The experience and expression of anger in posttraumatic stress disorder: the relationship with metacognition

Abstract

Background: Anger experience and expression are a common issue in those experiencing PTSD. However, it remains unclear what variables affect anger and its expression in PTSD.

Aims: To explore the relationships of synthetic forms of metacognition and metacognitive beliefs with anger experience and expression in PTSD, independent of the effects hyperarousal and depression symptoms.

Method: Participants were 51 veterans with diagnosed with PTSD. Metacognition was assessed using the Metacognition Assessment Scale-Abbreviated (MAS-A) and the Metacognitions Questionnaire (MCQ). Depression, PTSD symptom severity, and seven domains of anger expression were also assessed.

Results: Correlations showed after controlling for overall levels of hyperarousal, higher MAS-A total scores were related to lower levels of State Anger, Feeling Angry, Expressing Anger Physically, and Anger Expression in. Lower MCQ scores were related to lower State anger, Expressing anger verbally, and Expressing anger physically. Higher levels of depression were related to higher levels of Trait anger, Expressing anger physically, Anger expression out, and Anger expression in. Multiple regressions suggested that the MAS-A and MCQ predicted unique portions of the variance in anger experience and expression.

Conclusions: Metacognitive deficits may affect anger experience and expression in those with PTSD and may be an important treatment target.

Keywords:

• Posttraumatic stress disorder
• anger
• metacognition
• depression
• hyperarousal
• hostility

Declaration of interest

No potential conflict of interest was reported by the authors.

This research was supported in part by a grant from the VA Rehabilitation Research and Development Service 10.13039/100000738 [VA RR&D B7571N].