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روان شناسی و مشاوره::
ابراز خشم
The behavioral dimension is anger expression, referring to tendencies to be verbally or physically antagonistic.
as did 1 of 3 studies for trait anger33 and 5 of 9 studies for anger expression.34,12,35-37 Another 2 of 9 studies were positive for subsamples: one for women only,38 and one for 48- to 59-year-olds only.39 In populations with known CHD (15 reports, of which 14 assessed fatal or nonfatal MI), only 1 of 6 had positive results for cynical hostility,40 2 of 3 (one of those marginal) for trait anger,41,42 and 2 of 6 for anger expression.43,44 Suls and Bunde25 concluded that the effects of hostility, trait anger, and anger expression were difficult to identify or might not apply in all populations, and that results in patient samples were "very weak and inconsistent with respect to anger, hostility, and anger expression" (p. 284).
A meta-analysis assessed the association between anger, hostility, and anger expression and CHD in prospective studies.45 Twenty-five studies reported CHD outcomes in initially healthy populations and 19 studies with CHD samples.45 The hazard ratio of 1.19 (95% CI: 1.05 to 1.35) indicated greater risk of CHD events associated with higher anger/hostility/expression in the healthy population studies.
Both qualitative and quantitative reviews seem to agree that effects of anger, hostility and anger expression are mixed and when an association is significant it tends to be relatively modest in magnitude.
In a ten-year, prospective observational study conducted in Nova Scotia, constructive anger expression, destructive anger justification and destructive anger rumination (see description above) were assessed in a random sample of 800 men and women from middle- to old age.23 Even after adjusting for traditional risk factors, lower constructive anger scores in men and increased destructive anger justification in both sexes predicted increased risk of 10-year incident CHD.
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