Effects of Anger Expression on Self-Esteem in Dental Hygiene Students / 치위생과학회지

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.

Anger Assessment Using State-Trait Anger Expression Inventory in Middle-School Students in Korea and Association with Depression

OBJECTIVES: The purpose of this study was to assess anger of middle school adolescents in an urban community using State-Trait Anger Expression Inventory (STAXI)-Korean and Korean Child Behavior Checklist (K-CBCL), and to determine whether specific anger expression of adolescents is associated with certain psychopathology including depression. METHODS: Data were collected from 395 middle school students and their parents in Incheon city. The students completed the STAXI, Children's Depression Inventory, Korean version of Mood disorder Questionnaire, and Conners-Wells' Adolescent Self-Report Scale (Short Form), and their parents completed the K-CBCL. RESULTS: No significant correlation was observed between aggression subscale K-CBCL and each scale of the STAXI, except anger out (r=0.704). The scores for STAXI total and respective scales were significantly higher for female students than male students. A stepwise logistic regression model was used to explore the possible predictors for depression in adolescents and lower anger control and higher anger suppression were found to be predictors for depression in adolescence. CONCLUSION: There is a possibility of a large discrepancy between anger that the adolescents actually feel and parents' judgment of their children's anger. It must be considered in assessment of adolescent anger and use of further structured interviews is necessary. In addition, it may be useful to consider the anger expression style in adolescents who report depressive symptoms.

Multidimensional Comparison of Personality Characteristics in Genetic High Risk for Schizophrenia, First Episode Psychosis and Healthy Controls / 대한정신분열병학회지

OBJECTIVES: Previous studies have suggested that some personality characteristics are associated with the onset, prognosis and social function in schizophrenia patients. However few is known about the personality and affective characteristic of genetic high risk group (GHR) for schizophrenia. This study aimed to investigate the personality and the affective characteristic of GHR group for schizophrenia. METHODS: Participants were 54 healthy controls (HC), 26 subjects with GHR for schizophrenia and 28 subjects with first episode psychosis (FEP). We performed three self-report questionnaires; NEO-Personality Inventory-Revised, State and Anger Expression Inventory and Positive Affect and Negative Affect Schedule. RESULTS: The GHR group showed higher score in agreeableness item than the HC (p=0.028). In extraversion item, the FEP group showed significantly lower scores than the HC (p=0.001). The GHR group showed lower scores in neuroticism item compared with FEP group in trend level. The FEP group showed higher trait-anger, lower positive affect and higher negative affect compared with the others. CONCLUSION: The GHR group seem to share certain vulnerable personality and affective characteristics for schizophrenia with the FEP group. On the other hands, the GHR group appeared to be more agreeable than the other groups, which might act as the compensation for other impaired functions.

Comparison of Anger Expression, Assertive Behavior, and Self-esteem between a Nursing Student Group and an Educational Student Group

PURPOSE: The purposes of this study were to compare the degree of anger expression, assertive behavior, and self-esteem between a nursing student group and an educational student group, and to identify factors affecting their self-esteem. METHODS: This study adopted the descriptive comparative design. Data were collected by interviewing 97 nursing students and 89 educational students from three nursing schools and one educational school in Daegu, Korea from November to December, 2008. RESULTS: Major findings of this study were as follows. 1) The educational student group had a higher self-esteem score than the nursing student group. 2) There were significant correlations among anger expression, assertive behavior, and self-esteem. 3) Self-esteem was significantly associated with Grade Point Average (GPA) and assertive behavior in the nursing student group with 17.2% variance, and with assertive behavior and anger-out in the educational student group with 24.1% variance. CONCLUSION: These results may contribute to better understanding of hurt, anger expression, assertive behavior, and self-esteem in nursing students and educational students. Based on the results, there, it is required to develop programs that prompt students' self-esteem.

Perceived Hurts and Forgiveness in Clinical Nurses: The Status and Influencing Variables / 간호행정학회지

PURPOSE: The purposes of this study were to describe events resulting in perceived hurts in nursing, and to identify factors influencing forgiveness in clinical nurses. METHODS: The study was a descriptive correlation design. From May to July, 2009, the researcher used interviews to collect data from 148 clinical nurses from five hospitals in D city. RESULTS: Clinical nurses received perceived hurt from peer-nurses, care-givers, and doctors, and the reasons for the perceived hurts were blame, neglect, and valuation. Levels of forgiveness in clinical nurses were different according to who caused the perceived hurt, the degree of the perceived hurt, and endeavors to resolve the perceived hurts. Levels of forgiveness in clinical nurses were negatively correlated with age, degree of perceived hurt, and degree of anger expression, and positively correlated with degree of self-esteem. The strongest predictors of forgiveness in clinical nurses were degree of anger expression, age, and degree of hurt. CONCLUSION: The findings of the study suggest that nursing staff should be able to identify reasons for perceived hurt in clinical nurses and provide a forgiveness program for each nursing situation.

Effects of Lecture on Oral Presentation on Anger Expression, Assertive Behavior, and Self-Esteem in Nursing Students

PURPOSE: The purpose of this study was to develop a lecture on oral presentation and to evaluate changes in anger expression, assertive behavior, and self-esteem after lecture on oral presentation. METHODS: The design was a nonequivalent control group pretest-posttest design. The participants were university students in nursing, of which 17 were assigned to the experimental group and 15 to the control group. The education was carried out for 2 hours, once a week for 14 weeks. Data was analyzed with SPSS/WIN 14 program, and included chi-square test, independent t-test, and repeated measure ANOVA. RESULTS: Lecture on oral presentation showed significant differences in the changes of anger expression (F = 10.122, p = .003) and assertive behavior (F = 8.498, p = .007). CONCLUSION: Findings suggest that this lecture on oral presentation was effective in changing students' anger expression and assertive behavior. Therefore this lecture on oral presentation is recommended for inclusion in education for university students in nursing.

Interrelations Among Beverage Intake, Food Behavior and Personality in Adolescents / 대한지역사회영양학회지

This study investigated the influences of the beverage intake on food behavior and personality for 1295 adolescents. The results were as follows. The favorite beverage was 'fruit juice', and preference of 'coffee' was the lowest. 'Milk and dairy product' was highest and 'milkshake' was lowest in intake frequency of beverage. The preference correlated positively(r = 0.391) with the intake frequency of beverage, especially high in 'green tea and black tea'(r = 0.622), 'coffee'(r = 0.581), 'carbonated drink'(r = 0.538), and 'milk and dairy product'(r = 0.501). The explanation power(R2) of beverage preference on beverage intake was 0.153. The explanation power(R(2)) of beverage intake on food behavior was 0.127, and 'carbonated drink' and 'coffee' as well as 'milkshake' had a negative influence on food behavior: however, 'milk and dairy product', 'green tea and black tea', and 'fruit juice' had a positive influence on food behavior. The relationship of beverage intake and sociality was very low(R(2)= 0.013), and 'isotonic drink' and 'green tea and black tea' had a positive influence on sociality. The relationship between beverage intake and anger expression was also very low. 'Coffee' showed a positive relationship with anger-in. 'Carbonated drink' and 'milkshake' showed a positive result with anger-out. 'Milkshake' showed a negative relation with anger-control, but 'green tea and black tea' and 'milk and dairy product' showed a positive relation. From these results, it was necessary to develop the practical nutritioneducation program on proper beverage choice for adolescents leading to better metal and physical status.

The Relation between Anger Management Style and Organ System-Related Somatic Symptoms in Patients with Depressive Disorders and Somatoform Disorders

PURPOSE: The objective of this study was to examine the relation between anger management style and organ system- related somatic symptoms in depressive disorder and somatoform disorder patients. MATERIALS AND METHODS: The subjects included 73 patients with depressive disorders and 47 with somatoform disorders. Anger management styles were assessed by the Anger Expression Scale, while the severity of organ system-related somatic symptoms was evaluated using the Somatic Stress Response Scale (SSRS). The severity of depression and hostility was assessed by the Symptom Checklist-90-Revised (SCL-90-R) depression and hostility subscales. RESULTS: The results of multiple regression analyses showed that, in depressive disorder patients, the level of anger expression was significantly associated with the severity of somatic symptoms related to neuromuscular, cardiorespiratory and gastrointestinal systems. However, in these patients, the level of anger suppression was not significantly associated with the severity of somatic symptoms related to any specific organ systems. In patients with somatoform disorders, there was no significant association between the level of anger suppression or anger expression and the severity of the somatic symptoms related to any specific organ systems. CONCLUSION: These results suggest that, in depressive disorder patients, anger expression is likely to be predominantly involved in the neuromuscular, cardiorespiratory and gastrointestinal organ systems. However, in each of depressive disorder and somatoform disorder patients, anger suppression is not likely to be associated with any specific organ systems.

Interrelations Among Fast Food, Beverage Intake and Sociality, Anger Expression of Adolescents in the Busan Area / 대한지역사회영양학회지

The purpose of this study was to investigate the relation of the fast food and beverage intake on sociality and anger expression of adolescents. Questionnaires were distributed to the adolescents of 599 middle and high school students in Busan. According to the results, the preference-intake frequency analysis (PEA) on fast food grid, high preference and high intake frequency were 'dukbokki', 'chicken' and 'mandu' and low preference and high intake frequency were 'ramyon', 'gimbab. PEA on beverage grid, high preference and high intake frequency were 'milk dairy product', 'fruit juice', 'isotonic beverage' and low preference and high intake frequency were 'carbonate drink'. The intake frequency of 'pizza', 'sandwich', 'udong', and 'dukbokki' had a positive relationship with sociality. 'Hamburger', 'chicken', 'french fry', 'gimbab', 'mandu', and 'ramyon' showed a positive relationship with anger-out. The intake frequency of 'carbonated drink' had a negative relationship with anger-control, but 'green tea' showed a positive relation with it. 'Carbonate drink', 'isotonic beverage', 'coffee', and 'milkshake' had a negative relationship with anger-out. The explanation power (R2) of intake of fast food and beverage on sociality was 0.019~0.038, and 'carbonated drink' and 'coffee' had a negative influence on sociality. The explanation power (R2) of intake of fast food and beverage on anger expression was 0.011~0.041, and 'carbonated drink' had a negative influence on angercontrol. 'Hamburger', 'carbonated drink', and 'coffee' showed a positive influence on anger-out. From these results, it was necessary to develop the practical eating-out habits program on proper fast food and beverage choice for adolescents.

Association of Anger Expression Patterns and Health Status in Health Care Workers / 간호학회지

PURPOSE: The purpose of this study was to examine anger-expression patterns and their association with state and trait anger and physical and psychological health status in health care workers. METHOD: Four hundred and forty eight nurses, physicians and technicians from a large medical center completed standardized questionnaires of anger, anger-expression patterns and mood. They also had blood pressure, cholesterol, blood glucose and body mass index measured during their annual physical examinations. Data was analyzed using descriptive statistics, independent t-test, chi-square and ANOVA. RESULTS: Subjects showed two major clusters of anger-expression patterns: anger-control and anger-in/out. Subjects with the anger-in/out pattern reported higher state and trait anger and more anxiety, depression and fatigue than subjects with the anger-control pattern. Physical health indicators, however, were not significantly different between the two clusters of anger-expression patterns. CONCLUSION: Anger-expression patterns are associated with psychological health status but not with physical health status. Anger-expression patterns, however, need to be examined over time to assess their long-term effects on the physical and psychological health status in future studies.

Anger and Health Status in Late School-Age Children / 간호학회지

PURPOSE: This cross-sectional study was designed to identify anger-expression types in late school-age children and investigate the relation between the identified anger-expression types and their health status. METHOD: One thousand twenty seven children in elementary school fifth and sixth grades were recruited from November to December, 2004. Data was analyzed using descriptive statistics, cluster analysis, 2-test, ANOVA, Duncan's multiple comparison test, and Wilcoxon rank sum test. RESULTS: Three anger-expression types in late school-age children were found; Anger-out/in, Anger-control, and Low anger-expression types. Children frequently using the anger-out/in type among the three types and with a higher state anger reported higher psychosomatic symptoms and depression. Children from a divorced or separated family reported higher state anger. CONCLUSION: This study suggests that a specific anger management program needs to be developed for late school-age children with high state anger and frequently using the anger out/in expression type. For understanding the anger level and the anger expression types of Korean school-age children, further research needs to be done with large samples using a randomized sampling method.

The Relation of Trait anger and Anger Expression to Cardiovascular Responses and Depression in Middle-aged Korean Women / 간호학회지

PURPOSE: This study was designed to examine the relation of trait anger and anger expression to blood pressure, cholesterol, and depression in middle-aged Korean women. METHODS: This descriptive correlational design was conducted using a convenient sample taken from the health center of K University Hospital located in Kyungki province, Korea. The subjects were 252 women aged 40 to 64 years. Spielberger's state trait anger expression inventory - Korean version and Beck's depression inventory were used for measuring trait anger, state anger, anger expression and depression. Data was analyzed by descriptive statistics, t-test, Pearson correlation, two-way ANOVA, and cluster analysis using a pc-SAS program. RESULTS: The anger expression types by cluster analysis were Anger out/in type, Low anger expression type, and Anger control type. The level of cholesterol and depression were significantly higher in women with high anger in and high trait anger. In addition, the level of depression was significantly higher in women with a high anger temperament. CONCLUSIONS: Trait anger and anger in might be related to cholesterol and depression in women. However, this study does not reveal the relation between blood pressure and trait anger and anger expression.

The Relationship of Anger Expression and Alexithymia with Coronary Artery Stenosis in Patients with Coronary Artery Diseases

This study examined the relationship between anger expression or alexithymia and coronary artery stenosis in patients with coronary artery diseases. 143 patients with coronary artery diseases (104 males and 39 females) were enrolled in this study. The severity of their coronary artery stenosis was measured by angiography. The Anger Expression Scale and the Toronto Alexithymia Scale were used to assess the level of anger expression and alexithymia. The more stenotic group (occluded by 75% or more) exhibited a significantly higher level of alexithymia than the less stenotic group (occluded by less than 25%). Multiple regression anaylsis on the extent of stenosis also revealed that regardless of gender and age, the coronary artery disease patients with higher alexithymia were likely to show a greater level of stenosis. However, no significant differences were found on either the anger-in or anger-out subscale scores between the two groups. These results suggest that alexithymia is associated with the severity of coronary artery stenosis in patients with coronary artery disease. However, both anger expression and anger suppression were not shown to be associated with the severity of coronary artery stenosis.

Anger, Problem Behaviors, and Health Status in Adolescent Women / 간호학회지

PURPOSE: This cross-sectional study was designed to identify anger-expression typesof adolescent women and investigate the relation between the identified anger-expression types and their problem behaviors and health status. METHOD: One hundred ninety nine high school freshmen were recruited from September to November, 2003. Data wasanalyzed using descriptive statistics, cluster analysis, chi-square-test, ANOVA, and Duncan's multiple comparison test. RESULT: Three anger-expression types in adolescent women were found; Anger-out/in, Anger-control/in, and Anger- control type. Adolescent women with frequently using the anger-out/in type and with higher state anger reported more delinquent behaviors, more health risk behaviors, and higher psychosomatic symptoms. However, adolescent women with lower state anger and frequently using the anger-control type reported more depression scores. CONCLUSION: There is a need to further clarify the relationship between anger-expression typesand depression in adolescent women. The findings suggest the necessity of a development of the program for lowering the anger level and controlling the unfavorable anger expression types such as the anger-out in.

Modes of Anger Expression in Relation to Depression and Somatization / 신경정신의학

OBJECTIVES: In previous studies, significant correlations between depression or somatization and the mode of anger expression were reported. However few studies were done in psychiatric patients, while some evidences were found that anger expression as well as anger suppression were related to development of somatization. This study aimed to investigate the relationship of the state-trait anger and the mode of anger expression to depression and somatization in psychiatiric patients. METHODS: The depression and somatization questionnaire of SCL-90-R and Korean Adaptation of the State-Trait Anger Expression Inventory were administered to 53 psychiatric patients and 59 normals. The relationship of anger to depression and somatization was analyzed by correlation and regression analyses. RESULTS: In comparison with the normal control group, the psychiatric patient group showed significant differences on trait anger temperament but no significant differences on other anger variables. In regression analysis, the anger-in score was related to depression and somatization. However, the degree of explanatory power was higher in depression than in somatization. In the case of analyzing the state-trait anger, anger-in was significant predictor variable for depression in psychiatric patient group. CONCLUSION: These results suggested that anger-in is the important factor in the onset of depression and somatization. Rather than the relationship of anger-in and somatization, the relationship of anger-in and depression is higher; therefore the caution is necessary in the interpretation of previous studies. The relationship of anger-in to depression and somatization may have important implications for psychotherapy.

Anger Experience and Expression in Patients with Schizophrenia / 신경정신의학

OBJECTIVES: The prejudice against the mentally deranged persons has an effect on the treatment of the mental illness and is one of the reasons why they have difficulties in social adaptation and rehabilitation. We intended to examine the characteristics and expression of the anger in schizophrenic patients to find how much anger they feel compared with general population. And we tried to find the basis on which the prejudice can be corrected. METHOD: 105 schizophrenic patients were selected according to DSM-IV. Control groups were 43 patients who were admitted to the department of internal medicine in university hospital and 65 healthy adults. The experiences and expressive patterns of anger were surveyed by State-Trait Anger Expression Inventory, Korean edition. And the characteristics of the anger in the schizophrenic patients were compared with those in controls and analyzed. RESULTS: Stateanger was significantly higher in the schizophrenic patients group than in healthy control group and trait-temperament was significantly lower in schizophrenic patients group than in other two control groups. Among the anger expression scales, anger-in and anger-control were significantly lower in schizophrenic patients group than in healthy control group. But trait-reaction and angerout showed no significant difference among three groups. And no significant difference was shown among the anger scales of three groups according to the presence of insight of the disorder. CONCLUSION: It is shown that schizophrenic patients have considerably much anger when compared to healthy control group and insufficient ability to suppress and control the anger. But it may be said that the expressions of anger in schizophrenic patients are not apparent. These results may be due to either the weakness of ego function, which is one of the symptoms of schizophrenia, or negative symptoms following chronicity of the disorder. Unex-pected aggressiveness or violence of them may be triggered by stimuli from the circumstances, if they are not in acute phase. And the misunderstanding of general public that schizophrenic patients are dangerous unconditionally should be corrected by the education. We can't develop the appropriate strategy to cope with the anger of the schizophrenic patients until we under-stand well the characteristics of anger in them.

Impact of Anger Expression on Blood Pressure Levels in White-Color Workers with Low-Coping Behavior

To examine the relationships between anger expression and blood pressure (BP) levels and their effect modification by stress coping behaviors, the authors analyzed data from a cross−sectional study of 790 Japanese male workers aged 20−60 years. We used the Spielberger anger expression scales to measure anger−out, anger−in, and anger−control. Relationships between anger expression scales and mean systolic and diastolic BP levels were examined in the total sample and in two subgroups of high and low stress coping behaviors (low coping behavior group: having none, one, or two coping behaviors; and high coping behavior group: having three or more coping behaviors). Anger expression scales were not associated with BP levels in the total sample. Among men who reported only two or fewer coping behaviors, however, the anger−out score was significantly associated with systolic blood pressure (SBP) levels while no association was found among men who reported the larger number of coping behaviors. Anger−in and anger−control were not associated with BP levels in either low or high coping behavior groups. This study suggests that male workers who do not express their anger have a higher probability of developing high BP when they have no or few stress coping behaviors.

A Standardization Study of the Korean Version of the Adolescent's State-Trait Anger Expression Inventory / 신경정신의학

OBJECTIVES: The purpose of present study was to evaluate reliability and validity of Korean version of State-Trait Anger Expression Inventory(STAXI). METHODS: We applied to 416 second graders of middle and high school students, and 35 clinical conduct disorder subjects. Test-retest reliability test was done to 60 subjects with 4 weeks interval. To evaluate concurrent validity, aggression subscore of Achenbach's CBCL and Barratt's Impulsiveness Scale were also applied. RESULTS: The results were as follows. 1)Test-retest reliability, item-total correlation, and internal consistency were very satisfactory and concurrent validity with other scales was also good. 2)Anger expression scores were significantly increased by aging and males showed significantly higher scores than females. 3)Clinical population scored significantly higher than general population group in the level of anger expression. 4)In factror analysis, item composition of factors were somewhat different from those of original scales. CONCLUSION: The Korean version STAXI is validated and can be used usefully as evaluating anger of clinical adolescent population. Further research is needed for standardization in general population and clinical referred subjects. Finally, transcultural study should follow to find out difference of anger expression.