Skip to main content
SpringerLink
Log in

Response categories and anger measurement: do fewer categories result in poorer measurement?

Development of the DAR5

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Background

Anger is a key long-term outcome from trauma exposure, regardless of trauma type, and it is implicated as a moderator of response to treatment. It therefore seems important that anger is assessed in both epidemiological studies of trauma sequelae and in intervention evaluation research. This study explored the measurement properties of a recently investigated anger scale, the Dimensions of Anger Reactions (DAR) Scale. In our previous study, the DAR was found to be a measure of trait anger, but although brief, the nine response categories per item may have confused respondents, suggesting fewer response categories may work equally well. Additionally, our previous analysis suggested there were two redundant items within the DAR.

Methods

Three samples of Australian veterans were used to investigate the psychometric properties associated with alterations to the response categories of the DAR; veterans who participated in the DAR validation study, those participating in group therapy programmes for post-traumatic stress disorder, and veterans participating in lifestyle programmes. Item response theory analysis was used to explore the internal properties of competing DAR models, and models were assessed against external criteria.

Results

The results showed that the number of item responses in the DAR exceeded channel capacity, and that response bias occurred in the second half of the instrument. We hypothesized that this was due to respondents not discriminating among the many response categories. Based on a modelling exercise in which we reduced the number of DAR items from 7 to 5 and the number of response categories from 9 to 5, validation tests showed that there was no loss of sensitivity, reliability or validity. To avoid confusion with the DAR, we have referred to the revised version of the DAR as the DAR5.

Conclusions

We conclude that the DAR5, which abbreviates the original DAR to half its original length, has similar psychometric properties and is therefore to be preferred especially for use with persons who are under stress, cognitively impaired or less mature. The study findings regarding the optimum number of response categories have implications for the development of other instruments.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Notes

  1. Sources were derived from Refs. [29] and [46]

References

  1. Anastasi A (1976) Psychological testing. Macmillan, New York

    Google Scholar 

  2. Andrews B, Brewin CR, Rose S, Kirk M (2000) Predicting PTSD symptoms in victims of violent crime: the role of shame, anger, and childhood abuse. J Abnorm Psychol 109:69–73

    Article  CAS  PubMed  Google Scholar 

  3. Andrich D (1978) A rating formulation for ordered response categories. Psychometrika 43:561–573

    Article  Google Scholar 

  4. Babor T, de la Fuente J, Saunders J, Grant M (1989) AUDIT—the alcohol use disorders. World Health Organisation Division of Mental Health, Geneva, pp 1–23

    Google Scholar 

  5. Basoglu M, Jaranson JM, Mollica R, Kastrup M (2001) Torture and mental health. In: Gerrity E, Keane TM, Tuma F (eds) The mental health consequences of torture. Kluwer/Plenum, New York, pp 35–62

    Google Scholar 

  6. Beckham JC, Moorea SD, Reynolds V (2000) Interpersonal hostility and violence in Vietnam combat veterans with chronic posttraumatic stress disorder: a review of theoretical models and empirical evidence. Aggress Violent Behav 5:451–466

    Google Scholar 

  7. Beckham JC, Vrana SR, Barefoot JC, Feldman ME, Fairbank J, Moore SD (2002) Magnitude and duration of cardiovascular responses to anger in Vietnam veterans with and without posttraumatic stress disorder. J Consult Clin Psychol 70:228–234

    PubMed  Google Scholar 

  8. Berwick D, Murphy J, Goldman P, Ware J, Barsky A, Weinstein M (1991) Performance of a five-item mental health screening test. Med Care 29:169–176

    CAS  PubMed  Google Scholar 

  9. Biddle D, Creamer M, Forbes D, Elliott P, Devilly G (2002) Self-reported problems: a comparison between PTSD-diagnosed veterans, their spouses, and clinicians. Behav Res Ther 40:853–865

    CAS  PubMed  Google Scholar 

  10. Blake D, Weathers F, Nagy L, Kaloupek D, Klauminzer G, Chamey D, Keane T (1990a) Instruction manual: Clinician Administered PTSD Scale (CAPS). National Centre for Posttraumatic Stress Disorder, Boston

    Google Scholar 

  11. Blake D, Weathers F, Nagy L, Kaloupek D, Klauminzer G, Charney D, Keane T (1990b) A clinician rating scale for assessing current and lifetime PTSD: the CAPS-1. Behav Ther 13:187–188

    Google Scholar 

  12. Blaszczynski A, Gordon K, Silove D, Sloane D, Hillman K, Panasetis P (1998) Psychiatric morbidity following motor vehicle accidents: a review of methodological issues. Compr Psychiatry 39:111–121

    Article  CAS  PubMed  Google Scholar 

  13. Bullinger M, Alonso J, Apolone G, Leplège A, Sullivan M, Wood Dauphinee S, Gandek B, Wagner A, Aaronson N, Bech P, Fukuhara S, Kaasa S, Ware JE Jr (1998) Translating health status questionnaires and evaluating their quality: the IQOLA Project approach. International Quality of Life Assessment. J Clin Epidemiol 51:913–923

    Article  CAS  PubMed  Google Scholar 

  14. Chemtob CM, Hamada RS, Roitblat HL, Muraoka MY (1994) Anger, impulsivity, and anger control in combat-related posttraumatic stress disorder. J Consult Clin Psychol 62:827–832

    CAS  PubMed  Google Scholar 

  15. Chibnall JT, Duckro PN (1994) Post-traumatic stress disorder in chronic post-traumatic headache patients. Headache 34:357–361

    Article  CAS  PubMed  Google Scholar 

  16. Cohen J (1988) Statistical power analysis for the behavioural sciences. Erlbaum, Hillsdale

    Google Scholar 

  17. Conigrave K, Hall W, Saunders J (1995) The AUDIT questionnaire: choosing a cut-off score. Addiction 90:1349–1356

    CAS  PubMed  Google Scholar 

  18. Day NA, Dunt DR, Day S (1995) Maximizing response to surveys in health program evaluation at minimum cost using multiple methods: mail telephone and visit. Eval Rev 19:436–450

    Google Scholar 

  19. de Vaus DA (1991) Surveys in social research. Allen and Unwin, London

    Google Scholar 

  20. Dillman D (1978) Mail and telephone surveys: the total design method. Wiley, New York

    Google Scholar 

  21. Dillman DA, Sangster RL, Tarnai J, Rockwood TH (1996) Understanding differences in people's answers to telephone and mail surveys. New Dir Program Eval 70:45–61

    Google Scholar 

  22. Dunnegan SW (1997) Violence, trauma and substance abuse. J Psychoactive Drugs 29:345–351

    CAS  PubMed  Google Scholar 

  23. Ehlers A, Mayou RA, Bryant B (1998) Psychological predictors of chronic posttraumatic stress disorder after motor vehicle accidents. J Abnorm Psychol 107:508–519

    Article  CAS  PubMed  Google Scholar 

  24. Ehlers A, Mayou RA, Bryant B (2003) Cognitive predictors of posttraumatic stress disorder in children: results of a prospective longitudinal study. Behav Res Ther 41:1–10

    CAS  PubMed  Google Scholar 

  25. Elhai JD, Frueh BC, Gold PB, Gold SN, Hamner MB (2000) Clinical presentations of posttraumatic stress disorder across trauma populations: a comparison of MMPI-2 profiles of combat veterans and adult survivors of child sexual abuse. J Nerv Ment Dis 188:708–713

    CAS  PubMed  Google Scholar 

  26. Feeny NC, Zoellner LA, Foa EB (2000) Anger, dissociation, and posttraumatic stress disorder among female assault victims. J Trauma Stress 13:89–100

    CAS  PubMed  Google Scholar 

  27. Foa E, Riggs D, Massie E, Yarczower M (1995) The impact of fear activation and anger on the efficacy of exposure treatment for posttraumatic stress disorder. Behav Ther 26:487–499

    Google Scholar 

  28. Forbes D, Creamer M, Hawthorne G, Allen N, McHugh T (2003) Comorbidity as a predictor of symptom change following treatment in combat-related posttraumatic stress disorder. J Nerv Ment Dis 191:93–99

    Article  PubMed  Google Scholar 

  29. Forbes D, Hawthorne G, Elliott P, McHugh T, Biddle D, Creamer M, Novaco RW (2004) A concise measure of anger in combat-related posttraumatic stress disorder. J Trauma Stress 17:249–256

    Article  PubMed  Google Scholar 

  30. Groth AN, Burgess W, Holmstrom LL (1977) Rape: power, anger, and sexuality. Am J Psychiatry 134:1239–1243

    CAS  PubMed  Google Scholar 

  31. Groves R (1989) Temporal change in response rates. In: Groves R (ed) Survey errors and survey costs. Wiley, New York, pp 501–579

    Google Scholar 

  32. Hawthorne G, Biddle D, Goulopoulos J (2003) Australian Centre for Posttraumatic Mental Health, vol. 2005. Melbourne, p 79

  33. Hinton D, Hsia C, Um K, Otto MW (2003) Anger-associated panic attacks in Cambodian refugees with PTSD; a multiple baseline examination of clinical data. Behav Res Ther 41:647–654

    CAS  PubMed  Google Scholar 

  34. Kassinove H, Sukhodolsky DG, Eckhardt CI, Tsytsarev SV (1997) Development of a Russian State–Trait Anger Expression Inventory. J Clin Psychol 53:543–557

    Article  CAS  PubMed  Google Scholar 

  35. Katz J, Larson M, Phillips C, Fossel A, Liang M (1992) Comparative measurement sensitivity of short and longer health status instruments. Med Care 30:917–925

    CAS  PubMed  Google Scholar 

  36. Likert R (1932) A technique for the measurement of attitudes. Arch Psychol (Frankf) 140:55

    Google Scholar 

  37. Lin KM, Tazuma L, Masuda M (1979) Adaptational problems of Vietnamese refugees. I. Health and mental health status. Arch Gen Psychiatry 36:955–961

    CAS  PubMed  Google Scholar 

  38. Masters G (1982) A Rasch model for partial credit scoring. Psychometrika 47:149–174

    Article  Google Scholar 

  39. Mayne TJ, Ambrose TK (1999) Research review on anger in psychotherapy. J Clin Psychol 55:353–363

    Article  CAS  PubMed  Google Scholar 

  40. Mayou RA, Ehlers A, Bryant B (2002) Posttraumatic stress disorder after motor vehicle accidents: 3-year follow-up of a prospective longitudinal study. Behav Res Ther 40:665–675

    CAS  PubMed  Google Scholar 

  41. Mayou RA, Ehlers A, Hobbs M (2000) Psychological debriefing for road traffic accident victims—three year follow-up of a randomised controlled trial. Br J Psychiatry 176:589–593

    Article  CAS  PubMed  Google Scholar 

  42. McCall WA (1922) How to measure in education. Macmillan, New York

    Google Scholar 

  43. Miller GA (1956) The magical number seven, plus or minus two: some limits on our capacity for processing information. Psychol Rev 63:81–97

    CAS  PubMed  Google Scholar 

  44. Molenaar NJ (1982) “Response-effects of ‘formal’ characteristics of questions.” In: Dijkstra W, Van der Zouwen J (eds) Response behaviour and the survey interview. Academic, New York

    Google Scholar 

  45. Norman GR, Sloan JA, Wyrwich KW (2003) Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care 41:582–592

    PubMed  Google Scholar 

  46. Novaco RW (1975) Dimensions of anger reaction. University of California, Irvine

    Google Scholar 

  47. Novaco R (1994) Anger as a risk factor for violence among the mentally disordered. In: Monahan J, Steadman H (eds) Violence and mental disorder: developments in risk assessment. University of Chicago Press, Chicago, pp 21–59

    Google Scholar 

  48. Novaco RW, Chemtob CM (2002) Anger and combat-related posttraumatic stress disorder. J Trauma Stress 15:123–132

    Article  PubMed  Google Scholar 

  49. Novaco RW, Taylor JL (2004) Assessment of anger and aggression in male offenders with developmental disabilities. Psychol Assess 16:42–50

    PubMed  Google Scholar 

  50. Oppenheim AN (1992) Questionnaire design, interviewing and attitude measurement. Pinter, London

    Google Scholar 

  51. Patrick DL, Wild DJ, Johnson ES, Wagner TH, Martin MA (1994) Cross-cultural validation of quality-of-life measures. In: Orley J, Kuyken W (eds) Quality of life assessment: international perspectives. Springer, Berlin Heidelberg New York, pp 19–32

    Google Scholar 

  52. Pedhazur E, Schmelkin L (1991) Measurement, design and analysis: an integrated approach. Erlbaum, Hillsdale

    Google Scholar 

  53. Rabin R, Herdman M, Fox-Rushby J, Badia X (2003) In: Brooks R, Rabin R, de Charro F (eds) The measurement and valuation of health status using EQ-5D: a European perspective. Kluwer, Dordrecht, pp 191–205

    Google Scholar 

  54. Riggs D, Dancu C, Greenberg D, Foa E (1992) Anger and post-traumatic stress disorder in female crime victims. J Trauma Stress 5:613–626

    Article  Google Scholar 

  55. Saunders J, Aasland O, Babor T, de la Fuente J, Grant M (1993) Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on early detection of persons with harmful alcohol consumption-II. Addiction 88:791–804

    CAS  PubMed  Google Scholar 

  56. Schwenkmezger P, Hodapp V (1991) Fragebogen zur erfassung von arger und argerausdruck. Z Klin Psychol Psychopathol Psychother 39:63–68

    CAS  PubMed  Google Scholar 

  57. Singer MI, Anglin TM, Song LY, Lunghofer L (1995) Adolescents' exposure to violence and associated symptoms of psychological trauma. JAMA 273:477–482

    CAS  PubMed  Google Scholar 

  58. Snaith R, Zigmond A (1994) The hospital anxiety and depression scale. NFER-Nelson, Windsor

    Google Scholar 

  59. Speilberger C (1988) State–Trait Anger Expression Inventory, research edn. Professional manual. Psychological Assessment Resources, Odessa, FL

    Google Scholar 

  60. Speilberger C, Jacobs G, Russell S, Crane R (1983) In: Butcher J, Speilberger C (eds) Advances in personality assessment, vol. 2. Earlbaum, Hillsdale

    Google Scholar 

  61. Streiner D, Norman G (1995) Health measurement scales: a practical guide to their development and use. Oxford, Oxford

    Google Scholar 

  62. Tabachnick BG, Fidell LS (2001) Using multivariate statistics. Harper Collins, New York

    Google Scholar 

  63. Ware J, Kosinski M, Keller S (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233

    Article  PubMed  Google Scholar 

  64. Weathers F, Litz B, Herman D, Huska J, Keane T (1993) The PTSD Checklist: reliability, validity and diagnostic utility. In: Annual Meeting of the International Society for Traumatic Stress Studies, San Antonio, Texas

  65. WHOQoL Group (1998) Development of the World Health Organization WHOQoL-BREF Quality of Life Assessment. Psychol Med 28:551–558

    Google Scholar 

  66. Yammarino F, Skinner S, Childers T (1991) Understanding mail survey response behavior: a meta-analysis. Public Opin Q 55:613–639

    Article  Google Scholar 

  67. Zigmond A, Snaith R (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370

    CAS  PubMed  Google Scholar 

  68. Zoellner LA, Goodwin ML, Foa EB (2000) PTSD severity and health perceptions in female victims of sexual assault. J Trauma Stress 13:635–649

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to thank the staff of the PTSD programme at the Austin & Repatriation Medical Centre for their assistance. Ethics approval was given by the Department of Veterans' Affairs Human Research Ethics Committee, and all participants completed a written consent form. This research was funded by the Australian Department of Veterans' Affairs through a block grant.

Author information

Authors and Affiliations

  1. Australian Centre for Posttraumatic Mental Health, Dept. of Psychiatry, University of Melbourne, Melbourne, Australia

    Graeme Hawthorne & David Forbes

  2. Australian Centre for Posttraumatic Mental Health, P.O. Box 5444, West Heidelberg, VIC, 3081, Australia

    Graeme Hawthorne

  3. Centre for Psychotrauma, Amsterdam Medical Centre/De Meren, Amsterdam, The Netherlands

    Joanne Mouthaan

  4. Dept. of Psychology and Social Behavior, University of California, Irvine, CA, USA

    Raymond W. Novaco

Authors
  1. Graeme Hawthorne
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joanne Mouthaan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David Forbes
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Raymond W. Novaco
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Graeme Hawthorne.

Appendix

Appendix

DAR5Footnote 1

Please tick the box that best describes how you feel. There are no right or wrong answers.

1

I often find myself getting angry at people or situations

 

□ Not at all

□ A little

□ Moderately

□ A lot

□ Very much

2

When I get angry, I get really mad

 

□ Not at all

□ A little

□ Moderately

□ A lot

□ Very much

3

When I get angry, I stay angry

 

□ Not at all

□ A little

□ Moderately

□ A lot

□ Very much

4

When I get angry at someone, I want to hit or clobber the person

 

□ Not at all

□ A little

□ Moderately

□ A lot

□ Very much

5

My anger prevents me from getting along with people as well as I'd like to

 

□ Not at all

□ A little

□ Moderately

□ A lot

□ Very much

Note:

Scoring the DAR5 is by simple summation, where Not at all, 0; A little, 1; Moderately, 2; A lot, 3; and Very much, 4. The score range is 0–20. The higher the score is, the greater the anger is

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hawthorne, G., Mouthaan, J., Forbes, D. et al. Response categories and anger measurement: do fewer categories result in poorer measurement?. Soc Psychiat Epidemiol 41, 164–172 (2006). https://doi.org/10.1007/s00127-005-0986-y

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-005-0986-y

Key words

Search

Navigation