Gabriel Tolentino

BSN135- grp 139

Anger in Early Adolescent Boys and Girls with

Health Manifestations
I. Clinical Question

Which among the five variables of anger(sate anger, trait anger, anger-in, anger
out and anger control) is inversely related to current health, clinical health and
eudaimonistic health of 148 seventh and eight graders, ages 12 to 14 of early adolescent
with 67 boys and 81 girls.

II. Citation

Title: Anger in Early Adolescent Boys and Girls with Health Manifestations

Author: Adela Yarcheski, Noreen E. Mahon, Thomas J. Yarcheski

APA Yarcheski, A., Mahon, N. E., & Yarcheski, T. J. (2002). An empirical test
of alternate theories of anger in early adolescents. Nursing Research, vol. 51, 229-
235.

III.Study Characteristics

Population and Sample

The chronological ages 12 to 14 years represented early adolescence in this study

participating a 148 seventh and eight graders, ages 12 to 14 years; 81 were girls and 67
were boys. About 85% were white; and the remaining 15% were African-American,
Latino, or Asian-American.

Comparison

This study compared differences in five anger variables between boys and girls,
and examined relationships between the anger variables and health variables for boys and
girls separately. By which this study further discussed the different anger variables and
how it can be related to our current and eudaimonistic health considering both sexes. And
which sex is more vulnerable to health problems associated with anger.

Outcomes Monitored:

After approval for the study was granted by the researchers’ university
Institutional Review board, access was gained to an urban middle school located in a
 lower to middle class community. Prior to conducting the study, the principal and seventh
and eight grade teachers reviewed the instrument packets. All agreed that the content and
the reading levels of the instrument were appropriate for seventh and eight graders.

One week prior to testing, all seventh and eight grade students received an
envelope containing an explanation about the study and consent form to bring home to
parents. On the testing date one week later, students who had parental consent and gave
informed consent as well participated in the study, which took place in classrooms. The
students took approximately 20 to 30 minutes to complete the instrument packets which
included a demographic data sheet.

IV. Methodology/Design

Methodology used

The chronological ages 12 to 14 years represented early adolescence in this study

as suggested by Elliott Feldman (1990). The final sample of convenience consisted of
148 seventh and eight graders, ages 12 to 14 years; 81 were girls and 67 were boys.
About 85% were white; and the remaining 15% were African-American, Latino, or
Asian-American. A sample size of 148 subjects was deemed adequate given the number
of variables in the structural equation model tested in the present study.

Instruments

The State Anger and Trait Scales of the State-Trait Expression Inventory
(STAXI) were used to measure the experience and the expression of anger. The STAXI
consists of 44 items; the experience of anger is measured by the 20 items on the state and
trait anger scales. State anger is measured by 10 items with a 4-point summated rating
scale that assess the intensity of anger, or how angry one is feeling right now. Trait anger
is measured by 10 items with a 4-point summated rating scale that assess the frequency of
anger, or how angry one generally feels. The expression scale has 24 items with a 4-point
summated rating scale, which assesses angry feelings.

The general Health rating Index (GHRI) is a 22-item, 5-point, summated rating
scale that measures perceived health status. In this study the current health subscale,
which consists of 9 items, was used to measure current health; scores can range from 9 to
45. Higher scores indicate a more positive perception of current health status.

The clinical conception (CHC) and the Eudaimonistic Health conception (EHC)
substance are two of four substance on the Laffrey health conception scale (LHCS). Each
subscale consists of 7 items scored on a Likert-type format ranging from strongly
disagree (1) to strongly agree (6). Scores can range from 7 to 42 with higher scores
indicating a stronger clinical health conception and/or a eudaimonistic health conception.
Design

Variable- testing study with a complete correlational design.

The hypothesis predicted in the present study were supported in that all
independent variables were statistically, significantly correlated to the different variables
of anger. Descriptive statistics are presented; correlations and variance-covariance
matrices obtained among the five anger variables in the sample of boys and girls are
presented. The variance-covariance matrices were used to examine whether differences in
the experience of anger and expression of anger existed between boys and girls.

Setting

The study was conducted in an urban middle school located in a lower to middle
class community.

Data Source

Primary data sources: 148 seventh and eight graders in early adolescent (12 to 14
years) who answered questionnaires that were measured by the given instrument packets
which include a demographic data sheet.

Study Selection

Inclusion criteria: Adolescents, aged 12 to 14 years participated randomly

selected from the seventh and eighth grade that had parental consent and informed
consent and valid answer.

Exclusion criteria: Adolescents aged 12 to 14 years and above who do not have
parental consent and informed consent and who had invalid answer in the questionnaire.
In addition, all developmental stages above or below the aforementioned developmental
stage.

Has the study been replicated?

The researchers said that the extent to which the health of early adolescents is
compromised over time in relation to various types of anger needs to be studied using
longitudinal designs, whereby health outcomes in relation to anger are studied in boys
and girls separately across adolescence and into adulthood. Much has yet to be learned
about anger in adolescents, especially in terms of the impact of anger in their health and
wellbeing.
 What were the risks and benefits of the nursing action/intervention tested in the
study?

The risks of the nursing action/intervention are not clearly stated in the study. But
the benefits of the nursing action/intervention tested in the study is the expression of
anger is still considered masculine in men and unfeminine in women thus future
assessment regarding anger in early adolescent in both sexes can help the nursing
intervention improved.

V. Result of the study

Descriptive statistics are presented in Table no. 1 correlations and variance

covariance matrices obtained among the five anger variables in the samples of boys and
girls are presented in Table no. 2. The variance-covariance matrices (hereafter referred to
as covariance matrices) were used to examine whether differences in the experience of
anger (state anger and trait anger) and expression of anger existed between boys and
girls.

Table 1. Descriptive statistics for the study variables for boys and girls
Variable Mean (SD) Range
State anger
Boys 18.67 (10.53) 10-40
Girls 15.37 (8.44) 10-40
Trait anger
Boys 22.20 (8.34) 10-40
Girls 22.62 (7.19) 11-37
Anger-in
Boys 16.55 (4.82) 8-28
Girls 17.27 (5.25) 8-32
Anger-out
Boys 18.73 (5.38) 2-29
Girls 18.89 (5.39) 8-31
Anger control
Boys 19.57 (5.28) 10-32
Girls 19.89 (5.17) 8-32
Current health
Boys 33.89 (8.17) 9-45
Girls 31.68 (7.30) 13-45
Clinical Health
Boys 28.74 (7.86) 9-42
Girls 27.52 (6.88) 7-42
Eudaimonistic health
Boys 31.43 (7.12) 15-42
Girls 29.43 (8.28) 7-42

Table 2. correlations*, Variance+, and covariance** matrices for anger variables for boys
(N=67) and girls (N=81) in Descending order
Variable State anger Trait anger Anger-in Anger-out Anger
control
State anger 110.95 0.17ll 0.49ll 0.47ll -.38ll
71.29 0.59 0.46ll 0.52ll -.35ll
Trait anger 63.07 69.48 0.64ll 0.57ll -.37ll
35.82 51.69 0.60ll 0.73ll -.46ll
Anger-in 24.73 25.59 23.25 0.49ll -.22ll
20.16 22.46 27.51 0.38ll -.34ll
Anger-out 26.71 25.40 12.77 28.96 -.36ll
23.82 28.11 10.72 29.05 -.52ll
Anger -21.39 -16.16 -5.55 -10.33 27.92
control -15.15 -16.93 -9.21 -14.56 26.73

*Correlation are in upper right half of the matrix

+Variances are in the diagonal
**Co variances are in the lower half of the matrix
ll<.001

Table 3 presents the Pearson correlations among the five anger variables of current
health, clinical health, eudaimonistic health for boys and girls separately using two-tailed test of
significance.
Table 3. Correlations among anger variables and health variables for boys (N=67) and girls
(N=81)
Variable Current Health Clinical health Eudaimonistic health
State Anger
Boys -.45* -.32 -.46*
Girls -.53* -.34* -.34*
Trait Anger
Boys -.31 -.19 -.33
Girls -.53* -.18 -.32*
Anger-in
Boys -.31 -.13 -.32
Girls -.59* -.09 -.34*
Anger-out
Boys -.43* -.21 -.33
Girls -.29 -.06 -.18
Anger control
Boys .54* .33 .42*
Girls .20 .11 .05
For boys and girls, state anger was inversely related to their current health and
eudaimonistic health; state anger also was inversely related to clinical health for girls. For
girls both trait anger and anger-in were related inversely to their current health and their
eudaimonistic health. For boys anger-out was inversely related to current health, while
anger control was positively related to their current health and eudaimonistic health.

VI. AUTHOR’S CONCLUSION/RECOMMENDATIONS

Much has been written in the literature about the health consequences of anger,
but this is the first study to examine relationships between anger and health variables in
early adolescent boys and girls separately. There are different angers involving different
processes and that these different angers have different consequences to our mental and
physical health, which was assessed by current health status in this study. For both boys
and girls, current health was inversely related to state anger and correlations were
moderately strong.
Several theories have linked anger to psychosomatic disorders and bodily
symptoms. In the present study, the anger variables also were examined in relation to
clinical health, defined as the degree of symptoms experienced in adolescent boys and
girls.
The only statistically significant correlation found was the inverse one between
state anger and clinical health in girls, meaning the higher their state anger, the more
symptoms they reported. This finding is consistent with the one reported by Mahon et al.
(2000) whereby state anger and symptom patterns were positively related in 141 early
adolescent. Overall, the anger variables did not perform in meaningful ways with the
clinical health conception scale, which suggests that the scale may not be sensitive to the
wide array of physiological and physical symptomology that might be experienced in
relation to anger.

VII. Applicability

The study directly answered the clinical question about the different anger
variables affect the health of the early adolescent. It was supported by the different
statistics that shows how the intervention or the study related to current health,
eudaimonistic health and the clinical health. Findings in this study indicate early
adolescent boys and girls do differ in health outcomes in relation to different types of
anger, and it is clear that anger takes its toll on the health of both.

It is feasible to carry out nursing intervention in the real world for the reason that
anger is an emotion that can directly affect an individual’s health. As shown in the study
anger can result in a lot of things and that different angers involves different processes
and that these different angers have different consequences to our mental and physical
health. Anger is an emotion that is considered to be a manifestation of various emotional,
psychological, and physiological disorders that may lead to disorientation and injury.
Early prevention and understanding of this kind of emotion can also prevent further
 complications.

VIII. Reviewer’s Conclusion/Commentary

This study is very significant to each and everyone because we all feel anger at
times thus it tells us that anger can affect directly our physical, mental and physiological
health. And that it only varies on how we manage our anger whether you’re a boy or a
girl. This study is able to show that sex of an individual has an effect on how the
particular individual can actually handle an angry feeling and how to react on it. This
study shows that sex has a factor on how an individual can manage or react to an angry
feeling and that the health problems of it are also different. As different health related
problems associated with different variables of anger different intervention should be
done. Adolescent boys and girls as said in the study can learn to modify their expression
and experience of anger as they advanced developmentally. However, only longitudinal
research can determine changes that might occur in the experience and expression of
anger, measured by the STAXI, for boys and girls from early to middle to late adolescent.
As this need to have a further study for it to be more accurate and also should be done in
some part of the world like Philippines in particular, so we could know if this study also
has a great impact here in our country.