Magnitude of problematic anger and its predictors in the Millennium Cohort

Abstract

Background: Problematic anger is intense anger associated with elevated generalized distress and that interferes with functioning. It also confers a heightened risk for the development of mental health problems. In military personnel and veterans, previous studies examining problematic anger have been constrained by sample size, cross-sectional data, and measurement limitations. Methods: The current study used Millennium Cohort survey data (N = 90,266) from two time points (2013 and 2016 surveys) to assess the association of baseline demographics, military factors, mental health, positive perspective, and self-mastery, with subsequent problematic anger. Results: Overall, 17.3% of respondents reported problematic anger. In the fully adjusted logistic regression model, greater risk of problematic anger was predicted by certain demographic characteristics as well as childhood trauma and financial problems. Service members who were in the Army or Marines, active duty (vs. reserves/national guard), and previously deployed with high levels of combat had increased risk for problematic anger. Veterans were also more likely to report problematic anger than currently serving personnel. Mental health predictors included posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and comorbid PTSD/MDD. Higher levels of positive perspective and self-mastery were associated with decreased risk of problematic anger. Conclusion: Not only did 1 in 6 respondents report problematic anger, but risk factors were significant even after adjusting for PTSD and MDD, suggesting that problematic anger is more than an expression of these mental health problems. Results identify potential targets of early intervention and clinical treatment for addressing problematic anger in the military and veteran context.

Anger Dimensions and Mental Health Following a Disaster: Distribution and Implications After a Major Bushfire

“…Although standalone screening tools that may distinguish clinically significant anger problems, defined by impacts on performance, relationships, and health (Forbes et al, 2004), have been developed only recently (Forbes, Alkemade, Hopcraft, et al, 2014;Forbes, Alkemade, Mitchell, et al, 2014), preliminary studies have suggested that up to 80% of veterans engaged in treatment for PTSD exhibit such difficulties (Forbes, Alkemade, Hopcraft, et al, 2014). Comparable figures from nonclinical samples of U.S. service members and veterans have reported rates of around 17% (Adler et al, 2020). These findings are in addition to those from numerous studies of anger in veterans, which have highlighted the consequences for the course of posttraumatic mental health (Koenen et al, 2003), as well as for aggression or violent behaviors (Novaco & Chemtob, 2015), suicidality (Wilks et al, 2019), and further impacts on treatment for military-related PTSD (Forbes et al, 2008).…”

Pre-enlistment Anger Attacks and Postenlistment Mental Disorders and Suicidality Among US Army Soldiers

“…This adds to other evidence indicating that IED and related outcomes (eg, problematic anger, aggression) are associated with younger age, male sex, unmarried status, and lower educational/economic status. [23][24][25][26][27] Results of previous research examining racial and ethnic differences in anger-related outcomes have been mixed, with some studies finding increased prevalence among individuals identifying as Black, 24 Native American, 28 and other race and ethnicity 2 compared with White US individuals. These inconsistent findings suggest that more research is needed to clarify the association between race and ethnicity (and other sociodemographic characteristics) and angerrelated outcomes, in both military and nonmilitary samples.…”

Why anger matters: An introduction.

“…large survey study of U.S. military personnel and military veterans, one in six exceeded the established cutoff on a measure of problematic anger (Adler et al, 2020). Problematic anger is not simply a reflection of other mental health problems but can occur independent of disorders such as post traumatic stress disorder, depression, and alcohol abuse (Adler et al, 2020) and may reflect transdiagnostic biases and distortions in information processing (Owen, 2011).…”