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Abstract
Anger attacks have been defined as acute episodes of intense anger that involve activation of autonomic arousal similar to that experienced in anxiety. The experience is appraised by individuals to be precipitated by minor or trivial provocations (Fava, Anderson & Rosenbaum, 1990). Anger attacks may lead to personal suffering (including poor health, suicidal behaviour, drug and alcohol use) and risk to others (aggression, family violence and family disruption). Despite the debilitating nature of anger attacks, relatively little research has been undertaken to assess their phenomenology. Similarly, the outcomes and consequences of anger attacks are poorly understood.
The main aim of the present study is to qualitatively describe precipitators, phenomenology, and consequences of anger attacks and their association with anxiety and trauma. Study 1 was conducted at an anxiety disorders clinic. Patients entering the clinic for treatment were screened for anger attacks and subsequently invited to participate in the qualitative interview to examine the phenomenology of anger attacks. Study 2 was conducted at a facility providing treatment to survivors of torture and trauma. Patients who were refugees from the former Yugoslavia were invited to participate in the qualitative interview, assessing the phenomenology of anger attacks and examining its relationship to trauma.
In Study 1, the prevalence of anger attacks was estimated to be 40%, confirming earlier findings from clinical samples. Anger attacks were a common presentation in patients diagnosed with an Anxiety Disorder. A small percentage of patients who were receiving treatment for an anxiety disorder, identified anger attacks as their main reason for seeking help. Qualitative exploration of anger attacks found that they are experienced in multiple symptom domains including physical, affective, cognitive and behavioural. Abuse in childhood and traumatic events suffered during the war in the former Yugoslavia were subjectively linked to the onset of anger attacks. Anger attacks often led to physical aggression and violence, and were associated with impairment in relationships, problems with the law and poor physical health outcomes.