Anger attacks: Correlates and significance of an underrecognized symptom

Background: Anger attacks over provocations described as trivial by the ind ividual are an underrecognized symptom associated with aggressive acts. The y are usually followed by guilt and regret. Anger attacks among mothers are an important problem because they are often directed at the woman's spouse and/or children. This study examines the prevalence and correlates of ange r attacks in a psychiatric clinic for women who are either pregnant or up t o 18 months postpartum. Method: Fifty consecutive consenting patients were assessed at initial pres entation with the Structured Clinical Interview for DSM-IV Axis I Disorders , a modified Anger Attacks Questionnaire, self-reports of psychiatric sympt oms and psychosocial variables, and clinician ratings. Results: Thirty (60%) of 50 patients reported anger attacks. Of those with anger attacks, 76.7% worried about them, and 73.3% had tried to prevent the m. Compared with women without anger attacks, those with anger attacks were significantly more likely to report higher state and trait anger (p <.001) , have a diagnosis of unipolar depression (p <.01), report more aggression directed at immediate family, and avoid their children. Both groups display ed little angry affect in the interview, thus appearing similar at assessme nt. Conclusion: Anger attacks in response to children and spouse were common in this group of women and were associated with subjective distress. Because those with and without anger attacks appear similar at interview, inquiring about the presence of anger attacks is important to ensure that they becom e a focus of treatment.