Relationship of trait anger with quality of life and anger control among alcohol users

doi:10.4236/ojpsych.2012.24033

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Open Journal of Psychiatry, 2012, 2, 249-252 OJPsych

http://dx.doi.org/10.4236/ojpsych.2012.24033 Published Online October 2012 (http://www.SciRP.org/journal/ojpsych/)

Relationship of trait anger with quality of life and anger

control among alcohol users

Manoj Kumar Sharma1*, L. N. Suman1, Pratima Murthy2, P. Marimuthu3

1Department of Clinical Psychology, NIMHANS , Bangalore, India

2Centre for Addiction Medicine, Department of Psychiatry, NIMHANS, Bangalore, India

3Department of Biostatistics, NIMHANS, Bangalore, India

Email: [email protected]

Received 14 August 2012; revised 16 September 2012; accepted 27 September 2012

ABSTRACT

Background: Abstinence and anger control are pro-

moted as ways to improve quality of life. Trait anger

has been seen as one casual factor for alcohol related

aggression and poor quality of life. The present study

assesses anger control, quality of life and its relation

with trait anger among alcohol dependents, abstain-

ers & social drinkers. Material & Method: 150 sub-

jects (50 subjects in each group) in the age range of 20 -

45 years were taken for the study. Semi-structured

interview schedule, State-Trait Anger Expression In-

ventory-2, WHOQOL-BREF were administered in in-

dividual setting. Results: De pendent alcohol users and

abstainers reported the significant impact of alcohol

use on family & occupational functioning. Quality of

life has correlation with anger control (in/out), trait

anger, temperament & reaction in the control & ab-

stainers group, whereas quality of life has negative

correlation with trait anger expression among the

alcohol group. Conclusions: Alcohol use has been as-

sociated with the trait anger expression and poor

quality of life. It has implications for promoting alco-

hol abstinence, in improving quality of life and in an-

ger control.

Keywords: Trait Anger; Anger Control; Quality of Life

1. INTRODUCTION

Anger is a social emotion, its expression invariab ly has a

consequences to social relations within a culture or society .

Culture based expectations also influence the expression

and control of anger. Indian participants use more intro-

spective strategies like repression and rational self coping

statements to manage anger provocation than their west-

ern counterparts [1]. Gender and location of participants

also has a significant correlation with the anger expres-

sion inde x [2]. In a study c ompari ng an ger exp ression a n d

control carried out on Iranian and Indian patients (200 in

each group) using state trait anger ex pression inve ntory &

daily hassel ch ecklist. Ira nian m ale student s scored higher

on anger expression index whereas Indian males scored

higher on anger control [3]. Drug users experience anger

more frequently than nonusers and they are more likely to

feel less in control of their angry feelings. They are more

apt to express such anger toward other persons or objects

in their environment [4]. Alcohol interferes with those

processes which are needed to control behaviour and act

in a planful way to achieve the best outcomes in any

situation, namely attention, abstracting relevant informa-

tion, reasoning, problem-solving, planning, and self re-

gulation [5] and one specific set of skills to which these

processes are integral is social prob lem solving [6].

Participants with high trait anger are more prone to use

alcohol and drugs [7]. Trait anger has an association with

aggression among intoxicated men who reported low

level of anger cont rol [8]. Al coh ol use was reporte d more

among people with moderate levels of trait anger [9]. Ab-

stinence, controlled or minimal drinking has positive

impact on quality of life among alcohol users [10].

In a culture like India where abstinence is generally the

desired goal , there is a need to un derstand t he i nfluence o f

alcohol on trait anger, anger control and quality of life.

The present work assesses anger control, quality of life

and its relat ion with t rait anger am ong alco hol depen dents,

life time abstainers and social drinkers.

2. METHODS

2.1. Participants & Procedure

The study was reviewed and approved by the NIM-

HANS Ethics Committee. The total study sample com-

prised 150 subjects in the age range of 20 - 45 years.

Group I consisted of 50 patients with active alcohol de-

pendence drawn from both outpatient and inpatient set-

tings. Grou p II consisted of 50 wh o had been diagnosed of

*Corresponding a uthor.

OPEN ACCESS

M. K. Sharma et al. / Open Journal of Psychiatry 2 (2012) 249-252

250

alcohol dependence b ut currently maintaining abstinence

from alcohol for the last three months. Group III com-

prised of 50 social drinkers (no lifetim e use of more than 2

standard drinks per day). This group was drawn fr om the

community (20 - 45 years of age and gender matched

samples drawn fr om among the hospit al staf f, e ducatio nal

institutions and workplaces using a snowballing ap-

proach). Subjects who had organic disorders, poly sub-

stance use (except ni cot i ne), psychosis or sen s ory deficits

were excluded from the study. Each assessment session

lasted about 30 minutes and all the subjects were assured

of confidentiality.

2.2. Measurement

A Semi-structured interview schedule was developed by

the investigators to obtain information about socio-d emo-

graphic details, information about alcohol use, its rela-

tionshi p wit h a nge r a nd i ts effect s on a n ger c o nt rol . State -

Trait Anger Expression Inventory-2 [11], WHOQOL-

BREF [12] were used .

2.3. Statistical Analysis

It was carried out using percentage of score and factor

analysis.

3. RESULTS

While 76% of social users and 68% of active alcohol

dependent users perceived anger as a negative emotion,

these differences were not statistically significant. A ma-

jority of the dependent users (52%), abstainers (46%)

attributed anger to personal reasons (persisting irritation,

frustration, negative attitude toward the alcohol users, de-

crease communicat ion with others ). 60% of the depe ndent

users and a bstainers experi enced it as having a sig nifi cant

impact on the fam ily (decreas e communication with wife,

frequent fights) and workplace area (loss of job and con-

flict with employers).

Factor analysis was carried out to understand the cor-

related factor in each of the three groups (Ta ble 1 ). An

eigen value greater than 1 was selected for the factor to

be considered and the correlation greater than 0.33 was

considered for the rotated component matrices and the

rotation was done using varimax method. In Table 1,

Columns 1 to 3 is rotated matrix fro m the factor analysis

for the control group. Three factors (trait anger, trait an-

ger reaction and trait anger temperament) are seen to

have a high correlation with total quality of life scores,

the total quality of life alone explains 42.88% of th e vari-

ability of correlatio n and the trait anger correlation (with

anger control in and anger control out) explains 27.02%

and therefore, a total of 69.9% of the variability is ex-

plained by the total quality of life scores and trait anger

in the control group.

Columns 4 to 6 in Table 1 are th e rotated matrix from

the factor analysis for the Abstainers group. Here two

factors (trait anger, trait anger reaction) have a high cor-

relation with total quality of life score, and this explains

the 47.24% of the variability in the correlation. Trait an-

ger is also highly correlated with the three factors (total

quality of score, anger control out, anger control in) wh i c h

explains 24.54% of the variability. Therefore two factors,

viz. the total quality of life sco re and the trait anger score

both explained most of the variability ( 71 . 7 8 %) i n t h e co r -

relation matrix.

For the alcohol dependent group (Columns 6 and 7), it

is only the trait anger reaction score which explain the

correlation with the three variables (that is anger control

out and anger control in and trait anger expression with a

negative correlation). It is the trait anger reaction score

which alone explain almost 50% of variability in the

correlation matrix. If we consider the anger control out

also as a factor. then the total variability explained would

be 73.8%. Since the eigenvalue of the anger control out

is (0.955) less than 1, this factor is not selected for the

further analysis.

4. DISCUSSION

In this study, we found that the quality of life has a po si-

tive correlation with anger control (in/out), trait anger,

temperament and reaction in the control and abstainers

group, whereas quality of life has a negative correlation

Ta b le 1 . Factor analysis for three group controls, abstainers and alcohol (rotated matrix) for quality of life (QUL), trait anger, trait

anger reaction, anger control out, anger control in & trait anger temperament.

Controls Abstainers Alcohol

(1) Total QOL (2) Trait anger (3)Total QOL (4) (5)Trait anger (6)(7) Total QOL (8)

Total QOL Tot QOL 0.412 Tot QOL

Trait anger 0.962 Trait anger 0.918 Trait anger

Trait anger reaction 0.864 Trait anger reaction 0.963 Trait anger reaction –0.584

Anger control out 0.895 Anger control out 0.866 Anger control out 0.845

Anger control in 0.876 Anger control in 0.866 Anger control in 0.827

Trait anger temperament 0.882 Trait anger Temperament Trait anger ex pression –0.507

M. K. Sharma et al. / Open Journal of Psychiatry 2 (2012) 249-252 251

with trait anger expression among the active alcohol de-

pendent user s. Dependent users and abstain ers reported a

significant impact of alcohol use on family and occupa-

tional functioning. This indicates that alcohol use influ-

ences both quality of life and anger control (in/out). Anger

was perceived as negative emotion across the three

groups.

Our findin gs have been c orroborated by other studies as

well. Interactive effect of trait anger and alcohol con-

sumption on anger control was seen in the intoxicated

state. Whereas same relationship was not found between

alcohol consumption and trait anger in the self reported

sober state [13]. Alcohol also exerts proximal effects on

abusive behavior among individuals already prone to

respond to conflict w ith increased anger [14]. Males who

abuse alcohol experience and express more anger than

males who do not abuse alcohol [15]. Alcohol users ex-

perience lower quality of life in comparison to non alco-

hol users [1 6] . Abstinence or moderat e co nsumption also

leads to improved quality o f life [17]. It is also associated

with long term recovery [18]. Longitudinal research has

shown that early impulsivity is associated with both later

offending & problem drinking and it is also related with

poor executive functioning which in turn contributes to

aggressiveness [19]. Thus, in a culture which promotes

abstinence and anger restraint, alcohol use enhances the

expression of trait anger. These finding have implications

for psychoeducating people for abstinence from alcohol,

its role in improving the quality of life as well as for anger

control. Future research in this area shou ld focus on male

and female samples, trait anger expression and its rela-

tionship with alcohol use, resilience to stress, domestic

violence, relation with relapse and psychological comor-

bidity.

5. ACKNOWLEDGEMENTS

Grant agency: Research suppor t from the Center for Addiction Me dicine,

NIMHANS, Hosur Road, Bangalore, Karnataka, India, awarded to Dr.

Manoj Sharma.

Mrs Sowmya, HR, Research Assistant, for data collection & writing

the report.

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