Category: Anger Management

— A new national study reveals that nearly 7.8 million adolescents aged 12 to 17, almost one third (30.9 percent), participated in any of three violent behaviors over the past year. The study, conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), showed that 22.6 percent of adolescents reported having participated in a serious fight at school or work; 16.1 percent reported involvement in group-against-group fighting; and 7.5 percent reported attacking others with intent to seriously hurt them.

Overall, male adolescents were more likely to engage in violent behaviors than females (34.6 percent versus 27.0 percent), but the study found other demographic and socioeconomic factors were also associated with an adolescent’s risk for violent behaviors.

One of the key factors seems to be family income. Adolescents from families with higher annual incomes are less likely to engage in violent behaviors than those from lower income families. For example, adolescents from families with annual incomes of $75,000 or more are far less likely to be involved in violent behaviors than adolescents from families with annual incomes of less than $20,000 (24.6 percent versus 40.5 percent).

The study also indicates that academic performance is also associated with risk for participating in violent behaviors measured. Adolescents with “A” averages in school were less than half as likely to be involved in violent behaviors as adolescents earning “D” averages in school (17.7 percent versus 53.8 percent).

Low academic performance even seems to transcend the association with family income as a risk factor for violent behaviors. Among adolescents with “D” averages, those coming from families with annual incomes of $75,000 had nearly identical rates of violent behaviors as those who came from families with annual incomes of less than $20,000 (54.5 percent versus 55.9 percent).

“Youth violence has long lasting, devastating consequences –the alarming rates of violence found by this study reinforce the importance of our efforts to prevent violence,” said SAMHSA Administrator, Pamela S. Hyde J.D. “These rates also underscore the need to treat the psychological trauma that can result from youth exposure to violence. Community leaders and school officials can use this vital information in making decisions about creating safe learning environments, and effective treatment programs which can rebuild young lives and promote safer communities.”

Violent Behaviors and Family Income among Adolescents is based on data from the 2004 to 2008 SAMHSA National Survey on Drug Use and Health which involve interviews with 112,885 adolescents throughout the nation. This study was done as part of SAMHSA’s strategic initiative on data, outcomes, and quality – an effort to create an integrated data strategy that informs policy makers and service providers on the nature and scope of behavioral health issues.

Researchers from Utrecht University who studied the effect of negative emotions on pain perception in women with and without fibromyalgia found that anger and sadness amplified pain equally in both groups. Full findings are now online and will publish in the October print issue of Arthritis Care & Research, a journal of the American College of Rheumatology.

Fibromyalgia (FM), a chronic pain condition, has among the largest impact of all rheumatic and chronic pain conditions. In addition to chronic, widespread pain, patients report accompanying symptoms such as fatigue, functional disability, and psychological distress. FM is thought to involve heightened pain sensitivity to a variety of psychophysical and emotional stimuli, with negative emotions believed to be experienced more strongly in FM patients than in the general population.

The Utrecht team theorized that specific negative emotions such as sadness and anger also would increase pain more in women with FM than in healthy women. Their study examined the effects of experimentally-induced anger and sadness on self-reported clinical and experimentally-induced pain in women with and without FM. Participants consisted of 62 women with FM and 59 women without FM. Both groups were asked to recall a neutral situation, followed by recalling both an anger-inducing and a sadness-inducing situation, in counterbalanced order. The effect of these emotions on pain responses (non-induced clinical pain and experimentally-induced sensory threshold, pain threshold, and pain tolerance) was analyzed with a repeated-measures analysis of variance.

Self-reported clinical pain always preceded the experimentally-induced pain assessments and consisted of reporting current pain levels ("now, at this moment") on a scale ranging from "no pain at all" to "intolerable pain." Clinical pain reports were analyzed in women with FM only. Electrical pain induction was used to assess experimentally-induced pain. Participants pressed a button when they felt the current (sensory threshold) and when it became painful (pain threshold) and intolerable (pain tolerance). Four pain assessments were conducted per condition, and very high internal consistencies were obtained.

More pain was indicated by both the clinical pain reports in women with FM and pain threshold and tolerance in both groups in response to anger and sadness induction. Sadness reactivity predicted clinical pain responses. Anger reactivity predicted both clinical and electrically-stimulated pain responses.

Both women with and women without FM manifested increased pain in response to the induction of both anger and sadness, and greater emotional reactivity was associated with a greater pain response. "We found no convincing evidence for a larger pain response to anger or sadness in either study group (women with, or without FM), said study leader Henriët van Middendorp, Ph.D. "In women with FM, sensitivity was roughly the same for anger and sadness."

Dr. van Middendorp concludes, "Emotional sensitization of pain may be especially detrimental in people who already have high pain levels. Research should test techniques to facilitate better emotion regulation, emotional awareness, experiencing, and processing."

In a related study, a research team from Radboud University Nijmegen Medical Centre found that tailored cognitive-behavioral therapy (CBT) and exercise training tailored to pain-avoidance or pain-persistence patterns at a relatively early stage after diagnosis is likely to promote beneficial treatment outcomes for high-risk patients with FM.

The Nijmegen team evaluated the effects of this approach in a randomized controlled trial. The study compared a waiting list control condition (WLC) with patients in a treatment condition (TC) to demonstrate improvements in physical and psychological functioning and in the overall impact of FM.

High-risk patients were selected and classified into 2 groups (84 patients were assigned to a pain-avoidance group and 74 patients to the pain-persistence group) and subsequently randomized to either the TC or WLC. Treatment consisted of 16 sessions of CBT and exercise training, tailored to the patient's specific cognitive behavioral pattern, delivered within 10 weeks. Physical and psychological functioning and impact of FM were assessed at baseline, post-treatment, and 6-month follow-up.

The treatment effects were significant, showing notable positive differences in physical (pain, fatigue, and functional disability) and psychological (negative mood and anxiety) functioning, and impact of FM for the TC in comparison with the WLC. Clinically relevant improvement was found among patients in the TC group.

"Our results demonstrate that offering high-risk FM patients a treatment tailored to their cognitive behavioral patterns at an early stage after the diagnosis is effective in improving both short-and long-term physical and psychological outcomes," says junior investigator Saskia van Koulil. "Supporting evidence of the effectiveness of our tailored treatment was found with regard to the follow-up assessments and the low dropout rates. The effects were overall maintained at 6 months, suggesting that patients continued to benefit from the treatment."

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Journal References:

1. Henriët van Middendorp, Mark A. Lumley, Johannes W.G. Jacobs, Johannes W.J. Bijlsma, Rinie Geenen. The effects of anger and sadness on clinical pain reports and experimentally-induced pain thresholds in women with and without fibromyalgia. Arthritis Care & Research, 2010; DOI: 10.1002/acr.20230
2. Saskia van Koulil, Wim van Lankveld, Floris W. Kraaimaat, Toon van Helmond, Annemieke Vedder, Hanneke van Hoorn, Rogier Donders, Alphons J.L. de Jong, Joost F. Haverman, Kurt-Jan Korff, Piet L.C.M. van Riel, Hans A. Cats, Andrea W.M. Evers. Tailored cognitive-behavioral therapy and exercise training for high-risk fibromyalgia patients. Arthritis Care & Research, 2010; DOI: 10.1002/acr.20268

Impulsive behaviour can be improved with training and the improvement is marked by specific brain changes, according to a new Queen's University study.

A research team led by neuroscience PhD student Scott Hayton has pinpointed the area of the brain that controls impulsive behavior and the mechanisms that affect how impulsive behavior is learned. The findings could have a significant impact on the diagnosis and treatment of several disorders and addictions, including ADHD and alcoholism.

"In the classroom, kids often blurt out answers before they raise their hand. With time, they learn to hold their tongue and put up their hand until the teacher calls them. We wanted to know how this type of learning occurs in the brain," says Mr. Hayton, a PhD student at the Centre for Neuroscience Studies at Queen's. "Our research basically told us where the memory for this type of inhibition is in the brain, and how it is encoded."

The team trained rats to control impulsive responses until a signal was presented. Electrical signals between cells in the brain's frontal lobe grew stronger as they learned to control their impulses. This showed that impulsivity is represented, in a specific brain region, by a change in communication between neurons.

Impulsivity is often thought of as a personality trait, something that makes one person different from another.

Children who have difficulty learning to control a response often have behavioral problems which continue into adulthood, says Professor Cella Olmstead, the principal investigator on the study. She notes that impulsivity is a primary feature of many disorders including addiction, ADHD, obsessive compulsive disorder and gambling. Identifying the brain region and mechanism that controls impulsivity is a critical step in the diagnosis and treatment of these conditions.

"In conditions where learning does not occur properly, it is possible that it is this mechanism that has been impaired," adds co-investigator neuroscience Professor Eric Dumont.

The findings were recently published in The Journal of Neuroscience.

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Journal Reference:

1. S. J. Hayton, M. Lovett-Barron, E. C. Dumont, M. C. Olmstead. Target-Specific Encoding of Response Inhibition: Increased Contribution of AMPA to NMDA Receptors at Excitatory Synapses in the Prefrontal Cortex. Journal of Neuroscience, 2010; 30 (34): 11493 DOI: 10.1523/JNEUROSCI.1550-10.2010

Playing a violent video game can increase aggression, and when a player keeps thinking about the game, the potential for aggression can last for as long as 24 hours, according to a study in the current Social Psychological and Personality Science (published by SAGE).

Violent video game playing has long been known to increase aggression. This study, conducted by Brad Bushman of The Ohio State University and Bryan Gibson of Central Michigan University, shows that at least for men, ruminating about the game can increase the potency of the game's tendency to lead to aggression long after the game has been turned off.

The researchers randomly assigned college students to play one of six different video games for 20 minutes. Half the games were violent (e.g., Mortal Kombat) and half were not (e.g., Guitar Hero). To test if ruminating about the game would extend the games' effect, half of the players were told over "the next 24 hours, think about your play of the game, and try to identify ways your game play could improve when you play again."

Bushman and Gibson had the participants return the next day to test their aggressiveness. For men who didn't think about the game, the violent video game players tested no more aggressive than men who had played non-violent games. But the violent video game playing men who thought about the game in the interim were more aggressive than the other groups. The researchers also found that women who played the violent video games and thought about the games did not experience increased aggression 24 hours later.

This study is the first laboratory experiment to show that violent video games can stimulate aggression for an extended period of time. The authors noted that it is "reasonable to assume that our lab results will generalize to the 'real world.' Violent gamers usually play longer than 20 minutes, and probably ruminate about their game play in a habitual manner."

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Journal Reference:

1. B. J. Bushman, B. Gibson. Violent Video Games Cause an Increase in Aggression Long After the Game Has Been Turned Off. Social Psychological and Personality Science, 2010; DOI: 10.1177/194855061037950

As another round of talks continues between Israelis and Palestinians, a new University of Michigan study documents the impact the violence has been inflicting on the region's children.

Palestinian and Israeli children not only suffer the direct physical consequences of violence, they are also being psychologically scarred by the high levels of violence they witness, according to the study, presented earlier this summer at the International Society for Research on Aggression.

Nearly 50 percent of Palestinian children between the ages of 11 and 14 reported that they had seen other Palestinians upset or crying because someone they knew or loved had been killed by Israelis. Nearly the same proportion reported seeing in person other Palestinians who were injured or dead, lying on stretchers or on the ground, as a result of Israeli attacks in the last year.

For Israelis, the figures were lower but still appallingly high, according to the study. More than 25 percent of Israeli Jewish children of the same age reported seeing other Israelis upset or crying because someone they knew or loved had been killed by Palestinians, and nearly 10 percent reported that they had seen in person other Israelis who were injured or dead, lying on stretchers or on the ground, as a result of Palestinian attacks in the last year.

"The results show that Palestinian children in particular are seeing extraordinary amounts of very disturbing violence in their daily lives," said psychologist Rowell Huesmann, director of the Research Center for Group Dynamics at the U-M Institute for Social Research (ISR) and principal investigator of the project. "Furthermore, this exposure is very deleterious. It is associated with dramatic increases in post-traumatic stress symptoms and increases in aggressive behavior directed at peers."

Children who saw the most violence experienced the highest levels of fear, anxiety, nightmares, and incapacitating thoughts, according to results from the first year of the three-year, longitudinal study of 1,500 children ages 8 to 14. For example, more than 70 percent of Israeli Arab children who saw these things frequently had nightmares.

Even more disturbing, both Palestinian and Israeli youth who saw the most violence were significantly more likely to slap, choke, punch, beat, or threaten others of their own groups with a gun or a knife. For example, 51 percent of youth at the lowest levels of violence exposure reported having committed at least one of those acts during the past year versus 71 percent of youth at the highest levels of violence exposure.

"The results show that Palestinian children in particular are seeing extraordinary amounts of very disturbing violence in their daily lives, and the more they are exposed to violence, the more anxiety they experience and the more aggressively they behave," said ISR psychologist Eric Dubow, who along with Paul Boxer of Rutgers University is a co-principal investigator of the project.

The study was funded by the National Institute of Child Health and Development and the Fogarty Center for International Studies and is a collaboration between the ISR, Hebrew University of Jerusalem, and the Palestinian Center for Policy and Survey Research in Ramallah.

The researchers also showed that the relation between exposure and aggression and anxiety is not due to other characteristics of the youth or family. And although exposure to war-related violence seemed to stimulate more family and community violence as well, analyses showed that the effects on symptoms of post-traumatic stress and on aggressive behavior were a direct result of exposure to war-related violence.

"Because of the sophisticated sampling and interviewing techniques used by our collaborators — Khalil Shikaki at the Palestinian Center and Simha Landau at Hebrew University, we believe that this is the most accurate data every collected on this topic anywhere in the world," said Huesmann, who was recently appointed to the U.S. National Academy of Science, Institute of Medicine Forum on Global Violence.

"Given the accumulated scientific evidence showing that exposure to violence stimulates aggression, some of these results are not surprising," Huesmann said. "However, it is not well known that exposure to war violence committed against your own group by another group increases your aggressive behavior toward members of your own group.

"The truth is that violence is a contagious disease just like smallpox and typhoid, and children are particularly susceptible to catching it. In the Mideast, violence has reached epidemic proportions among children, and most of them are infected. The scar tissue from these infections may never go away, but new infections among children could be reduced if the Israelis and Arabs could only settle their conflict. Knowledge of the devastating psychological impact of violence on their children should be an added incentive for them to settle the conflict."