Anger and functioning amongst inpatients with schizophrenia or schizoaffective disorder living in a therapeutic community

Abstract

Aims: This study explored the functional correlates of anger amongst therapeutic community inpatients. Methods:The sample consisted of 44 subjects diagnosed with schizophrenic/schizoaffective disorder who were involved in a community treatment program. Assessment involved administration of the Health of Nation Outcome Scales and the Global Assessment of Functioning as well as self-evaluations using the Social Adaptation Self-evaluation Scale. Psychopathology was assessed with the Positive and Negative Symptoms Scale. Angry feelings and coping skills were self-assessed with the State-Trait Anger Expression Inventory and the Symptom Checklist-90 Hostility Scale. Multiple regression analyses correlated anger with functioning, controlling for psychopathology.Results: Angry feelings related to self-harm, hyperactivity, physical problems, and to global weight independently from Positive and Negative Symptoms Scale scores. They also predicted interest and pleasure in housekeeping, quality of social relationships and relational exchanges. Conclusions:Results showed that angry feelings were not merely derivations of schizophrenic psychopathology; rather, they were independently related to self-damaging behaviors, to attentional demands towards the staff, to agreement to community tasks and to low quality of social relationships. Indeed, anger was related to adaptation's level in a therapeutic community setting demonstrated by subjects with psychoses and it may represent an indirect measure of their experienced quality of life. Therapeutic and management approaches to anger amongst subjects with schizophrenia are discussed.

Lexical analysis of emotional responses to “real-world” experiences in individuals with schizophrenia

“…Consistent with Minor and colleagues, increased verbal expression of anger was strongly associated with more positive symptoms and increased depression in our sample. In previous reports, anger has also been associated with increased paranoia, self-harm, impaired psychosocial functioning, and decreased experience of hope in people with SZ (Bonfils et al, 2016;Fassino et al, 2009;Pinkham et al, 2011).…”

Validation of the Novaco Anger Scale–Provocation Inventory (Danish) With Nonclinical, Clinical, and Offender Samples

“…Anger is highly prevalent in clinical populations, signifying clinical needs, as well as risk for violent behavior by psychiatric patients. In treatment settings, it is also an important ward atmosphere variable bearing on clinical care in hospital (Eklund & Hansson, 1997; Middelboe et al, 2001; Røssberg & Friis, 2003), and it is associated with quality of life for patients in therapeutic community settings (Fassino, Amianto, Gastaldo, & Leombruni, 2009). Among nonpsychiatric community adults, those with high anger dispositions report more physical aggression and more substance use (Tafrate, Kassinove, & Dundin, 2002).…”

Anger and postcombat mental health: Validation of a brief anger measure with U.S. Soldiers postdeployed from Iraq and Afghanistan.

“…W. Smith, Glazer, Ruiz, & Gallo, 2004; Suinn, 2001; Taft, Vogt, Mechanic, & Resick, 2007) and related to alcohol consumption and health-related risk taking (O'Neill et al, 2009). Further, anger is associated with self-harm among those with PTSD and other psychiatric disorders (Chapman & Dixon-Gordon, 2007; Dyer et al, 2009; Fassino, Amianto, Gastaldo, & Leombruni, 2009; Giegling et al, 2009; Kotler, Iancu, Efroni, & Amir, 2001) and with violence toward others among veterans with PTSD (Taft, Street, et al, 2007), as well as for other clinical populations before, during, and after psychiatric hospitalization (e.g., McNiel, Eisner, & Binder, 2003; Monahan et al, 2001; Novaco & Taylor, 2004; Skeem et al, 2006).…”