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A questionnaire for assessing anger and expression of anger
Abstract
The State-Trait Anger Expression Inventory (STAXI) developed by Spielberger is a measure for state- and trait-anger and three different forms of anger expression. People differ in the extent to which they express anger overtly and directly (anger out), how often anger feelings are hold in or suppressed (anger in) or in the extent to which they are able to control their angry feelings or their overtly expressed anger (anger control). The scales are developed to determine the relevance of individual dispositions to express anger in the etiology and course of psychosomatic illness like hypertension, coronary heart disease etc. The present report is a summary of the research reports presented by Schwenkmezger and Hodapp (1986, 1989). It describes the development of the German adaptation of the STAXI, including itemmetrical and factor analytic results, detailed research on construct validity, and first experimental analyses.
... Furthermore, clinical and epidemiological studies have shown that girls are socialized in such a way that their expression of anger and aggression are strongly constrained [17,18]. This socially conform behavior of women could lead to an anger suppression problem (e.g. higher STAXI Anger-In -score; [19,20]. However, there is no study differentiating between women with or without a socially conform feminine behavior with respect to anger suppression and the development of psychosomatic disturbances such as TDCE and prolonged SOL. ...
... The STAXI [19,20] was used for dispositional state and trait anger, as well as for anger expression. It consists of three different scales, State Anger (10 items), Trait Anger (10 items), and anger expression (24 items). ...
... A high score on each of these scales represents a high tendency or frequency to express that mode of anger. The STAXI has demonstrated good internal reliability and validity based on results from a variety of samples and cultures [19,20]. ...
... Furthermore, clinical and epidemiological studies have shown that girls are socialized in such a way that their expression of anger and aggression are strongly constrained [17,18]. This socially conform behavior of women could lead to an anger suppression problem (e.g. higher STAXI Anger-In -score; [19,20] . However , there is no study differentiating between women with or without a socially conform feminine behavior with respect to anger suppression and the development of psychosomatic disturbances such as TDCE and prolonged SOL. ...
... The STAXI [19,20] was used for dispositional state and trait anger, as well as for anger expression. It consists of three different scales, State Anger (10 items), Trait Anger (10 items), and anger expression (24 items). ...
... A high score on each of these scales represents a high tendency or frequency to express that mode of anger. The STAXI has demonstrated good internal reliability and validity based on results from a variety of samples and cultures [19,20]. ...
BackgroundWomen with thermal discomfort from cold extremities (hands and feet; TDCE) often suffer from prolonged sleep onset latency
(SOL). Suppressed anger could contribute to the genesis of both TDCE and prolonged SOL. The aim of the study was to test the
hypothesis whether stereotypic feminine gender socialization (SFGS) is related to anger suppression (experienced anger inwards,
Anger-In), which in turn could affect TDCE and SOL.
Methods148 women, a sub-sample of a larger survey carried out in the Canton Basel-Stadt (Switzerland), sent back detailed postal
questionnaires about SOL, TDCE, anger expression (STAXI, state -trait -anger -expression -inventory) and SFGS using a gender
power inventory, estimating the degree of gender specific power expression explicitly within women by stereotypic feminine
or male attribution. Statistics was performed by path analysis.
ResultsA significant direct path was found from stereotypic feminine attribution to Anger-In and prolonged SOL. Additionally, a further
indirect path from Anger-In via TDCE to SOL was found. In contrast, stereotypic male attribution was not related to Anger-In
but was significantly associated with outwardly expressed anger.
LimitationsSelf-reported data, retrospective cross-sectional survey, prospective studies are required including physiological measurements.
ConclusionStereotypic feminine gender socialization may play an important determinant for anger suppression, which subsequently can
lead to thermal discomfort from cold extremities and prolonged sleep onset latency.
... The questionnaires used in this study were a translated version of the revised version of the Prosocial Tendencies Measure (PTM-R; Carlo and Randall, 2002;Carlo et al., 2003, Rodrigues et al., 2017, the German version of Buss e Perry aggression questionnaire (Buss and Perry, 1992;Herzberg, 2003), the German version of State-trait e anger e expression e inventory (STAXI; Schwenkmezger and Hodapp, 1991;Spielberger, 1988) and a German version of the empathic concern scale (Paulus, ...
... We computed four linear regressions with the mean of the relative amount of money spent in every condition ("punishment only", "compensation only", "punishment if both options are available", "compensation if both options are available") as the criterion for each of two predictors: "Trait altruism" (measured with PTM-R; Carlo et al., 2003) and "trait anger" (measured with STAXI; Schwenkmezger and Hodapp, 1991). Following our hypothesis, we expected trait altruism to predict compensation and trait anger to predict punishment. ...
Altruistic punishment and altruistic compensation are important concepts that are used to investigate altruism. However, altruistic punishment has been found to be correlated with anger. We were interested whether altruistic punishment and altruistic compensation are both driven by trait altruism and trait anger or whether the influence of those two traits is more specific to one of the behavioral options. We found that if the participants were able to apply altruistic compensation and altruistic punishment together in one paradigm, trait anger only predicts altruistic punishment and trait altruism only predicts altruistic compensation. Interestingly, these relations are disguised in classical altruistic punishment and altruistic compensation paradigms where participants can either only punish or compensate. Hence altruistic punishment and altruistic compensation paradigms should be merged together if one is interested in trait altruism without the confounding influence of trait anger.
... At the time of the EMG sleep recording session, other psychometric tests were also administered to the participants: the State-Trait Anxiety Inventory X-form (STAI-X) (18); the State-Trait Anger eXpression Inventory (STAXI) (19,20); and the Beck Depression Inventory (BDI-II) (21,22). All instruments were used with the adoption of a systematically translated Italian version currently used in the psychiatric setting and aimed at quantifying the presence of psychological symptoms that may be related to the occurrence of MMA events (23). ...
... A high score on each of these scales represents a high tendency or frequency to express that mode of anger. The STAXI has demonstrated good internal reliability and validity based on results from a variety of samples and cultures (20). ...
The present investigation attempts to describe the correlation between sleep-time masticatory muscle activity (MMA) and psychological symptoms by the use of a four-channel electromyography (EMG) home-recording device in a group of 15 healthy volunteers completing a battery of psychometric questionnaires for the assessment of anxiety, depression and anger. The integrated EMG signal was adopted to quantify the work (μV × s) produced by each of the four muscles (bilateral masseter and temporal) during the 5-h recording span and per each 1-h increment. The duration of MMA events and the muscle work during the first hour of sleep was related to trait anxiety scores for both masseter (P = 0·007) and temporalis muscles (P = 0·022). Trait anxiety was also significantly correlated to the total amount of MMA duration (in seconds) of the temporalis muscles (r = 0·558; P = 0·031). The present investigation provides support to the hypothesis that the duration of sleep-time masticatory muscle activity, especially during the early phases of a night's sleep, may be related to anxiety trait and not to anxiety state, depression or anger. These findings may support the view that features related to the individual management of anxiety, viz. trait, are likely to be more important than acute episodes of anxiety, viz. state, in the aetiology of sleep-time masticatory muscle activity. The role of other psychological symptoms is likely to be less important.
... Table 2). BPD symptom severity was assessed with the Borderline Symptom List (BSL; [86]), state and trait anger with the State-Trait-Anger-Expression Inventory (STAXI; [87]), emotion dysregulation with the Difficulties in Emotion Regulation Scale (DERS; [88]), and depressiveness with the Beck Depression Inventory (BDI-II; [89]). ...
Emotional dysregulation is a core feature of borderline personality disorder (BPD); it is, for example, known to influence one’s ability to read other people’s facial expressions. We investigated behavioral and neurophysiological foundations of emotional face processing in individuals with BPD and in healthy controls, taking participants’ sex into account. 62 individuals with BPD (25 men, 37 women) and 49 healthy controls (20 men, 29 women) completed an emotion classification task with faces depicting blends of angry and happy expressions while the electroencephalogram was recorded. The cortical activity (late positive potential, P3/LPP) was evaluated using source modeling. Compared to healthy controls, individuals with BPD responded slower to happy but not to angry faces; further, they showed more anger ratings in happy but not in angry faces, especially in those with high ambiguity. Men had lower anger ratings than women and responded slower to angry but not happy faces. The P3/LPP was larger in healthy controls than in individuals with BPD, and larger in women than in men; moreover, women but not men produced enlarged P3/LPP responses to angry vs. happy faces. Sex did not interact with behavioral or P3/LPP-related differences between healthy controls and individuals with BPD. Together, BPD-related alterations in behavioral and P3/LPP correlates of emotional face processing exist in both men and women, supposedly without sex-related interactions. Results point to a general ‘negativity bias’ in women. Source modeling is well suited to investigate effects of participant and stimulus characteristics on the P3/LPP generators.
... 15 Childhood trauma history: (1) Childhood Trauma Questionnaire. 4 Anxiety: (1) State-Trait Anxiety Inventory. 36 Impulsivity and anger: (1) Barratt Impulsiveness Scale (BIS-11), 23 (2) State-Trait Anger Expression Inventory, 33 and (3) Buss-Perry Aggression Questionnaire (AQ). 6 Empathy: (1) Interpersonal Reactivity Index. ...
This study aimed to investigate whether the differences in pain perception between patients with borderline personality disorder (BPD) and healthy subjects (HCs) can be explained by differences in the glutamate/GABA ratio in the posterior insula. In total, 29 BPD patients and 31 HCs were included in the statistical analysis. Mechanical pain sensitivity was experimentally assessed with pinprick stimuli between 32 and 512 mN on a numeric rating scale. The metabolites were measured in the right posterior insula using the MEshcher-GArwood Point-RESolved Spectroscopy sequence for single-voxel magnetic resonance spectroscopy (1H-MRS). The 256- and the 512-mN pinprick stimuli were perceived as significantly less painful by the BPD patient group compared with HCs. No differences were found between groups for the glutamate/GABA ratios. A positive correlation between the glutamate/GABA ratio and the pain intensity ratings to 256- and 512-mN pinpricks could be found in the combined and in the HC group. In the BPD patient group, the correlations between the glutamate/GABA ratio and the pain intensity ratings to 256- and 512-mN pinpricks did not reach significance. In conclusion, the study showed that individual differences in pain perception may in part be explained by the individual glutamate/GABA ratio in the posterior insula. However, this possible mechanism does not explain the differences in pain perception between BPD patients and HCs.
... The alpha reliability in our study was 0.54. − State-Trait Anger Expression Inventory (STAXI) [57,58]: we used the trait-anger scale of the STAXI with 10 items to assess the disposition to experience angry feelings as a personality trait dispositional anger on a 4-point Likert scale. The internal consistency has been found to be high with a test-retest reliability on a satisfactory level. ...
Background:
Little is known about narcissistic traits in borderline personality disorder (BPD). This exploratory study aimed to illustrate the associations between total, grandiose, and vulnerable narcissism and gender, diagnostic features of BPD and narcissistic personality disorder (NPD), and psychopathology in BPD patients.
Sampling and methods:
The Pathological Narcissism Inventory and psychometric measures for impulsivity, anger, borderline symptom severity, personality organization, depression, and rejection sensitivity were completed by 65 BPD patients. Statistical analyses were conducted using the t test, Pearson correlation, and multivariate regression analyses.
Results:
Male BPD patients displayed higher narcissistic scores than females (p < 0.01). Grandiose narcissism showed a stronger association with NPD than with BPD (p < 0.01) while vulnerable narcissism was only associated with BPD (p < 0.01). Rejection sensitivity (p < 0.01) and depression (p < 0.001) predicted vulnerable narcissism.
Conclusion:
Vulnerable narcissism is closely associated with BPD and appears to be more dysfunctional than grandiose narcissism. A comprehensive consideration of both traits is recommended. Our results might help to generate hypotheses for further research on pathological narcissism in the spectrum of personality disorders. Future studies are advised to apply complementary measures and take new diagnostic approaches of DSM-5 and ICD-11 into account.
... Intelligence was estimated using Raven's progressive matrices [29]. Additionally, questionnaires for assessing symptoms of depressiveness (Beck Depression Inventory (BDI-II); [30]) and borderline personality disorder [Zanarini Rating Scale (ZAN); [31]; Difficulties in Emotion Regulation Scale (DERS); [32]; State-Trait Anger Expression Inventory (STAXI); [33]] were used. All interviews were conducted by experienced diagnosticians who underwent standardized diagnostic training ahead of the study. ...
According to longitudinal studies, most individuals with borderline personality disorder (BPD) achieve remission. Since BPD is characterized by disturbed emotion recognition, this study investigated behavioral and electrophysiological correlates of facial emotion classification and processing in remitted BPD. 32 women with remitted BPD (rBPD), 32 women with current BPD (cBPD), and 28 healthy women (HC) participated in an emotion classification paradigm comprising blends of angry and happy faces while behavioral and electroencephalographic (event-related potentials) data were recorded. rBPD demonstrated a convergence in behavior towards HC in terms of responses and reaction times. They evaluated maximally ambiguous faces more positively and exhibited faster reaction times when classifying predominantly happy faces compared to cBPD. Group × facial emotion interaction effects were found in early electrophysiological processes with post hoc tests indicating differences between rBPD and cBPD but not between rBPD and HC. However, BPD-like impairments were still found in rBPD in later processing (P300). Our results suggest a reduction in negativity bias in rBPD on the behavioral level and a normalization of earlier stages of facial processing on the neural level, while alterations in later, more cognitive processing do not remit. Early processing may be more state-like, while later impairments may be more trait-like. Further research may need to focus on these stable components.
... It consists of seven subscales: State Anger, Trait Anger, Angry Temperament, Angry Reaction, Anger-In, Anger-Out and Anger Control. The good psychometric properties of the scale were reported by Schwenkmetzger and Hodapp (Schwenkmezger and Hodapp, 1991). 2) Questionnaire for Measuring Factors of Aggression (Fragebogen zur Erfassung von Aggressivit€ atsfaktoren, FAF): a German adaptation of the Buss Durkee Hostility Inventory. ...
Several lines of evidence indicate that suicidal behaviour is partly heritable, with multiple genes implicated in its aetiology. We focused on nine genes (S100A13, EFEMP1, PCDHB5, PDGFRB, CDCA7L, SCN2B, PTPRR, MLC1 and ZFP36) which we previously detected as differentially expressed in the cortex of suicide victims compared to controls. We investigated 84 variants within these genes in 495 suicidal subjects (299 completers and 196 attempters) and 1513 controls (109 post-mortem and 1404 healthy). We evaluated associations with: 1) suicidal phenotype; 2) possible endophenotypes for suicidal behaviour. Overall positive results did not survive the correction threshold. However, we found a nominally different distribution of EFEMP1 genotypes, alleles and haplotypes between suicidal subjects and controls, results that were partially replicated when we separately considered the subgroup of suicide completers and post-mortem controls. A weaker association emerged also for PTPRR. Both EFEMP1 and PTPRR genes were also related to possible endophenotypes for suicidal behaviour such as anger, depression-anxiety and fatigue. Because of the large number of analyses performed and the low significance values further replication are mandatory. Nevertheless, neurotrophic gene variants, in particular EFEMP1 and PTPRR, may have a role in the pathogenesis of suicidal behaviour.
... The low-activity Met allele was found to be over-represented in violent suicide attempters compared to the nonviolent attempters. In addition, the authors administered the State-Trait Anger Expression Inventory (STAI, [70,71] ) for various components of aggressive behavior. After controlling for age, sex, educational levels, and suicide attempter versus healthy control status, the high-activity Val allele appeared to be associated with State Anger and Angerin or inwardly directed anger, and the low-activity Met allele appeared to be associated with Anger-out or externalizing anger. ...
Aggressive behaviors have become a major public health problem, and early-onset aggression can lead to outcomes such as substance abuse, antisocial personality disorder among other issues. In recent years, there has been an increase in research in the molecular and genetic underpinnings of aggressive behavior, and one of the candidate genes codes for the catechol-O-methyltransferase (COMT). COMT is involved in catabolizing catecholamines such as dopamine. These neurotransmitters appear to be involved in regulating mood which can contribute to aggression. The most common gene variant studied in the COMT gene is the Valine (Val) to Methionine (Met) substitution at codon 158. We will be reviewing the current literature on this gene variant in aggressive behavior.
... All interviews were performed by experienced diagnosticians (masters in psychology or doctorate in medicine with several years of clinical training) who underwent standardized diagnostic training before the study. In addition, we assessed borderline symptom severity using the Borderline Symptom List (BSL 52 ), state and trait anger using the State-Trait Anger Expression Inventory (STAXI, 53 state, trait, reaction, angerin, anger-out, anger-control subscales), emotional dysregulation using the Difficulties in Emotion Regulation Scale (DERS, 54 acceptance, awareness, impulse, strategy, clarity, goals subscales) and depressiveness using the Beck Depression Inventory (BDI-II 55 ). ...
Borderline personality disorder (BPD) is characterized by a negative perception of others. Previous studies have revealed deficits and biases in facial emotion recognition. This study investigates the behavioural and electrophysiological correlates underlying facial emotion processing in individuals with BPD.
The present study was conducted between July 2012 and May 2014. In an emotion classification task, unmedicated female patients with BPD as well as healthy women had to classify faces displaying blends of anger and happiness while the electroencephalogram was recorded. We analyzed visual event-related potentials (ERPs) reflecting early (P100), structural (N170) and categorical (P300) facial processing in addition to behavioural responses.
We included 36 women with BPD and 29 controls in our analysis. Patients with BPD were more likely than controls to classify predominantly happy faces as angry. Independent of facial emotion, women with BPD showed enhanced early occipital P100 amplitudes. Additionally, temporo-occipital N170 amplitudes were reduced at right hemispherical electrode sites. Centroparietal P300 amplitudes were reduced particularly for predominantly happy faces and increased for highly angry faces in women with BPD, whereas in healthy volunteers this component was modulated by both angry and happy facial affect.
Our sample included only women, and no clinical control group was investigated.
Our findings suggest reduced thresholds for facial anger and deficits in the discrimination of facial happiness in individuals with BPD. This biased perception is associated with alterations in very early visual as well as deficient structural and categorical processing of faces. The current data could help to explain the negative perception of others that may be related to the patients' impairments in interpersonal functioning.
... A total score is computed for each scale. The scale has good psychometric properties in the German version, as reported by Schwenkmezger and Hodapp [50]. ...
MAOA and, to a lesser extent, MAOB poly-morphisms have been related to aggression traits and suicidality. We aimed to investigate the role of MAOA and MAOB in suicidal versus non-suicidal participants and interactions between genetic variation and suicidal status on aggression and anger-related traits. The sample was com-posed of three groups: one group of suicide attempters (n = 171, males 35.1 %), one group of suicide completers (n = 90, males 57.8 %) and a healthy control group (n = 317, males 43.8 %). We examined the following markers: MAOA rs909525, rs6323, and rs2064070, and MAOB rs1799836. Anger traits were measured with the state-trait anger expression inventory (STAXI) and aggression traits with the questionnaire for measuring fac-tors of aggression (FAF). Associations were separately examined for males and females. Variation in the three MAOA variants was associated with higher levels of anger expressed outwards (STAXI ''anger-out'' subscale) in male suicidal patients compared to controls (p \\ 0.001). In females, the C allele of rs6323 showed higher scores on the same subscale (''anger out'') (p = 0.002). Allele frequen-cies of the MAOA rs909525 were associated with suici-dality (p \\ 0.007). Our findings show an association between genetic variation in three polymorphisms of the MAOA and anger traits in suicidal males and one replication for the functional variant rs6323 in females. This relation-ship was stronger than a direct genetic association with suicide status. Future studies incorporating endophenotypic measures of anger and aggression in suicidal participants are warranted.
... The 29-item questionnaire (Buss and Perry, 1992) assesses four factors of aggressive behavior: physical aggression, verbal aggression, anger, and hostility. The self-rating concerning the emotional state of anger was surveyed with the state-trait anger expression inventory (STAXI) developed by Spielberger (1991); German version by Schwenkmezger and Hodapp, 1991). The STAXI contains five anger-related subscales: the current level of anger (state anger), anger as personality trait (tendency to experience anger, i.e., trait anger); Anger-out behavior (AO; frequency with which anger is expressed toward other people or objects); Anger-in behavior (AI; directing anger toward oneself or inwardly; also related to suppressed hostility); Anger-control behavior (AC; active management of feeling angry in order to avoid anger expression). ...
The A-kinase-anchoring protein 5 (AKAP5), a post-synaptic multi-adaptor molecule that binds G-protein-coupled receptors and intracellular signaling molecules has been implicated in emotional processing in rodents, but its role in human emotion and behavior is up to now still not quite clear. Here, we report an association of individual differences in aggressive behavior and anger expression with a functional genetic polymorphism (Pro100Leu) in the human AKAP5 gene. Among a cohort of 527 young, healthy individuals, carriers of the less common Leu allele (15.6% allele frequency) scored significantly lower in the physical aggression domain of the Buss and Perry Aggression Questionnaire and higher in the anger control dimension of the state-trait anger expression inventory. In a functional magnetic resonance imaging experiment we could further demonstrate that AKAP5 Pro100Leu modulates the interaction of negative emotional processing and executive functions. In order to investigate implicit processes of anger control, we used the well-known flanker task to evoke processes of action monitoring and error processing and added task-irrelevant neutral or angry faces in the background of the flanker stimuli. In line with our predictions, Leu carriers showed increased activation of the anterior cingulate cortex (ACC) during emotional interference, which in turn predicted shorter reaction times and might be related to stronger control of emotional interference. Conversely, Pro homozygotes exhibited increased orbitofrontal cortex (OFC) activation during emotional interference, with no behavioral advantage. Immunohistochemistry revealed AKAP5 expression in post mortem human ACC and OFC. Our results suggest that AKAP5 Pro100Leu contributes to individual differences in human aggression and anger control. Further research is warranted to explore the detailed role of AKAP5 and its gene product in human emotion processing.
... A commercial soft- [12]) was used to determine HRV with an adaptive autoregressive model (AAR) as proposed by Bianchi et al. [13], using a recursive least squares algorithm [14] (for further details see [15]). Psychometric Tests: The Freiburg Personality Inventory, German version (FPI [16]), State-Trait-Anger-Expression Inventory, German version (STAXI [17]), Health Survey, German version (SF-36 [18]), and the General Depression Scale (ADS-L [19]) were administered at days 1, 4, 7, and 10. In all four testing sequences, the same questionnaire set was used to ascertain uniformity. ...
In her book 'Living on Light', Jasmuheen tries to animate people worldwide to follow her drastic nutrition rules in order to boost their quality of life. Several deaths have been reported as a fatal consequence. A doctor of chemistry who believably claimed to have been 'living on light' for 2 years, except for the daily intake of up to 1.5 l of fluid containing no or almost no calories was interested in a scientific study on this phenomenon. PARTICIPANT AND METHODS: The 54-year-old man was subjected to a rigorous 10-day isolation study with complete absence of nutrition. During the study he obtained an unlimited amount of tea and mineral water but had no caloric intake. Parameters to monitor his metabolic and psychological state and vital parameters were measured regularly and the safety of the individual was ensured throughout the study. The subject agreed on these terms and the study was approved by the local ethics committee.
The most important observations were a permanent urinary excretion of ketones, up to a 3-fold increase in free fatty acid plasma levels, a mean weight loss of 0.26 kg/d, and an initially secondary hyperaldosteronism. Additionally, his ability to exercise was reduced. The subject remained psychologically stable and testing did not reveal any relevant changes.
The results refute the claim and indicate a phase-II fasting state.
... Given the above, the STAXI and NAS are not easily accommodated in cross-cultural work, although they have been translated [34,56]. A recently investigated anger scale which would, prima facie, be suitable is Novaco's Dimensions of Anger Reactions scale (DAR [29,46]). ...
Anger is a key long-term outcome from trauma exposure, regardless of trauma type, and it is implicated as a moderator of response to treatment. It therefore seems important that anger is assessed in both epidemiological studies of trauma sequelae and in intervention evaluation research. This study explored the measurement properties of a recently investigated anger scale, the Dimensions of Anger Reactions (DAR) Scale. In our previous study, the DAR was found to be a measure of trait anger, but although brief, the nine response categories per item may have confused respondents, suggesting fewer response categories may work equally well. Additionally, our previous analysis suggested there were two redundant items within the DAR.
Three samples of Australian veterans were used to investigate the psychometric properties associated with alterations to the response categories of the DAR; veterans who participated in the DAR validation study, those participating in group therapy programmes for post-traumatic stress disorder, and veterans participating in lifestyle programmes. Item response theory analysis was used to explore the internal properties of competing DAR models, and models were assessed against external criteria.
The results showed that the number of item responses in the DAR exceeded channel capacity, and that response bias occurred in the second half of the instrument. We hypothesized that this was due to respondents not discriminating among the many response categories. Based on a modelling exercise in which we reduced the number of DAR items from 7 to 5 and the number of response categories from 9 to 5, validation tests showed that there was no loss of sensitivity, reliability or validity. To avoid confusion with the DAR, we have referred to the revised version of the DAR as the DAR5.
We conclude that the DAR5, which abbreviates the original DAR to half its original length, has similar psychometric properties and is therefore to be preferred especially for use with persons who are under stress, cognitively impaired or less mature. The study findings regarding the optimum number of response categories have implications for the development of other instruments.
... p = .144; state-trait anger expression inventory, STAXI (Schwenkmezger and Hodapp, 1991)). Further information about the demographic and clinical characteristics of the sample is presented in Table 1. ...
Alcohol-dependence is often associated with comorbid psychiatric symptoms. However, the results concerning the influence of these symptoms on cognitive functioning in alcoholism are still inconsistent. The aim of this study was to determine performance monitoring in healthy volunteers and alcohol-dependent patients, and to assess the influence of trait anxiety on these processes. Sixteen healthy volunteers and 16 detoxified alcohol-dependent patients completed an auditory go/nogo paradigm. Functional magnetic resonance imaging, event-related potentials and behavioral data were acquired simultaneously. The patients were classified by median split based on level of self-rated trait anxiety (state-trait anxiety inventory; STAI). The results showed no significant differences regarding inhibition-associated electrophysiological and behavioral responses between alcohol-dependent patients with high-trait anxiety scores and alcohol-addicts with low-STAI scores. However, the functional MRI data revealed elevated activations during the response inhibition task especially in the middle frontal gyrus (BA 6/9), the superior frontal gyrus (BA 6/8/9) and the right inferior frontal gyrus, as well as temporo-parietal brain regions in patients with high-trait anxiety compared to non-anxious alcohol-addicts. Patients and healthy controls showed comparable results with regard to neural and behavioral responses. These results suggest that inhibitory control capacities of alcohol-dependent patients are not consistent: alcohol-addicts with high-trait anxiety ratings showed elevated neural responses compared to patients without any comorbid psychiatric symptoms. This may indicate that comorbid psychiatric symptoms need to be considered when assessing brain responses in alcohol-dependent patients.
Background
Maternal early-life maltreatment (ELM) increases the risk of subsequent child maltreatment, but the underlying mechanisms of these intergenerational effects remain largely unknown. Identifying these mechanisms is crucial for developing preventive interventions that can break the cycle of abuse. Notably, previous research has shown that ELM often results in attachment insecurity and altered anger characteristics. Therefore, this study determines whether these characteristics mediate the relationship between maternal history of ELM and child abuse potential.
Methods
The study sample included 254 mothers, of whom 149 had experienced ELM to at least a moderate degree. Maternal ELM was assessed using the Childhood Experience of Care and Abuse (CECA) interview. Attachment insecurity, trait anger and anger expression, and maternal abuse potential were assessed using the Vulnerable Attachment Questionnaire (VASQ), State–Trait Anger Expression Inventory (STAXI), and Child Abuse Potential Inventory (CAPI), respectively.
Results
The severity of maternal ELM predicted higher child abuse potential, with attachment insecurity and anger suppression mediating this effect. Specifically, higher levels of maternal ELM were associated with greater attachment insecurity and increased anger suppression, resulting in a higher child abuse potential. Although higher levels of trait anger were directly associated with higher child abuse potential, this parameter did not mediate the relationship with ELM. In addition, no significant associations were observed between outwardly expressed anger and ELM or child abuse potential. All analyses were adjusted for maternal mental disorders, years of education, and relationship status.
Discussion
Attachment insecurity and anger suppression may serve as pathways linking the maternal history of ELM to the risk of child abuse, even when considering maternal psychopathology. Overall, our findings indicate that interventions aimed at strengthening attachment and improving anger suppression may be beneficial for all mothers with ELM history and high child abuse potential, not just those who suffer from mental illness.
Risk proneness and the lack of loss aversion are two different reasons to show varying degrees of risk-taking in decision situations. So far, little is known about the extent to which these two processes underly the influence of trait greed, trait anxiety, and age. The present study investigated risk- taking in decision making in these trait contexts using two variants of the Balloon Analogue Risk Task (BART) in an online study: A gain only and a mixed gambling BART. This was done to separate risk proneness from loss aversion. Individuals with high trait greed showed an increased risk decision-making behavior due to an increased risk proneness and not due to a reduced loss aversion. This is partly in contrast with previous findings in other tasks assessing risk proneness and loss aversion. These differences may be caused by the changes of perception during the gain only task. No significant effects were found for trait anxiety or age concerning risk-taking in decision-making behavior. Possible explanations for the lack of influence of these constructs are skewed distributions, omitting pathologically anxious subjects in anxiety and a restricted age range. The findings suggest that a lack of loss aversion is not a driving factor to explain elevated risk-taking in decision-making behavior in persons with high trait greed, but a higher reaction to reward in predominantly rewarding contexts.
Supplementary information:
The online version contains supplementary material available at 10.1007/s12144-022-03553-6.
Punishment in economic games has been interpreted as “altruistic.” However, it was shown that punishment is related to trait anger instead of trait altruism in a thirdparty dictator game if compensation is also available. Here, we investigated the influence of state anger on punishment and compensation in the third-party dictator game. Therefore, we used movie sequences for emotional priming, including the target states anger, happy, and neutral. We measured the Feedback-Related Negativity (FRN) and midfrontal theta band activation, to investigate an electro-cortical correlate of the processing of fair and unfair offers. Also, we assessed single-trial FRN and midfrontal theta band activation as a predictor for punishment and compensation. We found that punishment was linked to state anger. Midfrontal theta band activation, which has previously been linked to altruistic acts and cognitive control, predicted less punishment. Additionally, trait anger led to enhanced FRN for unfair offers. This led to the interpretation that the FRN depicts the evaluation of fairness, while midfrontal theta band activation captures an aspect of cognitive control and altruistic motivation. We conclude that we need to redefine “altruistic punishment” into “costly punishment,” as no direct link of altruism and punishment is given. Additionally, midfrontal theta band activation complements the FRN and offers additional insights into complex responses and decision processes, especially as a single trial predictor.
Borderline Personality Disorder (BPD) and Attention Deficit Hyperactivity Disorder (ADHD) are both characterized by high impulsivity and difficulties in controlling anger and aggression. In BPD, comorbid ADHD may further increase impulsivity. For both disorders, altered MR spectroscopy levels of the neurotransmitters glutamate and GABA as well as some correlations with impulsivity were previously reported. The objective of this study was to investigate the neurotransmitters glutamate and GABA in relation to impulsivity and aggression as expressed in the anterior cingulate cortex (ACC) in groups of female patients with BPD and ADHD, respectively. Associations of glutamate and GABA levels with further BPD (symptom severity) and ADHD aspects (hyperactivity and inattention) were exploratively evaluated. 1H MRspectra were acquired at 3 T to determine glutamate to total creatine ratios (Glu/tCr) and GABA levels from the ACC in a BPD group (n=26), an ADHD group (n=22), and a healthy control (HC) group (n=30); all participants were females. Both patient groups showed higher scores on self-reported impulsivity, anger, and aggression compared to HCs. ACC GABA levels were significantly lower in ADHD than HC. While measures of impulsivity were positively related to glutamate and negatively to GABA, for aggression only a negative correlation with GABA could be demonstrated. These data provide human in vivo evidence for the role of ACC Glu/tCr and GABA in impulsivity and aggression. If distinct associations of Glu/tCr and GABA for BPD and ADHD can be confirmed in future studies, this might yield implications for more specific pharmacological treatments.Neuropsychopharmacology accepted article preview online, 04 June 2015. doi:10.1038/npp.2015.153.
Bruxisme (tandenknarsen en -klemmen) wordt geassocieerd met pijn in de kauwspieren en het kaakgewricht (TMD), en met psychosociale factoren als stress en angst. De precieze aard van deze associaties is echter nog onbekend. Daniele Manfredini deed een literatuurstudie naar de relatie tussen bruxisme en TMD. Ook bekeek hij de rol van psychosociale factoren in de etiologie van bruxisme. Verder bracht Manfredini de psychosociale belasting bij TMD-patiënten en de relatie van die belasting met fysieke TMD-diagnoses in kaart. Hij stelt dat pijn, bruxisme en psychosociale factoren onderlinge interacties hebben die verbeeld kunnen worden in een klinisch relevant driehoekig figuur. De mate van psychosociale hinder bij TMD-patiënten is volgens Manfredini niet gerelateerd aan hun fysieke diagnoses en hangt af van de aanwezigheid van pijn; niet van de pijnlocatie. Met andere woorden, psychosociale factoren zijn waarschijnlijk belangrijker als voorspellers voor de keuze van de behandeling en als prognostische factoren dan de fysieke bevindingen.
MAOA and, to a lesser extent, MAOB polymorphisms have been related to aggression traits and suicidality. We aimed to investigate the role of MAOA and MAOB in suicidal versus non-suicidal participants and interactions between genetic variation and suicidal status on aggression and anger-related traits. The sample was composed of three groups: one group of suicide attempters (n = 171, males 35.1 %), one group of suicide completers (n = 90, males 57.8 %) and a healthy control group (n = 317, males 43.8 %). We examined the following markers: MAOA rs909525, rs6323, and rs2064070, and MAOB rs1799836. Anger traits were measured with the state-trait anger expression inventory (STAXI) and aggression traits with the questionnaire for measuring factors of aggression (FAF). Associations were separately examined for males and females. Variation in the three MAOA variants was associated with higher levels of anger expressed outwards (STAXI "anger-out" subscale) in male suicidal patients compared to controls (p < 0.001). In females, the C allele of rs6323 showed higher scores on the same subscale ("anger out") (p = 0.002). Allele frequencies of the MAOA rs909525 were associated with suicidality (p < 0.007). Our findings show an association between genetic variation in three polymorphisms of the MAOA and anger traits in suicidal males and one replication for the functional variant rs6323 in females. This relationship was stronger than a direct genetic association with suicide status. Future studies incorporating endophenotypic measures of anger and aggression in suicidal participants are warranted.
Anger has been implicated in the etiology of hypertensive disease. Trait anger has been linked to enhanced cardiovascular responsiveness. However, whether this association reflects differences in context appraisal or a general hyper-reactivity of the cardiovascular system remains unclear. We studied the cardiovascular response to acoustic startle probes in 76 healthy Caucasian males in different affective contices (pleasant, neutral, and unpleasant). All participants completed the State-Trait-Anger-Expression-Inventory (STAXI) by Spielberger and the results were analysed with stepwise regression analysis according to the anger scores and traditional risk factors for hypertension. Our study reveals differential modulation of the cardiovascular response to startle stimuli by affective pictures in the dimensions "valence" for heart rate and "arousal" for blood pressure. Anger-in was identified as the most important determinant for blood pressure responses in unpleasant context, while anger-out was associated with less cardiovascular activation in neutral context. This is the first study that relates trait anger to cardiovascular reactivity and affective reflex modulation in normotensive subjects. We could demonstrate an interaction of affective context and trait anger for cardiovascular (hyper-)reactivity. Increased cardiovascular reactivity for higher scores of anger-in in unpleasant context may indicate enhanced sympathetic reactivity and constitute a risk factor for the development of essential hypertension.
Patients with implantable cardioverter defibrillator (ICD) often show comorbidity with anxiety, depression, helplessness. For the first time we could, out of a random sample of 147 ICD patients, identify a clinical important subgroup (26% of the sample) which meets the criteria of a posttraumatic stress disorder (PTSD). The symptoms were not associated with somatic factors or the discharge of icd-shocks. In contrast serious psychiatric symptoms were often. Permanent dealing with the disease or unstoppable thinking of it had a negative and meanigful effect on the quality of life of the PTSD patients.
Reduced heart rate variability (HRV) and delayed blood pressure recovery are associated with increased cardiovascular risk. Besides this evident link, the vagus is thought to play an inhibitory role in the regulation of other allostatic systems, including inflammation and the hypothalamic-pituitary-adrenal (HPA) axis. However, human evidence is scarce. To further explore these associations and with special regard to the postulated mediating role of the vagus, we hypothesised that subjects with low vagal tone as indexed by reduced resting HRV would show impaired post-stress recovery of cardiovascular, endocrine and immune system markers involved in cardiovascular pathology. 44 healthy men underwent a standardised mental stress test. Besides continuous measurement of systolic and diastolic blood pressure (SBP, DBP), heart rate (HR), and HRV serum cortisol, tumour necrosis factor-alpha (TNF-alpha), and interleukin-6 (IL-6) were measured before, after, 20, and 60 min after stress. Low versus high HRV groups was defined by median split on resting HRV (RMSSD). The task elicited significant time effects for SBP, DBP, HR, HRV, cortisol, and TNF-alpha. Subjects with low baseline HRV showed almost no modulation of HRV coupled with overall reduced HRV levels, and impaired recovery of DBP, cortisol, and TNF-alpha. Confirming our hypothesis, low vagal tone was associated with impaired recovery of cardiovascular, endocrine, and immune markers in healthy males. The data support an inhibitory role of the vagus in the regulation of allostatic systems as described in the neurovisceral integration model. We posit reduced resting HRV as a risk marker for future cardiovascular and other stress-related disease.
In a retrospective cross-sectional study 138 ICD patients have been surveyed with standardised psychometric tests regarding risk factors for impaired patient satisfaction and increased psychiatric comorbidity. Furthermore, it has been examined whether or not the posttraumatic stress disorder paradigm can explain maladaption. In general the patients showed high satisfaction and good adaptation to disease and treatment. Nevertheless a subgroup of patients has been identified which had a highly negative attitude toward the device, as well as significant affective comorbidity. In particular, maladaption was associated not only with frequent shocks but also with dysfunctional coping strategies, such as alexithymia and others.
Suicide is one of the leading causes of death worldwide, mortality from suicide being approximately 2%. Attempted suicide appears to be a major risk factor for suicide completion. Anger, aggression and impulsivity are personality traits associated with suicide attempt. In this study we analysed a part of a previously reported sample in order to test anger, impulsivity and temperament/character scales as predictors of aggression and self-aggression in suicide attempters and to compare anger- and aggression-related traits between impulsive and premeditated suicide attempts as well as between violent and non-violent suicide methods. One-hundred-eleven consecutively admitted inpatients with a lifetime history of attempted suicide were assessed for anger (State-Trait Anger Expression Inventory, STAXI), aggression (Questionnaire for Measuring Factors of Aggression, FAF) and temperament/character (Temperament and Character Inventory, TCI). Higher aggression scores, as measured by FAF, were predicted by being male, meeting criteria for borderline personality disorder and having higher angry temperament scores as assessed by STAXI; low cooperativeness was also associated with aggression but not after controlling for STAXI scales. TCI dimensions associated with self-aggression were high harm avoidance, high impulsivity and low self-directedness; state anger, inwardly directed anger and inhibition of aggression were also predictors of self-aggression. In conclusion, impulsivity and harm avoidance have emerged as temperament dimensions independently associated with self-aggressive tendencies in personality. Such interactions could explain the correlation between temperament and suicidality but further research is needed. Anger and self-directedness appear to have some effects on suicide attempt.
The available data about the hypothesis that psychological conditions cause urinary incontinence are contradictory. This study was based on a group of patients undergoing urodynamic investigation to define the type of incontinence. Patients were submitted to a battery of psychological tests, including STAXI, CES-D and IBQ (in their Italian version). Patients suffering from urge incontinence showed higher degrees of inner anger and anger trait than those suffering from stress or mixed incontinence. Neither group showed signs of depression. The conviction of illness was greatest in patients suffering from stress or mixed incontinence, whereas irritability and general hypochondria prevailed in patients suffering from urge incontinence. Such patients tend to develop psychosomatic reactions that may contribute to the severity of their symptoms.
The aim of the present study was to examine the reliability and validity of the Impact of Event Scale-Revised (IES-R) with special emphasis on the evaluation of the hyperarousal subscale against a standardized psychophysiological measurement.
A total of 129 survivors of a life-threatening cardiac event underwent a psychodiagnostic evaluation and a psychophysiological acoustic startle reflex (ASR) paradigm. The ASR assessed the magnitude and habituation of electromyogram (EMG) and skin conductance responses (SCR) in response to the delivery of 15 acoustic startle trials. Pearson correlation and factor analysis was used to measure reliability and construct validity. The hyperarousal subscale was validated against the ASR in terms of sensitivity and specificity mainly using receiver operating characteristic (ROC) curve analysis.
A high reliability was found for the intrusion and avoidance subscale (alpha>0.8); however, the hyperarousal subscale showed a weaker reliability (alpha=0.66). No avoidance item, one intrusion item but four hyperarousal items revealed higher correlations to another than its assigned subscale. The hyperarousal subscale was not able to discriminate sufficiently between patients with and without exaggerated startle reactions as indicated by ROC curves running near the diagonal line.
The scores in all three subscales are lower compared to subjects traumatized by non-cardiac events.
Reliability and construct validity for the intrusion and avoidance subscale proved to be high but was only sufficient for the hyperarousal subscale. Moreover, the criterion validity of the hyperarousal subscale regarding psychophysiological measurements is arguable and indicates further investigations in this area.
Anxiety disorders are highly prevalent in patients with alcohol use disorder. The purpose of the present study was to examine the neural correlates of behavioral inhibition in alcohol-dependent patients (ICD-10: F 10.2), and in healthy controls and to determine the influence of anxiety on these processes. Therefore, behavioral responses (reaction times; error rates) and event-related potentials of 16 patients with alcohol dependence syndrome and 16 age-and gender-matched healthy controls were recorded while the participants performed an auditory go/no-go task. The patient group was stratified according to their self-rated trait anxiety (STAI) with scores above and below median. We hypothesized that patients suffering from alcohol dependence would show reduced no-go P3 amplitudes involved in response inhibition compared to healthy subjects. In patients with alcoholism and high trait anxiety the decline of no-go P3 amplitudes was expected to be less distinct.
The estimation of effect size based on the reaction times of patients with high and low anxiety ratings revealed a cohen's d of 0.61 indicating a small effect. High trait anxiety ratings were also associated with slightly enhanced no-go P3 amplitudes in central brain regions (Mean no-go P3 amplitude at Cz: 10.43 μV) compared to patients with low anxiety scores (Mean 8.98 μV). The effect size (cohen's d) revealed a small effect. Using the Mann-Whitney-U-test for independent samples of the comparison of high- and low-anxious patients, however, did not reveal any significant differences concerning no-go P3 amplitudes. Patients with alcohol use disorder and healthy controls did not differ significantly with regard to reaction time, error rate and no-go P3 amplitudes.
This study suggests that no-go P3 amplitudes in patients with alcohol use disorder might be affected to some degree by habitual anxiety. The results emphasize the importance of monitoring trait anxiety in studies regarding cognitive functions in subjects with alcohol use disorder.
To evaluate the effects of a comprehensive outpatient rehabilitation program in chronic heart failure (CHF) on quality of life (QoL) in relation to emotional status and clinical severity of disease.
25 patients with CHF were included in the 12-week comprehensive rehabilitation program. Initially, and at the end of the program, patients underwent graded cardio-pulmonary exercise testing, echocardiography, and determination of brain natriuretic peptide (BNP) concentration. In addition, they were assessed using: The Minnesota Living with Health Failure Questionnaire [MLHFQ]) for disease Specific QoL, the Hospital Anxiety and Depression Scale [HADS], and the State-Trait Anger Expression Inventory [STAXI]).
After 12 weeks of rehabilitation improvements in NYHA class, left ventricular ejection fraction (LVEF), and peak oxygen consumption were found, while mean BNP concentrations did not change. Disease specific QoL demonstrated improvements in physical component and the total score. Relative improvement of psycho-emotional scores correlated positively with relative improvement of disease specific QoL. In patients with LVEF > or =30% at baseline, changes in BNP concentration were positively associated with both anxiety and state anger, and with the emotional component score of MLHFQ.
Improvements in disease-specific QoL were closely associated to improvements of psycho-emotional status and clinical severity of CHF.
Emotionally stressful events appear to trigger malignant ventricular arrhythmias and myocardial infarction in cardiac patients. However, the physiological pathways linking psychological stress to arrhythmias and adverse disease outcomes remain incompletely understood. In patients with implanted cardioverter-defibrillators (ICD) we investigated the impact of emotions and social support on cardiovascular recovery from mental stress. The hypothesis tested was that psychosocial resources help to maintain adaptive hemodynamic responses to mental stress.
In 55 ICD patients we noninvasively measured hemodynamic and autonomic parameters during two sequentially performed mental stress tests (arithmetic and anger recall tests). The cardiovascular data obtained were associated with results from well-validated psychometric self-rating tests for anxiety and depression (HADS), anger (STAXI), and perceived social support (FSozU).
In the rest period after mental stress application the majority of the study participants (82%) showed a rapid fall in cardiac index, arterial blood pressure, and heart rate, as well as an increase in high-frequency heart rate variability, while the remainder had no or unexpected changes in the hemodynamic parameters examined. Patients missing hemodynamic recovery in the post-stress phase reported significantly less social support than normally reacting patients (P<.05). Multivariate logistic regression models confirm that social support is an independent and significant predictor of preserved hemodynamic recovery from mental stress, even after controlling for somatic confounders (multivariate odds ratio 4.1; 95% confidence interval 1.3-12.7; P=.015).
Our data indicate that in ICD patients better perceived social support is associated with a more pronounced hemodynamic recovery after mental stress.
We conducted a study to investigate whether patients with somatization disorders (ICD-10, F45.0) show abnormal values in autonomic testing.
35 patients with a diagnosis of somatization disorder (SP) were matched to 35 healthy volunteers (HV). International standardized autonomic testing based on heart rate variation and continuously measured blood pressure signals was used to assess autonomic activity and establish baroreceptor sensitivity (BRS). Three different statistical procedures were used to confirm the reliability of the findings.
There were no statistical differences between the 2 groups in age, BMI, systolic and diastolic blood pressures, and spectral values (total power, low, and high frequency power). However, heart rate was higher (p=0.044) and baroreceptor sensitivity was lower (p=0.002) in the patients compared to the healthy volunteers. Median BRS (+/-S.E.M.) of patients was 9.09+/-0.65 compared to 12.04+/-0.94 ms/mmHg in healthy volunteers. Twenty-two of the 35 patients had a BRS of -1.0S.D. below the mean of HV. SP with lower values differed from SP with normal BRS in values of total power, low-, mid-, and high-frequency bands (p<0.01 to <0.0001). No differences in psychometric testing were found between patients with lower or higher BRS. In addition, no correlation whatsoever was found in relation to autonomic variables between HV and SP, except for a higher LF/HF quotient in the latter (p<0.05).
Autonomic regulation was impaired in 62% of patients with a somatization disorder. Severity of clinical symptoms measured by psychometric instruments did not preclude autonomic function impairment. Accordingly, autonomic dysfunction may constitute an independent somatic factor in this patient group.
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