Childhood trauma has long been known to have lasting psychological effects. A new study delves deeper into how different types of childhood trauma can impact various aspects of anger in adulthood. The findings, published in Acta Psychiatrica Scandinavica, provide valuable insights into the potential long-term consequences of childhood trauma and may have important implications for mental health treatment.
Childhood trauma, which includes physical and emotional abuse, sexual abuse, neglect, and more, is a serious public health concern, as it can have long-lasting effects on individuals’ mental and emotional well-being. Previous research has shown a strong link between childhood trauma and increased risk of depression and anxiety disorders in adulthood.
Emotion regulation, or the ability to manage and express emotions appropriately, is a key factor in this relationship. Children who experience trauma may struggle with emotion regulation due to their caregivers’ insensitivity or poor self-regulation. This heightened emotional awareness can lead to a faster perception of threat in later life and a lower threshold for experiencing anger. Moreover, exposure to uncontrolled anger from caregivers can increase the risk of individuals becoming angry and aggressive themselves.
Previous studies have found associations between childhood trauma and anger in adulthood, with some studies focusing on trait anger (the proneness to experience anger) and others examining various constructs of anger such as anger expression and control. Longitudinal studies have also shown that childhood maltreatment can predict anger in adulthood. However, the relationship between childhood trauma and anger has not been extensively studied among individuals with affective disorders, where anger is prevalent and can impact treatment outcomes.
“In our previous study, we found that anger is prevalent in patients with depressive and anxiety disorders,” said study author Nienke de Bles, a postdoctoral researcher at Leiden University Medical Center. “This could be problematic, as high levels of anger may lead to treatment dropout and poorer treatment outcomes in adults. So, to develop better and enduring effects of treatment for depressive and anxiety disorders, it could be of importance to consider who is prone to angry feelings and behaviors.”
“Previous studies showed that childhood maltreatment was predictive of anger in adulthood, although the relationship has not been studied often among patients with affective disorders. Therefore, the aim of the present study was to investigate the association between childhood trauma and anger in adulthood in a cohort that included participants without psychiatric disorders and with current, remitted or comorbid depressive and anxiety disorders.”
The study, conducted in the Netherlands, used data from the Netherlands Study of Depression and Anxiety (NESDA), a long-term prospective cohort study designed to investigate the course of depression and anxiety disorders over several years. The study included participants with various mental health statuses, including those with current or remitted depressive and anxiety disorders, comorbid conditions, and individuals without a lifetime history of psychiatric disorders (referred to as “healthy controls”).
At baseline, NESDA recruited 2,981 participants aged 18 to 65 years old between 2004 and 2007. The 4-year follow-up occurred between 2008 and 2011, during which anger-related measures were assessed. To explore the relationship between childhood trauma and anger in adulthood, the researchers excluded participants with missing data on childhood trauma or anger measures, resulting in a final sample of 2,271 participants.
The researchers found several significant associations between childhood trauma and various aspects of anger in adulthood. These findings were consistent even after adjusting for sociodemographic and clinical covariates.
“Our findings indicate that a history of childhood trauma is positively associated with anger outcomes in adulthood, including a dose-response relationship. This means that in case someone was more often exposed to childhood trauma, someone also reported more angry feelings and acted more angry in adulthood,” de Bles told PsyPost.
Participants who reported higher levels of childhood trauma also had higher trait anger scores. This suggests that individuals who experienced more childhood trauma were more prone to experiencing anger as adults.
The prevalence of anger attacks was significantly higher in participants who had suffered childhood trauma. This indicates that individuals with a history of childhood trauma were more likely to experience sudden spells of anger, often accompanied by autonomic activation.
Childhood trauma was associated with an increased prevalence of borderline personality traits. Emotional neglect and psychological abuse were particularly strong predictors of these traits, suggesting that these types of trauma had a significant impact on emotional regulation and interpersonal relationships.
While fewer participants in the study exhibited antisocial personality traits, childhood trauma, particularly physical abuse, was associated with an increased likelihood of these traits. This suggests that physical abuse in childhood may contribute to antisocial behavior in adulthood.
The researchers also examined the specific types of childhood trauma associated with anger outcomes. Emotional neglect emerged as a predominant factor, significantly predicting both trait anger and borderline personality traits. Physical abuse, on the other hand, was the primary predictor of anger attacks and antisocial personality traits. Interestingly, sexual abuse was only associated with borderline personality traits, indicating a unique relationship between this type of trauma and emotional regulation.
“All subtypes but sexual abuse were associated with different anger outcomes including anger embedded in someone’s personality and anger in the form of anger attacks,” de Bles said.
While this study provides valuable insights into the relationship between childhood trauma and anger in adulthood, there are some limitations to consider. The study relied on self-reported measures, which may introduce reporting bias. “Anger outcomes were only assessed once,” de Bles noted. “As we also could not differentiate between environmental and hereditary effects, it was not possible to draw firm conclusions about the causality of childhood trauma in the onset and development of anger in adulthood.”
Nevertheless, the findings have important practical implications for mental health professionals and their patients. Screening for a history of childhood trauma and assessing anger-related symptoms could help tailor treatment plans more effectively.
“As anger is a limiting factor in therapy, often leading to dropout and poorer treatment outcomes, it is of importance to address this in therapy,” de Bles explained. “Unfortunately, emotion regulation difficulties and impulsive behavior are often viewed upon as limiting factors in therapy, thinking it may worsen an individual’s symptoms. As a result, patients are prevented from receiving a beneficial additive treatment.”
“We believe that in order to stop the cycle of abuse, it is important that clinicians always enquire about feelings and attacks of anger, explore adverse childhood experiences and start trauma-focused therapeutic interventions when appropriate. In addition, it is important to explain the relationship between childhood trauma and anger in adulthood, as education on emotion regulation is an important part of the approaches to reduce anger.”
The study, “Childhood trauma and anger in adults with and without depressive and anxiety disorders“, was authored by N. J. de Bles, L. E. H. Pütz, N. Rius Ottenheim, A. M. van Hemert, B. M. Elzinga, B.W. J. H. Penninx, and E. J. Giltay.