“Can Anger Be a Disorder” was the question raised by Professor
Raymond DiGiuseppe in a presentation on March 21 at the New York Academy of Sciences in
Manhattan. Professor DiGiuseppe reviewed the perception of anger
over the centuries.
From classical times through the 19th century, philosophers and
physicians identified anger as a potential for human disturbance.
At the beginning of the 20th century, the development of modern
abnormal psychology, started by Emil Kraeplin and Sigmund Freud,
excluded anger as a form of psychopathology and relegated this
emotion to a secondary emotion subsumed under depression.
Anger has received little attention in psychology for the last
100 years compared with the emotions of anxiety and depression.
Presently, no anger disorders are included in modern psychiatric
diagnostic systems. Despite this lack of recognition by modern
psychiatry, court mandated anger management treatments are on the
rise, and there is a lack of research on the clinical features of
dysfunctional anger to guide these interventions.
Anger evolved, like other emotions, to serve a purpose. However,
like fear and sadness, it can be excessive and pathological. Our
present understanding of dysfunctional anger has lead to inadequate
assessment strategies, the lack of diagnostic models to help
clinicians understand anger, and few effective treatments. Dr.
DiGiuseppe proposed that anger should be recognized as a form of
psychopathology. He reviewed research to show that excessive anger
interferes with people’s vocational, recreational, and
interpersonal behaviors, leads to may clinical and legal problems,
and impairs health. New anger diagnostic categories will not be
accepted if dysfunctional anger occurs too frequently with another
disorders. Until now, modern theories of psychopathology suggested
that anger is not an independent disorder and that anger problems
can be accounted for by other disorders such as depression, mania,
impulse disorders, or personality disorders. Dr. DiGiuseppe
presented data that none of these other forms psychopathology
account for the occurrence of anger symptoms and that anger
displays sufficient independence form other diagnoses to be a
disorder by itself.
Dr. DiGiuseppe presented research on the self-report Anger
Disorder Scale to suggest that dysfunctional anger can be measured
and that people with anger problems can be identified. Several
variables were found to be characteristics of dysfunctional anger
that have not been recognized by modern theories. The desire for
revenge dominates the thinking of angry clients. A rich literature
has presented the dysfunctional nature of revenge in the classics,
the theater, and in novels. Psychologists though have not studied
the role of revenge much. Dr. DiGiuseppe suggested people would
learn more about revenge in the English department than in
psychology. He noted that we presently do not know how to change
people’s desire for revenge. Also, anger has long been thought to
encourage people to act impulsively. However, while angry patients
do report experiencing poor self-control, they also report serious
rumination problems. Until now, rumination was thought to be a
process that contributed to depression and anxiety disorders.
Rumination and impulsivity seem to be related. He suggested that
you might impulsively lose control of your behavior after long
periods of rumination. Dr. DiGiuseppe also reported that anger
patients often report that their anger intimidates others. This is
more evidence that angry behaviors may be less impulsive and more
instrumental in controlling others than psychologists have
thought.
While successful treatments for anger do exists, they are much
less effective than treatments that exist for depressive or anxiety
disorders. Dr. DiGiuseppe believes that psychologists will be more
successful in developing effective anger treatments if they first
identify the dysfunctional components of anger disorders.
For more information, please review programs and services
available at our Center for Psychological
Services and Clinical Studies.