Anger and Psychopathology

Abstract

Anger has semantic, conceptual, and empirical links to psychopathology. It has long been associated with madness, a diseased mind, and behavioral dyscontrol; claims of temporary insanity and the “heat of passion” defense feature anger. As an eruptive and turbulent emotion, anger activates violent behavior among psychiatric patients, before, during, and after hospitalization. Unlike anxiety and depression, there is no diagnostic category for anger, except perhaps intermittent explosive disorder, for which the criterion is aggressive behavior. Being intrinsically related to threat perception, anger is manifested in a wide variety of psychiatric disorders. With the inherent functionality of anger as point of departure, its involvement in adult psychopathology is presented. Anger emerges in conjunction with delusions and command hallucinations in psychotic disorders, the emotional instability attributes of personality disorders, irritability and “attacks” in mood disorders, impulse control disorders, intellectual disabilities, dementia, and exotic cultural-bound syndromes. As anger often results from trauma, it can be salient in PTSD, significantly affecting the severity and course of PTSD symptoms. The central characteristic of anger in the broad context of clinical disorders is dysregulation – its activation, expression, and experience occur without appropriate controls. Cautions against pathologizing an important emotional state are discussed, along with gains being made in anger treatment.