Gender-specific symptoms of depression and anger attacks

Depression is a serious and potentially life-threatening mental illness, which does not only lead to personal suffering but also impairs social functioning and has a significant socioeconomic effect. Epidemiological studies have found a life-time prevalence of up to 17% in the general population and death due to suicides of up to 15%. As women have a two-fold higher prevalence for depressive disorder, it is noteworthy that suicide rates are consistently higher for men. Previous studies have suggested that mainly men suffer from a specific irritable depressive syndrome, which is characterized by lowered impulse control, symptomatic substance abuse, an increased readiness to take risks, and anger attacks, which present as sudden spells of inappropriate anger with vegetative hyperarousal. This article reviews gender-specific aspects of depressive disorder focussing on anger attacks and their clinical management.     

Defensive hostility and anger expression: Relationship to additional heart rate reactivity during active coping

The main purpose of the present study was twofold: (a) to assess the relationship between defensive hostility (high hostility/high defensiveness) and additional heart rate reactivity during active coping and (b) to determine if the construct of anger-out might lend additional, sensitivity to the predictive power of the defensive hostility model. Forty individuals were randomly assigned to complete a mental arithmetic task with or without the threat of shock. Participants also completed the Cook-Medley Hostility Inventory (Ho), the Marlowe-Crowne Social Desirability Scale (MC), and the Spielberger Anger Expression Scale. Defensive hostile subjects (high Ho/high MC) were significantly more reactive than any other subgroup. In addition, the combination of low Ho/high anger-out scores yielded a subgroup significantly less reactive than any other subgroup. These findings clarify the complex relationship of hostility and cardiovascular reactivity.     

Effect of β-blockers on triggering of symptomatic atrial fibrillation by anger or stress

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Role of negative affects in pathophysiology and clinical expression of irritable bowel syndrome

Irritable bowel syndrome(IBS)is regarded as a multifactorial disease in which alterations in the brain-gut axis signaling play a major role.The biopsychosocial model applied to the understanding of IBS pathophysiology assumes that psychosocial factors,interacting with peripheral/central neuroendocrine and immune changes,may induce symptoms of IBS,modulate symptom severity,influence illness experience and quality of life,and affect outcome.The present review focuses on the role of negative affects,including depression,anxiety,and anger,on pathogenesis and clinical expression of IBS.The potential role of the autonomic nervous system,stress-hormone system,and immune system in the pathophysiology of both negative affects and IBS are taken into account.Psychiatric comorbidity and subclinical variations in levels of depression,anxiety,and anger are further discussed in relation to the main pathophysiological and symptomatic correlates of IBS,such as sensorimotor functions,gut microbiota,inflammation/immunity,and symptom reporting.     

Alexithymia and anger in patients with fibromyalgia

Our objective was to delineate the relevance of the personality construct alexithymia and anger-in in patients with fibromyalgia syndrome. Fifty subjects with fibromyalgia syndrome were compared to 20 subjects with rheumatoid arthritis and 42 healthy controls on the measures of anxiety, depression, anger, alexithymia, pain intensity and disability. There was a significant difference on the measures of anxiety and anger between FMS and RA groups, and also between FMS patients and healthy controls. There was a significant difference between FMS patients and healthy controls on the measures of depression, difficulty in identifying feelings subscale of TAS (TAS-dif), and total alexithymia scores. When the severity of pain was controlled for, there was a significant difference on the measures of anger and alexithymia between the FMS and the RA groups. Fibromyalgia patients were more alexithymic than rheumatoid arthritis patients even when the level of depression was controlled for. Anger towards oneself, which is anger-in, was higher in patients with fibromyalgia patients than in the rheumatoid arthritis sample. A stepwise regression model showed that the anger-out scores and the anxiety scores predicted the level of pain severity, and this explained 32% of the variance in the fibromyalgia syndrome group. Although anger-in is consistently higher in fibromyalgia patients, it is the behavioral expression of anger, together with anxiety, that predicts the severity of the pain. The difficulty of identifying feelings, rather than other dimensions of alexithymia, seems to be associated with fibromyalgia.Abbreviations CLBP Chronic low back pain - FMS Fibromyalgia syndrome - RA Rheumatoid arthritis - VAS Visual analog scale     

Neuroendocrine mechanisms of left ventricular dysfunction stimulated by anger stress in rats with atherosclerosis-a putative role of natriuretic peptide

Objective:To investigate the role of natriuretic peptide in the process of left ventricular dysfunction caused by emotional stress.Methods:Adult male SD rats(n=30)and Wistar rats(n=60)were selected in this study.Atherosclerosis models were induced with high-fat diet and excess VD3 injection(eight consecutive weeks),and anger stress models were prepared by residentintruder stress experiment(two consecutive weeks).Furthermore,left ventricular functions were examined by high-resolution echocardiograph,after which left ventricular myocardium and coronary arteries were prepared for pathological section and observed with electron microscope.At the same time,the hypothalamus,medulla oblongata and left ventricular myocardium were also prepared for pathological sections to detect the localization and expression of AMP,BNP and NPK-A with immunofluorescence and western blot.Results:We found that left ventricular functions of atherosclerosis or emotional stress modeled rats were both inferior to the healthy ones and superior to the combined(atherosclerosis and emotional stress)modeled ones(P0.05).We also found that atherosclerosis and emotional stress could both cause morphological changes of left ventricular cells and capillary which contribute to apoptosis and hyperblastosis.Further more,there was NPR—A distributed in hypothalamus,medulla oblongata,as well as left ventricular tissues with the same express trend between groups,with atherosclerosis modeled rats the highest and the healthy rats the lowest.Conclusions:The results of our study suggest that anger stress could cause an excess consumption of ANP,BNP and NPR-A in nervous and cardiovascular system which inhibit the compensatory self-repair function of atherosclerosis rats,leading to a promotion of fibrosis and lipid peroxidation,offering insight into the neuroendocrine mechanisms of left heart function obstacle.     

愤怒情志与阿尔茨海默病关系的病例对照研究

目的探讨愤怒情志与阿尔茨海默病(AD)的病因学关系,为愤怒长期积累可加速脑老化的论断提供流行病学依据。方法选取AD患者作为病例,以医院或社区无痴呆病、抑郁症等神经或精神疾病史者为对照,按同性别、同年龄段(±3岁)、同文化程度进行1∶1匹配的病例对照研究。调查方式为面对面访谈。结果 AD患者特质怒得分明显高于正常对照组(P<0.01);与正常对照组相比,高特质怒个体AD发病风险明显高于低特质怒个体(P<0.01),OR值(95%CI)为51.857(14.009,191.954);AD患者怒的表达(AX-O、AX-I)显著高于正常对照组(P<0.01),而怒的控制(AC-O、AC-I)显著低于正常对照组(P<0.01),AD患者怒表达指数显著高于正常对照组(P<0.01)。结论愤怒情志与AD发病相关,高特质怒是AD发病的危险因素;与正常人群相比,AD患者具有容易发怒或郁怒的倾向或特质,怒的表达程度高而控制力较弱。     

Anger Management Style and Endogenous Opioid Function: Is Gender a Moderator?

This study explored possible gender moderation of previously reported associations between elevated trait anger-out and reduced endogenous opioid analgesia. One hundred forty-five healthy participants underwent acute electrocutaneous pain stimulation after placebo and oral opioid blockade in separate sessions. Blockade effects were derived reflecting changes in pain responses induced by opioid blockade. Hierarchical regressions revealed that elevated anger-out was associated with smaller pain threshold blockade effects (less opioid analgesia) in females, with opposite findings in males (interaction p < .001). Similar marginally significant interactions were noted for blockade effects derived for nociceptive flexion reflex threshold, pain tolerance, and pain ratings (p < .10). Anger-in was also associated negatively with pain threshold blockade effects in females but not males (interaction p < .05). Across genders, elevated anger-in was related to smaller pain tolerance blockade effects (p < .01). Overlap with negative affect did not account for these opioid effects. The anger-in/opioid association was partially due to overlap with anger-out, but the converse was not true. These findings provide additional evidence of an association between trait anger-out and endogenous opioid analgesia, but further suggest that gender may moderate these effects. In contrast to past work, anger-in was related to reduced opioid analgesia, although overlap with anger-out may contribute to this finding.