Anger and Its Association with Substance Use Treatment Outcomes in a Sample of Adolescents

Abstract

Anger is a common affective experience, yet it is relatively understudied in the substance use treatment literature. This study explored anger as a predictor of treatment outcomes in a large sample of adolescents. Data were extracted from the Drug Abuse Treatment Outcome Study for Adolescents (DATOS-A). An anger profile was created based on adolescents’ pre-treatment responses to four items assessing history of temper outbursts and aggression. Individuals were classified as High Anger (n = 506) and Normal/Low Anger (n = 2,326) based on their pattern of responses to these items. High Anger at baseline was associated with several poor outcomes at the 12-month follow-up point, including a greater likelihood of experiencing delirium tremens, relapsing on drugs due to alcohol use, having difficulty controlling temper and behavior, and being arrested for attacks on persons.

Anger and substance abuse: a systematic review and meta-analysis

“…The studies were carried out in the United States, Brazil, Turkey, Saudi Arabia, Canada, Italy, Finland, and Hungary. The STAXI scales were used in 10 studies 18,26,[40][41][42][43][44][45][46][47][48][49] and the BPAQ in the other two studies. 26,40 Substance users had higher anger levels compared to non-users ( Figure 2) (SMD = 2.151; 95% confidence interval [95%CI] 1.16 to 3.14, p o 0.001).…”

“…Several factors need to be considered in interpreting these results, such as: the relationship of anger with psychiatric comorbidities, traumatic stress during childhood and adolescent development, personality and temperament features; our understanding of the neurobiological apparatus of emoticons and its relationship with neuroadaptation of the brain secondary to PSU; the type of substance used; the timing of anger measurement -whether during active use or abstinence/withdrawal; and the frequency of use. 33,50,51 Drug users appear to experience anger more often and more intensely than non-users. This may be attributable to several factors.…”

“…Prior studies have shown that compulsive drugseeking and relapse are partly mediated by psychoactive substance-induced changes in the orbitofrontal cortex. 47,69 The literature has shown that anger responses tend to decrease with age, perhaps due to a reduction in neurophysiological reactivity. 36,48 Still, this appears to be mediated by several psychosocial variables.…”

COVID-19 and Substance Use Disorder: Study Protocol for the International Society of Addiction Medicine Practice and Policy Interest Group Global Survey

“…Additionally, social isolation, chronic quarantine measures, and the pandemic outbreak itself have shown to be associated with increased emotional distress such as depression, anxiety, anger, irritability, and fear ( Lai, Shih, Ko, Tang, & Hsueh, 2020 ). People are more prone to relapse in these conditions, though experiencing a long-term a n ( Serafini, Toohey, Kiluk, & Carroll, 2016 ). Compounding this scenario, group-based effective therapies that were held before the start of the pandemic to support people with SUD with emotional and psychological distress have been canceled due to the restrictions imposed.…”

Relationship between anger and drug addiction potential as factors affecting the health of medical students

“…[11] Serafini et al showed that high anger was associated with a greater likelihood of experiencing delirium tremens, relapsing on drugs due to alcohol use, having difficulty controlling temper and behavior, and being arrested for attacks on persons. [12] Eftekhari et al suggested that expression of anger and avoidant coping are independent risk factors for substance use in incarcerated adolescents. [13]…”