Symposia
Anger
Katharine Romero, M.A. (she/her/hers)
Doctoral research fellow
St. John’s University
Queens, New York
Anger appears in the DSM5 often as a symptom across various mood and personality disorders. However, DSM lacks diagnostic categories for anger disorders that are equivalent to those of other affective disturbances. As a result, clinicians usually treat all angry clients the same. DiGiuseppe and Tafrate's (2007) proposed 13 subtypes. This study attempted to verify these subtypes and identify differences within subgroups of dysfunctional anger. We hoped this anger subtype refinement would lead to differential treatments for each subtype.
We collected a large sample of adults who completed the Anger Disorders Scale (ADS: DiGiuseppe & Tafrate, 2004). The ADS consists of 74 items divided into five dimensions: (1) Provocations, (2) Arousal, (3) Cognitions, (4) Motives, and (5) Behaviors and 18 subscales. One thousand seventy-four participants met our criteria for dysfunctional anger scores. These included subjects from the ADS normative sample (n = 463, 39.4%); general psychotherapy outpatients (n = 294, 25%); psychotherapy outpatients seeking help for anger problems (n = 149, 12.7%); court-mandated anger management patients (n = 25, 2.1%); inmates from the Connecticut State Department of Correction (n = 108, 9.2%); and angry drivers (n = 117, 10%); and incarcerated sex offenders (n = 18, 1.5%). This study includes the most scales used and most subjects used in any attempt to determine anger subtypes.
We used latent profile analysis (LPA) to identify anger subtypes of participants scoring in the clinically significant range on any higher-order factors (Anger-In, Expression/Reactivity, and Vengeance). Eighteen subscales of the ADS served as continuous variables and were entered as indicators of class membership.
The Fit indices supported eight profiles that fit into four higher-order subtypes of dysfunctional anger participants. These subtypes included: persistent - mild anger pathology, an expressive (but mild aggression), a subjective (mildly affective anger), a high anger primarily expressive type, a verbally-coercive group, a passive-aggressive type, an extreme anger type, situational anger only, an expressive (anger out), a subjective (anger in), and a combined anger out and anger in type,
We provide clinical descriptions for each subtype and recommendations for treatment that will address each subtype.