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The experience and expression of anger: Construction and validation of an anger expression scale
... Depressive symptoms and anger expression were chosen as outcome measures because of the strong evidence suggesting that both are related to adverse health and psychological outcomes. Depression and the expression of anger have been found to predict longterm negative effects (e.g., substance use and heart disease; Abraham & Fava, 1999;Everson, Goldberg, Kaplan, Julkunen, & Salonen, 1998;Lin, Bai, Hu, & Yeh, 1998;Siegman, Townsend, Blumenthal, Sorkin, & Civelek, 1998;Spielberger et al., 1985). Additionally, research suggests that both depression and anger expression are important when considering relationships (Hanson, Cadsky, Harris, & Lalonde, 1997;Katz, Monnier, Beach, Libet, & Shaw, 2000;Senchak & Leonard, 1993). ...
... Anger, The Anger Expression Scale (AX Scale) was designed to measure the expression of anger (Spielberger et al., 1985). The scale contains three subscales: Anger-Out, Anger-In, and Anger Control. ...
... FEWs and their partners reported levels of depressive symptoms on the CES-D comparable to levels reported by other groups of individuals (Barnes & Prosen, 1984;Lewinsohn & Ten, 1982;Lin & Ensel, 1984). Both FEWs and their partners reported less anger expression than other individuals sampled with the AX Scale (Spielberger et al., 1985). FEWs and their partners reported levels of relationship adjustment on the DAS comparable to other married individuals (Spanier, 1976). ...
The relationship of antisocial and prosocial coping behaviors to individual and relationship well-being was prospectively examined in a sample of fire-emergency workers (FEWs) and their marital or romantic partners (69 couples). Results of hierarchical multiple regression equations indicated that FEWs' antisocial coping was related to higher levels of depressive symptoms. Prosocial coping was related to decreased anger expression and increased relationship adjustment. Partners' prosocial coping was a significant predictor of FEWs' reports of better relationship adjustment. For partners, prosocial coping was positively related to their relationship adjustment. FEWs' coping was unrelated to partners' outcome. Results for the FEWs support the notion that coping has direct and crossover effects. Moreover, results indicate that prosocial and antisocial coping behaviors have differential effects on well-being.
... La contribución del eje neuroticismo-estabilidad emocional en la salud destaca por el reconocimiento auténtico de las diferencias individuales que vienen del temperamento emocional y cobra quizás su futura relevancia en la prometedora dimensión de la ira-hostilidad, en particular en la taxonomía propuesta por Spielberger et al. (1985), cuyo inventario de la expresión ira-hostilidad (State-Trait Anger Expression Inventory -STAXI) ha sido validado y adaptado a población latinoamericana (Moscoso, 2000). Aquí se propone una diferenciación en la categoría de «rasgo» frente a «estado» y una distinción entre «expresión» y «supresión» de la ira-hostilidad, lo que ha sido prácticamente ignorado en la investigación en términos de su influencia en el proceso salud-enfermedad Este es el caso de la personalidad «tipo A» (Friedman y Rosenman, 1959), la cual ha sido vinculada al factor de neuroticismo-establidad emocional y entendida como un patrón de comportamiento vulnerable a la enfermedad cardiovascular. ...
... Aquí se propone una diferenciación en la categoría de «rasgo» frente a «estado» y una distinción entre «expresión» y «supresión» de la ira-hostilidad, lo que ha sido prácticamente ignorado en la investigación en términos de su influencia en el proceso salud-enfermedad Este es el caso de la personalidad «tipo A» (Friedman y Rosenman, 1959), la cual ha sido vinculada al factor de neuroticismo-establidad emocional y entendida como un patrón de comportamiento vulnerable a la enfermedad cardiovascular. La línea de investigación del «tipo A» se h visto debilitada en las últimas décadas debido a una visión unicista y atemporal de relaciones simples con la salud y a la omisión de mecanismos específicos e intermedios que configuran distintas sinergias implicadas en este proceso, entre ellos, el manejo y expresión de las emociones, en particular el de la ira-hostilidad (Friedman, 2008;Spielberger et al., 1985;Williams, Barefoot y Shekelle, 1985). Cabe resaltar que el mismo «tipo A» de personalidad puede vislumbrarse a su vez como un mecanismo mediador y resultado de combinación de factores generales de personalidad tales como el neuroticismo, agradabilidad y la conciencia (Chapman et al., 2011;Friedman, 2000), los que pueden tener valencias positivas y negativas de su contribución a la salud dependiendo de la particularidad de sus sinergias y, por ello, quizás las inconsistencias previas en su estudio. ...
... • Inventario multicultural latinoamericano de la expresión de ira-hostilidad. Este inventario fue adaptado y validado por Moscoso (2000), cuya base se encuentra en el STAXI (Spielberger et al., 1985). Comprende 44 ítems que valoran la ira en términos de rasgo/estado y su expresión: manifiesta/contenida/ controlada. ...
El objetivo del presente trabajo fue proponer un modelo estructural que delinee la relación que guardan distintas características psicológicas en su relación con problemas de salud mental por medio de un modelo de ecuaciones estructurales. En una muestra no aleatoria e intencional de N = 231 estudiantes, el modelo especificado demuestra que las variables de ira-rasgo, abnegación y locus de control interno tienen efectos en problemas de salud mental a través de mediadores como la ira contenida, la falta de asertividad y la autoeficacia, y que estos guardan las relaciones teóricas esperadas (X2 = 50.24, gl = 35 y p = 0.04; razón X2/gl = 1.44, CFI = .98, NFI = .93, IFI = .98, RMSEA = .04). Se discuten estos hallazgos en términos de su contribución a la comprensión de los mecanismos de la compleja relación de las características psicológicas, la personalidad y la salud.
... Previous research conducted bySpielberger et al. (1985)and other researchers (Liu et al., 2011) demonstrated the importance of differentiating anger proneness from habitual styles of anger expression when examining the link between anger and psychosomatic complaints. Anger proneness is considered to be a relatively stable personality trait and is defined as a tendency to experience angry feelings (Spielberger et al., 1985). ...
... Previous research conducted bySpielberger et al. (1985)and other researchers (Liu et al., 2011) demonstrated the importance of differentiating anger proneness from habitual styles of anger expression when examining the link between anger and psychosomatic complaints. Anger proneness is considered to be a relatively stable personality trait and is defined as a tendency to experience angry feelings (Spielberger et al., 1985). Individuals with high levels of anger proneness tend to perceive a wider range of situations as anger-eliciting situations and to experience more persistent anger during these situations than individuals with low levels of anger proneness. ...
... et al., 1985). Individuals with high levels of anger proneness tend to perceive a wider range of situations as anger-eliciting situations and to experience more persistent anger during these situations than individuals with low levels of anger proneness. Comparatively, anger expression refers to people's habitual modes of expressing angry feelings.Spielberger et al. (1985)proposed two basic dimensions of anger expression, anger-in and anger-out. Anger-in refers to the extent to which people ruminate over and suppress angry feelings rather than expressing them overtly. By contrast, anger-out refers to the extent to which people openly express their anger to other people or the environment. Prior research h ...
Previous research has shown strong connections of anger experience and expression with obsessive–compulsive (OC) symptoms. Additionally, studies have demonstrated links between family environment variables and obsessive–compulsive disorder (OCD). Our study aims to integrate the perspectives from these two literatures by exploring the moderating roles of family cohesion and family adaptability in the relationship between anger proneness and suppression and OCD symptoms. A total of 2008 college students were recruited from a comprehensive university in Shanghai, China between February and May 2016. The subjects completed self-report inventories, including the Symptom Check List-90, State-Trait Anger Expression Inventory 2 (Chinese version), and Family Adaptability and Cohesion Scale, second edition (Chinese Version). Controlling for age, one-child family status, ethnicity, family income, current depression, and anxiety, our analyses showed that the association between anger proneness and OC symptoms was moderated by family cohesion among men and that family adaptability moderated the connection between anger suppression and OC complaints among women. The findings imply that a more cohesive and empathic family environment may protect male students with high levels of anger proneness from developing OC behaviors or thoughts. The results suggest that for female subjects who are accustomed to suppressing angry feelings, flexible family coping strategies and communication atmospheres would reduce their vulnerability to OC symptoms. The findings are somewhat consistent with those of previous studies on psychotherapy outcomes that showed that OCD patients benefitted from psychotherapeutic interventions that cultivated the clients’ family cohesion and adaptability.
... Asociadas a esta se encuentran la ira y la hostilidad, como factores facilitadores. La ira hace refencia al componente emocional o afectivo y se define como una emoción básica, que varía en intensidad desde el enfado leve o irritación, hasta la rabia y furia intensa (Spielberger, Johnson, Russell, Crane, Jacobs, & Worden, 1985), y que se asocian con procesos psicofisiológicos de elevada activación (Sanz, Magán & García-Vera, 2006). Por su parte, la hostilidad connota un conjunto de actitudes negativas complejas como la desconfianza, suspicacia, desprecio y juicios negativos hacia otros, que serían el componente cognitivo de la agresión (Berkowitz, 1996;Roncero Villareal, 2012). ...
... La hostilidad sería el factor común en la mayoría de las correlaciones halladas. Este constructo hace referencia al componente cognitivo de la agresión y connota un conjunto de actitudes y juicios negativos hacia los demás, que motivan los comportamientos agresivos encaminados a un fin, la destrucción o el daño físico de objetos o personas (Spielberger, Johnson, Russell, Crane, Jacobs, & Worden, 1985). Además, todas las dimensiones del TND (enfado / irritabilidad, discusiones / actitud desafiante y vengativa) están asociadas a un nivel de conducta agresiva moderada; (American Psychiatric Association APA, 2013) síntomas y conductas como: molestar con facilidad, susceptibilidad, discusiones, provocaciones, rencor y venganza, son aspectos inherentes al mismo. ...
El objetivo del trabajo fue explorar las relaciones entre los niveles de agresión (física, verbal, ira y hostilidad) y empatía en un grupo de niños y niñas escolares entre los 7 y 11 años de edad en la ciudad de Medellín (Colombia) con diagnóstico de Trastorno Negativista Desafiante. Para evaluar la agresión se utilizó la versión reducida del cuestionario AQ de Buss y Perry en idioma español, y para la empatía se aplicó el test de la mirada y el Interpersonal Reactivity Index. Los resultados indicaron mayores puntuaciones en agresión física en los varones que en relación con las mujeres. Se encontró que existe una relación entre el total de agresión y algunos niveles de empatía (directa en el caso del número de aciertos en el test de la mirada e inversa con los desaciertos del mismo); ambas relaciones fueron significativas.
... Es importante destacar que la agresividad puede manifestarse junto con ira y hostilidad, pero que se trata de conceptos diferenciados entre sí, por lo que no refieren al mismo constructo (Spielberger, 1985). La ira es un estado emocional que aparece ante eventos desagradables que puede fluctuar en el grado de intensidad, no estando dirigido a una meta. ...
La agresividad vial es un fenómeno que afecta a los conductores de todas las ciudades, sin importar ubicación geográfica o diferencias culturales. Aproximadamente uno de cada diez conductores se caracteriza por ser fuertemente agresivo. ¿Ha visto usted a algún conductor acercar su vehículo a otro de manera agresiva o no respetar la distancia entre vehículos en las vías de alta velocidad? ¿Ha escuchado el uso excesivo del claxon o bocina? Encontrarse con un conductor agresivo es un factor que promueve el estrés, favorece los accidentes y lleva a la pérdida de bienestar en general, tanto en contextos urbanos como en otros no tan urbanos. Reducir la agresividad vial no es una misión nada fácil. Para hacer que los conductores agresivos «reduzcan su velocidad», se requiere de la participación de todos los actores involucrados.
En este trabajo nos enfocaremos en la Agresividad Vial, y en su Gestión Política.
... Higher scores indicate greater emotional control, greater goal orientation, and less vigilance, respectively. Finally, we included the Anger-In Expression scale (Spielberger, 1985) to assess individual differences in tendencies to keep anger "inside". We computed a sum across all eight items in the scale. ...
Psychosocial factors are associated with the achievement of optimal cardiovascular disease risk factor (CVDRF) levels. To date, little research has examined multiple psychosocial factors simultaneously to identify distinguishing psychosocial profiles among individuals with CVDRF. Further, it is unknown whether profiles are associated with achievement of CVDRF levels longitudinally. Therefore, we characterized psychosocial profiles of individuals with CVDRF and assessed whether they are associated with achievement of optimal CVDRF levels over 15 years. We included 1148 CARDIA participants with prevalent hypertension, hypercholesterolemia and/or diabetes mellitus in 2000–2001. Eleven psychosocial variables reflecting psychological health, personality traits, and social factors were included. Optimal levels were deemed achieved if: Hemoglobin A1c (HbA1c) < 7.0%, low-density lipoprotein (LDL) cholesterol < 100 mg/dl, and systolic blood pressure (SBP) < 140 mm Hg. Latent profile analysis revealed three psychosocial profile groups “Healthy”, “Distressed and Disadvantaged” and “Discriminated Against”. There were no significant differences in achievement of CVDRF levels of the 3 targets combined across profiles. Participants in the “Distressed and Disadvantaged” profile were less likely to meet optimal HbA1c levels compared to individuals in the “Healthy” profile after demographic adjustment. Associations were attenuated after full covariate adjustment. Distinct psychosocial profiles exist among individuals with CVDRF, representing meaningful differences. Implications for CVDRF management are discussed.
... The suppression of hostility subscale is added in consideration of the characteristics of Chinese culture. That subscale is adapted from the subscale of "anger in" (which means holding anger inside without expression) in "Anger Expression Scale (AX)" [31] [32]. Higher scores indicate higher levels of hostility. ...
Background: In China, father absence is a very common phenomenon, causing many mental health problems, such as the hostility of depressed teenagers. This study is to explore the relationship between father absence and hostility of depressed adolescents as well as the mediating effects of self-esteem and psychological frustration tolerance.
Methods: We conducted a cross-sectional study among depressed adolescents in Wuhan mental health center. They were assessed with Father absence questionnaire, Chinese Hostility Inventory, Psychological Endurance Questionnaire and Self-esteem Scale. We used PROCESS macro for SPSS to perform mediation analyses.
Results: The level of adolescent hostility was positively correlated with father absence, and negatively correlated with self-esteem and psychological frustration tolerance. Father absence had not a direct impact on the level of hostility with depression, but had indirect impact via psychological frustration tolerance and self-esteem.
Conclusion: Psychological frustration tolerance and self-esteem has a chain mediating effect on the relationship between father absence and hostility. Future intervention strategies could focus on psychological frustration tolerance and self-esteem to reduce the level of hostility of adolescents with depression.
... The original scale was developed by Spielberger et al. (1983;1985) Table 2). Form (DERS-16). ...
Utanç Pusulası Ölçeği (UPÖ), bireylerin utançla baş etme biçimlerini ölçmek amacıyla geliştirilmiş bir ölçektir. Ölçek 48 madde ile dört faktörden (geri çekilme, başkalarına saldırma, kendine saldırma, kaçınma) oluşmaktadır. Bu çalışmada UPÖ’nün psikometrik özelliklerinin Türkiye örnekleminde incelenmesi amaçlanmıştır. Çalışma örneklemi, yaşları 18 ile 66 arasında değişen 496 yetişkinden (137 erkek, 359 kadın) oluşmaktadır. Test tekrar test güvenirliği için ilk ölçümden iki hafta sonra 76 katılımcıdan tekrar ölçüm alınmıştır. Katılımcılardan Utanç Pusulası Ölçeği, Sürekli Utanç ve Suçluluk Ölçeği, Sürekli Öfke ve Öfke İfadeleri Envanteri, Duygu Düzenleme Güçlüğü Ölçeği, Beck Depresyon Envanteri ve Demografik Form doldurmaları istenmiştir. UPÖ’nün yapı geçerliğini incelemek için varimax rotasyonlu açımlayıcı faktör analizi yapılmış ve teorik olarak ilişkili diğer yapılarla olan korelasyonları test edilmiştir. Faktör analizi sonuçları, orijinal ölçeğe benzer şekilde dört faktörlü bir yapı ortaya koymuştur. Korelasyon analizi sonuçlarına göre ise, UPÖ’nün kendine saldırma, başkalarına saldırma ve geri çekilme faktörleri sürekli utanç ve öfke, öfke ifade tarzları, duygu düzenleme güçlükleri ve depresif belirtiler ile anlamlı korelasyonlar göstermiştir. Kaçınma faktörü ise gurur, öfke ve bastırılmış öfke ile düşük ancak anlamlı düzeyde ilişki göstermiştir. Bu bulgular ölçeğin yapı geçerliğini destekler niteliktedir. Ölçeğin iç tutarlılık güvenirliğini test etmek amacıyla faktörlere ait Cronbach alpha katsayıları hesaplanmış ve katsayıların .71 ile .89 arasında değiştiği görülmüştür. Test-tekrar test güvenirliği için hesaplanan değerler .71 ile .80 arasında değişkenlik göstermektedir. Ayrıca, geri çekilme ve kendine saldırma faktörleri için anlamlı cinsiyet farklılıkları tespit edilmiş, bu faktörlerde kadınların erkeklerden anlamlı olarak daha yüksek puan aldıkları bulunmuştur. Tüm bu bulgular, Utanç Pusulası Ölçeği’nin Türkçe versiyonunun, geçerlik ve güvenirliğine dair güçlü kanıtlar sunmaktadır
... The original scale was developed by Spielberger et al. (1983;1985) Table 2). Form (DERS-16). ...
... Trait Anger was assessed using the 10-item subscale of the Anger Expression Scale (Spielberger, 1985). Trait Anger and Anger Expression Style Scale (STAXI) is a self-report scale comprised of 44 items; 10 items of this 44 item scale define trait anger, 10 items define state anger, and 24 items define anger expression style (Anger control, Anger-out and Anger-in). ...
The aim of the present study was to test the psychometric properties of the Aggression Questionnaire Short Form for adolescents and adults in Turkish. The adaptation study was conducted with 778 adolescents aged between 15-18 and 1067 adults aged between 19 and 44. The construct validity of the questionnaire was tested via Parallel
Analysis, Exploratory Factor Analysis and Confirmatory Factor Analysis. Furthermore, item-total correlations,
test-retest score correlation, and internal consistency (Cronbach Alpha and McDonald’s Omega) were calculated as reliability analyses. The Measurement Invariance test and Differential Item Functioning in male and female,
adolescent and adult samples were also conducted. The results yielded that the Turkish version of the Aggression Questionnaire Short Form is a reliable questionnaire with four-factors, and without sex and age differences, it can be used to measure aggression among Turkish adolescents and adults.
... This instrument is a well-known measurement in anger assessment which shows high reliability and validity. A high internal reliability has been reported which the Cronbach's alpha for all the 6 scales ranged from 0.70 to 0.93 (Spielberger, 1985) and the validity of the test has been also approved in other experiments. For instance, it is reported in one study that the validity of this test is strong and there is a correlation between anger related constructs and the STAXI-2 scales (Lievaart, Franken, & Hovens, 2016). ...
Background: Inducing emotions in laboratory were always a challenge for scientists and although previously different kinds of emotions were aroused in many experiments, the fact that how these experiments are close to the real-life experience is controversial. Recently, the Virtual Reality technology provide a well-controlled platform to simulate an environment similar to the real life which gives the scientist an opportunity to study human behavior in a more realistic way.
Objective: In this study, the effectiveness of the design and methodology of a pilot experiment which used the virtual reality technology to induce the emotion of anger has been evaluated.
Methods: Two male participants were asked to watch a neutral movie (control condition) and an anger arousing movie (experimental condition) in a virtual reality environment while their brain activities and their eye movements behavior have been observed with EEG and eye movement tracker. Participants’ intensity of anger were assessed before and after the test and later participants were invited to watch the anger arousing movie again and show on an online emotion rating scale which parts of the movie were more arousing in their opinion.
Results: The results of EEG data was in favor of the previous achievements in most of the anger arousing moments of the movie which claimed a left frontal alpha asymmetry activation (Chester & DeWall, 2016; Harmon-Jones, Gable, & Peterson, 2010) and also right-dominant frontal beta activity (Hofman & Schutter, 2012) during the experience of anger. The eye movements data also showed an increase in saccadic features in most of the anger arousing moments of the movie as it was also observed in the results of another study which has evaluated the eye movements behavior of the individuals during their exposure to violent video games (Hallema & Lemmens, 2013). Although participants did not report a difference in their anger level before and after watching the anger arousing movie, they considered many parts of the movie as the moments which was successful to induce their anger.
Conclusion: Although the results of all the measurements did not show arousal in participants' anger level, this pilot experiment was still successful to induce anger in many parts of the movie and combining different methodologies were successful in studying the emotion of anger therefore this experimental design can also be used in future experiments considering some improvements.
... All patients enrolled provided written informed consent, and the study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki, as reflected in a priori approval by the institution's human research committee. Anger aspects were assessed by Spielberger State-Trait Anger Expression Inventory (STAXI) [4,5], which was developed to be used in a variety of medical conditions. The STAXI instrument separately assesses two major domains using a Likert scale: trait of anger and expression of anger. ...
... Con el propósito de establecer la validez convergente y discriminante del IMECH se administraron colectivamente las siguientes escalas: El Inventario Multicultural de la Expresión de Cólera-Hostilidad (IMECH) de Spielberger (1985), el Inventario de Ansiedad Rasgo-Estado (IDARE) de Spielberger (1983); y el Inventario de Depresión (108) de Beck (1974). Estas escalas han sido especialmente elaboradas y analizadas factorialmente, siendo de fácil administración y calificación. ...
Se presentan las normas percentilares y puntuaciones estándar normalizadas T para la interpretación de los puntajes del Inventario Multicultural para la expresión de Cólera-Hostilidad (IMECH) obtenidas en base a una muestra normativa de 1502 estudiantes del primer ciclo de una universidad estatal y otra privada de la ciudad de Lima. Se determina la validez de construcción del IMECH mediante la técnica intrapruebas. Los coeficientes Alfa de Cronbach revelan la consistencia interna de las Escalas que se administraron: Expresión de Cólera-Hostilidad (lMECH), Ansiedad Rasgo-Estado (IDARE) y Depresión (IDB). Las correlaciones entre las variables cólera-hostilidad y ansiedad rasgo-estado son estadísticamente significativas. El análisis factorial de las correlaciones entre las once variables examinadas permiten encontrar mediante la rotación Varimax tres factores: Factor I en que convergen cólera rasgo, cólera contenida y cólera manifiesta (cargas factoriales > .53). Factor II que establece relación de convergencia entre cólera-estado, ansiedad rasgo y ansiedad estado (cargas factoriales > .59); Y Factor III que relaciona la cólera expresada conductual y cognitivamente (cargas factoriales > .80). La depresión es divergente en relación a los otros constructos psicológicos, las cargas factoriales son bajas y no presentan relación de dependencia con ninguno de los tres factores.
... Future research could include more detailed measures of the amount and frequency of using each illicit drug rather than using a simple dichotomous rating (1 = yes, 0 = no) of whether the substance was used in the past year. Future research could also include more detailed and psychometrically tested measures of psychological and social stress reported by study participants such as the Beck Depression Inventory (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961), the Rosenberg Self-Esteem Scale (Rosenberg, 1965), the Spielberger Anger-In and Anger-Out Expression Scales (Spielberger et al., 1985), the Foa Post-Traumatic Stress Scale (Foa, Cashman, Joycox, & Perry, 1997), the Social Support from Family and Friends Scale (Procidano & Heller, 1983), the Revised Conflict Tactics Scale to measure romantic partner conflict (Caulfield & Riggs, 1992), and measures of work stress such as the Job Stress Scale (Vagg & Spielberger, 1998). In addition, future research could examine the past 10 + years of illicit drug use to see when painkillers became " big-city heroin " that was significantly associated with psychosocial stressors in urban adults. ...
Nonmedical use of painkillers has increased in recent years, with some authors suggesting that painkillers serve as “hillbilly heroin”: a drug chosen by rural adults to cope with psychosocial stresses in their lives. The present study compared rural and urban adults for their reported use of 5 drugs during the past year (painkillers, marijuana, cocaine, methamphetamine, heroin) and for associations between these 5 drugs and their reported psychosocial stressors. This study conducted secondary analyses of anonymous survey data provided by the 2014 National Survey on Drug Use and Health with responses from 8,699 rural and 18,481 urban adults. The survey included demographics (gender, age, race, education, marital status, family income), reports of whether participants had used each of 5 illicit drugs during the past year, and measures of psychological distress and social functioning problems. Controlling for demographics, rural adults showed no greater prevalence of painkiller use than urban adults, but rural adults were more likely than urban adults to use methamphetamine and less likely to use marijuana, cocaine, and heroin. Controlling for demographics, rural adults showed no associations between psychological or social stressors and the use of painkillers, but such stressors were significantly associated with the use of marijuana, methamphetamine, and heroin. Urban adults showed significant associations of psychological and social stressors with the use of painkillers, as well as with the use of marijuana, cocaine, and heroin. Results suggest that painkillers are unlikely to serve as “hillbilly heroin” for rural adults, but they may serve as “big-city heroin” for urban adults.
... Los investigadores han distinguido entre la ira como una reacción emocional (estado) y la disposición (rasgo) para experimentar la ira (Spielberger, Jacobs, Russell, & Crane, 1983;Spielberger & Reheiser, 2009). Otra distinción importante fue hecha entre la experiencia y la expresión de la ira (Spielberger et al., 1985). Por lo tanto, podríamos distinguir entre las personas que: (a) experimentan sentimientos de enfado, (b) no experimentan sentimientos de enfado, (c) expresan sus sentimientos de enfado en la conducta verbal o física, y (d) mantienen o suprimen sus sentimientos de enfado. ...
The aims of this study were to verify the relationship between locus of control and athletic performance, and understand the relationship between locus of control and anger variables. The research sample consisted of 58 federated table tennis players from all Spanish geographic areas. Participants completed a sociodemographic questionnaire ad hoc, the Locus of Control Scale (ELC) and the State-Trait Anger Expression Inventory (STAXI-2). The results revealed no differences in mean levels of external locus of control in terms of the division of play and type of sport (amateur versus professional). On the other hand, we found relationship between external locus of control and anger. We showed statistically significant differences in outward expression of anger and groups of high and low external locus of control. Finally, it was concluded that the level of athletic performance did not interfere with the levels of locus of control, on the other hand, the ratio of external locus of control and outward expression of anger of table tennis players was confirmed. Therefore, internal locus of control is shown as an important protective variable to intervene with for players and coaches.
... Anger Expression Scale (AX; Spielberger et al., 1985) was used by Arntz et al. (2007). It contains 24 items that assess the degree to which feelings of anger are held within (internalized anger), expressed towards others (externalized anger), or controlled (anger control). ...
Interventions involving rescripting-based imagery have been proposed as a better approach than exposure-based imagery when posttraumatic stress disorder (PTSD) is associated with emotions other than fear. Prior research led to the study's hypotheses that (a) higher pretreatment non-fear emotions will predict relatively better response to rescripting as compared to exposure, (b) rescripting will be associated with greater reduction in non-fear emotions, and (c) pretreatment non-fear emotions will predict poor response to exposure. A clinically representative sample of 65 patients presenting a wide range of traumas was recruited from patients seeking and being offered PTSD treatment in an inpatient setting. Subjects were randomly assigned to 10 weeks of treatment involving either rescripting-based imagery (Imagery Rescripting; IR) or exposure-based imagery (Prolonged Exposure; PE). Patients were assessed on outcome and emotion measures at pretreatment, posttreatment and 12 months follow-up. Comparison to control benchmarks indicated that both treatments were effective, but no outcome differences between them appeared. None of the initial hypotheses were supported. The results from this study challenge previous observations and hypotheses about exposure mainly being effective for fear-based PTSD and strengthen the notion that exposure-based treatment is a generally effective treatment for all types of PTSD. Keywords: posttraumatic stress disorder, prolonged exposure, imagery rescripting, non-fear emotions.
... The cultures referred to by Leung and Cohen (2011) as dignity cultures are more frequently characterized as individualistic. Spielberger's State-Trait Anger Expression Inventory (STAXI) instrument was first developed and validated within the United States (Spielberger et al., 1985;Spielberger & Reheiser, 2009), thereby providing distinctive evidence that U.S. respondents do differentiate the three coping styles. Within individualist cultures, anger expression may be less regulated by norms and be more dependent upon individual choices and dispositions. ...
Hypotheses are tested that ways of handling anger and their consequences will differ in student samples drawn from dignity cultures (United Kingdom and Finland), honor cultures (Turkey and Pakistan), and face cultures (Hong Kong and China). In line with our hypotheses, holding anger in and controlling anger correlate positively in face cultures but not in other samples, whereas holding anger in and letting anger out correlate positively in honor cultures but not in other samples. Furthermore, holding anger in and letting anger out are more strongly predictive of high depression and low life satisfaction in honor cultures than in other samples. The results provide support for the cross-cultural validity of Spielberger’s Anger Expression Inventory and for the proposition that differences in ways of handling anger can be understood in terms of contrasting cultural contexts.
Increased interest in emotional expressivity has led to a proliferation of conceptions and measures. It is unclear, however, whether they all refer to the same construct and whether the domain of emotional expressivity is best conceptualized as unidimensional or multifaceted. Study 1 examined 6 common expressivity questionnaires, yielding 5 factors: Expressive Confidence, Positive Expressivity, Negative Expressivity, Impulse Intensity, and Masking. To develop a nomological network for these factors, the factors were related to broader personality taxonomies and their differential relations to sex and ethnicity were tested. Study 2 provided further evidence of discriminant validity in relation to (a) typical emotion expression in peer relationships, (b) ability to pose emotions in the laboratory, (c) likability, and (d) regulation of emotion and mood. These findings support a hierarchical model of individual differences in emotional expressivity.
Anger is an emotional state that occurs when unexpected things happen to or around oneself and is "an emotional state that varies in intensity from mild irritation to intense fury and rage." It is defined as "a strong feeling of displeasure and usually of antagonism," an emotion characterized by tension and hostility arising from frustration, real or imagined injury by another, or perceived injustice. It can manifest itself in behaviors designed to remove the object of the anger (e.g., determined action) or behaviors designed merely to express the emotion. For the Roman philosopher Seneca anger is not an uncontrollable, impulsive, or instinctive reaction. It is, rather, the cognitive assent that such initial reactions to the offending action or words are in fact unjustified. It is, rather, the cognitive assent that such initial reactions to the offending action or words are in fact unjustified. It seems that the year 2022 was a year when many Americans were plainly angry. "Why is everyone so angry?" the New York Times asked in the article "The Year We Lost It." We believe that Seneca is correct in that anger is unacceptable. Anger is a negative emotion that must be controlled, and Seneca provides us with the tools to avoid and destroy anger. Health care professionals will be more effective, content, and happier if they learn more about Seneca's writings about anger and implement his wisdom on anger from over 2000 years ago.
Purpose
The aim of the study was to determine the effects of workload on the styles of anger expression and “trait anger” of health professionals working in a COVID-19 pandemic hospital.
Design and Methods
This descriptive study was carried out at a COVID-19 pandemic hospital in Turkey. The sampling consisted of 493 healthcare professionals. The data were evaluated with the SPSS (23.0) software program.
Findings
The study found that the participants who perceived the workload as higher, and could not tolerate the work they performed, were high in “trait anger” levels and their anger was suppressed.
Practice Implications
Health institutions should consider the recognition of emotional risks and the planning of interventions as a priority for professionals involved in the care of COVID-19 infected patients.
While many organizations' hiring practices now incorporate artificial intelligence (AI) and machine learning (ML), research suggests that job applicants may react negatively toward AI/ML-based selection practices. In the current research, we thus examined how organizations might mitigate adverse reactions toward AI/ML-based selection processes. In two between-subjects experiments, we recruited online samples of participants (undergraduate students and Prolific panelists, respectively) and presented them with vignettes representing various selection systems and measured participants' reactions to them. In Study 1, we manipulated (a) whether the system was managed by a human decision-maker, by AI/ML, or a combination of both (an “augmented” approach), and (b) the selection stage (screening, final stage). Results indicated that participants generally reacted more favorably toward augmented and human-based approaches, relative to AI/ML-based approaches, and further depended on participants' pre-existing familiarity levels with AI. In Study 2, we sought to replicate our findings within a specific process (selecting hotel managers) and application method (handling interview recordings). We found again that reactions toward the augmented approach generally depended on participants’ familiarity levels with AI. Our findings have implications for how (and for whom) organizations should implement AI/ML-based practices.
In spite of the negative effects of anger, coaches are often seen becoming angry during games. This is especially worrying in U18 categories. Thus, the objective of this study was to identify the influence that the coach’s anger has on the performance of a basketball team in competition. For this, an ad hoc observation tool was designed, in which 587 moments of anger from the coaching staff (64 coaches) were recorded in the 24 semi-final and final matches of the Spanish Autonomous Region Team Championships in 2019 and 2020 in the infantil (M = 14 years old) and cadete (M = 16 years old) categories. The results show that, in response to most incidents of coach anger, the performance of the team did not change. Significant differences were identified in some scenarios, with low- or medium-intensity anger targeted at the defence, where the team performance improved. However, anger towards the referee in the last quarter with scores level had a negative influence on the team’s performance.
People tend to alleviate their negative emotions by shopping. Considering the change of shopping behavior during COVID-19 outbreak, negative emotions are the key contributors to this change. In this light, this study aims to investigate how negative emotions caused by COVID-19 affect shopping behaviors. This study classified consumer groups based on their perceived negative emotions (i.e., anxiety, fear, depression, anger, and boredom). By clustering analysis, four groups (i.e., group of anxiety, depression, anger, and indifference) were derived. Then, this study examined how each of the emotional groups differently affect the shopping-related motivations (i.e., mood alleviation, shopping enjoyment, socialization seeking, and self-control seeking) and shopping behaviors (i.e., shopping for high-priced goods and buying of bulk goods). Results revealed all emotional groups affect socialization seeking and influence high-priced shopping intentions. However, depression and indifference are positively associated with socialization seeking and influence bulk shopping intentions. In addition, other emotions except for anxiety affect mood alleviation and influence high-priced shopping intentions. Finally, anger is associated with self-control seeking and affects bulk shopping intentions. This study enables practitioners and researchers to better understand how people control negative emotions by shopping in pandemic situations such as the current COVID-19 crisis.
This study investigated the effects of supervisors’ incivility regarding employees’ deviant behavior, the mediating effect of anger, and the moderating role of moral identity in the relationship between incivility and deviant behavior. To test our hypotheses, we collected data from supervisor–employee dyads in South Korean military units, applying a time-lagged design, hierarchical regression, and SPSS macro. The results elicited three relevant findings. First, supervisors’ incivility was found to positively influence employees’ deviant behavior. Second, employees’ anger was confirmed to have a mediating effect between supervisors’ incivility and employees’ deviant behavior. Third, the analysis demonstrated that moral identity moderates the relationship between anger and deviant behavior, and incivility through anger has an indirect effect on deviant behavior. These findings imply that supervisors’ incivility, which is readily observed within the organization, is a harmful behavior that increases anger and deviant behavior. These findings suggest that negative leadership should be minimized and employees with high moral identity should be selected to reduce deviant behavior that harms the organization.
Background: Anger has been suggested as a risk factor for stroke. Perceived social support (PSS) may relieve anger, thus reducing the risk of stroke; however, evidence supporting this is limited. We aimed to examine whether PSS modifies the risk of stroke associated with anger expression.
Methods: A cohort study was conducted among 1,806 community residents aged 40–74 years who received a cardiovascular risk survey including anger expression in 1997. A Cox proportional hazards model was applied to the participants with low and high PSS to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of the risks of total stroke and its subtypes based on total anger expression after adjusting for known stroke risk factors.
Results: The median follow-up duration was 18.8 years, with 51 incident strokes. Among the participants with low PSS, anger expression had a positive association with the total stroke risk: The multivariable HR per SD increment of total anger expression was 1.43 (95% CI, 1.13-1.82). In contrast, no association was identified among those with high PSS. The corresponding HR was 0.83 (95% CI, 0.49-1.40), with a significant interaction between low and high PSS (p = 0.037). Similar associations regarding the risk of ischemic stroke were found.
Conclusions: We found an increased risk of stroke associated with anger expression among the participants with low PSS, but not among those with high PSS. Our results suggest that PSS might mitigate the risk of stroke associated with anger.
Limited research has examined precursors/risk factors for adolescent irritability. This study examines continuity of irritability from early childhood to adolescence and identifies antecedents of adolescent irritability. Across self-reports and mother-reports, evidence was found for continuity of irritability. A range of variables assessed at age 3 predicted irritability at age 15. These findings suggest that adolescent irritability is characterized by distinct developmental pathways from age 3 that have potential to result in an irritable phenotype at age 15. Adolescent-reported and mother-reported irritability may be capturing distinct underlying constructs of irritability; both should be considered in assessments of adolescent irritability.
Background
Under controlled conditions, mental stress can provoke decrements in ventricular function, yet little is known about the effect of mental stress on diastolic function in patients with heart failure (HF).
Methods and Results
Twenty-four HF patients with ischemic cardiomyopathy and reduced ejection fraction (HFrEF; n=23 men; mean LVEF=27±9%; n=13 with baseline elevated E/e’) completed daily assessment of perceived stress, anger, and negative emotion for 7 days, followed by a laboratory mental stress protocol. 2D Doppler echocardiography was performed at rest and during sequential anger recall and mental arithmetic tasks to assess indices of diastolic function (E, e’, and E/e’). Fourteen patients (63.6%) experienced stress-induced increases in E/e', with an average baseline to stress change of 6.5±9.3, driven primarily by decreases in early LV relaxation (e’). Age-adjusted linear regression revealed an association between 7-day anger and baseline E/e’; patients reporting greater anger in the week prior to mental stress exhibited higher resting LV diastolic pressure.
Conclusions
In patients with HFrEF, mental stress can provoke acute worsening of LV diastolic pressure, and recent anger is associated with worse resting LV diastolic pressure. In patients vulnerable to these effects, repeated stress exposures or experiences of anger may have implications for long-term outcomes.
Police are exposed to considerable amounts of stress while undertaking their work; confronting not only a plethora of stress factors common to the field of work, but also frequently experienced violence, aggression, environmental stressors and traumatic events, thus leading to poor physical and mental health. This study aims to expand evidence on the role of stress management in police forces. The study concerns a randomized control trial in a sample of police officers ( N = 54) randomly separated into intervention and control groups. The intervention group ( N = 27) underwent Pythagorean Self-Awareness Intervention (PSAI), a novel 8-week non-pharmaceutical self-referring intervention, whereas the control group completed self-reported questionnaires that were used pre- and post-intervention in both groups. The majority of participants were males in their mid-30s, with tertiary education, married, and had been working in police forces for more than a decade; more than half were shift workers. Statistical analyses revealed beneficial changes in the intervention group for the variables anger in, negative affect, cognitive speed and verbal memory compared with the control group. We aspire to the introduction of PSAI as a method that have beneficial effects on police stress, cognitive amelioration and management of negative feelings and anger.
Anger in young people is on the increase worldwide and effective anger treatment services are in demand. However, the lack of research on the construct of anger and little evidence-based practice makes it difficult to ascertain the best service for these angry young people. Moreover, there is a lack of extensive evidence and qualitative research in the combination of psychoeducation and positive psychology interventions in anger management programmes for young people. Therefore, this chapter will summarise a phenomenological study of an existing psychoeducational anger management programme in the UK and discuss its findings. This chapter will present anger and positive psychology in the context of developing an effective anger management programme and provide a simple anger management strategy to use as a foundation for developing anger management programmes in schools.
Background:
Young's contention that early maladaptive schemas mediate the relationship between adverse parenting and later emotional difficulties has been lrttle tested. Also, most relevant research focuses only on depression, and on maternal parenting.
Methods:
One hundred and fifty-five non-clinical adults completed the Young Parenting Inventory (YPI) regarding both their mothers and fathers, Young's Schema Questionnaire (YSQ), the State/Trait Anger Scale (STAS) and the Depression Anxiety Stress Scale-21 (DASS-21).
Results:
Young's suggested 17-factor YPI structure was not supported. Rather, participants differentiated between recalled paternal and maternal parenting, with rejecting and controlling components emerging for each parent. There was an indirect effect of rejecting fathering on symptoms of depression, via the social isolation schema, in support of Young's theory. However, despite some significant relationships between parenting and schemas, and schemas and emotions, most effects of parenting on emotions were direct. Rejecting fathering had a direct positive effect on trait anger, and controlling mothering on symptoms of depression and anxiety. Controlling fathering had a negative effect on anxiety symptoms.
Limitations:
The study was cross-sectional, limited to participants in a single city, and had a preponderance of female respondents.
Conclusions:
Most effects of adverse parenting seem to be direct rather than operating through schemas. Prevention through early parenting programs, and adult cognitive therapies that draw on a broad range of schemas, seem to be called for.
Background
The management of mentally ill offenders in the community is one of the great challenges imposed on community psychiatry.
Aim
The aim of this study was to analyze the association between sociodemographic, clinical, and psychosocial factors and violent behavior in a sample of outpatients with severe mental disorders.
Method
This was a prospective cohort study with a baseline cross-sectional design used to provide a detailed analysis of patients’ profiles, followed by a longitudinal design to measure aggressive and violent behavior during a 1-year follow-up. Patients with severe mental disorders, with or without a history of violence, were enrolled in four Italian Departments of Mental Health and underwent a comprehensive multidimensional assessment.
Results
The sample included 247 outpatients, for a total of 126 cases and 121 controls. Compared to controls, patients with a history of violence had a greater frequency of lifetime domestic violence, a greater lifetime propensity to misuse substances, and a higher number of compulsory admissions. The forthnightly monitoring during the 1-year follow-up did show statistically significant differences in aggressive and violent behavior rates between the two groups. Verbal aggression was significantly associated with aggression against objects and physical aggression. Moreover, outpatients with an history of violence showed statistically significant higher MOAS scores compared to both residential patients with an history of violence, assessed in the first wave of this project, and all controls.
Conclusions
Patients with a history of violence had specific characteristics and showed a greater occurrence of additional community violence during a 1-year observation period. Our results may assist clinicians in implementing standardized methods of patient assessment and violence monitoring in outpatient mental health services and may prompt improved collaboration between different community services.
Potential psychosocial risk factors of coronary heart disease (CHD) include type A personality, hostility and anger, alexithymia, type D personality, stress, depression, anxiety, denial, and social support. These patients often show psychopathology such as anxiety, depression, and delirium. Psychotherapeutic interventions and psychopharmacotherapy for these psychopathologies were reviewed. Psychotherapeutic interventions with heart disease patient are aimed at reducing anxiety and depression, enhancing compliance, and modifying risk factors. To treat them effectively, the clinician should look beyond the symptoms to their function and meaning. In psychopharmacotherapy, interactions between cardiac drugs and psychiatric drugs need to be examined in addition to cardiac side effects of psychiatric drugs and psychiatric side effects of cardiovascular drugs. For the mentally ill cardiac patients, it is desirable to combine psychiatric treatment with a cardiac rehabilitation. Physicians need to keep in mind that countertransference might influence the progress of a cardiac disease.
Cognitive behavioral intervention for individuals with risk factors of coronary heart diseases such as type A behavior and hypertension was reviewed. Cognitive strategies misused by patients with type A behavior include all-or-nothing thinking, excessive selective attention, personalization, and attribution of causality. How to apply cognitive behavioral therapy to basic features of the type A pattern such as time urgency, perfectionism, achievement striving, excessive work involvement, low self-esteem, hostility, and depression was described. Cognitive behavioral approach for patients with hypertension helps the clients recognize and monitor anger-engendering conflict, identify characteristic styles of responding, and experiment with alternative ways of managing anger and conflict. The therapist needs to consider therapeutic interventions tailored to each individual’s characteristic and problems, because predominant features of type A can vary from person to person.
This title was first published in 2000: The first book to examine stress in doctors' families in the United Kingdom, this book outlines the results of both qualitative and quantitative research data and a thorough literature review of stress in the medical profession. It has been organised in five chapters beginning with medical students, junior doctors and consultants' stress. Chapter two focuses on specific problems experienced by general practitioners. The content of the third chapter outlines the experiences of women doctors and their family lives. In chapter four overseas doctors, their spouses and their children talk about their experiences which are characterised by cultural diversities. Chapter five focuses on the experiences of non-doctor spouses and children's point of view. The final chapter reviews issues raised by the doctors, their spouses and their children. Approaches to the problems of different groups are suggested and some individual and organisational stress management strategies are outlined. This book is aimed at medical students, hospital doctors and their spouses, general practitioners and their spouses, other health care professionals and students in medicine, social sciences and allied health professions. It will also be of value to counsellors helping doctors and their families suffering from emotional problems.
Background and objectives
The ubiquitous Internet connections by smartphones weakened the traditional boundaries between computers and mobile phones. We sought to explore whether smartphone-related problems differ from those of computer use according to gender using latent class analysis (LCA).
Methods
After informed consents, 555 Korean middle-school students completed surveys on gaming, Internet use, and smartphone usage patterns. They also completed various psychosocial instruments. LCA was performed for the whole group and by gender. In addition to ANOVA and χ² tests, post-hoc tests were conducted to examine differences among the LCA subgroups.
Results
In the whole group (n = 555), four subtypes were identified: dual-problem users (49.5%), problematic Internet users (7.7%), problematic smartphone users (32.1%), and “healthy” users (10.6%). Dual-problem users scored highest for addictive behaviors and other psychopathologies. The gender-stratified LCA revealed three subtypes for each gender. With dual-problem and healthy subgroup as common, problematic Internet subgroup was classified in the males, whereas problematic smartphone subgroup was classified in the females in the gender-stratified LCA. Thus, distinct patterns were observed according to gender with higher proportion of dual-problem present in males. While gaming was associated with problematic Internet use in males, aggression and impulsivity demonstrated associations with problematic smartphone use in females.
Conclusions
An increase in the number of digital media-related problems was associated with worse outcomes in various psychosocial scales. Gaming may play a crucial role in males solely displaying Internet-related problems. The heightened impulsivity and aggression seen in our female problematic smartphone users requires further research.
The main aim of the current study was to examine the role of co-occurring emotions and their interactive effects with the Big Five personality traits in anger expression. Everyday anger expression (“anger-in” and “anger-out” behavior) was studied with the experience-sampling method in a group of 110 participants for 14 consecutive days on 7 random occasions per day. Our results showed that the simultaneously co-occurring emotions that buffer against anger expression are sadness, surprise, disgust, disappointment, and irritation for anger-in behavior, and fear, sadness and disappointment for anger-out reactions. While previous studies have shown that differentiating one's current affect into discrete emotion categories buffers against anger expression (Pond et al., 2012), our study further demonstrated the existence of specific interactive effects between the experience of momentary emotions and personality traits that lead to higher levels of either suppression or expression of anger behavior (or both). For example, the interaction between the trait Openness and co-occurring surprise, in predicting anger-in behavior, indicates that less open people hold their anger back more, and more open people use less anger-in behavior. Co-occurring disgust increases anger-out reactions in people low in Conscientiousness, but decreases anger-out reactions in people high in Conscientiousness. People high in Neuroticism are less likely to engage in anger-in behavior when experiencing disgust, surprise, or irritation alongside anger, but show more anger out in the case of co-occurring contempt. The results of the current study help to further clarify the interactions between the basic personality traits and the experience of momentary co-occurring emotions in determining anger behavior.
The present study examined whether there was a difference in the mode of anger expression according to different adult attachment styles suggested Brennan et al. (1998). The subjects of this study were 194 adult who were given self report measure of adult attachment styles and anger expression. They were divided into secure, dismissing, preoccupied, fearful attachment groups. The data was according to repeated-measures analysis of variance. The results showed that there was a significant difference in anger expression according to different adult attachment styles. There were relatively high CAI (control-anger-in) scores in secure group, whereas the dismissing, preoccupied, fearful groups showed relatively high AI (anger-in) scores. In the cases of the secure attachment style groups, they could effectively control over the internalization of anger. But insecure group exhibited unilateral repression and the internalization of anger. This study also showed that there was a generational difference in the mode of anger expression according to different adult attachment styles. In 10s∼20s group, proportion of fearful attachment style was more than 30s∼40s group. In 30s∼40s group, they could relevantly control over the internalization/externalization of anger more than 10s ∼20s group. Finally, the implications and limitations of this research were discussed and suggestions for future research were proposed. (Korean J Str Res 2009;17:35∼44)
This study investigated whether trait anger linked to actual sleep behavior and what anger tendencies play the most important role for particular aspects of sleep. Data from 436 adults in Midlife of the United States Study were used to link anger tendencies to both objectively (actigraphy) and subjectively (daily diary) assessed sleep across a week. Overall, individuals who had poor anger control also had worse objectively and subjectively measured sleep and these relations were robust to effects of gender, age, race, socioeconomic status, and stress. The findings tie actual sleep behavior to individual differences in anger, suggesting poor anger control plays the most important role, and add to the growing evidence that anger and sleep depend on each other.
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.
Background:
Coronary heart disease (CHD) is the most common cause of death globally, although mortality rates are falling. Psychological symptoms are prevalent for people with CHD, and many psychological treatments are offered following cardiac events or procedures with the aim of improving health and outcomes. This is an update of a Cochrane systematic review previously published in 2011.
Objectives:
To assess the effectiveness of psychological interventions (alone or with cardiac rehabilitation) compared with usual care (including cardiac rehabilitation where available) for people with CHD on total mortality and cardiac mortality; cardiac morbidity; and participant-reported psychological outcomes of levels of depression, anxiety, and stress; and to explore potential study-level predictors of the effectiveness of psychological interventions in this population.
Search methods:
We updated the previous Cochrane Review searches by searching the following databases on 27 April 2016: CENTRAL in the Cochrane Library, MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), and CINAHL (EBSCO).
Selection criteria:
We included randomised controlled trials (RCTs) of psychological interventions compared to usual care, administered by trained staff, and delivered to adults with a specific diagnosis of CHD. We selected only studies estimating the independent effect of the psychological component, and with a minimum follow-up of six months. The study population comprised of adults after: a myocardial infarction (MI), a revascularisation procedure (coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI)), and adults with angina or angiographically defined coronary artery disease (CAD). RCTs had to report at least one of the following outcomes: mortality (total- or cardiac-related); cardiac morbidity (MI, revascularisation procedures); or participant-reported levels of depression, anxiety, or stress.
Data collection and analysis:
Two review authors independently screened titles and abstracts of all references for eligibility. A lead review author extracted study data, which a second review author checked. We contacted study authors to obtain missing information.
Main results:
This review included 35 studies which randomised 10,703 people with CHD (14 trials and 2577 participants added to this update). The population included mainly men (median 77.0%) and people post-MI (mean 65.7%) or after undergoing a revascularisation procedure (mean 27.4%). The mean age of participants within trials ranged from 53 to 67 years. Overall trial reporting was poor, with around a half omitting descriptions of randomisation sequence generation, allocation concealment procedures, or the blinding of outcome assessments. The length of follow-up ranged from six months to 10.7 years (median 12 months). Most studies (23/35) evaluated multifactorial interventions, which included therapies with multiple therapeutic components. Ten studies examined psychological interventions targeted at people with a confirmed psychopathology at baseline and two trials recruited people with a psychopathology or another selecting criterion (or both). Of the remaining 23 trials, nine studies recruited unselected participants from cardiac populations reporting some level of psychopathology (3.8% to 53% with depressive symptoms, 32% to 53% with anxiety), 10 studies did not report these characteristics, and only three studies excluded people with psychopathology.Moderate quality evidence showed no risk reduction for total mortality (risk ratio (RR) 0.90, 95% confidence interval (CI) 0.77 to 1.05; participants = 7776; studies = 23) or revascularisation procedures (RR 0.94, 95% CI 0.81 to 1.11) with psychological therapies compared to usual care. Low quality evidence found no risk reduction for non-fatal MI (RR 0.82, 95% CI 0.64 to 1.05), although there was a 21% reduction in cardiac mortality (RR 0.79, 95% CI 0.63 to 0.98). There was also low or very low quality evidence that psychological interventions improved participant-reported levels of depressive symptoms (standardised mean difference (SMD) -0.27, 95% CI -0.39 to -0.15; GRADE = low), anxiety (SMD -0.24, 95% CI -0.38 to -0.09; GRADE = low), and stress (SMD -0.56, 95% CI -0.88 to -0.24; GRADE = very low).There was substantial statistical heterogeneity for all psychological outcomes but not clinical outcomes, and there was evidence of small-study bias for one clinical outcome (cardiac mortality: Egger test P = 0.04) and one psychological outcome (anxiety: Egger test P = 0.012). Meta-regression exploring a limited number of intervention characteristics found no significant predictors of intervention effects for total mortality and cardiac mortality. For depression, psychological interventions combined with adjunct pharmacology (where deemed appropriate) for an underlying psychological disorder appeared to be more effective than interventions that did not (β = -0.51, P = 0.003). For anxiety, interventions recruiting participants with an underlying psychological disorder appeared more effective than those delivered to unselected populations (β = -0.28, P = 0.03).
Authors' conclusions:
This updated Cochrane Review found that for people with CHD, there was no evidence that psychological treatments had an effect on total mortality, the risk of revascularisation procedures, or on the rate of non-fatal MI, although the rate of cardiac mortality was reduced and psychological symptoms (depression, anxiety, or stress) were alleviated; however, the GRADE assessments suggest considerable uncertainty surrounding these effects. Considerable uncertainty also remains regarding the people who would benefit most from treatment (i.e. people with or without psychological disorders at baseline) and the specific components of successful interventions. Future large-scale trials testing the effectiveness of psychological therapies are required due to the uncertainty within the evidence. Future trials would benefit from testing the impact of specific (rather than multifactorial) psychological interventions for participants with CHD, and testing the targeting of interventions on different populations (i.e. people with CHD, with or without psychopathologies).
This study investigates the reliability and validity of the State-Trait-Anger-Expression-Inventory-2 (STAXI-2; in the German version by Rohrmann et al., 2013) in a sample of n=57 male inmates (aged 25-67 years). Internal consistencies reveal a high reliability of the STAXI-2 and subscale intercorrelations are close to those of the standardization sample. A confirmatory factor analysis confirms the four-dispositional-factor structure of the STAXI-2. Construct validity is supported by correlations with personality traits of inmates that play a key role in inmate misconduct (e.g., aggressiveness & social adjustment). Anger-Expression-Out and Anger-Expression-In are significant predictors of the length of sentence and Trait-Anger is associated with the age of first offense, both indicating criterion-related validity. These results support the use of the STAXI-2 for inmates and suggest that it can serve as an diagnostic tool in correctional institutions.
Tutti, almeno una volta nella vita, abbiamo provato stress. Non sorprende che l’esposizione allo stress sia generalmente associata a una vasta gamma di esiti negativi tra cui diminuzione del benessere, maggiore incidenza di malattie, Post-Traumatic Stress Disorder, Disturbo d’Ansia Generalizzato e Depressione Maggiore [24, 54
The present study tested a Western a cognitive model of obsessive-compulsive (OC) symptoms in China, that thought–action fusion (TAF) could mediate the relation between inflated responsibility and OC symptoms, which in turn would be associated with general distress. A cross-sectional sample of 622 Chinese undergraduates and postgraduates completed a battery of measures on inflated responsibility, TAF, OC symptoms, anxiety and depression. Results suggested good fit for the mediation model. However, only one type of TAF—TAF-Likelihood—emerged as a mediator. This was not the case for the other type, called TAF-Morality. These findings suggest that this specific Western cognitive model of OCD may generalize to China, although there may be subtle appraisal differences based on culture.
Das Ausmaß der Stressbelastung eines Patienten wird über die Beurteilung seines Anpassungsstatus bestimmt. Präoperativ interessieren negative Affekte wie Angst und die Güte zentraler Körperfunktionen. Intraoperativ werden Kriterien wie Herzfrequenz, Blutdruck sowie Parameter des Anästhesieverlaufs herangezogen. Die postoperative Phase befasst sich mit dem Zustand unmittelbar nach dem Eingriff, der Erholung nach Rückkehr des Patienten auf die Station und der Anpassung nach Entlassung aus der Klinik. Untersuchungen weisen darauf hin, dass eine erhöhte Stressbelastung Einfluss auf den Verlauf der Anästhesie haben kann sowie Reaktionen im Aufwachraum oder auf der Intensivstation beeinflusst. Ferner wurden fremd- oder selbsteingeschätzte Körperfunktionen, Schmerzbelastung, Wundheilung, kognitive Dysfunktionen und die Verweildauer in der Klinik untersucht. Bei der längerfristigen Anpassung zeigten sich Zusammenhänge von Stress mit der psychophysische Erholung, der Wiederanpassung an den Alltag, der allgemeinen sowie auf die durchgeführte Operation bezogenen Lebensqualität und dem Mortalitätsrisiko.
Drei Auffassungen von Stress werden einander gegenübergestellt: Die reizbezogene Sicht bestimmt Stress als eine Anforderung aus der Umwelt eines Organismus, die in diesem eine Notfallreaktion auslöst. Nach der reaktionsbezogenen Konzeption ist Stress ein durch äußere Umstände ausgelöster Extremzustand des Organismus, der durch unterschiedliche Reizarten (unspezifisch) ausgelöst werden kann, aber ein spezifisches Reaktionsmuster zeigt, das Allgemeine Adaptationssyndrom. Nach der transaktionalen Auffassung ist Stress eine Beziehung zwischen Person und Umwelt, die bedeutsam für das Wohlergehen der Person ist, zugleich aber Anforderungen stellt, die deren Bewältigungsmöglichkeiten beanspruchen oder überfordern. Die Stressbelastung kann sich in drei Arten von Indikatoren niederschlagen, auf denen entsprechende Messverfahren basieren: in subjektiven Variablen, erfasst z. B. über Fragebogen, in verhaltensmäßig-expressiven Merkmalen (Gesichtsausdruck, Stimme, Körperhaltung) sowie in einer Vielzahl physiologisch-biochemischer Parameter.
The purpose of this study was to examine the relationship between anger expression and self-esteem of female college students of dental hygiene. Participants were 598 female students who majored in dental hygiene from randomly selected colleges, located in Daejeon and Chungcheongbuk-do. Data were gathered from May 20 to June 5, 2014, using structured questionnaires. The major findings of the study were as follows: the correlation between anger expression and self-esteem was analyzed, and self-esteem was found to have a weak significant negative correlation with anger expression. On analyzing data to explore which variables affected self-esteem, it was found that self-esteem was influenced by grade, school record, harassment, language psychological violence, and bullying. The above-mentioned findings suggest that anger expression is related to self-esteem. After graduation from college, dental hygiene students, encounter a variety of interpersonal relationships in their work. Therefore self-esteem programs need to be developed and implemented at an individual, departmental, and collegiate level to help students learn to respect themselves and others, and to provide appropriate care.
Purpose: The purpose of this study was to investigate the influencing factors on externalized and internalized problem behaviors among high school students. Methods: The subjects for this study were 707 students in two high schools in K province. The data were collected during the period from October to November, 2014 by use of questionnaires. The instruments used were the Korean Youth Self-report, Daily Hassles Questionnaire, State-Trait Anger Expression Inventory, and Ego Resiliency Scale. The data were analyzed using SPSS. Results: Significant predictors to explain externalized problem behaviors comprised anger-out, anger-in, anger-control, relation with parents, daily stress, and religion. It was found that these factors explained 46% of externalized problem behavior. Ego resiliency, anger-in, daily stress, gender, relation with parent, and anger-out were significant predictors to explain internalized problem behaviors. It was found that these factors explained 45% of internalized problem behaviors. Conclusion: This study suggests that the influencing factors on problem behaviors differ from externalized and internalized problem behaviors. So these findings will provide the basic data to develop a program that is differentiated by problem behavior type.
Janisse and Dyck concern themselves in this chapter with the Type A behavior pattern and review some central issues for the theory of Type A. They focus upon both physiological and psychological attempts to understand the behavior pattern and review three notions in particular. They begin with the concept of enhanced or exaggerated physiological responsivity on the part of Type As relative to Type Bs. This proposal holds that habitual cardiovascular overreaction during a lifetime is somehow linked to coronary heart disease. The second notion explored, continuing a theme of Endler’s, is that of control. It is said that for Type As, control of their environment and the people in it is of paramount importance, and that great amounts of energy are spent by them to maintain control, or to regain it when lost. It is argued that this may explain the hypervigilance and high activity temperament of the Type A. Finally, the role of hostility in the Type A character is related to the concept of coronary-prone behavior and the need to control. Hostility has long been tied to cardiovascular disease, as shown by Rosenman in Chapter 1, but it has begun to be suspected that this is the key component of the Type A behavior pattern that makes it a coronary-prone pattern. With regard to control, issues about its nature are discussed, giving particular concern to how its maintenance and loss may be related to the emergence and expression of hostility in the Type A. The chapter concludes by advancing several questions about control, hostility, and the Type A behavior pattern that look to future research for answers.
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