Fits of anger (tantrums)

The anger is an emotion based, developmentally time to defend themselves for survival and with a fundamentally adaptive function.

It can become dysfunctional or problematic when anger attacks  (also called tantrums ) compromise relationships or quality of life, or create suffering by prompting them to take harmful actions towards oneself or others.

Although anger attacks are a much observed problem in our life, it appears little explored compared to anxiety and depression .

The various manifestations of anger attacks extend from the family to the workplace, to relationships more generally, and to the clinical therapeutic setting.

This has prompted many scholars to develop anger assessment tools , especially self-report questionnaires as interest in this emotion grows and to make emotional regulation interventions aimed at containing outbursts more specific .

The anger has been defined in many ways according to the different aspects emphasized. There is a broad consensus that angry feelings are commonly regarded as “wrong” and accompanied by actions to counter or remedy such bouts of anger .

In general, anger has been characterized in terms of psycho-physiological patterns and facial activation. Although it may be considered to have some beneficial effects, such as the role of mobilizing psychological resources, stimulating behavior and protecting self-esteem , it is typically regarded for its negative emotional value with potentially harmful consequences.

The outbursts of anger, when poorly regulated, constitute psycho-physical distress. The term hostility is more specifically reserved to define recurrent bouts of anger or a general propensity to anger .

It is considered the result of an attitudinal bias or a cognitive pattern of strong disapproval towards others or similar to a personality trait.

L ‘ aggression instead is defined in social psychology as behavior intended to harm or hurt mentally or physically.

Finally, violence is a subtype of physical aggression in which the damage is actually materialized.

In recent years, psychological interventions have been designed to improve the regulation of anger attacks , commonly known as anger management programs, and have been developed to treat a wide range of mental and physical health problems.

The rationale of the treatment is based on research that showed an association between anger and for example, cardiovascular disorders , personality disorders , substance abuse and brain organic disorders .

L ‘ anger is also commonly identified as the most significant antecedent aggression and attack. Thus, one of the main reasons for treating anger attacks is to reduce the risk of engaging in violent or aggressive behavior.

A series of meta-analyzes on the efficacy of anger management treatments (DiGiuseppe & Tafrate, 2003) have demonstrated sufficiently positive results to produce reliable clinical changes.

Despite this there are groups of patients with anger problems that seem to be quite difficult to treat. For example, there is limited evidence to support anger management treatments for violent offenders, perhaps because in this case there may be associated problems such as substance abuse, personality disorders , family difficulties or psychopathological disorders that interfere with treatment progress. .

A recent article analyzed the ways in which psychological trauma affects the frequency of anger attacks , the corresponding treatment and the strategies implemented especially in those who experience a type of problematic anger related to traumatic stories.

There is evidence showing an association between trauma symptoms and dysregulated anger , but there are no anger management treatments that directly address traumatic experiences.

Cognitive-behavioral methods for managing anger attacks include treatment modules or sessions. They involve researching and identifying the nature of the problem, trigger events and contextual stressors, as well as changing dysfunctional patterns and cognitive causal inferences.

The intervention can then include an increase in skills such as the improvement of coping responses, the control of physiological activation, the prevention of the escalation of the anger attack and the reinforcement of the commitment to change.

More recent interventions, on the other hand, consider the deficits relating to the processing of social information as an important element on which to direct the treatment of outbursts , in particular in relation to the aggressor’s ability to take the victim’s perspective.

This includes, for example, examining how the person responds to perceived provocations, both at the time of the event (judgments about who was responsible or guilty), and afterwards (e.g. ruminations on legal disputes that intensify the emotional experience ).

An important part of the intervention concerns the events that act as triggers of the attacks of anger , which could be misinterpreted as threatening and malevolent, and in this sense the manifestations of unregulated anger could be counterproductive.

The concept of trauma can be described as an emotional shock that results from particular events which lead the traumatized person to feel anesthetized, frightened, vulnerable and isolated. The post-traumatic stress disorder (PTSD) is a psychiatric diagnosis that involves psychological distress, triggered by exposure to the traumatic event, in which the individual perceives a threat to its own or others’ safety or physical integrity and in which experiences fear , helplessness or terror (APA, 1994).

The disorder is characterized by intrusive memories about the traumatic experience, in the form of “flashbacks” or nightmares, avoidance of the stimuli that trigger such memories, emotional anesthesia, and hyper-arousal symptoms such as impulsivity, insomnia , irritability and anger attacks.

Although research has historically identified fear as an emotion that characterizes the disorder, significant attention has been given in recent years to anger as a key emotion associated with hyper-activation.

Anger was shown to be strongly associated with the severity of PTSD. Indeed, a meta-analysis of 39 trauma-exposed adult studies conducted by Orth and Weiland (2006) concluded that anger and hostility were associated with PTSD.

This analysis also reported that, on average, the strength of the association between rabies attacks and PTSD increases especially in the first few months after exposure to the traumatic event, before slowly diminishing over time.

A group of people for whom anger dysregulation appears to be particularly problematic are those who have experienced what is termed ” complex PTSD “, or extreme stress disorder not otherwise specified (APA, 1994).

The term complex PTSD is commonly used for those who have experienced early, protracted and repeated exposure to trauma, for example characterized by experiences such as torture, sexual abuse, domestic violence, chronic exposure to confrontation and conflict, and severe social deprivation.

A number of studies have shown that rates of assault and violence are high in those who have experienced PTSD and report a history of childhood sexual abuse, leading Dyer et al. (2009) to observe that one of the more “clinically urgent” aspects of PTSD complex is problematic anger and the high levels of aggression and self-harm associated with it.

There are numerous studies that try to explain the association between traumatic experience and anger attacks . For some authors, there is a theory of anger regulation according to which, during exposure to stress, anger would activate attack or survival behaviors, suppression of feelings of helplessness, and likely allow the individual to gain a sense of control over the situation. .

Traumatized individuals might develop a propensity to perceive situations as threatening and the perception of threat would activate a biologically predisposed mode of survival that includes fear and flight reactions or attacks of anger and aggression. They would then be more or less able to regulate the fits of anger and are consequently more likely to experience this form of problematic anger and to act aggressively.

Other scholars suggest that fear is essentially a prospective emotion, which grows during the event and is activated with respect to potential future harm, while other emotions such as anger and guilt can be considered retrospective emotions, which grow widely after post evaluations. -trauma of the event and its consequences.

This hypothesis is supported by studies that show that outbursts of anger gradually increase after the traumatic event, while fear tends to decrease.

In the literature there are some authors who rely on appraisal theories to understand how the evaluation of the meaning of experience determines the consequent emotion. The nuclear relational theme of anger mainly analyzed would be “the blame or blame of others”.

Applying this hypothesis to the experience of trauma it has been suggested that problematic anger is more likely to arise when another person is held responsible for the traumatic event.

However, research suggests that anger management programs should also consider “self-blame or self-blame” ratings as particularly relevant for those with symptoms of post-traumatic disorder.

Finally, for many of those who have been traumatized, it is possible that angry outbursts and fits of anger are actually associated with pathological over-control (inhibition of expression) of anger and, as such, treatment should address the buildup. of frustration and perception of injustice (related both to the traumatic event and to the daily “annoyances”) in such a way as to develop appropriate emotional expressive skills.

Dyer et al. (2009) identified in complex trauma studies that “alterations in self-perception” would be a significant correlator of anger, aggression, avoidance and hyper-arousal.

The term “alterations in self-perception” is used to refer to feelings of shame, ineffectiveness, guilt , responsibility , isolation, and a sense of being permanently damaged, leading Dyer and colleagues to conclude that ” post-traumatic shame ” could play a role. significant in both outbursts of anger and aggression in traumatized individuals.

Thus, the more global negative self-assessments following the trauma increase, the more this contributes to the dysregulation of anger. This offers an evolutionary explanation for how historical events (such as abuse or neglect) can, at least for some people, lead to the development of stable personality traits as well as high levels of expressiveness of anger or a reduced threshold for expression. of the same.

Problematic anger (high levels of trait anger, expression of anger, and low levels of anger control) has been associated with long-term rather than acute effects of trauma, which are reflected in difficulties sometimes related to an inadequate sense of self. self and personal identity (Day et al., 2008).

 

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