Structural and functional brain networks of individual differences in trait anger and anger control: An unsupervised machine learning study.

The ability to experience, use and eventually control anger is crucial to maintain well-being and build healthy relationships. Despite its relevance, the neural mechanisms behind individual differences in experiencing and controlling anger are poorly understood. To elucidate these points, we employed an unsupervised machine learning approach based on independent component analysis to test the hypothesis that specific functional and structural networks are associated with individual differences in trait anger and anger control. Structural and functional resting state images of 71 subjects as well as their scores from the State-Trait Anger Expression Inventory entered the analyses. At a structural level, the concentration of grey matter in a network including ventromedial temporal areas, posterior cingulate, fusiform gyrus and cerebellum was associated with trait anger. The higher the concentration, the higher the proneness to experience anger in daily life due to the greater tendency to orient attention towards aversive events and interpret them with higher hostility. At a functional level, the activity of the default mode network (DMN) was associated with anger control. The higher the DMN temporal frequency, the stronger the exerted control over anger, thus extending previous evidence on the role of the DMN in regulating cognitive and emotional functions in the domain of anger. Taken together, these results show, for the first time, two specialized brain networks for encoding individual differences in trait anger and anger control.

Anger Assessment in Clinical and Nonclinical Populations: Further Validation of the State-Trait Anger Expression Inventory-2.

OBJECTIVE: The most commonly used instrument for measuring anger is the State-Trait Anger Expression Inventory-2 (STAXI-2; Spielberger, 1999). This study further examines the validity of the STAXI-2 and compares anger scores between several clinical and nonclinical samples. METHOD: Reliability, concurrent, and construct validity were investigated in Dutch undergraduate students (N = 764), a general population sample (N = 1211), and psychiatric outpatients (N = 226). RESULTS: The results support the reliability and validity of the STAXI-2. Concurrent validity was strong, with meaningful correlations between the STAXI-2 scales and anger-related constructs in both clinical and nonclinical samples. Importantly, patients showed higher experience and expression of anger than the general population sample. Additionally, forensic outpatients with addiction problems reported higher Anger Expression-Out than general psychiatric outpatients. CONCLUSION: Our conclusion is that the STAXI-2 is a suitable instrument to measure both the experience and the expression of anger in both general and clinical populations.

The Applicability of Virtual Reality-Based Training for Controlling Anger in Aggressive Individuals.

Because a failure of anger control leads to emotional and social problems, appropriate anger management may be important for social well-being. Virtual reality (VR) may potentially be effectively utilized in anger management, and this study aimed to verify the applicability of the VR-based anger control training program. The data obtained by having 60 young male participants divided into 2 groups, the high aggression group and the low aggression group, based on their Aggression Questionnaire scores to execute this program were analyzed. The program consisted of "Anger Exposure Training" for provoking anger and facilitating anger control and "Mindfulness Training" for providing the meditation experience for controlling anger. The anger scores and comfort scores obtained from these tasks, respectively, were analyzed for differences between the groups and between the experimental conditions. The anger regulation and comfort enhancement rates were analyzed for correlations with psychological variables. In Anger Exposure Training, the anger scores in angry expression were reduced in managed expression of anger in both groups. In Mindfulness Training, meditation increased comfort score as well in both groups, and the comfort enhancement rates were negatively correlated with the levels of self-differentiation and open communication with mother only in the high aggression group. These results indicate that the VR environments can provide an effective means of trainings for managing anger. Therefore, further research on the effectiveness of the VR-based anger control training program is worthy conducting in individuals who express excessive aggression.

A "Proof of Concept" Randomized Controlled Trial of a Video Game Requiring Emotional Regulation to Augment Anger Control Training.

Emotional dysregulation leading to clinically significant anger and aggression is a common and substantial concern for youth and their families. While psychotropic medications and cognitive behavioral therapies can be effective, these modalities suffer from drawbacks such as significant side effects, high rates of attrition, and lack of real-world skill translation. Regulate and Gain Emotional Control (RAGE-Control) is a video game designed as an engaging augment to existing treatments. The game facilitates emotional regulation skill building through practice modulating physiological arousal while completing a challenging inhibitory task. We compared reduction in anger, aggression, oppositionality, and global severity between two treatment conditions: Anger Control Training (ACT) augmented with RAGE-Control and ACT with a sham version of the game, in a pilot double-blind randomized controlled trial. To begin to understand mechanisms of change, we examined heart rate during game play over the course of the study and explored associations between symptom changes and heart rate changes. Materials and Methods: Forty youth with clinically significant anger dyscontrol (age 10-17) were randomly assigned to 10 sessions of ACT with RAGE-Control or ACT with sham video game. Results: Both treatments similarly reduced self-reported anger. However, ACT with RAGE-Control led to larger improvements in aggression (CI: -17 to -1.0, ES: 0.55, p = 0.015); oppositionality (CI: -9.0 to -7e-6, ES: 0.48, p = 0.032); and global severity (CI: -1.0 to -5e-6, ES: 0.51, p = 0.023) relative to sham. Participants in the RAGE-Control group saw a decrease in median heart rate during game play (ß = 1.2, p < 0.001). Larger pre to post decreases in heart rate were significantly associated with larger pre to post decreases in aggression and oppositional behaviors. Discussion: Augmenting ACT with RAGE-Control reduced behavioral expression of anger, but not the experience of angry feelings, as compared to ACT with a sham version of the game. Increased heart rate control, demonstrated by reduction in median heart rate during gameplay, was associated with decreased aggression and oppositional behavior. Together these findings support that augmenting traditional treatment with technology facilitating heart rate control through skill practice translates to enhancements in real-life behavioral change. Therefore, further exploration into engaging skill-focused games such as RAGE-Control is warranted. Clinical Trial Registration:ClinicalTrials.gov, identifier: NCT01551732.

The effect of anger management skills training on anger status of the people with HIV.

PURPOSE: This study investigated the effect of anger management skills training on the anger status of people with HIV. DESIGN AND METHODS: This interventional study was conducted on 60 people with HIV. The intervention group was trained on anger management skills. Data were collected using Spielberger's State-Trait Anger Expression Inventory-II. FINDINGS: The intervention group's training on anger management skills showed a significant reduction in mean scores of the state-trait anger, and anger expression as well as a significant increase in mean scores of anger control-out and anger control-in. PRACTICE IMPLICATIONS: Expert counselors, psychologists, community health, and psychiatric nurses are recommended to train anger management skills to people with HIV.

Effects of mental and physical performance on attention, anger control and sleep quality.

PURPOSE: This study aimed to determine the effective parameters on individual working performance, daily working order, and even on choosing a vocation. DESIGN AND METHODS: This prospective study was conducted on 288 students from Inönü University Medical School and Physical Education Vocational High School by applying the evaluation form, the Multidimensional Anger Scale, the Wender Utah Attention Rating Scale, the 25-item short form of the Pittsburg Sleep Quality Scale. FINDINGS: In the BESYO students, the ratio of attention disturbances were higher, whereas in medical school students the ratio of sleep disturbances were higher. We also found that the quality of sleep affects daily functionality significantly. PRACTICE IMPLICATIONS: This study demonstrates the importance of regulating intense mental processes in sleep quality and consequently functional regulation.

Funny or Angry? Neural Correlates of Individual Differences in Aggressive Humor Processing.

Humor has been a hot topic for social cognition in recent years. The present study focused on the social attribute of humor and showed different stories to participants, which were divided into four types according to the model of humor style, to explore the underlying neural mechanism of point-to-self aggressive humor and how individual differences modulated it. Measuring the degree of anger and funniness, results suggested that aggressive humor helped us in social communication by reducing the degree of anger. The neural activities showed that bilateral temporal lobes and frontal lobes played a synergistic role in the point-to-self aggressive humor processing, while point-to-self non-aggressive humor was dominant in the left-side brain. Results from the region of interest (ROI) analysis showed that the individual differences of the self-control level and the self-construal level may influence the neural processing of point-to-self aggressive humor by modulating the activated levels and patterns of the right inferior orbital frontal gyrus, the right superior temporal lobe, and the right superior frontal lobe.

Peeking into the black box: mechanisms of action for anger management treatment.

We investigated potential mechanisms of action for anger symptom reductions, specifically, the roles of anger regulation skills and therapeutic alliance on changes in anger symptoms, following group anger management treatment (AMT) among combat veterans with posttraumatic stress disorder (PTSD). Data were drawn from a published randomized controlled trial of AMT conducted with a racially diverse group of 109 veterans with PTSD and anger symptoms residing in Hawaii. Results of latent growth curve models indicated that gains in calming skills predicted significantly larger reductions in anger symptoms at post-treatment, while the development of cognitive coping and behavioral control skills did not predict greater symptom reductions. Therapeutic alliance had indirect effects on all outcomes mostly via arousal calming skills. Results suggest that generalized symptom reduction may be mediated by development of skills in calming physiological arousal. In addition, arousal reduction skills appeared to enhance one's ability to employ other anger regulation skills.

Topiramate for anger control: A systematic review.

BACKGROUND: Uncontrolled anger while being most commonly associated with personality disorders could also be part of many other conditions such as chronic low back ache and post-traumatic stress disorder. The intensity of anger as an emotional state at a particular time is known as "State Anger," whereas how often angry feelings are experienced over time is known as "Trait Anger." Anger could also manifest as expression of anger toward other persons or objects in the environment (Anger-Out), holding in or suppressing angry feelings (Anger-In) and controlling angry feelings by preventing the expression of anger toward other persons or objects in the environment or controlling suppressed angry feelings by calming down or cooling off (Anger Control). OBJECTIVE: To prove the effectiveness of topiramate in the control of anger as compared to placebo and to disprove that its use leads to psychiatric adverse events by systematically reviewing the available randomized controlled trials. MATERIALS AND METHODS: The basic search was performed in MEDLINE (1966 through November 2008) combined with the optimal search strategy for randomized controlled trials described in the Cochrane Reviewers' Handbook. To update this search, we regularly screened citations from PubMed till November 2008 for eligible studies or reviews that might include eligible studies. The Cochrane Central Register of Controlled Trials (CENTRAL) was searched using the terms "topiramate" and "anger or aggression." In addition, we screened bibliographies of reviews and identified articles. Randomized clinical trials wherein study participants were aggressive adults were included. RESULTS: We could arrive at a weighted mean difference of -3.16 (-3.64 to -2.68) in State Anger. The reduction in the score was highest in borderline personality disorder (BPD) patients as compared to those with low back ache. Trait Anger dropped by -2.93 (-3.49 to -2.37), especially in female BPD patients. Anger In reduced more or less uniformly across the studies by -1.43 (-1.84 to -1.03). Anger Out decreased by -2.8 (-3.19 to -2.42). This effect was minimal among the male BPD patients. Anger Control uniformly increased across the four studies by 2.32 (2.00-2.64). There is sufficient evidence to suggest that topiramate is significantly effective in stabilizing the "trait anger" while reducing the "state anger." "Anger Out" and "hostility" were significantly reduced. "Anger In" was the feature that was the least affected, although this was significant. This suggests that topiramate is effective in controlling anger. There was no suggestion of topiramate precipitating psychomorbidity. CONCLUSIONS: Topiramate appears to be a safe and effective drug in the management of anger/aggression. Additional research is needed to determine whether these results can be reproduced and how long lasting are the benefits of long-term treatment with topiramate.