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Title: Anger and Depression in Middle-Aged Men: Implications for a Clinical Diagnosis of Chronic Traumatic Encephalopathy.
Austin Authors: Iverson, Grant L;Terry, Douglas P;Luz, Matthew;Zafonte, Ross;McCrory, Paul R;Solomon, Gary S;Gardner, Andrew J
Affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.
Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, Mass.
Massachusetts General Hospital for Children Sports Concussion Program
the Vanderbilt Sports Concussion Center, Vanderbilt University School of Medicine, Nashville, Tenn.
Departments of Neurological Surgery, Orthopaedic Surgery and Rehabilitation, and Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, Tenn.
Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Spaulding Research Institute, Harvard Medical School, Boston, Mass.
The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
Hunter New England Local Health District Sports Concussion Program and Centre for Stroke and Brain Injury, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
Issue Date: 2019 2019-04-25
Publication information: The Journal of neuropsychiatry and clinical neurosciences 2019; 31(4): 328-336
Abstract: In recent years, it has been proposed that problems with anger control and depression define clinical features of chronic traumatic encephalopathy (CTE). The authors examined anger problems and depression in middle-aged men from the general population and related those findings to the proposed clinical criteria for CTE. A sample of 166 community-dwelling men ages 40-60 was extracted from the normative database of the National Institutes of Health Toolbox. All participants denied prior head injury or traumatic brain injury (TBI). Participants completed scales assessing anger, hostility, aggression, anxiety, and depression. In response to the item "I felt angry," 21.1% of men reported "sometimes," and 4.8% reported "often." When asked "If I am provoked enough I may hit another person," 11.4% endorsed the statement as true. There were moderate correlations between anger and anxiety (Spearman's ρ=0.61) and between depression and affective anger (ρ=0.51), hostility (ρ=0.56), and perceived hostility (ρ=0.35). Participants were dichotomized into a possible depression group (N=49) and a no-depression group (N=117) on the basis of the question "I feel depressed," specific to the past 7 days. The possible depression group reported higher anxiety (p<0.001, Cohen's d=1.51), anger (p<0.001, Cohen's d=0.96), and hostility (p<0.001, Cohen's d=0.95). Some degree of anger and aggression are reported by a sizable minority of middle-aged men in the general population with no known history of TBI. Anger and hostility are correlated with depression and anxiety, indicating that all tend to co-occur. The base rates and comorbidity of affective dysregulation in men in the general population is important to consider when conceptualizing CTE phenotypes.
DOI: 10.1176/appi.neuropsych.18110280
PubMed URL: 31018811
Type: Journal Article
Subjects: Mood Disorders (Neuropsychiatric Aspects)
Appears in Collections:Journal articles

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