Anger

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Overview

What is anger?

Anger is a commonly experienced emotion,1 which can range in intensity from mild annoyance to rage.1, 2 Anger is often triggered when a person feels wronged by someone, that something deeply unfair has happened, or that important things like wellbeing, social status, possessions, or the social rules he or she lives by are either not being respected or are under threat.1, 3 Whether someone gets angry typically depends on the person’s mood, perspective, physical wellbeing, ability to manage stress, coping skills, and available supports.4

Although anger is often seen as a negative emotion, it can be a normal and healthy response depending on the context and the way it is expressed. Indeed, anger can be helpful; it can motivate a person to take positive action to change a situation for the better5 or to achieve his or her goals.6

Some people have character traits that make them more likely to experience anger, as they habitually see themselves as being wronged or treated unfairly. People with these traits tend to make impulsive choices, as they are less likely to see risk in certain situations. They are also more likely to experience work, relationship, and health problems.7

Frequently experiencing anger can increase an individual’s vulnerability to illness, affecting the immune system, increasing cholesterol, and making pain feel stronger.8 However, holding in or suppressing anger is not a helpful solution. A range of other health and emotional problems can occur when the sources of anger are not addressed and there is no healthy release.9, 10

What causes problem anger?

Although everyone experiences anger, some individuals are at greater risk for experiencing problem anger and its associated behaviours.

  • Anger-related memories and images, such as those related to the experience of trauma, can trigger and add to the experience of anger.4
  • Family and culture provide messages about the acceptability of extreme anger and aggression, and can shape what is seen as a normal and appropriate response to stress.16 
  • Fixed ways of thinking about the world that set inflexible standards and expectations can increase the likelihood of anger when situations do not work out as expected.4
  • Anger is also a symptom of some mental health disorders, such as oppositional defiant disorder, post-traumatic stress disorder, and borderline personality disorder,2  and is therefore more likely in individuals with these diagnoses. Frequent experiences of anger might therefore indicate broader mental health problems.
  • A tendency to respond to stress with anger, hostility or aggression seems to be partly genetic and partly determined by the environment where a person was raised or currently lives.17

Signs and symptoms

The experience of anger involves thoughts, emotions, physical responses, and behaviours that all relate to one another.4

Cognitive

The cognitive component of anger involves thoughts of being wronged, harmed or treated unfairly by others, and these thoughts can often be exaggerated. When angry, people are more likely to blame others, and not see themselves as playing a role in the situation. Thoughts might also focus on putting the other person down, or trying to get revenge.4

Emotional

Anger also involves an emotional response, related to the person’s thoughts and beliefs about a situation. It can range from mild annoyance or irritation to more extreme feelings of rage or fury.4

Physical

The sympathetic nervous system is activated during anger, raising the heart rate, increasing muscle tension, and creating the sensation of feeling hot.4 The neurotransmitter serotonin, which helps control mood, sleep, appetite, learning, and memory, also seems to be involved in the expression and experience of anger.11

Behavioural

A range of behaviours are associated with anger that have found to be consistent across cultures.12 These include changes in facial expression, characterised by lowered eyebrows and tightened lips,12 and changes in speech, characterised by increased rate and volume, and by a rise in pitch.13

Signs and symptoms of problem anger

Problem anger is typically frequent, intense, and enduring, and can lead to physical aggression, hurtful putdowns, and a number of other harmful consequences. It is associated with a range of negative behaviours, particularly aggression and violence, which cause further difficulties for the person and his or her relationships.4, 6 Spouse abuse, child abuse, road rage, assault, and other violent crimes have all been associated with problem anger.6, 14 Individuals with problem anger are also more likely to experience difficulties at work, and to have problems with substance use.15

Evidence-based psychological approaches and strategies

Research supports the effectiveness of the psychological treatment of anger, particularly those which focus on peoples’ thoughts or behaviours and their ways of looking at situations.2, 6, 18, 19

Different types of anger problems can be addressed effectively by a range of techniques.2, 6 Therefore, an approach that combines several of these strategies may be worthwhile, including:

  • Addressing the motivation for change: Learning to monitor and be aware of the negative consequences of problematic anger can help with setting goals for changing behaviour.20
  • Managing physiological arousal: Decreasing bodily tension has been found to be an important first step in addressing anger problems.20 Learning relaxation techniques can help reduce tension and anger.21
  • Promoting changes in thinking: Developing more flexible, realistic, and accurate perceptions of events helps to reduce angry reactions.20, 22 Cognitive reappraisal, where an individual changes his or her interpretation of an event (e.g. seeing a driver who cuts them off as possibly rushing to an important appointment rather than purposefully holding them up) can be helpful in reducing or preventing angry responses.23, 24
  • Learning effective problem-solving: Learning skills to identify problem situations which might trigger an angry response and finding effective solutions25 can lead to lower levels of problem anger.18
  • Behaviour change: Learning and practicing new responses to situations, particularly through facing real or role-played situations that typically lead to anger,26 can promote new, calmer responses.20
  • Improving communication skills: Learning effective communication and conflict resolution skills, such as compromise and negotiation, can help people to respectfully and calmly express their anger.27

Additional strategies may also be helpful, including:

  • Managing impulsive behaviours: Strategies involving avoiding or removing oneself from situations that trigger anger can help to decrease its harm to relationships in the short term; but, they appear less helpful in the long term if new skills and strategies are not being learnt and practiced at the same time.20
  • Incorporating forgiveness: Encouraging forgiveness can be effective particularly when the focus may be on revenge or blame.20
  • Considering systemic (family) interventions: Problem anger can often negatively affect families and personal relationships. Involving family members or partners can provide helpful information regarding the individual’s anger and its negative consequences,20 and can help to improve communication, conflict resolution and problem-solving skills, break cycles of anger and aggression, and encourage hope and the sharing of praise and emotions other than anger (both positive and negative).27
  • Rebuilding relationships: Taking steps to repair damaged relationships can help promote wider change.20
  • Changing social groups: Avoiding social groups that reinforce anger and developing new, more helpful relationships can help with the reduction of anger and problem behaviour.20

How psychologists can help

Effective treatment aims to develop more helpful responses to situations that typically provoke anger. In order to carry out effective treatment, the psychologist and client develop a shared understanding of the causes of the person’s anger, his or her thoughts and understanding of past events where anger became a problem, associated behaviours, and the consequences of the anger.4

The psychologist may combine these discussions with surveys in order to gather relevant information, and will use this information to develop an appropriate treatment plan.4, 20

The psychologist might also assist the individual with any lifestyle factors that may be contributing to anger problems, such as drug or alcohol use.27 Significant anger may be experienced as part of other mental health problems such as depression, anxiety, or trauma, among others;11 therefore, the psychologist will also assess whether other mental health problems might be contributing to the anger as part of treatment planning.

Other professionals who might be involved

Agitation, irritability, and problem anger can occur in the context of several medical conditions or as a result of some medications, so a medical examination with a GP might be recommended. A referral to a GP or psychiatrist might also be suggested when medications could be beneficial.11, 28 Where problem anger is secondary to another mental health disorder, a psychiatrist may provide further evaluation and treatment. 

When to seek professional help

The negative outcomes of problem anger often motivate help-seeking. These outcomes might include relationship or legal problems, or property damage.4, 20 If anger is affecting an individual’s work, school, home life, or relationships, psychological assistance should be considered.

The APS Find a Psychologist service can be used to locate a psychologist in your local area: call 1800 333 497 or visit the website at www.findapsychologist.org.au. A GP can also organise a referral to an APS psychologist under the Better Access to Mental Health Care items.

More information

The Australian Psychological Society
Australia's largest professional association for psychologists
www.psychology.org.au

beyondblue
Provides information on anxiety, depression, and related disorders
www.beyondblue.org.au

headspace
Australia's National Youth Mental Health Foundation, providing assistance for individuals aged 12-25
www.headspace.org.au

Lifeline
A 24-hour counselling, suicide prevention and mental health support service
Telephone: 13 11 14
www.lifeline.org.au

  • Contributor(s)
    APS Member Resources Team

    Dr Lisa Warren, PhD, MAPS
    Centre for Forensic Behavioural Sciences
    Monash University
  • Publish date
    07 Jul 2014
  • References
    View

References

1.            DiGiuseppe, R., & Tafrate, R. (2007). Understanding anger disorders. New York, NY: Oxford University Press.

2.            Saini, M. (2009). A meta-analysis of the psychological treatment of anger: Developing guidelines for evidence-based practice. Journal of the American Academy of Psychiatry and the Law Online, 37(4), 473-488.

3.            Wranik, T., & Scherer, K. R. (2010). Why do I get angry? A componential appraisal approach. In M. Potegal, G. Stemmler & C. Spielberger (Eds.), International handbook of anger: Constituent and concomitant biological, psychological, and social processes (pp. 243-266). New York, NY: Springer.

4.            Deffenbacher, J. L. (2011). Cognitive-behavioral conceptualization and treatment of anger. Cognitive and Behavioral Practice, 18(2), 212-221.

5.            Tafrate, R. C., Kassinove, H., & Dundin, L. (2002). Anger episodes in high- and low-trait anger community adults. Journal of Clinical Psychology, 58(12), 1573-1590.

6.            Del Vecchio, T., & O'Leary, K. D. (2004). Effectiveness of anger treatments for specific anger problems: A meta-analytic review. Clinical Psychology Review, 24(1), 15-34. doi: http://dx.doi.org/10.1016/j.cpr.2003.09.006

7.            Lerner, J. S., & Keltner, D. (2001). Fear, anger, and risk. Journal of Personality and Social Psychology, 81(1), 146-159.

8.            Suinn, R. M. (2001). The terrible twos—anger and anxiety: Hazardous to your health. American Psychologist, 56(1), 27.

9.            Burns, J. W., Bruehl, S., & Quartana, P. J. (2006). Anger management style and hostility among patients with chronic pain: Effects on symptom-specific physiological reactivity during anger-and sadness-recall interviews. Psychosomatic Medicine, 68(5), 786-793.

10.          Quartana, P. J., & Burns, J. W. (2007). Painful consequences of anger suppression. Emotion, 7(2), 400-414.

11.          Bond, A. J., & Wingrove, J. (2010). The neurochemistry and psychopharmacology of anger. In M. Potegal, G. Stemmler & C. Spielberger (Eds.), International handbook of anger: Constituent and concomitant biological, psychological, and social processes (pp. 79-102). New York, NY: Springer.

12.          Matsumoto, D., Yoo, S. H., & Chung, J. (2010). The expression of anger across cultures. In M. Potegal, G. Stemmler & C. Spielberger (Eds.), International handbook of anger: Constituent and concomitant biological, psychological, and social processes (pp. 125-137). New York, NY: Springer.

13.          Green, J. A., Whitney, P. G., & Gustafson, G. E. (2010). Vocal expressions of anger. In M. Potegal, G. Stemmler & C. Spielberger (Eds.), International handbook of anger: Constituent and concomitant biological, psychological, and social processes (pp. 139-156). New York, NY: Springer.

14.          Chereji, S. V., Pintea, S., & David, D. (2012). The relationship of anger and cognitive distortions with violence in violent offenders' population: A meta-analytic review. European Journal of Psychology Applied to Legal Context, 4(1), 59-77.

15.          Kassinove, H., & Tafrate, R. C. (2006). Anger-related disoders: Basic issues, models, and diagnostic considerations. In Eva L. Feindler (Ed.), Anger-related disorders: A practitioner's guide to comparative treatments (pp. 1-28). New York, NY: Springer.

16.          Thomas, S. P. (2006). Cultural and gender considerations in the assessment and treatment of anger-related disorders. In E. L. Feindler (Ed.), Anger-related disorders: A practitioner's guide to comparative treatments (pp. 71-96). New York, NY: Springer.

17.          Reuter, M. (2010). Population and molecular genetics of anger and aggression: Current state of the art. In M. Potegal, G. Stemmler & C. Spielberger (Eds.), International handbook of anger: Constituent and concomitant biological, psychological, and social processes (pp. 27-37). New York, NY: Springer.

18.          DiGiuseppe, R., & Tafrate, R. C. (2003). Anger treatment for adults: A meta-analytic review. Clinical Psychology: Science and Practice, 10(1), 70-84.

19.          Glancy, G., & Saini, M. A. (2005). An evidenced-based review of psychological treatments of anger and aggression. Brief Treatment and Crisis Intervention, 5(2), 229-248.

20.          DiGiuseppe, R. A., & Tafrate, R. C. (2001). A comprehensive treatment model for anger disorders. Psychotherapy: Theory, Research, Practice, Training, 38(3), 262.

21.          Deffenbacher, J. L., Filetti, L. B., Lynch, R. S., Dahlen, E. R., & Oetting, E. R. (2002). Cognitive-behavioral treatment of high anger drivers. Behaviour Research and Therapy, 40(8), 895-910.

22.          Wright, J. H. (2006). Cognitive behavior therapy: Basic principles and recent advances. FOCUS: The Journal of Lifelong Learning in Psychiatry, 4(2), 173-178.

23.          Mauss, I. B., Cook, C. L., Cheng, J. Y., & Gross, J. J. (2007). Individual differences in cognitive reappraisal: Experiential and physiological responses to an anger provocation. International Journal of Psychophysiology, 66(2), 116-124.

24.          Szasz, P. L., Szentagotai, A., & Hofmann, S. G. (2011). The effect of emotion regulation strategies on anger. Behaviour Research and Therapy, 49(2), 114-119.

25.          Nezu, A. M., Nezu, C. M., & McMurran, M. (2008). Problem-solving therapy. In W. T. O'Donohue & J. E. Fisher (Eds.), Cognitive behavior therapy: Applying empirically supported techniques in your practice (2nd ed., pp. 402-407). Hoboken, NJ: John Wiley.

26.          Kassinove, H., & Tafrate, R. C. (2011). Application of a flexible, clinically driven approach for anger reduction in the case of Mr. P. Cognitive and Behavioral Practice, 18(2), 222-234.

27.          Potter-Efron, R. T. (2005). Handbook of anger management: Individual, couple, family, and group approaches. New York, NY: Haworth Press.

 

28.          Glancy, G., & Knott, T. (2002). Part III: The psychopharmacology of long-term aggression - Toward an evidence-based algorithm. CPA Bulletin, 35, 13-16.

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