Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-27T07:17:38.310Z Has data issue: false hasContentIssue false
  • English
  • Français

High Anger Expression is Associated with Reduced Cortisol Awakening Response and Health Complaints in Healthy Young Adults

Published online by Cambridge University Press:  29 April 2016

Ángel Romero-Martínez  and
Luis Moya-Albiol
Ángel Romero-Martínez*
Affiliation:
Universidad de Valencia (Spain)
Luis Moya-Albiol
Affiliation:
Universidad de Valencia (Spain)
*
*Correspondence concerning this article should be addressed to Ángel Romero-Martínez. Universidad de Valencia (Spain). E-mail: Angel.Romero@uv.es
Get access Rights & Permissions [Opens in a new window]

Abstract

The extant evidence suggests a robust positive association between expression (anger expression-out) and suppression (anger expression-in) of anger and compromised health. Nevertheless, the underlying psychobiological mechanisms which explain these relationships are not well understood. This study examined whether anger expression would predict general health, cortisol awakening response (CAR) and evening cortisol levels in a community sample of 156 healthy young adults of both genders. Participants were distributed into two groups according to their anger expression scores: high and low anger expression (HAE and LAE, respectively). Findings indicated that those with HAE had worse self-reported health (p = .02) and higher CAR than the LAE group (p = .04). Moreover, high levels of anger expression-out (p < .01) and -in (p < .01, for all) predicted a worse self-reported health in both groups. On the other hand, high anger expression-out was associated with flattened CAR but only in the HAE group (p < .01). This study reinforces the need to develop effective strategies to provide mechanisms to regulate anger expression by promoting personal growth and positive skills that enhance individuals’ well-being and quality of life and, in turn, their own health.

Keywords

anger expression-inanger expression-outcortisol awakening responsehealth
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 19 , 2016 , E19
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adam, E. K., Hawkley, L. C., Kudielka, B. M., & Cacioppo, J. T. (2006). Day-to-day dynamics of experience-cortisol associations in a population-based sample of older adults. Proceedings of the National Academy of Sciences of the United States of America, 103, 17058–17063. http://dx.doi.org/10.1073/pnas.0605053103 CrossRefGoogle Scholar
Aldenderfer, M. S., & Blashfield, R. K. (1984). Cluster analysis. Beverly Hills, CA: Sage Press.CrossRefGoogle Scholar
Barefoot, J. C., Beckham, J. C., Haney, T. L., Siegler, I. C., & Lipkus, I. M. (1993). Age differences in hostility among middle-aged and older adults. Psychology and Aging, 8(1), 3–9. http://dx.doi.org/10.1037/0882-7974.8.1.3 CrossRefGoogle ScholarPubMed
Barker, E. T., Greenberg, J. S., Seltzer, M. M., & Almeida, D. M. (2012). Daily stress and cortisol patterns in parents of adult children with a serious mental illness. Health Psychology, 31(1), 130–134. http://dx.doi.org/10.1037/a0025325 CrossRefGoogle ScholarPubMed
Birditt, K. S., & Fingerman, K. S. (2003). Age and gender differences in adults’ descriptions of emotional reactions to interpersonal problems. Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 58, 237–245. http://dx.doi.org/10.1093/geronb/58.4.P237 CrossRefGoogle ScholarPubMed
Bouma, E. M. C., Riese, H., Ormel, J., Verhulst, F. C., & Oldehinkel, A. J. (2009). Adolescents’ cortisol responses to awakening and social stress; effects of gender, menstrual phase and oral contraceptives. The TRAILS study. Psychoneuroendocrinology, 34, 884–893. http://dx.doi.org/10.1016/j.psyneuen.2009.01.003 CrossRefGoogle ScholarPubMed
Boylan, J. M., & Ryff, C. D. (2013). Varieties of anger and the inverse link between education and inflammation: Toward an integrative framework. Psychosomatic Medicine, 75, 566–574. http://dx.doi.org/10.1097/PSY.0b013e31829683bd CrossRefGoogle ScholarPubMed
Caska, C. M., Hendrickson, B. E., Wong, M. H., Ali, S., Neylan, T., & Whooley, M. A. (2009). Anger expression and sleep quality in patients with coronary heart disease: Findings from the Heart and Soul Study. Psychosomatic Medicine, 71, 280–285. http://dx.doi.org/10.1097/PSY.0b013e31819b6a08 CrossRefGoogle ScholarPubMed
Carstensen, L. L., Fung, H. H., & Charles, S. T. (2003). Socioemotional selectivity theory and the regulation of emotion in the second half of life. Motivation and Emotion, 27, 103–123. http://dx.doi.org/10.1023/A:1024569803230 CrossRefGoogle Scholar
Chida, Y., & Steptoe, A. (2009). The association of anger and hostility with future coronary heart disease: A meta-analytic review of prospective evidence. Journal of the American College of Cardiology, 53, 936–946. http://dx.doi.org/10.1016/j.jacc.2008.11.044 CrossRefGoogle ScholarPubMed
Choi, I. R. (2009). Anger expression type and mental health in middle aged women. Journal of Korean Academy of Nursing, 39, 602–612. http://dx.doi.org/10.4040/jkan.2009.39.4.602 CrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical power analysis for the behavioral sciences, (2nd Ed.). New Jersey, NJ: Lawrence Erlbaum.Google Scholar
Everson-Rose, S. A., & Lewis, T. T. (2005). Psychosocial factors and cardiovascular diseases. Annual Review of Public Health, 26, 469–500. http://dx.doi.org/10.1146/annurev.publhealth.26.021304.144542 CrossRefGoogle ScholarPubMed
Fekedulegn, D. B., Andrew, M. E., Burchfiel, C. M., Violanti, J. M., Hartley, T. A., Charles, L. E., & Miller, D. B. (2007). Area under the curve and other summary indicators of repeated waking cortisol measurements. Psychosomatic Medicine, 69, 651–659. http://dx.doi.org/10.1097/PSY.0b013e31814c405c CrossRefGoogle ScholarPubMed
Fries, E., Dettenborn, L., & Kirschbaum, C. (2009). The cortisol awakening response (CAR): Facts and future directions. International Journal of Psychophysiology, 72(1), 67–73. http://dx.doi.org/10.1016/j.ijpsycho.2008.03.014 CrossRefGoogle ScholarPubMed
Goldberg, D. P., & Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 139–145. http://dx.doi.org/10.1017/S0033291700021644 CrossRefGoogle ScholarPubMed
Grice, J. E., & Jackson, R. V. (2004). Letter to the editor: Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change. A letter to the editor in response to J. C. Preussner et al. (2003). Psychoneuroendocrinology 28, 916–931. Psychoneuroendocrinology, 29, 563–564. http://dx.doi.org/10.1016/j.psyneuen.2003.10.002 CrossRefGoogle Scholar
Gross, J. J., Carstensen, L. L., Pasupathi, M., Tsai, J., Skorpen, C. G., & Hsu, A. Y. C. (1997). Emotion and aging: Experience, expression, and control. Psychology and Aging, 12, 590–599. http://dx.doi.org/10.1037/0882-7974.12.4.590 CrossRefGoogle ScholarPubMed
Haukkala, A. (2002). Socio-economic difference in hostility measures: A population based study. Psychology and Health, 17, 191–202. http://dx.doi.org/10.1080/08870440290013671 CrossRefGoogle Scholar
Henry, J. P. (1992). Biological basis of the stress response. Integrative Psychological and Behavioral Science, 27, 66–83. http://dx.doi.org/10.1007/BF02691093 CrossRefGoogle ScholarPubMed
Hodapp, V., Bongard, S., & Heiligtag, U. (1992). Active coping, expression of anger, and cardiovascular reactivity. Personality and Individual Differences, 13, 1069–1076. http://dx.doi.org/10.1016/0191-8869(92)90022-H CrossRefGoogle Scholar
Keltikangas-Järvinen, L., Räikkönen, K., Hautanen, A., & Adlercreutz, H. (1996). Vital exhaustion, anger expression, and pituitary and adrenocortical hormones. Implications for the insulin resistance syndrome. Arteriosclerosis, Thrombosis, and Vascular Biology, 16, 275–280. http://dx.doi.org/10.1161/01.ATV.16.2.275 CrossRefGoogle ScholarPubMed
Martin, R., Wan, C. K., David, J. P., Wegner, E. L., Olson, B. D., & Watson, D. (1999). Style of anger expression: Relation to expressivity, personality, and health. Personality and Social Psychology Bulletin, 25, 1196–1207. http://dx.doi.org/10.1177/0146167299258002 CrossRefGoogle Scholar
Matthews, K. A., Owens, J. F., Kuller, L. H., Sutton-Tyrrell, K., & Jansen-McWilliams, L. (1998). Are hostility and anxiety associated with carotid atherosclerosis in healthy postmenopausal women? Psychosomatic Medicine, 60, 633–638. http://dx.doi.org/10.1097/00006842-199809000-00021 CrossRefGoogle ScholarPubMed
Miguel-Tobal, J. J., Casado, M. I., Cano-Vindel, A., & Spielberger, C. D. (2001). Adaptación española del Inventario de Expresión de Ira Estado-Rasgo STAXI-II (Spanish adaptation of Anger Expression Inventory State-Trait STAXI-II). Madrid, Spain: Tea Ediciones.Google Scholar
Munck, A., Guyre, P. M., & Holbrook, N. J. (1984). Physiological functions of glucocorticoids in stress and their relation to pharmacological actions. Endocrine Reviews, 5, 25–44. http://dx.doi.org/10.1210/edrv-5-1-25 CrossRefGoogle ScholarPubMed
Pérez-García, A. M., Sanjuán, P., Rueda, B., & Ruiz, M. A. (2011). Cardiovascular health in women: The role of anger and its expression. Psicothema, 23, 593–598.Google ScholarPubMed
Pfattheicher, S., & Keller, J. (2014). Towards a biopsychological understanding of costly punishment: The role of basal cortisol. PLoS One, 9(1), e85691. http://dx.doi.org/10.1371/journal.pone.0085691 CrossRefGoogle ScholarPubMed
Phillips, L. H., Henry, J. D., Hosie, J. A., & Milne, A. B. (2006). Age, anger regulation and well-being. Aging & Mental Health, 10, 250–256. http://dx.doi.org/10.1080/13607860500310385 CrossRefGoogle ScholarPubMed
Platje, E., Vermeiren, R. R. J. M., Raine, A., Doreleijers, T. A. H., Keijsers, L. G. M. T., Branje, S. J. T., … Jansen, L. M. C. (2013). A longitudinal biosocial study of cortisol and peer influence on the development of adolescent antisocial behavior. Psychoneuroendocrinology, 38, 2770–2779. http://dx.doi.org/10.1016/j.psyneuen.2013.07.006 CrossRefGoogle ScholarPubMed
Popma, A., Vermeiren, R., Geluk, C. A. M. L-, Rinne, T., van den Brink, W., Knol, D. L., … Doreleijers, T. A. H. (2007). Cortisol moderates the relationship between testosterone and aggression in delinquent male adolescents. Biological Psychiatry, 61, 405–411. http://dx.doi.org/10.1016/j.biopsych.2006.06.006 CrossRefGoogle ScholarPubMed
Pruessner, J. C., Kirschbaum, C., Meinlschmid, G., & Hellhammer, D. H. (2003). Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change. Psychoneuroendocrinology, 28, 916–931. http://dx.doi.org/10.1016/S0306-4530(02)00108-7 CrossRefGoogle ScholarPubMed
Révész, D., Verhoeven, J. E., Milaneschi, Y., de Geus, E. J., Wolkowitz, O. M., & Penninx, B. W. (2014). Dysregulated physiological stress systems and accelerated cellular aging. Neurobiology Aging, 35, 1422–1430.CrossRefGoogle ScholarPubMed
Romero-Martínez, A., Lila, M., Conchell, R., González-Bono, E., & Moya-Albiol, L. (2014). Immunoglobulin A response to acute stress in intimate partner violence perpetrators: The role of anger expression-out and testosterone. Biological Psychology, 96, 66–71. http://dx.doi.org/10.1016/j.biopsycho.2013.11.009 CrossRefGoogle ScholarPubMed
Schum, J. L., Jorgensen, R. S., Verhaeghen, P., Sauro, M., & Thibodeau, R. (2003). Trait anger, anger expression, and ambulatory blood pressure: A meta-analytic review. Journal of Behavioral Medicine, 26, 395–415. http://dx.doi.org/10.1023/A:1025767900757 CrossRefGoogle ScholarPubMed
Siegman, A. W., Anderson, R. A., Herbst, J., Boyle, S., & Wilkinson, J. (1992). Dimensions of anger-hostility and cardiovascular reactivity in provoked and angered men. Journal of Behavioral Medicine, 15, 257–272. http://dx.doi.org/10.1007/BF00845355 CrossRefGoogle ScholarPubMed
Smith, T. W., Glazer, K., Ruiz, J. M., & Gallo, L. C. (2004). Hostility, anger, aggressiveness, and coronary heart disease: An interpersonal perspective on personality, emotion, and health. Journal of Personality, 72, 1217–1270. http://dx.doi.org/10.1111/j.1467-6494.2004.00296.x CrossRefGoogle ScholarPubMed
Spielberger, C. D., Gorusch, R. L., Lushene, R., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
Steptoe, A., Cropley, M., Griffith, J., & Kirschbaum, C. (2000). Job strain and anger expression predict early morning elevations in salivary cortisol. Psychosomatic Medicine, 62, 286–292. http://dx.doi.org/10.1097/00006842-200003000-00022 CrossRefGoogle ScholarPubMed
Suarez, E. C., & Williams, R. B. (1990). The relationships between dimensions of hostility and cardiovascular reactivity as a function of task characteristics. Psychosomatic Medicine, 52, 558–570. http://dx.doi.org/10.1097/00006842-199009000-00008 CrossRefGoogle ScholarPubMed
Vandervoort, D. J., Ragland, D. R., & Syme, S. L. (1996). Expressed and suppressed anger and health problems among transit workers. Current Psychology, 15, 179–193. http://dx.doi.org/10.1007/BF02686950 CrossRefGoogle Scholar
Vermeersch, H., T’Sjoen, G., Kaufman, J. M., & Vincke, J. (2008). The role of testosterone in aggressive and non-aggressive risk-taking in adolescent boys. Hormones and Behavior, 53, 463–471. http://dx.doi.org/10.1016/j.yhbeh.2007.11.021 CrossRefGoogle ScholarPubMed
Wüst, S., Federenko, I., Hellhammer, D. H., & Kirschbaum, C. (2000). Genetic factors, perceived chronic stress, and the free cortisol response to awakening. Psychoneuroendocrinology, 25, 707–720.CrossRefGoogle ScholarPubMed