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PubMed1991

Psychological frailness and strength in an AIDS-affected community: a study of seropositive gay men and voluntary caregivers.

Addressed both the psychological frailness and strength in an AIDS-affected community. The gay community in Sydney, Australia, was represented by men who were seropositive (n = 60) and voluntary caregivers (n = 60). They were compared with two samples of men outside the gay community, who were ill with non-AIDS-related medical conditions (n = 30), and well (n = 30). Their psychological frailness and strength were measured by content analysis scales. Both the seropositive men and the caregivers showed the frailness of anxiety, indirectly expressed anger and helplessness, but also the compensating strength of greater personal competence and good feeling relative to the other men. The men who were seropositive or had other illnesses showed the predicted frailness of anxiety and depression but neither indirectly expressed anger nor helplessness. The seropositive men and caregivers of the gay community differed from each other only in the high levels of depression of the former.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Topiramate in treatment of patients with chronic low back pain: a randomized, double-blind, placebo-controlled study.

OBJECTIVE: Chronic low back pain (CLBP) is a widespread ailment. The aim of this study was to assess the efficacy of topiramate in the treatment of CLBP and the changes in anger status and processing, body weight, subjective pain-related disability and health-related quality of life during the course of treatment. METHODS: We conducted a 10-week, randomized, double-blind, placebo-controlled study of topiramate in 96 (36 women) patients with CLBP. The subjects were randomly assigned to topiramate (n=48) or placebo (n=48). Primary outcome measures were changes on the McGill Pain Questionnaire, State-Trait Anger Expression Inventory, Oswestry Low Back Pain Disability Questionnaire and SF-36 Health Survey scales, and in body weight. RESULTS: In comparison with the placebo group (according to the intent-to-treat principle), significant changes on the pain rating index of McGill Pain Questionnaire (Ps<0.001), State-Trait Anger Expression Inventory Scales (all Ps<0.001), Oswestry Low Back Pain Disability Questionnaire (P<0.001), and SF-36 Health Survey scales (all P<0.001, except on the role-emotional scale) were observed after 10 weeks in the patients treated with topiramate. Weight loss was also observed and was significantly more pronounced in the group treated with topiramate than in those treated with placebo (P<0.001). Most patients tolerated topiramate relatively well but 2 patients dropped out because of side effects. DISCUSSION: Topiramate seems to be a relatively safe and effective agent in the treatment of CLBP. Significantly positive changes in pain sensitivity, anger status and processing, subjective disability, health-related quality of life, and loss of weight were observed.

Adult↗
PubMed2005

African-American adolescents' stress responses after the 9/11/01 terrorist attacks.

PURPOSE: To examine the impact of indirect exposure to the 9/11/01 attacks upon physical and emotional stress-related responses in a community sample of African-American (AA) adolescents. METHODS: Three months after the 9/11/01 terrorist attacks, 406 AA adolescents (mean age [SD] of 16.1 +/- 1.3 years) from an inner-city high school in Augusta, GA were evaluated with a 12-item 5-point Likert scale measuring loss of psychosocial resources (PRS) such as control, hope, optimism, and perceived support, a 17-item 5-point Likert scale measuring post-traumatic stress symptomatology (PCL), and measures of state and trait anger, anger expression, and hostility. Given the observational nature of the study, statistical differences and correlations were evaluated for effect size before statistical testing (5% minimum variance explained). Bootstrapping was used for testing mean differences and differences between correlations. RESULTS: PCL scores indicated that approximately 10% of the sample was experiencing probable clinically significant levels of post-traumatic distress (PCL score > 50). The PCL and PRS were moderately correlated with a r = .59. Gender differences for the PCL and PRS were small, accounting for 1% of the total variance. Higher PCL scores were associated with higher state anger (r = .47), as well as measures of anger-out (r = .32) and trait anger (r = .34). Higher PRS scores were associated only with higher state anger (r = .27). Scores on the two 9/11/01-related scales were not statistically associated (i.e., less than 5% of the variance explained) with traits of anger control, anger-in, or hostility. CONCLUSIONS: The majority of students were not overly stressed by indirect exposure to the events of 9/11/01, perhaps owing to the temporal, social, and/or geographical distance from the event. Those who reported greater negative impact appeared to also be experiencing higher levels of current anger and exhibited a characterologic style of higher overt anger expression.

Adolescent↗
PubMed2006

Aripiprazole in the treatment of patients with borderline personality disorder: a double-blind, placebo-controlled study.

OBJECTIVE: Aripiprazole is a relatively new atypical antipsychotic agent that has been successfully employed in therapy for schizophrenia and schizoaffective disorders. A few neuroleptics have been used in therapy for patients with borderline personality disorder, which is associated with severe psychopathological symptoms. Aripiprazole, however, has not yet been tested for this disorder, and the goal of this study was to determine whether aripiprazole is effective in the treatment of several domains of symptoms of borderline personality disorder. METHOD: Subjects meeting criteria for the Structured Clinical Interview for DSM-III-R Personality Disorders for borderline personality disorder (43 women and 9 men) were randomly assigned in a 1:1 ratio to 15 mg/day of aripiprazole (N=26) or placebo (N=26) for 8 weeks. Primary outcome measures were changes in scores on the symptom checklist (SCL-90-R), the Hamilton Depression Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A), and the State-Trait Anger Expression Inventory and were assessed weekly. Side effects and self-injury were assessed with a nonvalidated questionnaire. RESULTS: According to the intent-to-treat principle, significant changes in scores on most scales of the SCL-90-R, the HAM-D, the HAM-A, and all scales of the State-Trait Anger Expression Inventory were observed in the subjects treated with aripiprazole after 8 weeks. Self-injury occurred in the groups. The reported side effects were headache, insomnia, nausea, numbness, constipation, and anxiety. CONCLUSIONS: Aripiprazole appears to be a safe and effective agent in the treatment of patients with borderline personality disorder.

Aggression↗
PubMed1994

Dying in palliative care units and in hospital: a comparison of the quality of life of terminal cancer patients.

A comparison of the quality of life of terminal cancer patients in two palliative care units with that of those in a general hospital is reported here. Quality of life was considered as a multidimensional concept. It was assessed for the 182 patients by applying content analysis scales to transcripts of their responses to part of a standardized interview. A personal construct model of dying provided the specific hypotheses about differences in quality of life. Patients in specialized palliative care units were, as predicted, found to differ from those dying in hospital, showing less indirectly expressed anger but more positive feelings. They also reported more anxiety about death but less anxiety about isolation and general anxiety, and fewer influential and nonspecified shared relationships. Against prediction, the patients in the two specialized units were also found to differ from each other, those in the smaller unit showing more directly expressed anger and helplessness than those in the larger unit.

Attitude to Death↗
PubMed2006

Pregnant women with bronchial asthma benefit from progressive muscle relaxation: a randomized, prospective, controlled trial.

BACKGROUND: Asthma is a serious medical problem in pregnancy and is often associated with stress, anger and poor quality of life. The aim of this study was to determine the efficacy of progressive muscle relaxation (PMR) on change in blood pressure, lung parameters, heart rate, anger and health-related quality of life in pregnant women with bronchial asthma. METHODS: We treated a sample of 64 pregnant women with bronchial asthma from the local population in an 8-week randomized, prospective, controlled trial. Thirty-two were selected for PMR, and 32 received a placebo intervention. The systolic blood pressure, forced expiratory volume in the first second, peak expiratory flow and heart rate were tested, and the State-Trait Anger Expression Inventory and Health Survey (SF-36) were employed. RESULTS: According to the intend-to-treat principle, a significant reduction in systolic blood pressure and a significant increase in both forced expiratory volume in the first second and peak expiratory flow were observed after PMR. The heart rate showed a significant increase in the coefficient of variation, root mean square of successive differences and high frequency ranges, in addition to a significant reduction in low and middle frequency ranges. A significant reduction on three of five State-Trait Anger Expression Inventory scales, and a significant increase on seven of eight SF-36 scales were observed. CONCLUSIONS: PMR appears to be an effective method to improve blood pressure, lung parameters and heart rate, and to decrease anger levels, thus enhancing health-related quality of life in pregnant women with bronchial asthma.

Adult↗
PubMed2004

Elevation of the cortisol/dehydroepiandrosterone ratio in schizophrenia patients.

Dehydroepiandrosterone (DHEA) and its sulfate derivative DHEA-S are neurosteroids, produced in the brain, and neuroactive steroids, produced in the adrenals and affecting the brain. We compared the ratios of serum cortisol/DHEA or DHEA-S in schizophrenia patients with normal subjects, and determined the correlation of these ratios with psychopathology and distress. Early morning plasma concentrations of DHEA, DHEA-S, and cortisol were determined by radioimmunassay in 40 medicated schizophrenia inpatients, and 15 healthy subjects with similar age and sex distribution. Subjects were assessed for psychopathology using the Positive and Negative Syndrome Scale (PANSS) and the Montgomery and Asberg Depression Rating Scale (MADRS), anxiety, anger, emotional and somatic distress levels. Schizophrenia inpatients demonstrated significantly higher levels of state and trait anxiety, anger expression index, emotional and somatic self-reported distress scores. Cortisol/DHEA and cortisol/DHEA-S ratios were significantly higher in schizophrenia patients than in healthy comparison subjects. Both ratios correlated positively with age and duration of illness; cortisol/DHEA-S ratio also showed positive association with age of illness onset. When age, illness duration and age of onset were controlled, cortisol/DHEA-S ratio significantly correlated with severity of depression (MADRS, r=0.33, p=0.048), state and trait anxiety (r=0.43, p=0.008 and r=0.40, p=0.014, respectively), trait anger (r=0.41, p=0.012), angry temperament (r=0.46, p=0.004), anger expression index (r=0.36, p=0.033), and hostility (r=0.42, p=0.010). No significant association was found between these ratios and severity of psychopathology, and type or dosage of antipsychotic agents. Thus, elevated cortisol/DHEA and/or cortisol/DHEA-S ratios in schizophrenia patients are positively associated with higher scores for anxiety and anger, depression and hostility, age and age of onset/duration of illness, but are independent of severity of psychopathology (PANSS) and antipsychotic treatment.

Adult↗
PubMed2002

Anger, and plasma lipid, lipoprotein, and glucose levels in healthy women: the mediating role of physical fitness.

The association between anger, lipid profiles, and glucose levels were examined in this study of 103 middle aged, healthy women. A principal component factor analysis of Spielberger's Trait Anger and Anger Expression scales yielded two anger factors: Impulsive Anger-Out and Neurotic Anger. Impulsive anger-out significantly predicted a negative lipid profile (high total serum cholesterol (TSC), low density lipoproteins (LDL), TSC/HDL (high density lipids), and triglyceride levels) and heightened glucose levels, but only in physically unfit women. Neurotic anger did not predict lipid and glucose levels. These findings parallel previous findings regarding the two anger dimensions and CHD, with only impulsive anger-out predicting CHD. Furthermore, our findings indicate that the protective effect of physical fitness, previously documented for men, also occurs in women.

Adult↗
PubMed1992

How loss affects anger and alienates potential supporters.

The effects of loss of resources and illness symptoms on experienced anger, anger expression, and supporter's anger was studied among patients with severe chronic breathing disorder. Both illness symptoms and resource loss were related to greater anger. Angry feelings, in turn, led to more angry behavior. This angry behavior, in turn, resulted in increased anger of supporters. This process illustrates how chronic stress depletes both personal resources and social resources, making the individual increasingly vulnerable to further stressful experiences, inevitably to be confronted in chronic stress sequences.

Adaptation, Psychological↗
PubMedDate not supplied

Women's anger, aggression, and violence.

Themes of powerlessness, power, and paradox predominate in this reflection on more than 15 years of research on women's anger. Studies conducted in the United States, France, and Turkey are highlighted. These studies have negated several myths while illuminating the general rationality of women's anger: It is squarely grounded in interpersonal interactions in which people deny women power or resources, treat them unjustly, or behave irresponsibly toward them. The offenders are not strangers; rather they are their closest intimates. But few women learned healthy anger expression while growing up. Anger is a confusing and distressing emotion for women, intermingled with hurt and pain. Its complexity requires greater attention by researchers, with regard to health-promoting interventions and to cultural differences, because anger in non-Western cultures has seldom been explored.

Adaptation, Psychological↗
PubMedDate not supplied

Behavioral antecedents of coronary heart disease and atherosclerosis.

Over 50 epidemiologic, clinical, and experimental studies of behavioral influences on atherosclerosis and CHD have been reviewed; of these investigations, no more than five were published prior to 1975. Despite some inconsistencies and occasional conceptual and methodologic problems in the studies comprising this relatively young literature, the preponderance of available evidence indicates that psychosocial variables play a significant role in coronary disease. To summarize briefly, the Type A behavior pattern has been found predictive of new CHD in nearly all prospective studies of initially healthy individuals, and therapeutic modification of Type A has been shown to reduce risk of recurrent nonfatal MI. Among most prospective studies of post-MI patients and of persons at heightened risk for CHD due to elevations in traditional risk factors, however, Type A has not been found to predict, respectively, recurrence of MI or initial clinical events. Additionally, Type A individuals have shown more extensive coronary artery atherosclerosis on angiographic examination than Type Bs in a minority of studies, and, generally, only where Type A behavior has been measured by the SI. It is noted that many of these clinical studies may be faulted, though, for their use of small and heterogeneous patient samples and for possible biases in the selection and recruitment of subjects. In contrast to the globally defined Type A pattern, a high potential for hostility and an inability or unwillingness to express anger (anger-in) have emerged as significant predictors or correlates of coronary disease in all epidemiologic and clinical studies in which these variables have been examined. These consistent results suggest that a predisposition to hostility and anger, and the inhibited expression of such feelings, represent a "toxic" component of the Type A pattern. Several recent prospective investigations indicate also that high levels of life stress and possession of poor or inadequate social resources are predictive of CHD. The concepts of life stress, social network, and social support, as well as relationships among these variables, are not well-understood, however, and much additional work is needed to identify specific pathogenic and protective attributes of the social environment. In addition to studies of the psychosocial antecedents of CHD in human beings, there now are several published studies of behavioral influences on the development of coronary lesions in animal models.(ABSTRACT TRUNCATED AT 400 WORDS)

Arteriosclerosis↗
PubMed1996

Psychological sequelae to assassination attempts.

The experiences of nine subjects who were the victims of assassination attempts are described. All but one were the victims of shootings or attempted shootings. Post Traumatic Stress Disorder (PTSD) was an almost invariable response. Brief alcohol abuse was quite common. Most subjects displayed considerable feelings of anger. Only a minority expressed anger against their assailants while much anger was displaced towards the medical profession and institutions of the state. This displacement of anger is discussed as are the implications for treatment of such displacement.

Adult↗
PubMed2004

Anger management style, blood pressure reactivity, and acute pain sensitivity: evidence for "Trait x Situation" models.

BACKGROUND: Anger management style is related to acute and chronic pain, but it is not clear whether anger arousal is needed for these associations to emerge or whether physiological mechanisms mediate these links. PURPOSE: "Trait x Situation" models were examined to determine whether relationships between anger-out and pain and anger-in and pain depended on anger provocation's preceding pain induction and whether pain sensitivity variance explained by anger management style overlapped with variance in harassment-induced blood pressure reactivity. METHODS: Healthy individuals (N = 53) underwent either mental arithmetic with harassment and then a cold pressor (MA/CP) or vice versa (CP/MA). The Spielberger Anger Expression Inventory assessed anger-out using the Anger-Out subscale (AOS) and anger-in using the Anger-In subscale (AIS). RESULTS: AOS x Order and AIS x Order interactions for pain tolerance emerged, such that (a) AOS was related negatively to tolerance among MA/CP participants, whereas AOS and tolerance were not related in CP/MA; (b) AIS was related positively to tolerance in MA/CP, whereas AIS was related negatively to tolerance in CP/MA; and (c) tolerance variance accounted for by AOS in MA/CP overlapped substantially with tolerance variance accounted for by diastolic blood pressure reactivity. CONCLUSIONS: Findings support the notion that anger management style affects pain and are consistent with evidence that deficient endogenous opioid functioning may be one mechanism through which anger-out is linked to both pain sensitivity and cardiovascular stress reactivity, a connection that appears most reliably when anger is provoked.

Adaptation, Psychological↗
PubMed2004

[Relationship between depression and anger in patients with antisocial personality disorder].

OBJECTIVE: This study examined the relationship between aggression and depression in male antisocial patients with and without comorbid depression and in normal control subjects. METHOD: Seventy-two antisocial patients were evaluated for depression using SCID. The antisocial patients were treatment-seeking soldiers, mostly substance use is recruited from military hospitals. The control group consisted of forty age and sex matched subjects. Twenty of these antisocial patients were diagnosed with depressive disorder (major depression or dysthymia). In order to assess aggression and depression the Beck Depression Inventory and the State-Trait Anger Scale (STAS) were used. RESULTS: Antisocial patients with depression and without depression had higher trait anger, anger-in and anger-out scores than the controls. Antisocial patients without comorbid depression had lower scores than the antisocial patients without depression in the anger control subscales of STAS. On the other hand, in this subscale, scores of the antisocial patients with depression did not differ from those of the normal controls. Correlation analysis revealed a significant positive relationship between BDI scores and trait anger, anger-in and anger-out scores. CONCLUSION: The result of our study did not fully support the view of depression which assumes that depressive disorder is related to anger and hostility at least in antisocial patients. According to our results higher anger scores and lower anger control scores were related to being antisocial rather than being depressive and also not only suppressed anger but also outwardly expressed anger were increased in depressive antisocial patients.

Adult↗