Objectives: People express themselves through language that includes but extends beyond words. The objective of this study was to explore adolescent anger expression through words, blood pressure (BP), and hostility by examining the: 1) relationship of BP with angry words recorded simultaneously as adolescents talked about a time when they felt angry; 2) relationship of talking-about-anger BP with hostility and 3) contexts shared in descriptions of anger. The adolescent voice of anger may be instructive, as efforts are made to reach adolescents to curtail angry tendencies and promote health.
Design: The design has correlational and descriptive components. The correlational component examined two relationships: 1) words-used to describe anger with simultaneously recorded BP and 2) hostility with BP during talking. The descriptive component used content analysis to examine the context for angry words used by adolescents. This was a secondary analysis of a subset of existing data, which were collected to examine BP and anger in urban adolescents.
Sample & Setting: Data were collected in a large city in Southern United States. Testing occurred in a quiet room in the adolescent’s school. The sample included 34 males and 38 females, whose average age was 13 (+ 1.3) years. Fifty percent of the participants were African-American; 22% were Hispanic; 22% were Anglo-American and 6% represented other ethnic minorities.
Variables Studied: BP during talking about anger, angry words used in descriptions of anger, and hostility.
Methods: BP was recorded with a Dinamap 1846 SX automatic monitor twice during each of three periods [quiet (4 minutes) – talking about anger (2 minutes) – quiet (4 minutes)]. Average talking BP was used for this analysis. Talking was audiotape-recorded. Descriptions of anger were transcribed and analyzed with Linguistic Inquiry and Word Count (LIWC), a text analysis software which groups words into categories, such as the anger category used in this analysis. The anger category includes 121 words or word stems, expressive of angry feelings. The LIWC program reports the percentage of angry words-used relative to all words-used by a subject. The BP–angry word-use relationship was analyzed using a Spearman-Rho correlation. A 27-item adolescent version of the Cook-Medley scale was used to measure hostility. High hostility is indicated with a lower score on the measure. Alpha reliability of the scale was .79. Content analysis combined inductive and deductive approaches to examine the contexts for use of angry words.
Findings: Hostility was related to systolic BP (r=-.26; p < .05) and diastolic BP (r=-.31; p < .01) during talking. Angry word-use was negatively correlated with diastolic BP during talking (r=-.25, p < .05). “Mad” was used by the majority (63%) of subjects. It was the only angry word used, often repeatedly, for 24 subjects. Twenty-one additional subjects used a combination of “mad” with other angry words, such as “pissed”, “punish”, “jealous”, and “ticked”. Ten subjects used no angry words while describing a time of feeling angry. Content analysis indicated that the contexts for angry words centered on relationships with peers, parents and teachers and included the themes of wrongful accusation, felt-aggression, abandonment, self-evaluated failure and authority-imposed limits. Examples from the descriptions of the 10 subjects who used no angry words included: dad’s death 4 years prior; unexpected sharing of a family secret, which had been told in confidence; and being overlooked for a basketball game by cousins year after year.
Conclusions: Higher trait hostility may predispose adolescents to higher BP when talking about anger. Disclosure of anger with anger words may enable an experience of “letting go” of burdensome feelings, which would explain the lower diastolic BP with more frequent use of anger words. Adolescents predominantly used one anger word (mad), when describing situations of anger. Addition of adolescent-chosen anger words to the LIWC anger dictionary is worth consideration. The ten subjects who described anger without angry words demand special attention to determine their talking BP and hostility levels. Anger occurred in relationship with important others and focused on experiences of enduring transgression (wrongful accusation and felt-aggression) and loss (abandonment, self-evaluated failure and authority-imposed limits).
Implications: It is beneficial to listen for the use of appropriate feeling words when talking to adolescents about what makes them mad. Further research on BP, relative to the match between word-use and angry feelings is warranted; predisposition to hostility may provide further insight. Evaluation of the complex voice of adolescent anger has implications for the personal health of adolescents and provides rudimentary understanding of angry tendencies, which may threaten adolescent health.
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