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Hostility, anger expression, cardiovascular responsivity, and social support.

Sixty male subjects completed the Cook-Medley Hostility Scale (Ho), the anger-in, anger-out, and anger-discuss measures of anger expression from the Framingham Heart Study, and a measure of social support. Subjects also performed two challenging tasks while systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate (PR) were monitored. Neither SBP, DBP, nor PR responses to the tasks were found to be related to the Ho or anger expression scales. Quality of social support was not found to be related to the Ho scale but was related negatively to the anger-discuss scale. The more subjects reported discussing their anger with others, the less social support they reported having. A negative correlation was found between the Ho and anger-out scales. The possibility is discussed that the relation between either of these two measures and coronary heart disease may be mediated or moderated by the other variable.

Adolescent↗

Anger feelings and anger expression as a mediator of the effects of witnessing family violence on anxiety and depression in Japanese adolescents.

The effects of anger feelings (rated by the State-Trait Anger Expression Inventory) and witnessing family violence on anxiety and depression (rated by the Hospital Anxiety and Depression Scale) were examined in 457 junior high school students. Anxiety and depression scores were correlated with frequencies of witnessing family violence. In a regression analysis, however, after controlling for the demographic variables and depression score, the anxiety score was predicted by State Anger, Anger-Out, and Anger-Control; the depression score was predicted, after controlling for the demographic and anxiety score, by State Anger, Anger-In positively, and by Anger-Out and Anger-Control negatively. Witnessing family violence failed to add significant contribution in predicting anxiety or depression. These results were generally supported by structural equation modeling. The effects of witnessing family violence on dysphoric mood may be mediated by anger feelings. The style of dysphoric mood may be predicted by the style of anger expression.

Adolescent↗

Trait anger, anger expression, stress, and health status of American and Turkish midlife women.

In a cross-cultural study, we investigated the relationships of trait anger, anger expression modes, and stress to physical and mental health in Turkish and American midlife women. Zero-order correlations and multiple regression analyses indicated that regardless of cultural origin, stress was a strong predictor of health status. Stress was negatively related to physical health and positively related to depression. Trait anger, the angry temperament dimension of trait anger, and anger-out were positively related to depression in both American and Turkish women. The negative relationship between somatic mode of anger expression and health was also consistent for both groups. However, anger-in was positively correlated with depression only in American women; suppression of anger was unrelated to health status in Turkish women. Cross-cultural comparisons indicated that Turkish midlife women were higher in trait anger, somatic anger symptoms, perceived stress, and depression than American women. American women, on the other hand, had higher scores on physical health status. These findings are discussed with regard to theory, previous research, and sociocultural context.

Adult↗

Family communication patterns and adolescent depressive symptoms: sequential mediating effects of hedonic capacity and anger expression.

OBJECTIVE: Depression is increasingly prevalent among adolescents, highlighting the need to explore its underlying developmental mechanisms to inform effective prevention. This study examined how different family communication patterns longitudinally impact adolescent depressive symptoms, with a focus on the mediating roles of diminished hedonic capacity and anger expression. METHOD: A total of 729 Chinese adolescents from five high schools participated in this two-wave longitudinal study over a six-month period. Participants completed the Family Communication Patterns Scale (FCPS), the Children's Depression Inventory (CDI), the Anhedonia Scale for Adolescents (ASA), and the Children's Inventory of Anger (ChIA). Mediation analyses were conducted using Hayes' PROCESS macro, alongside cross-lagged panel analyses to explore longitudinal effect. RESULTS: Cross-sectional analyses indicated that diminished hedonic capacity and anger experience sequentially mediated the relationship between family communication patterns and adolescent depressive symptoms. Specifically, this mediating effect existed for conversation orientation in junior high school students and female senior high school students, as well as for conformity orientation among female junior and senior high school students. In addition, longitudinal analyses revealed that diminished hedonic capacity mediated the associations at Wave 2. CONCLUSION: Our findings suggest that enhanced hedonic capacity and reduced anger expression may play a key role in the relationship between family communication patterns and adolescent depression, and hedonic capacity should be prioritized in practical interventions. These results support the potential value of interventions that promote positive family communication patterns as a means of mitigating adolescent depression, particularly for families with daughters.

anger expression↗

Shame and guilt and their relationship to positive expectations and anger expressiveness.

College students (174 females, 91 males) completed measures of shame, guilt, expectations for future success, and styles of anger expression. Significant gender differences were found in proneness for both shame and guilt, with young women exhibiting a greater propensity for shame and guilt than young men. For both females and males, however, shame-proneness was positively related to expressions of inward anger. Among males and females, guilt-proness was negatively related to outward anger, but positively related to anger control. For females, guilt-proness was also negatively related to expectations for future success. Multiple regression analyses indicated that for male and female late adolescents, the best positive predictor of shame-proneness was inward anger. Gender differences emerged in predicting guilt-proneness; greater anger control, lower outward anger, and lower expectations for future success significantly predicted this variable among females.

Adolescent↗

Development of a Russian State-Trait Anger Expression Inventory.

We examined the possible universality of Spielberger's (1988) model of anger by validating a Russian State-Trait Anger Expression Inventory (STAXI). In Eckhardt, Kassinove, Tsytsarev, and Sukhodolsky (1995), support was found for all STAXI factors except anger-in, using students from St. Petersburg State University. In the present study, 346 students from Russian high schools and the Pavlov Medical School served as subjects. Using new items, we found strong support for the factor structure hypothesized by Spielberger. All scales showed good to excellent alphas, and there was substantial similarity of the current means with results from the earlier study. The Russian samples, however, showed a lower level of state anger. The data support the possibility that state anger consists of two subscales, a simple experience and an experience combined with an action tendency. Trait anger occurs as a general temperament or as a reaction to specific triggers. It is positively related to anger-out and negatively related to anger control. Future studies can use this instrument to evaluate the stability of anger in Russian speaking populations, and to assess anger experiences and expression in response to specific triggers.

Adolescent↗

Adolescent blood pressure, anger expression and hostility: possible links with body fat.

An uncertain relation between health and angry/hostile behaviour exists in the literature on adolescents. With data from a pilot study, one possible reason for this is explored: health measures such as blood pressure as well as angry/hostile behaviours may change with, or depend upon physical maturity, body size and body fatness. The sample consists of 60 African-, Hispanic-, and Anglo-American adolescents (15 to 16 years of age) drawn from a public school in Houston, TX. Using resting diastolic blood pressure as a model, in a sex stratified analysis, the following conclusions were reached: Physical maturity in girls and body height in boys were related to ethnicity in the sample and were confounders of the blood pressure and anger relationship. In girls secretive anger ('anger-in') and hostility were associated with increased body fat; expressive anger ('anger-out') in boys is associated with increased conicity (central body fat distribution) (p < 0.01). These associations were independent of height and physical maturity. Hostility was not significantly related to diastolic blood pressure in boys after adjusting for height and conicity. 'Anger-in' was significantly and positively related to diastolic blood pressure in girls (p < 0.01). This relationship was strongly mediated by per cent body fat, because the association of 'anger-in' and blood pressure was no longer statistically significant when the model included body fat. The results suggest that measures of physical maturity and more refined measures of body fat and body fat distribution should be considered in studies attempting to link adolescent blood pressure with anger expression.

Adolescent↗

A prospective study of social support, anger expression and risk of periodontitis in men.

BACKGROUND: Stress is associated with poor oral hygiene, increased glucocorticoid secretion that can depress immune function, increased insulin resistance and potentially increased risk of periodontitis. METHODS: The authors examined the association between social support, anger expression and periodontitis in 42,523 male, U.S.-based, health professionals. Subjects were aged 40 to 75 years in 1986, and more than half were dentists. The men were free of a diagnosis of periodontitis at the start of follow-up in 1996. RESULTS: Subjects who reported having at least one close friend had a 30 percent lower risk of developing periodontitis compared with those who did not have a close friend (relative risk, or RR = 0.70; 95 percent confidence interval, or CI, 0.51-0.96). Men who participated in religious meetings or services had a 27 percent lower risk of developing periodontitis compared with men who did not participate in religious meetings (RR = 0.73; 95 percent CI, 0.64-0.83). After the authors adjusted for potential confounding variables, men whose anger scores were in the top quintile were 72 percent more likely to report having periodontitis compared with men whose scores were in the lowest quintile (RR = 1.72; 95 percent CI, 1.39-2.12). Men who reported being angry on a daily basis had a 43 percent higher risk of developing periodontitis compared with men who reported being angry seldom. CONCLUSION: Reduced social isolation and anger expression may play an important role in maintaining oral health, as well as general health and well-being. CLINICAL IMPLICATIONS: When treating patients with periodontitis, clinicians should be cognizant of the social and behavioral factors that may affect oral health.

Adult↗

The relationship between personality, anger expression, and perceived family control among incarcerated male juveniles.

The literature suggests that a multitude of psychological and social factors can interact to place adolescents at risk for aggression and violence. This study examined three of these factors: personality, affect, and family. Using a heterogeneous sample of male adolescents at risk for violence, a hierarchical, agglomerative cluster analysis was conducted to categorize these adolescents in terms of personality characteristics. Results of the analysis suggested three clusters of at-risk adolescents. Examination of the three cluster types found distinctions between groups on anger expression, trait anger, and trait anxiety, but not family control. It was concluded that, among male delinquents, elevated psychopathology is associated with higher anger and anxiety, but not higher family control.

Adolescent↗

Assessment of self-reported anger expression in pre- and early-adolescent African Americans: psychometric considerations.

This study examined the psychometric properties of the Speilberger state-trait anger expression inventory (STAXI) and Framingham (FAS) anger scales in 86 African American youth. Significant gender differences were not observed for the STAXI or FAS subscales scores (all p>0.17). Inter-scale correlations revealed that the anger-in and anger-out subscales of the STAXI and FAS were measuring similar, yet different constructs. For the STAXI, intra-scale correlations indicated that the anger-in and anger-out subscales were not independent (p<0.001), whereas the anger-in and anger-out subscales (FAS) were not statistically related (p>0.05). The component structures for the anger-control subscale (STAXI) and the anger subscales (FAS) were similar to those reported by the scale authors.

Adolescent↗

Anger expression in the Picture-Frustration study under stressful conditions.

In order to study anger expression in health and illness, the Rosenzweig Picture-Frustration study was administered to hospitalized depressives, parents of seriously ill children, and healthy controls. A follow-up study then compared responses of acutely and chronically ill adults. Externally directed aggression was lower in people experiencing more severe stress, and was negatively correlated with external locus of control and with depression. It is suggested that within limits outer-direction of blame for frustration may characterize unstressed, well-adjusted people, and that further research with the Rosenzweig in relation to assertion training would be valuable.

Adult↗

Anger expression and life stress among blacks: their role in physical health.

This study examines the relationship between anger expression and life stress in a nationally representative sample of black adults. Recent research of mostly white subjects has shown that anger-hostility, one of the components of the Type A behavioral pattern, is an important predictor of health problems. The findings of the present inquiry indicate that anger-hostility is an important predictor of life stress, and that people with higher levels of anger conflict are more likely to experience negative life events. Moreover, negative life events and anger are shown to be independent predictors of health problems among blacks. The implications of these results for future studies of the health of black Americans are discussed.

Adolescent↗

The Spielberger Anger Expression Scale: some psychometric data.

Some general population norms for the Spielberger, Johnson et al. (1984) Anger Expression Scale (AX) are reported for a sample of over 1000 adults tested in a general health survey of a New Zealand community. Factor analysis confirmed the independence of the Anger/In and Anger/Out subscales, and the measure was found to have satisfactory levels of reliability.

Adolescent↗

Relationship of racial stressors to blood pressure responses and anger expression in black college students.

The physiological effects of racism, as a stressor, were examined as they related to blood pressure (BP) and anger experiences in Black college students. Current research has failed to consider the stressful effects of racism as a factor contributing to the higher incidence of essential hypertension among Blacks. Twenty-seven Black college students viewed three excerpts showing racist situations involving Blacks; anger-provoking, nonracist situations; and neutral situations. After each scene, BP was taken, and a mood checklist was administered. The Framingham Anger Scale and the Anger Expression Scale were administered. Analyses revealed that BP significantly increased during the presentation of racist stimuli but not of anger-provoking or neutral stimuli. Self-reports of state anger, as measured by the mood checklist, were significant for both the anger-provoking and racist stimuli. BP scores were significantly correlated to the two trait anger measures. Exposure to racist stimuli was associated with BP increases among Blacks. Such cumulative exposure to racism may have important implications for the etiology of essential hypertension.

Adaptation, Psychological↗

Trait anger, anger expression, and ambulatory blood pressure: a meta-analytic review.

A meta-analysis of 15 studies was conducted to investigate the relationship between trait anger and ambulatory blood pressure. Overall, the experience of anger was significantly and positively associated with systolic blood pressure (r+ = 0.049), but not reliably associated with diastolic blood pressure (r+ = 0.028). After removing an outlier, the expression of anger was found to have a reliable inverse relationship with diastolic blood pressure (r+ = -0.072). No reliable relationship between expression of anger and systolic blood pressure (r+ = -0.041) was found. These results continue to support the modest role of self-reported trait anger and anger expression in blood pressure levels. Several suggestions for future research are discussed, including increasing the focus on the complexity and synergism of these effects.

Adult↗

The utility of the State-Trait Anger Expression Inventory with offenders.

Self-report instruments can provide useful information as part of a thorough clinical assessment. However, their use in forensic settings can be problematic. The State-Trait Anger Expression Inventory (STAXI) has recently been proposed as an effective instrument for screening and outcome measurement in anger management programs. This study evaluated the effectiveness of this instrument in a sample of both voluntary and court-ordered anger-management clients, all of whom were determined through diagnostic interviews to have significant anger problems. Contrary to findings in nonforensic samples, the STAXI Trait Anger scale identified only about half of the participants as having anger-management problems severe enough to require intervention. Supplemental analysis with two additional scales did not significantly improve sensitivity. In addition to thorough diagnostic interviewing, forensic use of the STAXI (like similar assessment methods) may require additional validity scales to detect denial or socially desirable response patterns.

Adolescent↗

Trait anger expressiveness and pain-induced beta-endorphin release: support for the opioid dysfunction hypothesis.

The anger management styles of anger-in (inhibition) and anger-out (direct expression) are positively associated with pain responsiveness. Opioid blockade studies suggest that hyperalgesic effects of trait anger-out, but not those of trait anger-in, are mediated in part by opioid analgesic system dysfunction. The current study tested the opioid dysfunction hypothesis of anger-out using an alternative index of opioid function: pain-induced changes in plasma endogenous opioids. Plasma beta-endorphin (BE) was assessed at rest and again following exposure to three laboratory acute pain tasks (finger pressure, ischemic, and thermal) in 14 healthy controls and 13 chronic low back pain (LBP) subjects. As expected, acute pain ratings correlated positively with measures of anger-in (both groups) and anger-out (LBP group; p's<.05). Greater pain-induced increases in BE were associated with significantly lower pain ratings in both groups (p's<.05). Hierarchical multiple regression indicated that greater anger-out significantly predicted smaller pain-induced BE increases (p<.05). Subject type did not moderate this association (p>.10). Anger-in did not display significant main or interaction effects on pain-induced BE changes (p's>.10). The significant association between anger-out and BE release partially mediated the hyperalgesic effects of anger-out on pain unpleasantness, and was not attenuated by statistical control of general negative affect. This suggests unique associations with expressive anger regulation. Elevated trait anger-out therefore appears to be associated with opioid analgesic system dysfunction, whether it is indexed by responses to opioid blockade or by examining circulating endogenous opioid levels. Possible "statextrait" interactions on these anger-related opioid system differences are discussed.

Acute Disease↗

Defensive hostility and anger expression: relationship to additional heart rate reactivity during active coping.

The main purpose of the present study was twofold: (a) to assess the relationship between defensive hostility (high hostility/high defensiveness) and additional heart rate reactivity during active coping and (b) to determine if the construct of anger-out might lend additional sensitivity to the predictive power of the defensive hostility model. Forty individuals were randomly assigned to complete a mental arithmetic task with or without the threat of shock. Participants also completed the Cook-Medley Hostility Inventory (Ho), the Marlowe-Crowne Social Desirability Scale (MC), and the Spielberger Anger Expression Scale. Defensive hostile subjects (high Ho/high MC) were significantly more reactive than any other subgroup. In addition, the combination of low Ho/high anger-out scores yielded a subgroup significantly less reactive than any other subgroup. These findings clarify the complex relationship of hostility and cardiovascular reactivity.

Adult↗