MH 25 & 26

CHAPTER 25: ANGER & AGGRESSION

Definitions

  • Anger:

    • A normal emotional response to a perceived threat, frustration, or distressing event.
    • Purposes:
    • Serves as a coping mechanism.
    • Motivates people to act.

  • Aggression:

    • A forceful attitude or action expressed physically, symbolically, or verbally.

  • Passive Aggression:

    • Indirect expression of anger through subtle, evasive, or manipulative behaviors.

  • Assertiveness:

    • Ability to directly express feelings or needs while respecting the rights of others.

History of Violence

  • Noted historical context:
    • Long history of war, genocide, and uprisings.
    • Significant violence against women has been documented.
    • Legal change: In 1871, it became illegal for a husband to beat his wife.

CHAPTER 26: OUTWARD-FOCUSED EMOTIONS: VIOLENCE

Aggression Throughout the Life Cycle

  • Infants:

    • Display anger when basic needs are unmet.

  • Toddlers:

    • May have temper tantrums and target anger toward perceived responsible parties.

  • School-age Children:

    • May engage in hitting or directing anger at peers.

  • Preadolescents:

    • Should learn to channel anger in healthier and constructive ways.

  • Adolescents:

    • Often express anger in purposeful, perhaps more sophisticated ways.

  • Aging Adults:

    • Expected to gain greater control over their emotions as they mature.

Theories of Anger and Aggression

  • Biological Theories:

    • Suggest that aggression and violence result from neurotransmitter imbalances.

  • Psychosocial Theories:

    • View aggression and violence as learned responses from the environment.

  • Sociocultural Theories:

    • Propose aggression is shaped by cultural values, beliefs, norms, and rituals.

  • Functional Models:

    • Argue that aggression and violence serve specific functions within society.

  • Conflict Theories:

    • Consider aggression as a natural aspect of human interactions.

  • Resource Theory:

    • Claims that aggression is a fundamental social condition.

  • General Systems Model:

    • Argues that violence arises from systemic instability.

The Cycle of Assault

  • Five Stages of the Assault Cycle:
    1. Trigger
    2. Escalation
    3. Crisis
    4. Recovery
    5. Depression

Levels of Intervention

  • Level 1 - Prevention:

    • Effective during the trigger stage.

  • Level 2 - Protection:

    • Effective in the escalation stage.

  • Level 3 - Control:

    • Necessary during the crisis stage.

  • Recovery Stage Interventions:

    • Include injury assessment and providing a calm environment.

Anger-Control Disorders

  • Anger and aggression are elements in many mental health disorders.
  • Common associations of aggressive behavior include:
    • Substance abuse disorders.
    • Mood disorders.
    • Anxiety disorders.
    • Depressive disorders.

Aggressive Disorders of Childhood

Conduct Disorder

  • Characterized by behavior patterns that:
    • Violate others' rights.
    • Disregard major social norms.
    • Traits include:
    • Aggression in non-threatening situations.
    • Lack of empathy and guilt.
    • Callous, unemotional personality.
    • Limited social interaction.
    • Bullying, threats, or physical cruelty, including animal abuse.
    • Temper outbursts and reckless behaviors.

Oppositional Defiant Disorder

  • Characterized by negative, aggressive behaviors directed at authority figures:
    • Involvement in power struggles and a desire for control.
    • Traits include:
    • Stubbornness.
    • Uncooperative behavior.
    • Arguments with authority.
    • Refusal to obey rules and constant irritability.
    • Loss of temper and blaming others for problems.

Impulse Control Disorders

  • Defined by the inability to control impulses that result in harmful acts.
  • Named after the type of impulse. Examples include:
    • Intermittent Explosive Disorder
    • Kleptomania
    • Pathological Gambling
    • Pyromania
    • Trichotillomania

Adjustment Disorders

  • Emotional or behavioral problems arising from identifiable stressors, divided into five subtypes:
    1. Adjustment disorder with depressed mood
    2. Adjustment disorder with anxiety
    3. Adjustment disorder with mixed anxiety and depressed mood
    4. Adjustment disorder with disturbance of conduct
    5. Adjustment disorder with disturbed emotions and conduct

Guidelines for Intervention

  • Essential first step is assessing the client’s propensity for violent behaviors:
    • Conduct a mental status assessment as soon as feasible.
    • Conduct a psychosocial assessment thereafter.

Communicating with Angry Clients

  • Techniques include:
    • Active listening.
    • Identifying the client’s emotions.
    • Exploring options with the client.
    • Offering positive comments to reinforce constructive dialogue.

Outward-Focused Emotions: Violence

  • Agitation:

    • Behavior that is verbally or physically offensive.

  • Aggression:

    • Forceful attitude or actions expressed in various forms.

  • Abuse:

    • Intentional misuse of another that results in harm, injury, or trauma.

  • Violence:

    • An outburst of physical force that harms another person or object.

  • Neglect:

    • Harm to another’s health or welfare by failing to meet basic needs or by placing them at risk.

  • Exploitation:

    • Use of an individual for selfish gain or profit.

Theories of Violence

  • Psychiatric/Mental Illness Model:

    • Proposes that both victims and abusers are mentally disturbed.

  • Social Learning Theory:

    • Indicates violence is learned through social interactions.

  • Sociological Theories:

    • Identify environmental and social factors as contributors to violence.

  • Anthropological Theories:

    • View violence and aggression through cultural and social organization lenses.

  • Machismo:

    • Suggests that males are socialized to adopt aggressive behaviors from childhood.

Domestic Violence

  • Defined as abuse or battering within family contexts, often unreported.
  • Characteristics of functional families:
    • Clear, supportive communication.
    • Effective conflict resolution.
    • Goal setting.
    • Utilization of internal and external resources.

Gender Abuse

  • No typical profile for abused women; many are raised to avoid aggression.
  • Typical abuser characteristics:
    • Poor emotional control.
    • Superior attitudes toward women.
    • History of substance abuse.
    • High jealousy and insecurity levels.
    • Utilization of threats, punishment, and violence to control others.

Abuse During Pregnancy

  • Trauma leading cause of maternal death during pregnancy.
  • Increased frequency and severity of abuse and homicide correlate with pregnancy.
  • Abused women may delay prenatal care.

Child Abuse

  • Defined as abuse, neglect, or sexual exploitation of minors:
    • Shaken baby syndrome can occur in infants.
    • Child sexual abuse is a global issue; certain cultures view female infants as less desirable.
    • Physical punishment has been banned in many schools.

Adolescent Abuse

  • Commonly overlooked, can lead to:
    • Eating disorders.
    • Substance abuse issues.
    • Delinquent actions.
    • PTSD.
    • Suicide attempts.
    • Premature sexual activity and accidental fatalities.
  • Research shows a cycle of abuse, where adults that abuse were themselves abused as youth.
  • Violence among siblings is often normalized in cultural contexts.

Elder Abuse

  • Older adults, especially women with impairments living with relatives, are particularly vulnerable.
  • Family members are the most frequent abusers.
  • Neglect and exploitation are prevalent forms of abuse in the elderly.

Sexual Abuse

  • Defined as unwanted sexual attention from others.
  • Incest:
    • Sexual activities occurring between family members.
  • Long-lasting mental health repercussions are common among sexually abused children.
  • Women experience higher rates of sexual abuse, often from partners.
  • Elder sexual abuse is often neglected in discussions.

Violence, Trauma, and Crime

  • Rising global violence trends, leading to societal normalization of aggression.
  • Impulsive crime often involves physical violence.
  • Long-term mental health issues may linger for victims post-incident.

Group Abuse

  • Individuals in groups may not be inherently violent, yet group association can legitimize violent actions.
  • The phenomenon of group violence contributes to higher numbers of enslaved individuals than ever before in history.

Mental Health Disorders

  • Associated issues include:
    • PTSD.
    • Rape trauma syndrome.

Stages of Recovery from Violence

  1. Impact:
    • Disorganization phase; occurs minutes to days after the incident.
  2. Recoil:
    • Efforts to adapt; lasts weeks to months post-incident.
  3. Reorganization:
    • The reconstruction process; spans months to years after the incident.

Therapeutic Interventions

  • Primary Goal:
    • Prevent reoccurrence of violence.
  • Secondary Goal:
    • Early recognition and treatment for violent individuals.
  • Special assessments are crucial; preserving evidence is vital.
  • Treatment for victims should involve numerous strategies, including ensuring clients are not left alone and supporting their control over situations to deter further violence.
  • Awareness of signs and symptoms of aggression is necessary to prevent violent situations.