Anger In Posttraumatic Stress Disorder Research Articles

A Study on the Factors Affecting Anger in Patients With Post-traumatic Stress Disorder.

To identify the factors affecting anger in post-traumatic stress disorder (PTSD) patients who underwent Clinician-Administered PTSD Scale (CAPS) and Minnesota Multiphasic Personality Inventory-2 (MMPI-2). We retrospectively reviewed patients who underwent CAPS and MMPI-2 at Veteran Health Service Medical Center, Seoul, Korea. Based on the CAPS score, the patients were divided into the PTSD group (n=46) and the trauma exposed without PTSD group (n=29). After checking the correlation between anger, CAPS, and MMPI-2 scales, logistic regression analysis was performed to identify the risk factors for clinically relevant symptoms. The PTSD group showed significant differences in schizophrenia-related symptoms, ideas of persecution, aggressiveness, psychoticism, and anger scales compared to the trauma-exposed without PTSD group. There was a significant correlation between anger, CAPS, and MMPI-2 except masculinity/femininity, disconstraint, and MacAndrew Alcoholism-Revised. In particular, anger has been shown to have a substantial connection with paranoia, schizophrenia-related symptoms, ideas of persecution, aberrant experiences, and psychoticism. Multiple regression analysis identified that the only significant risk factor for anger was the negative emotionality/neuroticism scale (odds ratio=1.152, p<0.001). The PTSD group had increased anger compared to the trauma-exposed without PTSD group, and that negative emotions may be a risk factor for PTSD.

Neural correlates of anger expression in patients with PTSD.

Anger is a common and debilitating symptom of post-traumatic stress disorder (PTSD). Although studies have identified brain circuits underlying anger experience and expression in healthy individuals, how these circuits interact with trauma remains unclear. Here, we performed the first study examining the neural correlates of anger in patients with PTSD. Using a data-driven approach with resting-state fMRI, we identified two prefrontal regions whose overall functional connectivity was inversely associated with anger: the left anterior middle frontal gyrus (aMFG) and the right orbitofrontal cortex (OFC). We then used concurrent TMS-EEG to target the left aMFG parcel previously identified through fMRI, measuring its cortical excitability and causal connectivity to downstream areas. We found that low-anger PTSD patients exhibited enhanced excitability in the left aMFG and enhanced causal connectivity between this region and visual areas. Together, our results suggest that left aMFG activity may confer protection against the development of anger, and therefore may be an intriguing target for circuit-based interventions for anger in PTSD.

Anger as an underlying dimension of posttraumatic stress disorder

In this study, we examined the underlying role of anger in posttraumatic stress disorder (PTSD). Although anger is currently considered within two symptoms of PTSD (i.e., anger/irritability; and negative emotional state), some research has found that anger is more than just a diagnostic symptom of PTSD. The sample consisted of 375 trauma-exposed individuals that completed the PTSD Checklist-5 and Dimensions of Anger Reactions Scale. Confirmatory factor analysis was used to assess PTSD's factor structure based on the four-factor DSM-5 PTSD model. Subsequently, the model was re-tested, statistically controlling for anger by regressing PTSD's items on an observed anger score. Individual factor loading differences were then compared to determine anger's underlying role. Results indicated that a significant amount of variance in PTSD, at both the item level and factor level, was attributable to an underlying dimension of anger. The largest factor attenuation was for the symptom of irritability/anger and the smallest attenuation was recklessness. The results suggest that anger underlies more of PTSD than the two diagnostic symptom criteria.

The experience and expression of anger in posttraumatic stress disorder: the relationship with metacognition

Background: Anger experience and expression are a common issue in those experiencing PTSD. However, it remains unclear what variables affect anger and its expression in PTSD.Aims: To explore the relationships of synthetic forms of metacognition and metacognitive beliefs with anger experience and expression in PTSD, independent of the effects hyperarousal and depression symptoms.Method: Participants were 51 veterans with diagnosed with PTSD. Metacognition was assessed using the Metacognition Assessment Scale-Abbreviated (MAS-A) and the Metacognitions Questionnaire (MCQ). Depression, PTSD symptom severity, and seven domains of anger expression were also assessed.Results: Correlations showed after controlling for overall levels of hyperarousal, higher MAS-A total scores were related to lower levels of State Anger, Feeling Angry, Expressing Anger Physically, and Anger Expression in. Lower MCQ scores were related to lower State anger, Expressing anger verbally, and Expressing anger physically. Higher levels of depression were related to higher levels of Trait anger, Expressing anger physically, Anger expression out, and Anger expression in. Multiple regressions suggested that the MAS-A and MCQ predicted unique portions of the variance in anger experience and expression.Conclusions: Metacognitive deficits may affect anger experience and expression in those with PTSD and may be an important treatment target.

Fear and Loathing: A Meta-Analytic Review of the Specificity of Anger in PTSD

The available empirical literature suggests that anger may be characteristic of posttraumatic stress disorder (PTSD). Meta-analytic strategies were used to evaluate the extent to which the experience of anger is specific to PTSD rather than anxiety disorders in general. Thirty-four anxiety disorder patient samples ( n = 2,169) from 28 separate studies were included in the analysis. Results yielded a large effect size indicating greater anger difficulties among anxiety disorder patients versus controls. Compared to control samples, a diagnosis of PTSD was associated with significantly greater difficulties with anger than was any other anxiety disorder diagnosis. Other anxiety disorder diagnoses did not differ significantly from each other. However, the specific association between PTSD and anger did vary depending on the anger domain assessed. Difficulties with anger control, anger in, and anger out significantly differentiated PTSD from non-PTSD anxiety disorder samples, whereas difficulties with anger expression, state anger, and trait anger did not. These findings are discussed in the context of future research on the role of anger in PTSD.

Cognitive-behavioral treatment for severe anger in posttraumatic stress disorder.

Cognitive-behavioral treatment for severe anger in posttraumatic stress disorder.