Understanding Anger Disorders Raymond DiGiuseppe Raymond Chip Tafrate OXFORD UNIVERSITY PRESS Understanding Anger Disorders This page intentionally left blank Understanding Anger Disorders Raymond DiGiuseppe and Raymond Chip Tafrate 1 2007 1 OxfordUniversityPress,Inc.,publishesworksthatfurther OxfordUniversity’sobjectiveofexcellence inresearch,scholarship,andeducation. Oxford NewYork Auckland CapeTown DaresSalaam HongKong Karachi KualaLumpur Madrid Melbourne MexicoCity Nairobi NewDelhi Shanghai Taipei Toronto Withofficesin Argentina Austria Brazil Chile CzechRepublic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore SouthKorea Switzerland Thailand Turkey Ukraine Vietnam Copyright#2007byOxfordUniversityPress PublishedbyOxfordUniversityPress,Inc. 198MadisonAvenue,NewYork,NewYork10016 www.oup.com OxfordisaregisteredtrademarkofOxfordUniversityPress Allrightsreserved.Nopartofthispublicationmaybereproduced, storedinaretrievalsystem,ortransmitted,inanyformorbyanymeans, electronic,mechanical,photocopying,recording,orotherwise, withoutthepriorpermissionofOxfordUniversityPress. LibraryofCongressCataloging-in-PublicationData DiGiuseppe,Raymond. Understandingangerdisorders/RaymondDiGiuseppeandRaymondChipTafrate. p.cm. Includesbibliographicalreferencesandindex. ISBN-13978-0-19-517079-5 ISBN0-19-517079-2 1. Anger. 2. Anger—Treatment. I. Tafrate,RaymondChip. II. Title. RC569.5.A53D542006 616.85081—dc22 2006002297 9 8 7 6 5 4 3 2 1 PrintedintheUnitedStatesofAmerica onacid-freepaper To Roseanne, Anna, Thomas, Dan, and Matt —RD Lauren, Jacob, and Samantha —RCT This page intentionally left blank Acknowledgments Overthe10yearswehaveworkedonthisprojectwehavediscussedthetopicof angerwithalmosteveryoneweknow.Wewouldliketotakethisopportunityto acknowledgethosewhohavebeenmosthelpfultous.Firstwewanttothank Joan Bossert, our editor at Oxford University Press. When most other pub- lisherswantedaquickandspeedy‘‘how-to-do-it’’manual,sheencouragedus toanswerthemoredifficultquestionsaboutangerandtakethetimetowrite thoughtfullyaboutthem.Joansharedourvisionforthisbookandwithouther itwouldhaveremainedatreatmentmanualratherthanamoreinterestingand extensive volume. Joan also secured two reviewers to whom we remain in- debtedfortheirfeedbackonanearlierversionofthisproject.Theymanagedto strikeabalancebetweenpositivereinforcementandmeaningfulsuggestionsfor change. Their recommendations are echoed throughout the final work. We thankMalloryJensenandStephanieAttiaatOxfordUniversityPressfortheir detailed,quick,andhelpfulworkinthefinal,productionphaseofthisproject. We are also grateful for the support we have received from our re- spectiveuniversities.St.John’sUniversityanditsDepartmentofPsychology have provided us with research assistants, library resources, and financial support for research without which we could not have completed this project. Central Connecticut State University and its Department of Crimi- nology and Criminal Justice have provided release time for research, funding for anger-related projects, and a sabbatical leave, all of which contributed to the completion of this work. Wewouldalsoliketoacknowledgeourcommonmentors.AlbertEllishas alwaysbeen a dedicatedmentorand his inspiration helped usinmanyways. viii Acknowledgments Watching him practice psychotherapy provided the insight for our focus on developingthetherapeuticalliancewithangryclients.Wealsocametoseethat hisREBTmodel,theplacewebothstartedclinically,maybeamongthemost valuableinterventionsforassistingthosewithproblematicangerreactions. Howard Kassinove mentored both our doctoral dissertations, although some years apart. He has always been a model for good science and good clinical practice based on science. Whenever we wrote something, we con- sidered how Howie would challenge us to prove it and make it clearer and more parsimonious. He remained with us throughout the project. Several peers have joined us at symposia over the years and we have benefitedfromtheirinsightsandpiercingquestions. Firstwewanttothank ChrisEckhardt,whohelpedlaunchourinterestinthisinvestigationandhas mademajorstridesonhisownintheunderstandingofangerandintimate- partner violence. Of course Jerry Deffenbacher has been extremely gracious and helpful throughout the years. He single-handedly created an anger- outcome literature. Jerry has always been an honest, straightforward, ac- cepting colleague by whom one could float any bad idea; he would always respond with candor and kindness. A. G. Ahmed, from the University of Ottawa,startedanangerdisordersclinicatoururging,therebyhelpingusby puttingourideasintopractice.A.G.’sfeedbackhasprovidedourworkwith numerous clinical insights. We would also like to thank the division of In- dependentPracticeoftheAmericanPsychologicalAssociation.Almostevery yearoverthepastdecadewehavesubmittedproposalstopresentsymposiaat theassociation’sannualconvention.Thesepresentationsallowedustoshare ideaswithpractitionersandgettheirfeedbackandinsights. In addition we would like to thank our graduate assistants who have worked on anger projects with us over the years: Sharon Leis, Jeffrey Froh, Carol Cannella, Jill Kelter, Danielle Rannazzi, and Andrea Camilli at St. John’s University. We want to thank Ryan Fuller, who served as Ray’s postdoctoral fellow and read and critiqued earlier drafts of the manuscript. Wewould like toacknowledgeLouisDundinandMarkLudwig,bothfrom Central Connecticut State University, whose creativity and courage in working with offender samples was always valued. We would like to acknowledge Jennifer Jablonski, who conducted the literaturereviewonangerinpersonalitydisordersandpreparedafirstdraft of chapter 11. Jennifer was a doctoral student at St. John’s University when shetookupthistask.AndwethankFaithUnger,whoworkedasRay’spost- doctoralfellowandwhomadeseveralrevisionstochapter11andhelpedout with many other tasks; and Bernard Gorman, who contributed valuable technicalassistanceintheclusteranalysisthatledtotheangersubtypesthat are presented in chapter 15. Finally, we would like to thank our clients. We have often sought their opinions about how anger operated in their lives and have tried out new assessmentandinterventionstrategieswiththem.Wehavelearnedthemost from them. Contents Introduction xi Part I Theory and Research 1 Anger: The Forgotten Emotion 3 2 Ubiquitous and Intangible: The Problem of Defining Anger 18 3 How Anger Differs From Other Emotions 32 Part II Anger and Aggression 4 Theories of Anger and Aggression 59 5 Anger as a Mediator of Violence 77 6 A Proposed Model of the Relationship Between Anger and Aggression 92 Part III Cognitive and Behavioral Models of Anger 7 Behavioral Models of Anger 117 8 Cognitive Models of Anger 133 Part IV Anger and Comorbidity 9 Anger and Axis I Pathology 163 10 Anger and Depression 185 11 Anger and Personality Disorders 202 ix
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