PTSD, Anger, and Aggression: Epidemiology, Etiology and Clinical Practice

Abstract

Anger and aggression are common phenomena in PTSD, with many negative consequences as reduced physical health and poor family functioning. When PTSD is accompanied by anger and aggression, treatment outcome is worse. Anger and aggression itself are difficult conditions to treat. Given the negative consequences of anger and aggression, it is important to gain knowledge regarding the etiology of the complaints. The original focus on PTSD as an anxiety disorder is extended to emotion regulation, including anger and aggression. That is illustrated by the growing amount of research into the etiology of PTSD and the role of other stress responses to trauma, especially that of anger and aggression in PTSD. Anger and aggression seem to be related to the hyperarousal symptoms in PTSD, involving a lowered threshold for threat. Biologically, the close link between PTSD, anger, and aggression can be found in brain regions that regulate aggression, hyperarousal, and anxiety. Furthermore, the role of rumination, visual imagery, and language processing will be discussed, as well as treatment directions.