Journal of Traumatic Stress

, Volume 10, Issue 1, pp 17–36 | Cite as

Anger Regulation Deficits in Combat-Related Posttraumatic Stress Disorder

  • Claude M. Chemtob
  • Raymond W. Novaco
  • Roger S. Hamada
  • Douglas M. Gross
  • Gary Smith


We describe a typology of regulatory deficits associated with anger in combat-related posttraumatic stress disorder (PTSD). Cognitive, arousal, and behavioral domain deficits in anger regulation were observed clinically in PTSD patients with high levels of anger who were participating in a multi-year trial of a structured anger treatment. We also describe a category of patients whose anger type we have termed “ball of rage.” These patients exhibit regulatory deficits in all three domains of anger regulation. We offer a conceptual framework to advance the understanding of anger associated with PTSD and to guide its effective treatment.

anger regulatory deficits combat-related PTSD 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Averill, J. (1982). Anger and aggression: An essay on emotion. New York: Springer-Verlag.Google Scholar
  2. Bandura, A. (1983). Psychological mechanisms of aggression. In R. G. Green & E. I. Donnerstein (Eds.), Aggression: Theoretical and empirical reviews (Vol. 1, pp. 1–40). New York: Academic Press.Google Scholar
  3. Bandura, A. (1973). Aggression: a social learning analysis. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  4. Berkowitz, L. (1990). On the formation and regulation of anger and aggression. American Psychologist, 45, 494–503.Google Scholar
  5. Berkowitz, L. (1993). Aggression: Its causes, consequences, and control. New York: McGraw-Hill.Google Scholar
  6. Blake, D. D., Nagy, L. M., Kaloupek, D. G., Klauminzer, G., Charney, D. S., & Keane, T. M. (1990). A clinician rating scale for assessing current and lifetime PTSD: The CAPS-I. The Behavior Therapist, 187–188.Google Scholar
  7. Chemtob, C. M., Roitblat, H. L., Hamada, R. S., Carlson, J. G., & Twentyman, C. T. (1988). A cognitive action theory of post-traumatic stress disorder. Journal of Anxiety Disorders, 2, 253–275.Google Scholar
  8. Chemtob, C. M., Hamada, R. S., Roitblat, H. L., & Muraoka, M. (1994). Anger, anger control, and impulsivity in combat related post traumatic stress disorder. Journal of Consulting and Clinical Psychology, 62, 827–832.Google Scholar
  9. Chemtob, C. M., Novaco, R. N., Hamada, R., & Gross, D. (in press). Cognitive-behavioral treatment of severe anger in posttraumatic stress disorder. Journal of Consulting and Clinical Psychology.Google Scholar
  10. Hamilton, V., & Warburton, D. M. (1979). Human stress and cognition: An information processing approach. New York: Wiley.Google Scholar
  11. Hokanson, J. E., & Shelter, S. (1961). The effects of overt aggression on physiological arousal level. Journal of Abnormal and Social Psychology, 63, 446–448.Google Scholar
  12. Keane, T. M., Caddell, J. M., & Taylor, K. L. (1988). Mississippi Scale for Combat-Related Posttraumatic Stress Disorder: Three studies in reliability and validity. Journal of Consulting and Clinical Psychology, 56, 85–90.Google Scholar
  13. Konecni, V. J. (1975a). Annoyance, type, and duration of post-annoyance activity, and aggression: The ‘cathartic effect.’ Journal of Experimental Psychology: General, 104, 76–102.Google Scholar
  14. Konecni, V. J. (1975b). The mediation of aggressive behavior: Arousal level versus anger and cognitive labeling. Journal of Personality and Social Psychology, 32, 706–712.Google Scholar
  15. Kulka, R. A., Schlenger, W. E., Fairbank, J. A., Hough, R. L., Jordan, B. K., Marmar, C. R., & Weiss, D. S. (1990). Trauma and the Vietnam war generation. New York: Brunner/Mazel.Google Scholar
  16. Lang, P. J. (1979). A bio-informational theory of emotional imagery. Psychophysiology, 16, 495–512.Google Scholar
  17. Lasko, N. B., Gurvits, T. V., Kuhne, A. A., Orr, S. P., & Pitman, R. K. (1994). Aggression and its correlates in Vietnam veterans with and without chronic posttraumatic stress disorder. Comprehensive Psychiatry, 35, 373–381.Google Scholar
  18. Lund, M., Foy, D., Sipprelle, C., & Strachan, A. (1984). The Combat Exposure Scale: A systematic assessment of trauma in the Vietnam war. Journal of Clinical Psychology, 40, 1323–1328.Google Scholar
  19. Novaco, R. W. (1975). Anger control: The development and evaluation of an experimental treatment. Lexington: D.C. Heath.Google Scholar
  20. Novaco, R. W. (1976). The function and regulation of the arousal of anger. American Journal of Psychiatry, 133, 1124–1128.Google Scholar
  21. Novaco, R. W. (1986). Anger as a clinical and social problem. In R. Blanchard & C. Blanchard (Eds.), Advances in the study of aggression, Vol. 2. New York: Academic Press.Google Scholar
  22. Novaco, R. W. (1994). Anger as a risk factor for violence among the mentally disordered. In J. Monahan & H. Steadman (Eds.), Violence and mental disorder: Developments in risk assessment (pp. 21–56). Chicago: University of Chicago Press.Google Scholar
  23. Rosenheck, R., Fontana, A., Spencer, H., & Errera, P. Manual for War Stress Interview. Northeast Program Evaluation Center: Department of Veterans Affairs.Google Scholar
  24. Scurfield, R. M., Corker, T. M., & Gongla, P. A. (1984). Three post-Vietnam “rap/therapy” groups: An analysis. Group, 8, 3–21.Google Scholar
  25. Spitzer, R. L., Williams, J. B., & Gibbon, M. (1989, Sept.). Structured Clinical Interview for DSM-III-R, nonpatient Vietnam version (SCID-NP). Biometrics Research Department: New York State Psychiatric Institute.Google Scholar
  26. Zillmann, D. (1971). Excitation transfer in communication-mediated aggressive behavior. Journal of Experimental Social Psychology, 7, 419–434.Google Scholar
  27. Zillmann, D. (1983). Arousal and aggression. In R. Geen & E.I. Donnerstein (Eds.), Aggression: Theoretical and empirical reviews (pp. 75–101). New York: Academic Press.Google Scholar

Copyright information

© International Society for Traumatic Stress Studies 1997

Authors and Affiliations

  • Claude M. Chemtob
    • 1
  • Raymond W. Novaco
    • 2
  • Roger S. Hamada
    • 3
  • Douglas M. Gross
    • 1
  • Gary Smith
    • 1
  1. 1.Department of Veterans AffairsHonolulu
  2. 2.University of CaliforniaIrvine
  3. 3.Kapiolani Medical CenterHonolulu

Personalised recommendations