Findings from a study from The Netherlands presented at the European Psychiatric Association (EPA) 2023 Congress held last month in Paris suggest that individuals who often experience anger may have experienced some trauma as children.^1,2

In this study, researchers examined data of 2276 participants, who had been a part of the Netherlands Study of Depression and Anxiety (NESDA) to examine the association of childhood trauma with anger episodes as adults. The average of the participants was 42.1 years and two-thirds were female. The Childhood Trauma Interview (CTI) was used to evaluate childhood trauma at the time of enrolment. After 4 years, anger was measured with the help of the Spielberger Trait Anger Subscale, the Anger Attacks Questionnaire and Cluster B personality traits (borderline, antisocial) of the Personality Disorder Questionnaire 4 (PDQ4).

All types of childhood trauma, barring sexual abuse, showed a greater association with trait anger along with higher prevalence of anger attacks and antisocial personality traits as adults. This association was independent of anxiety and depression.

Participants who had experienced emotional neglect as children were 40% more likely to be angry as adults. Adults who had faced emotional neglect during their childhood were at higher risk of trait anger with adjusted odds ratio (OR) of 1.42. For anger attack, the OR was 1.42, for borderline personality traits, the OR was 1.76 and for antisocial personality traits, the OR was 1.88. Those who had experienced psychological abuse during childhood had a 30% increased probability of anger. The OR for trait anger in later life with childhood psychological abuse was 1.28. For anger attack, the OR was 1.31, for borderline personality traits, the OR was 1.77 and for antisocial personality traits, the OR was 1.69. Childhood physical abuse was also associated with 40% higher risk of anger in adults with OR of 1.37 for trait anger, 1.48 for anger attacks, 1.71 for borderline personality traits and 1.98 for antisocial personality traits.

This study highlights the correlation between childhood trauma and anger later on in life. Although it does not conclusively prove a cause-and-effect interrelationship, it suggests anger as “a red flag for a history of childhood trauma”.² The association was particularly robust for trait anger and borderline personality traits. People with anxiety and/or depression should be enquired about anger. A history of past trauma, emotional or physical, should be elicited followed by initiation of “trauma-focused interventions when appropriate”.

Anger can be expressive anger (anger-out) or suppressive anger (anger-in). Both are risky. Expressive anger manifests as aggressive behavior, violence or hostility; it may trigger a heart attack/stroke, whereas suppressed anger may cause depression, behavioral changes, anxiety, acidity and diarrhea. Anger recall also has similar harmful effects as anger itself. Hence, we must learn to manage our anger.

References

1. N De Bles, et al. Abstract O0065. Childhood trauma and anger in adults with and without depressive and anxiety disorders. European Psychiatric Association (EPA) 2023 Congress. Available at: https://cuptexsupport.spi-global.com/CUPTexSupport/FlippingBook/EPA_2300007_1%201..1/98/. Accessed on April 10, 2023.
2. Anger in adults a red flag for childhood trauma - Medscape - Apr 05, 2023.