Women's anger: relationship of suppression to blood pressure

Effects of various factors on Doppler flow ultrasonic radial and coccygeal artery systolic blood pressure measurements in privately-owned, conscious dogs

OBJECTIVE

The purpose of this study was to assess the effects of age, body condition score (BCS) and muscle condition score (MCS) on indirect radial and coccygeal Doppler systolic arterial blood pressure (SAP) measurements in dogs.

METHODS

Sixty-two privately-owned dogs were enrolled between June and July 2016. The BCS and MCS were determined by two investigators. Blood pressure was measured per published guidelines and using headphones, and the order of measurement site was randomized. Dogs were positioned in right lateral recumbency for radial measurements and sternal recumbency or standing for coccygeal measurements. Associations between SAP and other variables were assessed by correlation coefficients and analysis of covariance.

RESULTS

Radial and coccygeal SAP measurements were moderately correlated (r = 0.45, P < 0.01). Radial SAP measurements were higher than coccygeal SAP measurements (mean difference 9 mmHg, P < 0.01), but discordance occurred in both directions. No difference was observed between the first measurement taken, the average of measurements 2-6, or the average of all 6 measurements for either the radial (128, 129, and 129 mmHg; P = 0.36) or coccygeal (121, 122, and 122 mmHg; P = 0.82) site. Associations were not found between SAP measurements for either site and age, weight, BCS, MCS, anxiety score, or cuff size. Heart rate decreased significantly from the start of acclimation to the end of the first data collection series regardless of site (P < 0.01).

CONCLUSIONS AND CLINICAL RELEVANCE

Initial measurement site can be based on patient and operator preference given lack of associations with patient variables, but the same site should be used for serial SAP measurements given discordant results between sites.

Anger Expression and Blood Pressure in Adolescents

The clinical significance of childhood hypertension is important as elevated pressures during childhood are found to follow a progressively increasing track into adulthood. Little work has been done to examine the relationship of emotions and emotional behavioral factors to the development of hypertension in children. Using the Roy Adaptation Model as a guide, this study investigated the relationship of anger expression and blood pressure (BP) among adolescents 16–18 years of age. Participants were 63 urban high school seniors. Measurements included the Anger Expression Inventory, a Demographic Questionnaire, and measures of systolic and diastolic blood pressure. Analysis revealed significant positive relationships between anger expression with blood pressure, and a significant inverse relationship between blood pressure and the control of anger for girls. No significant relationships between anger expression and blood pressure were noted for boys. The majority of students (53%) were found to have high normal or hypertensive blood pressure readings, putting them at increased cardiovascular risk.

Racism and Hypertension Among African Americans

The purpose of this study was to examine the relationship of racism and blood pressure (BP). Participants were 162 urban African American adults. Measurements included the Racism and Life Experiences Scale, Krieger Racial Discrimination Questionnaire, State-Trait Personality Inventory (anxiety and depression), State-Trait Anger Expression Inventory, and automated measures of BP. Correlational and multiple regression analyses were done to examine relationships among key variables,t tests and ANOVA tested group differences by age, gender, and racism category. There was a high prevalence of perceived racism, which was not associated with higher BP. The racism/BP relationship was moderated by age with significant age related differences noted. Older participants (40 years or older) experienced more distress from racism, more anger suppression, and higher BP but lower levels of stress emotions. The highest levels of BP were noted in older adults reporting the lowest level of perceived racism, raising the issue of “internalized oppression.”

Confidant Relations in Italy

Confidants are often described as the individuals with whom we choose to disclose personal, intimate matters. The presence of a confidant is associated with both mental and physical health benefits. In this study, 135 Italian adults responded to a structured questionnaire that asked if they had a confidant, and if so, to describe various features of the relationship. The vast majority of participants (91%) reported the presence of a confidant and regarded this relationship as personally important, high in mutuality and trust, and involving minimal lying. Confidants were significantly more likely to be of the opposite sex. Participants overall were significantly more likely to choose a spouse or other family member as their confidant, rather than someone outside of the family network. Familial confidants were generally seen as closer, and of greater value, than non-familial confidants. These findings are discussed within the context of Italian culture.

Religiousness/Spirituality and anger management in community-dwelling older persons

Mismanaged anger is associated with adverse health outcomes. This study examined whether dimensions of religiousness/spirituality could predict healthy anger management in a sample of 82 community-dwelling older Americans. A correlational research design was employed using the Deffenbacher Anger Scale and the Brief Multidimensional Measure of Religiousness/Spirituality. Higher scores on Forgiveness, Daily Spiritual Experiences, Religiousness/Spirituality as Coping, and Self-Ranking of Religiousness/Spirituality were correlated with healthier anger management; however forgiveness was the only significant predictor in the regression analysis. Interventions to facilitate forgiveness may promote healthy anger management and minimize the adverse health effects of mismanaged anger.

Relationship of trait anger and anger expression to C-reactive protein in postmenopausal women

Coronary heart disease (CHD) is the leading cause of death for women worldwide. Chronic inflammation and risk factors, such as obesity, smoking, and high cholesterol, are well-established risk factors for CHD. Little is known, however, about the mechanisms by which psychosocial factors, such as general anger proneness (trait anger) and anger expression style, may be associated with proinflammatory processes that contribute to cardiovascular morbidity and mortality in women. Our purpose in conducting this study was to examine the relationship of trait anger and anger expression to the proinflammatory biomarker C-reactive protein (CRP). A cross-sectional between-groups design was used to determine differences in serum levels of CRP in 42 American postmenopausal women, ages 45 to 65, who scored high on the selected anger characteristics, compared with women with lower scores. We did not find differences between high anger women and low anger women in mean levels of CRP, but we did find significant inverse relationships between CRP and some anger control characteristics. Specific health-promoting anger coping behaviors could minimize the deleterious effects of inflammatory responses in postmenopausal women.

Choices: anger and anger management in rehabilitative care

BACKGROUND AND PURPOSE

Violent acts are on rise and rehabilitation providers as caregivers may encounter anger on a daily basis. The purpose of this article is to discuss anger and describe anger management strategies based on behavioral interventions grounded in Choice Theory.

CHOICE THEORY

Applying choice theory to anger is the belief that people are internally, not externally motivated, and that outside events do not make people do anything. Thus, what drives people's anger behaviors are internally developed notions of what is important and satisfying for them.

CLINICAL RELEVANCE AND CONCLUSION

Anger becomes a choice along with its management. Choosing strategies to manage anger are key to reducing the potential for angry emotions to escalate to the point of aggressive and violent acts that threaten caregivers and clients safety. Anger-free environments promote mental/physical health and establish elements of safe living and working environments in a variety of rehabilitative care settings.

The relationships among anxiety, anger, and blood pressure in children

Relationships between anger and anxiety have been examined in adults but less frequently in children. This investigation explored relationships among trait anxiety, trait anger, anger expression patterns, and blood pressure in children. The participants were 264 third- through sixth-grade children from five elementary schools who completed Jacob's Pediatric Anger and Anxiety Scale and Jacob's Pediatric Anger Expression Scale and had their blood pressure measured. Data were analyzed using descriptive and correlational statistics and hierarchical regression. Results have implications for the way in which anxiety and anger are perceived in children and the importance of teaching children to deal with emotions.

CORRELATES AND CONSEQUENCES OF ANGER AT THEIR CHILDREN IN IMMIGRANT TURKISH WOMEN

This study was conducted in order to determine and explain the anger of mothers in reaction to their relations with their children, as well as how to deal with this anger. The sample was taken from 539 volunteers living in Antalya, who were married women aged 15–49 with children. According to results of this study, fighting with other children, disobeying mother, needing interest and truancy were the main causes of anger for mothers. Statistically meaningful relations were found for the reasons of anger, their reactions to anger, coping methods, age of mother, education level and number of children. It was seen that mothers needed proper ways, parental education, methods and solutions in coping with anger.

Women's Anger, Aggression, and Violence

Themes of powerlessness, power, and paradox predominate in this reflection on more than 15 years of research on women's anger. Studies conducted in the United States, France, and Turkey are highlighted. These studies have negated several myths while illuminating the general rationality of women's anger: It is squarely grounded in interpersonal interactions in which people deny women power or resources, treat them unjustly, or behave irresponsibly toward them. The offenders are not strangers; rather they are their closest intimates. But few women learned healthy anger expression while growing up. Anger is a confusing and distressing emotion for women, intermingled with hurt and pain. Its complexity requires greater attention by researchers, with regard to health-promoting interventions and to cultural differences, because anger in non-Western cultures has seldom been explored.

Relationship between trait-anger and sleep disturbances in middle-aged men and women

OBJECTIVE

The present study was performed to determine whether high levels of trait-anger (T-Anger) are independently associated with sleep disturbances and quantitative and qualitative measurements of sleep in middle-aged adults.

METHODS

Enrolled in the study were 2404 men and 2291 women derived from the Korean Health and Genome Study (KHGS), which is an ongoing population-based prospective study. The Spielberger Trait Anger Scale was used to measure T-Anger.

RESULTS

Sleep disturbances, including difficulty in initiating and maintaining sleep (DIS and DMS, respectively) and early morning awakening (EMA), significantly increased with increasing levels of T-Anger (P<.05 by test for trend). Nonrestorative feelings in the morning and excessive daytime sleepiness were also strongly associated with higher levels of T-Anger. After adjusting for other potential risk factors, the high and/or moderate T-Anger showed 40% to 70% increases in the odds for sleep disturbances.

CONCLUSION

The present study provides evidence that high levels of T-Anger are independently associated with symptoms of disturbed sleep in middle-aged adult population.

Everyday life for black american adults: stress, emotions, and blood pressure

The purpose of this study was to examine the stress process in Black Americans by exploring chronic stress, emotions, age, body mass index, and blood pressure within the context of gender and socioeconomic position (SEP). The convenience sample of middle-class Black Americans ( N = 211) ranged from ages 25 to 79 years. A sociopsychophysiological model of everyday life for Black American adults was tested using structural equation modeling. The model explained 27% of the variance in systolic and 17% of the variance in diastolic blood pressure. SEP had a significant effect on chronic stress, and chronic stress had a significant effect on negative affect. Although men had lower negative affect scores than women, men's diastolic blood pressures were on average 4 mm Hg higher than women's. These findings are useful to the development and implementation of interventions to eliminate health disparities and improve years of healthy life for Black Americans.

The effect on ambulatory blood pressure of working under favourably and unfavourably perceived supervisors

AIMS

To investigate the role played by employees' perceptions of their supervisors' interactional styles as a possible source of workplace stress that may be associated with increased morbidity and mortality rates from cardiovascular disorders in workers in the lower strata of organisational hierarchies.

METHODS

A controlled, quasi-experimental, field study of female healthcare assistants. Allocation to the experimental and control groups was based on participants' responses to a supervisor interactional style questionnaire. Experimental participants (n = 13) reported working under two divergently perceived supervisors at the same workplace, on different days. The control group (n = 15) worked either under one supervisor, or two similarly perceived supervisors. Ambulatory blood pressure was recorded every 30 minutes, over a 12 hour period for three days.

RESULTS

The control group showed a 3 mm Hg difference in systolic blood pressure (SBP) and a non-significant difference in diastolic blood pressure (DBP; mean difference 1 mm Hg) between the two supervisor conditions. The experimental group showed significantly higher SBP (15 mm Hg) and DBP (7 mm Hg) when working under a less favoured compared to a favoured supervisor. The degree of divergence in perceptions of supervisors shows a significant positive relation with the difference in blood pressure between the two workdays. Divergence in perceptions of interpersonal fairness is the strongest predictor of difference in blood pressure.

CONCLUSION

An unfavourably perceived supervisor is a potent workplace stressor, which might have a clinically significant impact on supervisees' cardiovascular functioning.

Stress-related influences on blood pressure in African American women

The relationship of blood pressure status to three stress-related variables, anger, coping resources, and strain, was evaluated in 90 African American women. The majority of the participants (57%) were normotensive, 32% of the participants reported current use of hypertensive medication, and an additional 16% had a mean blood pressure greater than 140/90 mmHg but were not on hypertensive therapy. From an analysis using ANCOVA, participants in the latter group were found to have significantly higher scores on rational-cognitive coping resources, controlling for age, waist/hip ratio, and pack-years. No significant differences among the blood pressure groups were found in anger or personal strain. Fostering rational-cognitive coping skills, which represent the ability to problem-solve effectively and to set priorities, may be beneficial for African American women and should be evaluated further in a larger sample.

Physical and Emotional Effects of Whistle blowing

This research examined the stress-induced health effects of whistleblowing and non-whistleblowing on nurses in Western Australia. A descriptive survey design was used to explore the physical and emotional problems experienced by nurses who did and did not blow the whistle on misconduct in the workplace. A questionnaire based on Lazarus and Folkman's Model of Stress and Coping was developed and posted anonymously to general and mental health nurses. Ninety-five nurses responded to the questionnaire, and 70 were identified as whistleblowers and 25 were identified as non-whistleblowers. Results indicated that 70% of whistleblowers and 64% of non-whistleblowers experienced stress-induced physical problems from being involved in a whistleblowing situation. The most common physical problems experienced by nurses were restless sleep, fatigue, headaches, insomnia, and increased smoking. In addition, 94% of whistleblowers and 92% of non-whistleblowers suffered stress-related emotional problems, the most frequent being anger, anxiety, and disillusionment. Whistleblowers and non-whistleblowers suffered a similar percentage of physical health problems, whereas non-whistleblowers suffered a higher percentage of emotional health problems, especially feelings of guilt, shame, and unworthiness. These findings suggest that whistleblowing situations are stressful and may cause physical and emotional health problems whether one blows the whistle or not.

Teaching healthy anger management

TOPIC

Teaching anger management in the community.

PURPOSE

To describe anger management and offer guidelines for assessing potential participants and teaching healthy behaviors.

SOURCES

Drawing from the literature, more than 10 years of quantitative and qualitative studies by our research team, and 5 years of experience in conducting anger management groups, the author presents basic principles of teaching anger management. A model is described for a 4-week group for women.

CONCLUSIONS

Anger management has wide applicability to a variety of constituencies for both primary and secondary prevention. Advanced practice psychiatric nurses are well-qualified to provide this psychoeducational intervention.

Thought suppression

Although thought suppression is a popular form of mental control, research has indicated that it can be counterproductive, helping assure the very state of mind one had hoped to avoid. This chapter reviews the research on suppression, which spans a wide range of domains, including emotions, memory, interpersonal processes, psychophysiological reactions, and psychopathology. The chapter considers the relevant methodological and theoretical issues and suggests directions for future research.

Women and ANGER

Through gender role socialization, women have learned to suppress anger. This leads to somatization and a denial of a sense of self. To teach women how to express anger, methods of anger acknowledgment and expression have been provided. Through the teaching of these techniques, nurses can assist women to experience a paradigm shift: from the belief that "others are responsible for meeting women's needs" to the belief that "women are personally responsible for meeting their own needs." By teaching women assertive communication, nurses can provide women with effective tools to regain control of their life experiences. The "Exercise Application" presents an example of a paradigm shift for the experience of anger.

Mood and blood pressure responses in black female caregivers and noncaregivers

BACKGROUND

Substantial interaction between mood and blood pressure, especially in the context of caregiving for a dependent elder, could increase the risk in the already at-risk population of black women for either higher blood pressure or the onset of hypertension.

OBJECTIVES

To examine the relationship between mood symptoms and daytime ambulatory blood pressures during a 12-hour period in Black female caregivers and noncaregivers.

METHOD

A prospective cohort design was employed to study black females 18 years of age or older identified by randomly selected elders as the provider or potential provider of 5 or more hours of care per week to the elder. Mood symptoms were measured on visual analogue scales by the subjects in a diary attached to a retractable clip key ring worn by the subject. Blood pressure responses were measured with automated portable blood pressure monitors every 30 minutes. Additional risk and treatment factors were considered for descriptive purposes.

RESULTS

The two groups were equivalent on all hypertension risk and treatment factors except alcohol use (more noncaregivers consumed alcohol). Among caregivers, anger and mean diastolic blood pressure (DBP) were negatively related (parameter = -0.64, SE = .23, p = .01) and the negative relationship between anger and systolic blood pressure approached significance (parameter = -0.81, SE = 0.65, p = 0.10). Anxiety and sadness were not significant predictors.

CONCLUSION

Among black caregivers, elevated anger was associated with significant decreases in DBP, while lowered anger was associated with significant increases in DBP. Whether lower anger scores reflect a low level of perceived anger or suppressed anger among black caregivers should be explored in future studies.

It hurts most around the heart: a phenomenological exploration of women's anger

Women's anger experience has been poorly understood and insufficiently researched. Yet the emotion of anger is vitally important to women's physical and mental health, and to the quality of their relationships. This phenomenological study was undertaken as an expansion and extension of the Women's Anger Study, the first large survey of the genesis, manifestations and correlates of anger in American women. Although the earlier study contributed to understanding of anger, a deeper examination of the context and meanings of anger experience was sought. Twenty-nine Caucasian women ranging in age from 21 to 66 years were interviewed. Illustrative occupations ranged from homemaker, student, waitress to business executive, professor, and human service professional. Analysis involved thematizing by the researchers independently and within a multidisciplinary phenomenological research group. The thematic structure of women's anger involved a building over time of a confusing mixture of feelings (hurt, frustration, disillusionment) precipitated by a violation of the core values of the self. The precipitant of anger was unfair and/or disrespectful treatment or lack of reciprocity in relationships. When the anger was confined within self, the woman felt helpless and powerless. However, powerlessness was also evident when anger was externalized in an outburst. To the study participants, an angry outburst meant a loss of control rather than ability to achieve control. Women reported a sense of power when using anger to restore justice, respect, and relationship reciprocity. Clinicians can assist women to reflect on their core values and use the power of their anger effectively. Further studies are in progress to examine the relevance of these findings for women of other races and cultural contexts.