Short Fuses & Bad Tempers: Neurocognitive Insights in Trait Anger
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Marien Lievaart Short Fuses & Bad Tempers: Neurocognitive Insights in Trait Anger Short Fuses & Bad Tempers: Neurocognitive Insights in Trait Anger Marien Lievaart Short Fuses & Bad Tempers: Neurocognitive Insights in Trait Anger Copyright © 2016 D.M. Lievaart Cover design by Robert Kroon Layout by Marien Lievaart Printed by Stout Grafische Dienstverlening v.o.f. ISBN: 978-90-75938-82-1 All rights reserved. No part of this dissertation may be reproduced or transmitted in any form, by any means, electronic or mechanical, without the prior permission of the author, or where appropriate, of the publisher of the articles. The research presented in this dissertation was funded by Antes Mental Health Care. 2 Short Fuses & Bad Tempers: Neurocognitive Insights in Trait Anger Korte lontjes & vaatjes buskruit: Neurocognitieve inzichten in een dispositie tot woede Proefschrift ter verkrijging van de graad van doctor aan de Erasmus Universiteit Rotterdam op gezag van de rector magnificus Prof.dr. H.A.P. Pols en volgens besluit van het College voor Promoties. De openbare verdediging zal plaatsvinden op 9 september om 11.30 door Marien Lievaart geboren te Maassluis 3 Promotiecommissie Promotoren Prof. dr. Johannes E. Hovens Prof. dr. Ingmar H.A. Franken Overige leden van de commissie Prof. mr. dr. Eric Rassin Prof. dr. Jan W. van Strien Prof. dr. Henk Nijman Copromotoren Dr. Frederik M. Van der Veen Dr. Jorg Huijding 4 Promotiecommissie Contents Chapter One 7 Promotoren Prof. dr. Johannes E. Hovens General introduction Prof. dr. Ingmar H.A. Franken Chapter Two 35 Overige leden van de commissie Anger Assessment in Clinical and Nonclinical Populations: Prof. mr. dr. Eric Rassin Further Validation of the State-Trait Anger Expression Inventory-2 Prof. dr. Jan W. van Strien Prof. dr. Henk Nijman Chapter Three 61 Trait Anger in Relation to Neural and Behavioral Correlates of Copromotoren Response Inhibition and Error-Processing Dr. Frederik M. Van der Veen Dr. Jorg Huijding Chapter Four 83 The Relation between Trait Anger and Impulse Control in Forensic Psychiatric Patients: An EEG Study Chapter Five 103 The Impact of Angry Rumination on Anger-Primed Cognitive Control Chapter Six 125 Does Mental Fatigue Have an Impact on Anger and Refusal to Cooperate Following Provocation Chapter Seven 145 Summary, Discussion, and Concluding Remarks References 169 Nederlandse Samenvatting (Summary in Dutch) 193 Dankwoord (Acknowledgements in Dutch) 217 Publications 225 Curriculum Vitae 229 4 5 6 . Chapter One General introduction 6 7 Chapter One A frustrated father who suddenly snaps and hits his child after several previous warnings. A previous loyal coworker who suddenly remains absent for several days at work due to disagreement with his boss. A married couple giving each other the silent treatment after repeated arguments. A usually reasonable man erratically flipping the bird after being cut off on the road. A war veteran resenting the army and harboring grudges after losing his legs and multiple friends after stepping on a landmine. A once beloved partner that gets killed after suspected infidelity. These short vignettes described above, illustrate the variety of situations that can lead to and behavioral outcomes that can result from an emotion we are all familiar with, yet understand little about: anger1. Anger, in short, can be defined as “an emotional state that varies in intensity from mild irritation to intense fury and rage” (Spielberger, 1999 p. 1). Although little understood, its link with adverse outcomes is evident, making the understanding of anger a valuable enterprise. There is especially a need to better understand the key factors underlying a disposition towards anger, as individuals scoring high on this personality trait have impairments in their day-to-day functioning. To this purpose, the current thesis investigates the (neuro)cognitive aspects underlying anger and a disposition towards anger (i.e., trait anger). Before reviewing existing research on trait anger and its underpinnings in more detail, we first focus on anger as an emotional state. This is followed by a paragraph devoted to describing the clinical relevance of the construct trait anger in more detail. Next, a paragraph in which definitions and distinctions regarding constructs related to trait anger will be reviewed. Finally, cognitive models with respect to trait anger and reactive aggression will be discussed and an overview of the current thesis will be provided. 1 DiGiuseppe and Trafrate (2010) highlight the scarcity of research around this topic and its neglect in clinical practice as evidenced by an absence of diagnostic categories for anger disorders, making it a challenging construct to define. Note that the intermittent explosive disorder has its main focus on aggressive behavior rather than anger. 8 General introduction A frustrated father who suddenly snaps and hits his child after several previous warnings. A 1.1. Anger defined: its origins and its consequences previous loyal coworker who suddenly remains absent for several days at work due to Anger is an emotion that is part of everyday live. Together with happiness, sadness and fear, disagreement with his boss. A married couple giving each other the silent treatment after anger is considered to be a basic emotion that is innate and universal to all humans (Ekman, repeated arguments. A usually reasonable man erratically flipping the bird after being cut 1999; Panksepp, 1998; Strongman, 2003)2. Diary studies conducted in community samples 1 off on the road. A war veteran resenting the army and harboring grudges after losing his show that people report to experience and express mild to moderate anger from several legs and multiple friends after stepping on a landmine. A once beloved partner that gets times daily to at least several times a week (Averill, 1983; Kassinove, Sukhodolsky, Tsytsarev, killed after suspected infidelity. & Solovyova, 1997; Meltzer, 1933; Schieman, 2010; Tafrate, Kassinove, & Dundin, 2002). These short vignettes described above, illustrate the variety of situations that can Most of these angry episodes involve significant persons in our live that we love, like or rely 2 lead to and behavioral outcomes that can result from an emotion we are all familiar with, on (Averill, 1983; Schieman, 2010). Anger can be elicited by a broad range of triggers of yet understand little about: anger1. Anger, in short, can be defined as “an emotional state which perceived threats (to the self or to those one feels related to), deliberate harm- that varies in intensity from mild irritation to intense fury and rage” (Spielberger, 1999 p. 1). doings, disrespect, insults, injustice, unwanted actions of other people, and norm or rule Although little understood, its link with adverse outcomes is evident, making the violations are the most common (Potegal & Novaco, 2010). Especially in situations where 3 understanding of anger a valuable enterprise. There is especially a need to better triggers are appraised as preventable and intentional anger arises. Novaco (2011) also understand the key factors underlying a disposition towards anger, as individuals scoring points out the intrinsic role threat perceptions play in the activation of anger. In line with high on this personality trait have impairments in their day-to-day functioning. To this this notion, it is found that the neurobiological threat system (amygdala, hypothalamus, and purpose, the current thesis investigates the (neuro)cognitive aspects underlying anger and a periaqueductal gray) becomes activated in conditions that elicit anger (Blair, 2012). Like disposition towards anger (i.e., trait anger). Before reviewing existing research on trait anger other emotions, the intensity of anger is experienced on a continuous scale, ranging from 4 and its underpinnings in more detail, we first focus on anger as an emotional state. This is mild forms of anger (e.g., irritation and annoyance) to severe forms (e.g., fury and rage)3, followed by a paragraph devoted to describing the clinical relevance of the construct trait and is usually short-lived (Potegal & Qiu, 2010). Typically, anger episodes last around five up anger in more detail. Next, a paragraph in which definitions and distinctions regarding till fifteen minutes (Potegal & Qiu, 2010). However, angry rumination and thoughts of constructs related to trait anger will be reviewed. Finally, cognitive models with respect to revenge can prolong the timecourse of anger substantially (Novaco, 2011). Moreover, angry 5 trait anger and reactive aggression will be discussed and an overview of the current thesis feelings can be experienced over longer period of times (from several hours up till several will be provided. days) in less intense forms as well, often referred to as an angry mood (Fernandez, 2013). 6 2 Although anger is considered to be a basic emotion that is universally expressed and recognized, the behavioural expression of anger at the same time is also evidently culturally modified, sometimes even cultural-specific, and governed by display rules (Matsumoto et al., 2010). Constructivists go as far as to suggest that anger is “a role or a socially constructed, reinforced behavioural script that we learn to play” (Kassinove & Tafrate, 2002, 1 DiGiuseppe and Trafrate (2010) highlight the scarcity of research around this topic and its p. 16) and consider anger a fuzzy concept (Russell & Fehr, 1994) that cannot be defined with 7 neglect in clinical practice as evidenced by an absence of diagnostic categories for anger absolute certainty. disorders, making it a challenging construct to define. Note that the intermittent explosive 3 Note that we conceptualize anger here as a single construct that can vary in intensity disorder has its main focus on aggressive behavior rather than anger. rather than qualitatively differentiating between forms of anger. 8 9 Chapter One Anger as an emotional state is a multidimensional construct with its own distinct physiological and neurophysiological responses, sensations, feelings, cognitions, and action tendencies (DiGiuseppe & Tafrate, 2010). Phenomenologically, anger is often experienced as a “hot” emotion (Stemmler, 2010), i.e. feeling warm bodily sensations.