Assessing Anger Expression: Construct Validity of Three Emotion Expression-Related Measures

Autistic Traits and Aggressive Behavior in Chinese College Students: A Serial Mediation Model and the Gender Difference

Background

The existence of aggressive behavior in autism spectrum disorders (ASD) raises questions about whether cognitive and emotional factors in social information processing play a role between autistic traits (ATs) and aggressive behavior in the general population, especially in the context of Chinese culture. Moreover, given a possible gender difference in these variables, the study aimed to examine the effect of ATs on aggressive behavior, and the potential mediating role of hostile attribution bias and alexithymia on this association, as well as gender difference.

Methods

850 Chinese college students participated in the assessment, including their ATs, hostile attribution bias, alexithymia, and aggressive behavior. Pearson correlation, mediation effects analyses, and multiple-group comparison were conducted.

Results

The results indicated that ATs indirectly predicted increased aggressive behavior through attribution bias and alexithymia. Gender difference in mediating effects was revealed: ATs indirectly predicted increased aggressive behavior through the serial mediating effect only in males.

Conclusion

Hostile attribution bias and alexithymia completely mediated the association between ATs and aggressive behavior, which contained the separate mediating effects of (a) hostile attribution bias and (b) alexithymia and the serial mediating effect of (c) hostile attribution bias and alexithymia. Gender differences in mediating effects were found only in the serial mediating effect, which was significant in males but not in females. The findings revealed the internal mechanism of ATs affecting aggressive behavior and gender difference, which have implications for the intervention of aggressive behavior of individuals with autism and those with high levels of ATs.

Gender differences in aggression: A multiplicative function of outward anger expression

Individuals with a higher (vs. lower) tendency to outwardly express anger (i.e., greater anger-out) generally exhibit greater aggression; men (vs. women) also tend to be more aggressive. Although the general aggression model posits that multiple person variables trigger aggression, the combined effects of multiple person variables are poorly understood. Thus, the aim of this study was to examine the nature of the relation between gender, anger-out, and reactive aggression. In particular, we were interested in whether the effects of anger-out and gender are additive or multiplicative. Specifically, we tested whether men exhibit higher levels of aggression than women at a consistent ratio across all levels of anger-out (i.e., the multiplicative model) or at a fixed amount depending on the level of anger-out (i.e., the additive interaction model). To this end, undergraduate participants (N = 203) completed a task in which they were falsely instructed that their objective was to respond more quickly than a same-sex opponent. They were told that whoever responded more quickly would administer a white noise burst to the opponent and choose its intensity, which served as our measure of aggression. Compared to an additive interaction model, the multiplicative model exhibited a better fit. Specifically, men displayed proportionately more aggression than women with the same level of anger-out. Research on and treatment for aggression should consider the multiplicative effects of factors related to aggression.

Specificity in Associations of Anger Frequency and Expression With Different Causes of Mortality Over 20 Years

OBJECTIVE

Although evidence has linked anger and hostility with all-cause mortality risk, less research has examined whether anger frequency and expression (outwardly expressing angry feelings) are linked to all-cause and cause-specific mortality.

METHODS

In 1996, men (n = 17,352) free of medical conditions from the Health Professionals Follow-Up Study reported anger frequency and aggressive expression levels. Deaths were ascertained from participants' families, postal authorities, and death registries. Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality risk until 2016 with a 2-year lag, adjusting for a range of relevant covariates.

RESULTS

There were 4881 deaths throughout follow-up. After adjustment for sociodemographics and health status, moderate and higher (versus lower) levels of anger frequency and aggressive expression were generally unrelated to the risk of death from all-cause, neurological, or respiratory diseases. However, cardiovascular mortality risk was greater with higher anger frequency (HR = 1.17, 95% CI = 1.01-1.34), whereas cancer mortality risk was greater with higher anger expression (HR = 1.14, 95% CI = 0.98-1.33). Results were similar after including all covariates and stronger when considering anger expression's interaction with frequency.

CONCLUSIONS

In this cohort of men, experiencing angry feelings and expressing them aggressively were related to an increased risk of dying from cardiovascular disease and cancer but not from other specific causes, over two decades. These results suggest that not only the experience of negative emotions but also how they are managed may be critical for some but not all health outcomes, highlighting the importance of considering causes of death separately when investigating psychosocial determinants of mortality.

Emotional approach coping among young adults with cancer: Relationships with psychological distress, posttraumatic growth, and resilience

OBJECTIVE

Cancer, particularly, during young adulthood, can evoke difficult emotions, interfere with normative developmental activities, and challenge coping responses. Emotion-regulating coping efforts aimed at active emotional processing (EP) and emotional expression (EE) can be beneficial to cancer adjustment and perceptions of positive growth. However, it may be that EP and EE work differently to influence well-being. This study examines relationships of EP and EE with psychological distress, posttraumatic growth (PTG), and resilience. We expect that EP will be positively associated with PTG and resilience, whereas EE will be negatively associated with psychological distress.

METHODS

Young adults with cancer (M age  = 34.68, N = 57) completed measures of emotional; approach coping (EP and EE), psychological distress (depressive symptoms, fear of cancer; recurrence [FCR]) and indicators of positive adjustment and growth (resilience and PTG).

RESULTS

Greater use of EP was associated with higher resilience (β = 0.48, p = 0.003) and PTG (β = 0.27, p = 0.05), whereas greater use of EE was associated with lower resilience (β = -0.33, p = 0.04). The EE × EP interaction was significant for FCR (β = 0.29, p = 0.04) such that low EE was associated with lower FCR in those with high EP. Interaction effects were not significant for depressive symptoms, resilience, or PTG.

CONCLUSIONS

Findings highlight differing relationships between EP and EE among young adults with cancer. Interventions aimed at increasing emotion-regulating coping strategies may prove useful in facilitating positive adjustment and growth, strengthening young adults' ability to cope with the diverse effects of disease, treatment, and survivorship.

Alexithymia in individuals with chronic pain and its relation to pain intensity, physical interference, depression, and anxiety: a systematic review and meta-analysis

Numerous studies have examined how alexithymia (difficulty identifying and describing one's emotions and a preference for externally oriented thinking) relates to chronic pain and associated disability. We conducted a systematic review and meta-analysis to summarize individual studies that either assessed alexithymia in individuals with chronic pain vs controls or related alexithymia to pain intensity, physical interference, depression, and anxiety. We searched MEDLINE, Embase, and PsycINFO from inception through June 2017; 77 studies met the criteria (valid assessment of alexithymia in adults or children with any chronic pain condition) and were included in analyses (n = 8019 individuals with chronic pain). Primary analyses indicated that chronic pain samples had significantly higher mean alexithymia scores compared with nonclinical (d = 0.81) and clinical nonpain (d = 0.55) controls. In chronic pain samples, alexithymia was significantly positively associated with pain intensity (d = 0.20), physical interference (d = 0.17), depression (d = 0.46), and anxiety (d = 0.43). Secondary meta-analyses of 14 studies that conducted partial correlations that controlled for negative affect-related measures revealed that alexithymia was no longer significantly related to pain intensity or interference. Meta-analysis findings demonstrated that alexithymia is elevated in individuals with chronic pain and related to greater pain intensity and physical interference, although the latter relationships may be accounted for by negative affect. Critical future work is needed that examines alexithymia assessed using non-self-report measures, develops a person-centered perspective on this construct, and identifies how alexithymia is relevant to the assessment and treatment of individuals with chronic pain.

Validation of a Questionnaire for Personality Profiling using Cognitive Diagnostic Modeling

This article describes the development of the ENCUIST (Extroversion, Neuroticism, Callous-Unemotional, Instability, Short-Test) questionnaire, which has been created to provide a personality profiling method based on a cognitive diagnostic modeling framework. The ENCUIST measures the attributes of extroversion, neuroticism, callous unemotionality and overt expressions of anger that are relevant in a forensic context. The scores provided by the ENCUIST are binary classifications of the individuals (high/low) in these attributes. The ENCUIST was developed using a sample of 516 subjects to study its validation through psychometric procedures, including factor analysis, cognitive diagnostic modeling and structural equation modeling. The results supported a four-factor structure. Linear regressions were used to evaluate the predictive validity of the scores provided by ENCUIST with respect to two external criteria that are relevant in the forensic context, namely behavioral activation and behavioral inhibition. The results showed that the extroversion dimension is positively related to behavioral activation, although the effect size is modest and the proportion of explained variance is only 11%. Moreover, the dimensions of neuroticism and anger expression are positively related to behavioral inhibition, with 7% of the variance explained. Together, these results suggest that cognitive diagnostic models are useful tools for the elaboration of personality profiles based on classifying subjects along binary attributes.