Anger expression, body fat, and blood pressure in adolescents: Project HeartBeat!

Do Hypertensive Men Spy With an Angry Little Eye? Anger Recognition in Men With Essential Hypertension - Cross-sectional and Prospective Findings

BACKGROUND

Higher trait anger has inconsistently been associated with hypertension and hypertension development, but social context in terms of recognition of other persons' anger has been neglected in this context.

PURPOSE

Here, we investigated anger recognition of facial affect and trait anger in essential hypertensive and normotensive men in addition to prospective associations with blood pressure (BP) increases.

METHODS

Baseline assessment comprised a total of 145 participants including 57 essential hypertensive and 65 normotensive men who were otherwise healthy and medication-free. Seventy-two eligible participants additionally completed follow-up assessment 3.1 (±0.08 SEM) years later to analyze BP changes over time. We assessed emotion recognition of facial affect with a paradigm displaying mixed facial affect of two morphed basic emotions including anger, fear, sadness, and happiness. Trait anger was assessed with the Spielberger trait anger scale.

RESULTS

Cross-sectionally, we found that with increasing BP, hypertensive men overrated anger displayed in facial expressions of mixed emotions as compared to normotensive men (ps ≤ .019) while there were no differences in trait anger (p = .16). Prospectively, the interaction between mean anger recognition and trait anger independently predicted BP increases from baseline to follow-up (ps ≤ .043), in that overrating displayed anger predicted future BP increases only if trait anger was high.

CONCLUSIONS

Our findings indicate an anger recognition bias in men with essential hypertension and that overrating displayed anger in combination with higher trait anger seems to predict future BP increases. This might be of clinical relevance for the development and progression of hypertension and cardiovascular disease.

Anger Expression and Blood Pressure in Adolescents

The clinical significance of childhood hypertension is important as elevated pressures during childhood are found to follow a progressively increasing track into adulthood. Little work has been done to examine the relationship of emotions and emotional behavioral factors to the development of hypertension in children. Using the Roy Adaptation Model as a guide, this study investigated the relationship of anger expression and blood pressure (BP) among adolescents 16–18 years of age. Participants were 63 urban high school seniors. Measurements included the Anger Expression Inventory, a Demographic Questionnaire, and measures of systolic and diastolic blood pressure. Analysis revealed significant positive relationships between anger expression with blood pressure, and a significant inverse relationship between blood pressure and the control of anger for girls. No significant relationships between anger expression and blood pressure were noted for boys. The majority of students (53%) were found to have high normal or hypertensive blood pressure readings, putting them at increased cardiovascular risk.

Anger, stress and blood pressure in overweight children

Among adults, trait anger, patterns of anger expression, and stress have been associated with blood pressure (BP). Less apparent is the effect of these variables on BP in overweight and obese children. To characterize the relationships between these psychological variables and BP, the authors conducted a secondary analysis of data from 73 overweight and obese 9- to 11-year-old children. Findings indicate a positive correlation between trait anger and systolic BP (SBP). Regression results indicate that the overall model significantly predicted SBP by explaining 15.4% of the variance and that trait anger was a significant predictor of SBP.

Spirituality, anger, and stress in early adolescents

The purpose of this study was to explore the relationship of spiritual beliefs and involvement with anger and stress in early adolescents. Early adolescents (n = 53) completed the Spiritual Involvement and Beliefs Scale (Hatch et al. 1998), the State-Trait Anger Expression Inventory (Spielberger 1999), and the Perceived Stress Scale (Cohen and Williamson 1988). Contrary to expectations, spirituality was significantly and positively related to anger and stress. Implications and possible explanations for the unanticipated findings in this study are discussed.

Modalities of anger expression and the psychosocial adjustment of early adolescents in eastern Cuba

Culture influences the acceptability of the overt expression of anger. In many cultures, overt expression of anger is considered legitimate for males but not for females. We explored the implications of anger expression among early adolescents in Cuba, expecting that overt, explosive expression of anger would be particularly maladaptive in a society that is collectivistic by virtue of both its cultural heritage and ideology. Given the sharp gender-role distinctions in traditional Latin American society, we expected to find more overt expression of anger by males. However, the analyses revealed no significant gender differences in anger expression. Overt expression of anger was significantly associated with multiple measures of maladjustment. Evidence that the inhibition of anger is associated with maladjustment was not as consistent, but holding anger in was linked with internalizing difficulties. Sociometric data indicated that early adolescents who demonstrate control of their anger are highly accepted and considered as leaders.

Anger expression in children and adolescents: A review of the empirical literature

Understanding the links between anger expression by children and adolescents, their health, and their interpersonal interactions is important given the evidence that anger is associated with maladjustment and illness among adults. This review covers: 1) possible origins of the awareness and expression of anger; 2) assessment of anger in children and adolescents, including both self-report and observational approaches; 3) implications of anger expression for interpersonal relationships; and 4) outcomes of anger expression. Dimensions of anger expression found in adults have been corroborated to some extent in child and adolescent data. Reliable and valid measures of these dimensions have been developed. There has been much less research on the correlates of maladaptive anger expression in children or adolescents than in adults. Nevertheless, the current data base provides some confirmation that youth who cope inappropriately with their anger are at risk for problematic interpersonal relationships and negative outcomes in terms of both mental and general health.

The relationships among anxiety, anger, and blood pressure in children

Relationships between anger and anxiety have been examined in adults but less frequently in children. This investigation explored relationships among trait anxiety, trait anger, anger expression patterns, and blood pressure in children. The participants were 264 third- through sixth-grade children from five elementary schools who completed Jacob's Pediatric Anger and Anxiety Scale and Jacob's Pediatric Anger Expression Scale and had their blood pressure measured. Data were analyzed using descriptive and correlational statistics and hierarchical regression. Results have implications for the way in which anxiety and anger are perceived in children and the importance of teaching children to deal with emotions.

Differences in Trait Anger Among Children with Varying Levels of Anger Expression Patterns

PROBLEM

Little research has been done with children to determine effects of using various patterns of anger expression on trait anger. The purpose was to examine differences in trait anger of children who indicated high, moderate, or low use of three patterns of anger expression.

METHODS

A convenience sample of 1,060 third through sixth graders completed trait anger and patterns of expressing anger instruments.

FINDINGS

High users of anger-out (anger expressed outwardly) had the highest trait anger for every grade while high users of anger-reflection/control had the lowest.

CONCLUSIONS

Anger-reflection/control may be more effective than anger-out in reducing trait anger in school-age children.

Epidemiology of hypertension among a population of school children in Sousse, Tunisia

BACKGROUND

Pediatric hypertension is a field of increasing interest and importance. Early identification of children at risk for hypertension is important to prevent the serious, long-term complications associated with the condition. In Tunisia, there are no data available on the cardiovascular disease risk profile, such as hypertension, in the population of children.

OBJECTIVE

To establish the prevalence of hypertension, the percentile distribution of blood pressure and the inter-relationships between hypertension and other cardiovascular disease risk factors among school children.

METHODS

An epidemiological survey was conducted based on a representative sample of 1569 urban school children in Sousse, Tunisia.

RESULTS

The prevalence of arterial hypertension was 9.6%, with no significant difference between boys (9.2%) and girls (9.9%). The prevalence of systolic and diastolic hypertension was 6.4% and 4.5%, respectively. In both boys and girls, systolic pressure had a highly significant positive correlation with height (boys: r=0.33, P<0.001; girls: r=0.08, P=0.02), weight (boys: r=0.47, P < or = 0.001; girls: r=0.35, P<0.001) and triglyceride concentrations (boys: r=0.13, P<0.001; girls: r=0.10, P=0.006). Among boys, a positive correlation was found between systolic blood pressure and age (r=0.12, P=0.001) and, among girls, a negative correlation was found (r=-0.12, P=0.001).

CONCLUSION

This information will be used to help launch a regional program of heart health promotion in schools.

Negative emotion and disordered eating among obese college students

The present study examined the relationship between negative emotions, body dissatisfaction, exercise, and disordered eating attitudes and behaviors among obese college students. It also examined whether there were gender differences in these variables. A total of 88 males and 102 females, who reported a BMI score above 30, completed a survey. Females reported higher levels of disordered eating, body dissatisfaction, and more frequent dieting than males and as predicted, males reported higher levels of exercise behaviors. Body dissatisfaction, anger discomfort, and self dissatisfaction all correlated with drive for thinness for both genders. Anger discomfort was the only variable to predict disordered eating for both genders. The results support numerous studies that have found that females are at greater risk of disordered eating than males, and also suggest that anger management may be an important component in treatment of disordered eating among obese young adults.

Utility of different body composition indicators: demographic influences and associations with blood pressures and heart rates in adolescents (Heartfelt Study)

PRIMARY OBJECTIVE

To compare the utility of 10 commonly used body composition indicators (BCIs) in relation to demographic characteristics and cardiovascular risk factors.

RESEARCH DESIGN

A cross-sectional, school sample was studied.

SUBJECTS

Three hundred and eighty-four Black, White and Hispanic adolescents 11-16 years of age from Houston, Texas, USA (Heartfelt Study) were studied.

METHODS

BCIs include impedance and skinfold estimates of fat-free mass (FFM); fat mass (FM) and per cent body fat (PBF); resistance mass index (RMI); body mass index (BMI); and waist and abdomen circumferences. The cardiovascular risk factors (blood pressures/heart rates) are summarized by factor analysis. Sexual maturity was clinically assessed.

RESULTS

Two distinct classes of BCIs emerged with respect to demographic influences: (1) RMI, impedance and skinfold estimators, for which sexual dimorphism is evident, and (2) BMI and circumferences, for which it is not. All BCIs were strongly related to general (systolic) blood pressure, but only body fat variables were related to heart rates. Skinfold-derived FM, PBF and mid-body circumferences were the variables most strongly related to cardiovascular risk factors.

CONCLUSIONS

RMI, impedance or skinfold estimators are necessary for research requiring an accurate description of body composition changes during adolescence and for assessing the role of lean and fat tissue in disease aetiology. A 2-skinfold method is just as effective as the more complicated impedance. Mid-body circumferences are closely related to blood pressures and heart rates, suggesting their importance as indicators of abdominal fat in adolescents.

A research note on body mass, physical aggression, and the competitiveness of Asian-Pacific Islander adolescents in Guam

This study uses the evolutionary model to guide an exploration of the effects of body mass on aggressive and competitive behaviors among Asian-Pacific adolescents in Guam. Using a probability sample of Guam's high-school students, the results of logistic regressions suggest that adolescent females with greater body mass are more likely to engage in physical fights (aggression) and to participate in team sports (competitiveness). Ethnic differences indicate the possibility that individuals with lower body mass may be less likely to participate in physically aggressive acts and team sports. Alternate theoretical explanations for the results are also considered.

Percentiles of body composition from bioelectrical impedance and body measurements in U.S. adolescents 8-17 years old: Project HeartBeat!

Reference percentiles (5th, 10th, 50th, 85th, 90th, and 95th) of black and nonblack children ages 8-17 years from Project HeartBeat! (n = 678) are presented for body mass index (BMI), percent body fat (PBF), fat-free mass (FFM), and fat mass (FM) derived from bioelectrical impedance. Project HeartBeat! is a mixed longitudinal study in which three cohorts of children (seen initially at age 8, 11, or 14 years) were followed for 4 years and measured thrice-yearly from 1991 through 1995. Weight, height, and BMI of Project HeartBeat! children are similar in central tendency and variability to those of nationally representative samples for nonblack children but not black children, for whom there is an excess of children at or above the 95th percentile for weight and BMI. Values of PBF above which cardiovascular risk variables increase (as suggested in the literature) are located at the 85th percentile of the Project HeartBeat! distributions. This percentile of PBF may be tentatively considered as a cutoff point with epidemiological significance for children.

Mood, eating attitudes, and anger in obese women with and without Binge Eating Disorder

OBJECTIVE

The aim of this study was to evaluate the anger levels and their management in obese patients.

METHODS

A total of 103 obese women [51 with Binge Eating Disorder (BED) and 52 without BED] were included in the study and compared to 93 healthy controls. They were assessed with the State-Trait Anger Expression Inventory (STAXI), Beck Depression Inventory (BDI), and Eating Disorder Inventory-2 (EDI-2).

RESULTS

The BDI score is higher in obese subjects than in controls and obese binge eaters have higher levels of depression than obese patients without BED. Differences among the three groups can be found in almost all subscales of the EDI-2, even after controlling for the variable depression (BDI). For STAXI, the only difference among the three groups, which remains significant after controlling for depression, is the tendency to express anger outside (AX-OUT), which is higher in obese binge eaters. The correlation study highlights the importance of impulsivity in the group of obese binge eaters, whereas in obese patients without BED, the tendency toward anger suppression (AX-IN) is seen.

DISCUSSION

Obese patients with BED might be considered a subgroup deserving greater psychiatric interest, both for the greater severity of the eating disorder and for the comorbidity with subthreshold depressive symptoms and with borderline personality traits. In obese patients without BED, eating behavior seems more correlated to the psychological functioning typical of psychosomatic disorders. Implications for treatment are discussed.

Assessment of self-reported anger expression in pre- and early-adolescent African Americans: psychometric considerations

This study examined the psychometric properties of the Speilberger state-trait anger expression inventory (STAXI) and Framingham (FAS) anger scales in 86 African American youth. Significant gender differences were not observed for the STAXI or FAS subscales scores (all p>0.17). Inter-scale correlations revealed that the anger-in and anger-out subscales of the STAXI and FAS were measuring similar, yet different constructs. For the STAXI, intra-scale correlations indicated that the anger-in and anger-out subscales were not independent (p<0.001), whereas the anger-in and anger-out subscales (FAS) were not statistically related (p>0.05). The component structures for the anger-control subscale (STAXI) and the anger subscales (FAS) were similar to those reported by the scale authors.