Anger attacks: correlates and significance of an underrecognized symptom.
BACKGROUND
Anger attacks over provocations described as trivial by the individual are an underrecognized symptom associated with aggressive acts. They are usually followed by guilt and regret. Anger attacks among mothers are an important problem because they are often directed at the woman's spouse and/or children. This study examines the prevalence and correlates of anger attacks in a psychiatric clinic for women who are either pregnant or up to 18 months postpartum.


METHODS
Fifty consecutive consenting patients were assessed at initial presentation with the Structured Clinical Interview for DSM-IV Axis I Disorders, a modified Anger Attacks Questionnaire, self-reports of psychiatric symptoms and psychosocial variables, and clinician ratings.


RESULTS
Thirty (60%) of 50 patients reported anger attacks. Of those with anger attacks, 76.7% worried about them, and 73.3% had tried to prevent them. Compared with women without anger attacks, those with anger attacks were significantly more likely to report higher state and trait anger (p < .001), have a diagnosis of unipolar depression (p < .01), report more aggression directed at immediate family, and avoid their children. Both groups displayed little angry affect in the interview, thus appearing similar at assessment.


CONCLUSIONS
Anger attacks in response to children and spouse were common in this group of women and were associated with subjective distress. Because those with and without anger attacks appear similar at interview, inquiring about the presence of anger attacks is important to ensure that they become a focus of treatment.
Mammen
O K
OK
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, PA 15213, USA.
Shear
M K
MK
Pilkonis
P A
PA
Kolko
D J
DJ
Thase
M E
ME
Greeno
C G
CG
D000328:Adult; D000374:Aggression / Q000523:psychology*; D000786:Anger; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005195:Family Relations; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D010555:Personality Inventory; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires
D000928:Antidepressive Agents