest that: (a) physical inactivity is a prevalent risk factor among family caregivers that requires systematic attention; (b) a significant proportion of family caregivers of both sexes are interested in improving their physical activity levels, especially through programs that do not require ongoing attendance at a class or group; and (c) supervised home-based programs that focus on brisk walking and similar moderate-intensity physical activities appear to be both feasible and potentially beneficial in health (e.g. ambulatory blood pressure) as well as mental health (e.g. anger expression) areas.

Adaptation, Psychological↗

PubMed2003

Negative affect and mortality in older persons.

The authors examined the relation of negative affect to mortality in the Religious Orders Study, a longitudinal cohort study of older persons, between 1994 and 2002. Participants were 851 Catholic clergy members without dementia at baseline (mean age, 75.4 (standard deviation, 6.9) years; 68% women). They completed standard measures of depressive symptoms, proneness to anxiety and anger, and patterns of anger expression at baseline and then underwent annual clinical evaluations for a mean of 4.7 (standard deviation, 2.7) years. The association of each scale with mortality was examined in proportional hazards models adjusted for age, sex, education, measures of cognitive function, lower limb function, chronic illness, smoking, alcohol, and obesity. During follow-up, 164 persons died. Measures of internally experienced negative affect, such as depressive symptoms and suppressed anger, were related to mortality, but measures of externally directed negative affect, such as the tendencies to be angry with others and to express anger overtly, were not. Persons with a high score (90th percentile) on a summary measure of internally experienced negative affect were nearly twice as likely to die as persons with a low score (10th percentile). The results suggest that negative affect in older persons, especially internally experienced distress, is associated with an increased mortality risk.

Affect↗

PubMed2005

Factors related to severity of vomiting behaviors in bulimia nervosa.

Assessments of the severity of vomiting (weekly frequency), depressive and eating-related psychopathology, anger level and management, and personality dimensions were used to characterize patients with bulimia nervosa binge purging type (BN-BP). The sample comprised 130 outpatients with BN and 130 control women. The Eating Disorder Inventory-2 (EDI-2), the State-Trait Anger Expression Inventory, the Beck Depression Inventory, and the Temperament and Character Inventory (TCI) were administered to all patients. The Self-Directedness dimension of the TCI and the Bulimia subscale of the EDI-2 were the strongest predictors of the severity of bulimic behavior; anger levels and anger expression were not so strongly related to illness severity. A more severe form of bulimic symptomatology probably has substrata in specific character deficits (low Self-Directedness on the TCI) and particular psychopathological features (high bulimia on the EDI-2). Patients with a high frequency of vomiting need specific therapeutic interventions to enhance the character dimension of Self-Directedness.

Adolescent↗