The resting electrophysiological profile in adults with ADHD and comorbid dysfunctional anger: a pilot study.

Although dysfunctional anger is not a Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision [DSM-IV-TR]) diagnosis, it sometimes presents as a primary clinical complaint and as a comorbid feature in a subset of adults with attention-deficit/hyperactivity disorder (ADHD). No known studies have examined electroencephalographic (EEG) profiles in adults with comorbid dysfunctional anger and ADHD (ADHD + anger). Resting EEG was recorded in 14 ADHD + anger adults (11 males) and 14 controls. Relative power was assessed at standard frequencies, as was frontal absolute α power asymmetry. A modest increase was noted in ß1 power in the ADHD + anger group. Unexpectedly, relatively decreased left (or increased right) frontocortical activity (α assessed) was noted in the ADHD + anger group, which was also characterized by a more diffuse θ/ß ratio scalp distribution. Nonmedicated ADHD + anger adults exhibited modest resting cortical hyperarousal, consistent with the findings in a subset of children with ADHD characterized by anger-associated problems. The unexpected frontal α asymmetry may reflect enhanced activity of frontal inhibitory mechanisms.

A pilot study of electrocortical activity in dysfunctional anger: decreased frontocortical activation, impaired attention control, and diminished behavioral inhibition.

Dysfunctional anger, though not a primary clinical diagnosis per se, does present clinically as a pathological mood for which treatment is sought. Few studies have probed the neurocortical correlates of dysfunctional anger or assessed if cognitive processes, such as attention, are altered in dysfunctional anger. Though dysfunctional and high trait anger appears to be associated with biased processing of anger-eliciting information, few studies have examined if dysfunctional anger modulates attention more generally. This is a notable gap as volitional attention control is associated with effective emotive regulation, which is impaired in dysfunctional anger and in associated acts of aggression. In this pilot study, we examined performance and electroencephalographic (EEG) profiles during a 12-min continuous performance task (CPT) of sustained attention in 15 adults with dysfunctional anger (Anger group) and 14 controls (control group). The Anger group had fewer hits at the end of the CPT, which correlated with decreased frontocortical activation, suggesting decreased engagement of frontal circuits when attention is taxed. The Anger group had more false alarms overall indicating impaired response inhibition. Increased right cortical activation during the initial portion of CPT existed in the Anger group, perhaps reflecting greater engagement of frontal circuits (i.e. effort) during initial stages of the task compared to controls. Finally, increased overall beta1 power, suggesting increased cortical activation, was noted in the Anger group. These EEG patterns suggest a hypervigilant state in dysfunctional anger, which may interfere with effective attention control and decrease inhibition. Such impairments likely extend beyond the laboratory setting, and may associate with aggressive acts in real life.

Resting electrocortical activity in adults with dysfunctional anger: a pilot study.

Although dysfunctional anger is not a DMS diagnosis, some individuals present with dysfunctional anger, to the exclusion of other psychiatric disorders, as the primary clinical feature. However, our understanding of the neural basis of dysfunctional anger is limited. Though previous work has examined electroencephalographic (EEG) activity in individuals with high trait anger, and in youth with disorders consistent with dysfunctional anger, no studies have assessed EEG activity in adults with dysfunctional anger. This study examined resting EEG by way of relative power in the beta and alpha bands, as well as absolute frontal and parietal alpha(1/2) asymmetry, in 15 adults with psychiatrist-assessed and psychometrically rated dysfunctional anger (Anger) and 14 control participants (Control). The Anger group had increased overall relative beta(1) power during both eyes-open and closed conditions. Inconsistent with most precedent literature, the Anger group also exhibited greater relative right fronto-cortical activation (alpha(1)-indexed frontal asymmetry) during the eyes-closed condition. This may reflect greater anxious arousal and/or compensatory activation of inhibitory tendencies associated with right frontal activation in individuals with dysfunctional anger. Enhanced beta(1) activity may index greater tonic cortical arousal or a chronic hypervigilant state, which may predispose individuals with dysfunctional anger to over-react to relatively innocuous stimuli.