Anger Expression Scale Research Articles

An investigation of the anger levels of residents: medical compared with surgical disciplines

Objective: To evaluate medical and surgical residents’ anger levels with regard to the department in which they worked, seniority, sex, satisfaction with their work environment, and the number of nightshifts...

Psychometric Properties of the Trauma Stages of Recovery

Of the trauma theories available, Herman's has captured the essential features common to most traumatic etiologies. Continued development of this theory has included dimensions within stages of recovery. The Trauma States of Recovery is presented here as a way of assessing stages of recovery and inherent components. Three samples of about 500 college students each and a clinical sample (n=34) were recruited. Independent principal components analyses, employing a scree plot, gave a five-component solution accounting for 40.2% of the total variance. The component solution employed Promax rotation for the correlated components. The five components were named Emotional Awareness and Control, Symptom Mastery, Coping, Memory, and Relationships. Internal consistencies, test-retest reliability, and split-half reliability were acceptable. Response bias was low. Convergent validity (with various subscales from the Beck Depression Inventory, the Self-esteem Scale, the Spielberger Anger-Expression Scale, and the Dissociative Experiences Scale) and discriminant validity (with various subscales of the AIDS Knowledge and Attitudes Survey and Jackson's Personality Research Form Dominance Scale) were promising. The Trauma Stages of Recovery also significantly discriminated between clinical and nonclinical samples on three of the five components, Symptom Mastery, Coping, and Memory.

The Relation Between Anger Expression, Depression, and Somatic Symptoms in Depressive Disorders and Somatoform Disorders

In previous studies, the relationship between either anger suppression and depression or anger suppression and somatic symptoms was examined. However, the relationship between anger expression, depression, and somatic symptoms was not examined in depressive disorders and somatoform disorders. The DSM-IV-diagnosed subjects included 73 patients with depressive disorders and 47 patients with somatoform disorders. The Anger Expression Scale was used to assess the level of anger expression or suppression. The severity of depression was assessed using the Symptom Checklist-90-Revised (SCL-90-R). The Somatization Rating Scale and the SCL-90-R somatization subscale were used to assess the severity of somatic symptoms. Data were collected from March 2000 to March 2001. The results of the path analyses showed that in depressive disorder patients, anger expression had a stronger effect on somatic symptoms through depression than did anger suppression, although both anger expression and anger suppression had a significant indirect effect on somatic symptoms. The depressive disorder group also showed a significant but negative direct effect of anger suppression on anger expression in the path from anger suppression to anger expression to depression to somatic symptoms. However, only anger suppression had an indirect effect on somatic symptoms through depression in somatoform disorder patients. The results suggest that anger expression might play a more predominant role in depression and somatic symptoms of depressive disorder patients than anger suppression, but only anger suppression might be associated with depression and somatic symptoms of somatoform disorder patients. In addition, incomplete anger suppression followed by anger expression is likely to be associated with depression and somatic symptoms in depressive disorders.

Genetic and Environmental Influences on Anger Expression, John Henryism, and Stressful Life Events: The Georgia Cardiovascular Twin Study

To examine the genetic and/or environmental origin of variation and covariation of perceived stressful life events and two stress-related coping styles, anger expression and John Henryism. Data were available from 306 European American (EA) and 213 African American (AA) twin pairs, including monozygotic and dizygotic of same as well as opposite sex (mean age, 14.8 +/- 3.1 years; range, 10.0-25.9 years). Anger expression, John Henryism, and life events were measured with the Anger Expression Scale (subscales: Anger-in, Anger-out, and Anger-control), the John Henryism Active Coping Scale, and the Adolescent Resources Challenges Scale, respectively. Model fitting showed no ethnic or sex differences for any of the scales. All traits showed at least some degree of familial resemblance, best explained by shared environment for Anger-in (18%), heritability for Anger-control (34%), John Henryism (34%), and life events (47%), and a combination of heritability (14% and 15%) and shared environment (10% and 20%) for Anger-out and overall anger expression, respectively. The remaining part of the variation for all traits was explained by environmental influences that are unique to the individual. Anger expression and life events were correlated (r = 0.28), and bivariate genetic modeling showed that 61% of this correlation was mediated by common genetic factors. Individual differences in coping styles and life events in youth can be explained by moderate genetic and substantial environmental influences, of which most are idiosyncratic to the individual. The association between anger expression and life events is largely the result of common genes.

A Correlational Study among Perceived Stress, Anger Expression, and Depression in Cancer Patients

This study was to identify the relationship between perceived stress, anger expression, and level of depression in cancer patients. A cross-sectional descriptive study design was used. Data was collected by questionnaires from 185 in- and out-patients who were diagnosed with cancer at 3 university hospitals and the National Cancer Center using Spielberger et al.'s Anger Expression Scale, Cohen, Kamarch & Mermelstein's Perceived Stress, and Derogatise's SCL-90. The data was analyzed using descriptive statistics, Pearson correlation coefficient, and stepwise multiple regression with SAS/PC. The perceived stress in cancer patients indicated a significant positive correlation to anger-in(r=.288, p=.000), anger-out(r=.232, p=.001), and depression(r=.68, p=.000), but no significant correlation to anger-control. The anger-in of cancer patients showed a significant positive relationship to anger-out(r=.53, p=.000), and depression(r=.383, p=.000), but no significant correlation to anger-control. Anger-out showed a significantly negative correlation to anger-control(r=-.248, p=.001) and a positive correlation to depression(r=.240, p=.001). The most significant predictor which influenced depression in cancer patients was perceived stress, followed by anger-in and hobby, and these factors explained their depression with a variance of 54%. These results suggested that cancer patients with a high degree of perceived stress are likely to be high in anger-out and anger-in. Perceived stress and anger-in are major factors which affect depression in cancer patients.

Psychological Traits and Emotion-Triggering of ICD Shock-Terminated Arrhythmias

We have previously reported on the triggering of arrhythmia and hence, implanted cardioverter-defibrillators (ICD) shock by strong emotion. The purpose of the present study was to examine whether concordant psychological traits distinguish patients who experience emotion-triggered ICD shock. Two hundred forty ICD patients completed the Speilberger Trait Anxiety and Anger Inventories and Anger Expression Scale, and the abridged Cook-Medley Hostility Scale approximately 2 months after ICD implantation. Patients were also given a structured diary to record mood states retrospectively for the period 0 to 15 minutes preceding ICD shock and for a period corresponding to the same time of day 1 week later. Patients who reported emotion-triggered ICD shock were compared on concordant psychological measures to patients who did not. Patients who reported at least moderate anger in the 0 to 15 minutes before ICD shock scored significantly higher on Speilberger Trait Anger (24.18 +/- 3.97 vs. 17.04 +/- 2.17, p < .0001), and Cook-Medley Aggressive Responding (5.76 +/- 0.75 vs. 3.96 +/- 1.30, p < .0001) and Hostile Affect (3.59 +/- 0.80 vs. 2.04 +/- 1.02, p < .0001), and lower on Speilberger Anger Control (7.94 +/- 1.43 vs. 10.64 +/- 1.19, p < .001) than those who did not. In multivariate analysis, only Trait Anger remained a significant predictor of anger-triggered shock (chi2 = 7.10, p < .008). Patients who reported at least moderate anxiety in the 0 to 15 minutes before ICD shock scored significantly higher on Speilberger Anxiety (22.43 +/- 1.65 vs. 19.96 +/- 1.71, p < .0001) than those who did not. Stable psychological factors are associated with risk for ICD-shock triggered by concordant strong emotion.

The relationship of anger expression and alexithymia with coronary artery stenosis in patients with coronary artery diseases.

This study examined the relationship between anger expression or alexithymia and coronary artery stenosis in patients with coronary artery diseases. 143 patients with coronary artery diseases (104 males and 39 females) were enrolled in this study. The severity of their coronary artery stenosis was measured by angiography. The Anger Expression Scale and the Toronto Alexithymia Scale were used to assess the level of anger expression and alexithymia. The more stenotic group (occluded by 75% or more) exhibited a significantly higher level of alexithymia than the less stenotic group (occluded by less than 25%). Multiple regression analysis on the extent of stenosis also revealed that regardless of gender and age, the coronary artery disease patients with higher alexithymia were likely to show a greater level of stenosis. However, no significant differences were found on either the anger-in or anger-out subscale scores between the two groups. These results suggest that alexithymia is associated with the severity of coronary artery stenosis in patients with coronary artery disease. However, both anger expression and anger suppression were not shown to be associated with the severity of coronary artery stenosis.

Factor structure of the Spielberger Anger Expression scales when used with Australian prisoners.

The State-Trait Anger Expression Inventory administered to prison inmates has supported the factor structure of the three anger expression scales although this structure has not been verified with Australian participants. Data collected from 397 Western Australian male prisoners produced a factor structure consistent with the scale structure outlined in the 1991 manual. Scale means and standard deviations were similar to those reported for U.S. and Canadian prisoners. It is therefore appropriate to use the standard scoring procedures with Australian male prisoners.

FACTOR STRUCTURE OF THE SPIELBERGER ANGER EXPRESSION SCALES WHEN USED WITH AUSTRALIAN PRISONERS

The State-Trait Anger Expression Inventory administered to prison inmates has supported the factor structure of the three anger expression scales although this structure has not been verified with Australian participants. Data collected from 397 Western Australian male prisoners produced a factor structure consistent with the scale structure outlined in the 1991 manual. Scale means and standard deviations were similar to those reported for U.S. and Canadian prisoners. It is therefore appropriate to use the standard scoring procedures with Australian male prisoners.

Anger and coronary calcification in individuals with and without risk factors of coronary artery disease.

The authors investigated the relationship between anger and the calcification of the coronary artery in individuals with and without risk factors for coronary artery disease in Korea. Sixty-one subjects with risk factors of coronary artery disease and 31 subjects without risk factors were enrolled in this study. Electron Beam Computed Tomography was used to measure the calcium level of coronary artery. The anger expression scale was used to measure the anger levels. The anxiety, depression, hostility, and somatization subscales of the symptom checklist-90-revised (SCL-90-R) and the global assessment of recent stress (GARS) scale were used to assess the psychopathology and perceived stress. The logistic regression analysis results showed that only the anger-total score was significantly associated with the coronary calcification regardless of the risk factors. These results suggest that anger plays an important role in the calcification of the coronary artery.

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

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. 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. 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%. 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.

Expression of anger and alexithymia in patients with psychogenic excoriation: a preliminary report.

Psychogenic excoriation (PE), which is characterized by lesions formed by self-picking, has a significant place among the dermatoses related to psychological factors. Emotions, particularly anger that cannot be expressed, may be important in the etiology. The objective of this study was to evaluate the sociodemographic characteristics of patients with PE and with another psychodermatosis, and compare them in terms of anger, manner of anger expression, and alexithymia. Thirty-one consecutive subjects with PE and thirty-one patients with chronic urticaria were recruited from an outpatient dermatology clinic. All of the subjects completed Toronto Alexithymia Scale and Trait Anger and Anger Expression Scale. PE patients had higher levels of anger (p < .01), tended not to show their anger (p < .05), and were more alexithymic (p < .05). There was also a positive correlation between anger and alexithymia scores (r = .49, p < .05). PE, a severe and chronic psychiatric and dermatological problem, may be related to affect-regulation, particularly anger and alexithymia. Due to the fact that it has a different place among psychodermatoses, individuals with PE might benefit from learning how to regulate their affects other than by excoriation.

The Role of Stress and Negative Emotions in an Occupational Crisis

The study examined how negative affects and exposure to various stressors are related to an occupational crisis. Two hundred and seventy-seven employees (53% women) from various occupations filled in the Occupational Crisis Scale, a stressor questionnaire, the Anger Expression Scale (measuring both suppressed and overt anger), Spielberger's Anxiety Inventory (measuring both state and trait anxiety) and Beck's Depression Inventory. The results showed that occupational crisis was a function of work overload, interpersonal problems and frustration at work, organizational changes, a threat of job loss, and/or family worries. In addition, occupational crises were typically experienced by women and were characterized more by trait anxiety, suppressed anger and depressive symptoms than by overtly expressed anger or state anxiety. Of the three female employee groups who were most vulnerable to the crisis, the group which had suffered from interpersonal problems and frustration at work displayed the most indices of the crisis.

Perfectionism in children: associations with depression, anxiety, and anger

The relationships among measures of dimensions of perfectionism, depression, anxiety, stress, and anger were investigated in 114 children (45 males and 69 females, aged 10–15 years). Based on previous research [e.g. Hewitt, P. L. & Flett, G. L. (1993). Dimensions of perfectionism, daily stress, and depression: a test of the specific vulnerability hypothesis. Journal of Abnormal Psychology, 102, 58–65], self-oriented perfectionism and socially prescribed perfectionism were hypothesized to interact with either achievement stress or social stress to predict concurrent depression. Participants completed the Child-Adolescent Perfectionism Scale, Children's Depression Inventory, Children's Manifest Anxiety Scale-Revised, Children's Hassles Scale, and Pediatric Anger Expression Scale. Results revealed that self-oriented perfectionism was significantly associated with depression and anxiety, whereas socially prescribed perfectionism was significantly correlated with depression, anxiety, social stress, anger-suppression, and outwardly directed anger. Findings also indicated that: (1) self-oriented perfectionism interacted with social stress to predict anxiety; and that (2) self-oriented perfectionism interacted with achievement stress and with social stress to predict depression. Results suggest that dimensions of perfectionism may be relevant variables in, and differential predictors of, maladjustment and distress in children.

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.

Silencing the self and suppressed anger: relationship to eating disorder symptoms in adolescent females

AbstractObjective:This study examined the extent to which inhibited expression of negative feelings and an interpersonal style that focuses on others' needs and expectations are related to eating disorder symptoms in adolescent females.Method:Female high school adolescents (N = 235) completed the Anger Expression Scale, the Silencing the Self Scale, and measures of eating disorder symptoms, self‐esteem, and psychological adjustment.Results:Adolescents with higher eating disorder symptom scores had significantly higher levels of anger inhibition and silencing the self scores. In regression analyses, the Silencing the Self and Anger Expression Scales contributed statistically significant unique variance to cognitive and behavioural eating disorder symptoms scores after controlling for shape‐ and weight‐based self‐esteem. A similar, though weaker, pattern of results was found after controlling for global self‐esteem.Discussion:These results partially replicate relationships found between inhibited self‐expression and eating disorder symptoms in adult clinical samples. Implications for the development of eating disorder symptoms are addressed. Copyright © 2002 John Wiley &amp; Sons, Ltd and Eating Disorders Association.

Ambulatory blood pressure in women: Family history of hypertension and personality

The presence of certain personality traits in individuals with a strong family history of hypertension was expected to increase ambulatory blood pressure (BP) in healthy working women. Ambulatory BP was recorded on two work and two off work days during waking and sleeping hours in healthy nurses, 24-50 years of age, with varying parental history: Two hypertensive parents (n = 14); one hypertensive parent (n = 77); two normotensive parents (n = 112). BP during wake and sleep was potentiated in subjects with two hypertensive parents. Assessments were made of hostility (Cook-Medley Hostility Scale), defensiveness (Marlowe Crowne Social Desirability Scale), anxiety (Spielberger Trait Anxiety Inventory) and anger-out (Spielberger Anger Expression Scale). The offspring of two-parent hypertensive families who were hostile, defensive, anxious or did not express anger had elevated ambulatory BP, which was highest during work days. Preventive measures are particularly important for individuals with the combination of certain personality traits and a strong family history of hypertension, who may themselves be at risk for the development of hypertension.

The relationship between anger-coping styles and lifestyle behaviors in teenagers

Purpose: To investigate the relationship between anger-coping styles (anger expression and anger suppression) and lifestyle behaviors (physical activity and consumption of alcohol, cigarettes, and caffeine) in adolescents. Methods: A sample of 411 adolescents (198 males: 101 white, 97 black; 213 females: 101 white, 112 black) aged 13–20 years (mean age 15.6 years) completed the Anger Expression Scale and brief self-report questionnaires assessing physical activity (weekly amount, comparison with peers) and consumption of alcohol (frequency and amount over the past 2 weeks), cigarettes (amount over past 2 weeks), and caffeine (from coffee and soda over past week). Results: Correlational and Chi-square analyses showed teenagers high in anger suppression reported consuming alcohol more frequently, spending fewer hours per week in aerobic activity, and being less physically active than their peers. Teenagers high in anger expression reported consuming more caffeinated soda and coffee. Conclusions: Results suggest that excessive anger suppression or expression may be associated with an imprudent lifestyle relatively early in life.

Impact of anger expression on blood pressure levels in white-color workers with low-coping behavior

To examine the relationships between anger expression and blood pressure (BP) levels and their effect modification by stress coping behaviors, the authors analyzed data from a cross-sectional study of 790 Japanese male workers aged 20-60 years. We used the Spielberger anger expression scales to measure anger-out, anger-in, and anger-control. Relationships between anger expression scales and mean systolic and diastolic BP levels were examined in the total sample and in two subgroups of high and low stress coping behaviors (low coping behavior group: having none, one, or two coping behaviors; and high coping behavior group: having three or more coping behaviors). Anger expression scales were not associated with BP levels in the total sample. Among men who reported only two or fewer coping behaviors, however, the anger-out score was significandy associated with systolic blood pressure (SBP) levels while no association was found among men who reported the larger number of coping behaviors. Anger-in and anger-control were not associated with BP levels in either low or high coping behavior groups. This study suggests that male workers who do not express their anger have a higher probability of developing high BP when they have no or few stress coping behaviors.

Female Violence and Personality

The present study investigated the validity of the overcontrolled hostility construct in explaining violent crime among 186 female state-prison inmates who were classified as nonviolent (NV), one-time violent (OV), or repeat violent (RV) offenders. The women's prison records were reviewed, and a complete Minnesota Multiphasic Personality Inventory (2nd ed.) (MMPI-2) protocol and Spielberger et al.'s Anger Expression Scale were administered. Overcontrolled Hostility (O-H) scale scores on the MMPI-2 effectively differentiated the OV group from the NV and RV offender groups. The OV women were overrepresented among female violent offenders, had significantly shorter nonviolent criminal histories than the other two groups, and were more likely to have committed an extremely violent act than the RV group. The RV offenders reported greater acting out when angered and exhibited more prison aggression compared to the other two groups. These data highlight the importance of the overcontrolled hostility construct and the undercontrolled/overcontrolled distinction in the analysis of violent offending among female inmates.