Anger Expression in Children and Adolescents: A Review of The Empirical Literature

Available online at www.sciencedirect.
com
Clinical Psychology Review 28 (2008) 559 – 577
Anger expression in children and adolescents:

A review of the empirical literature
Matthew A. Kerr ⁎, Barry H. Schneider
University of Ottawa, Department of Psychology, 145 Jean-Jacques Lussier StreetOttawa, Ontario, Canada K1N 6N5
Received 22 January 2007; received in revised form 31 July 2007; accepted 1 August 2007
Abstract
Understanding the links between anger expression by children and adolescents, their health, and their interpersonal interactions
is important given the evidence that anger is associated with maladjustment and illness among adults. This review covers:
1) possible origins of the awareness and expression of anger; 2) assessment of anger in children and adolescents, including both
self-report and observational approaches; 3) implications of anger expression for interpersonal relationships; and 4) outcomes of
anger expression. Dimensions of anger expression found in adults have been corroborated to some extent in child and adolescent
data. Reliable and valid measures of these dimensions have been developed. There has been much less research on the correlates of
maladaptive anger expression in children or adolescents than in adults. Nevertheless, the current data base provides some
confirmation that youth who cope inappropriately with their anger are at risk for problematic interpersonal relationships and
negative outcomes in terms of both mental and general health.
© 2007 Elsevier Ltd. All rights reserved.
Contents
1. Anger expression in children and adolescents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 560

1.1. Defining anger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 560
2. Possible origins of the awareness and expression of anger. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 560
3. Assessing anger in children and adolescents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 563
3.1. Self-report measures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 563
3.2. Behavioral observation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 567
3.3. Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 567
4. Anger expression and interpersonal relationships . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 568
4.1. Hiding anger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 568
4.2. Display rules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 570
4.3. Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 571
5. Potential outcomes of anger expression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 571
5.1. Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 573
5.2. Aggression and externalizing behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 573
⁎ Corresponding author. Tel.: +1 613 562 5800x4465; fax: +1 613 562 5147.
E-mail address: mkerr031@uottawa.ca (M.A. Kerr).
0272-7358/$ - see front matter © 2007 Elsevier Ltd. All rights reserved.
doi:10.1016/j.cpr.2007.08.001
560 M.A. Kerr, B.H. Schneider / Clinical Psychology Review 28 (2008) 559–577
5.3. Anger and health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 573

5.4. Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 574
6. Conclusions and future directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 574
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 575
1. Anger expression in children and adolescents
The experience and expression of anger in children and adolescents has received relatively little empirical attention
compared with childhood aggression and externalizing behavior problems. This is unfortunate given the associations
found in adults between anger and long-term health risks, such as hypertension and cardiovascular disease (e.g.,
Harburg, Julius, Kaciroti, Gleiberman, & Schork, 2003), asthma (Friedman & Booth-Kewley, 1987) and cancer
(Thomas et al., 2000). Higher levels of anger also predict mortality rates (Harburg et al., 2003). Elevated anger in youth
is linked with higher blood pressure and heart rate (Hauber, Rice, Howell, & Carmon, 1998), suggesting that the health
risks posed by anger may begin at an early age. Unfortunately, research on childhood anger to date seems to lack
direction and coherence. The intent of this paper is to summarize empirical studies that address four areas of childhood
anger and its expression: 1) possible origins of the awareness and expression of anger; 2) measurement of anger in
children and adolescents; 3) anger expression and interpersonal relationships; and 4) health/mental health outcomes
potentially associated with anger expression in youth.
1.1. Defining anger
Anger is a state of arousal that results from social conditions involving threat or frustration (Averill, 1982). In
addition to this affective component, known as state anger, cognitions and behaviors play important roles in the
experience of anger (Spielberger et al., 1985). The cognitive facet of anger is made up of thoughts and attitudes with
which one assesses the environment and with which one may interpret it as anger-inducing. These thoughts or attitudes
tend to be relatively stable over time and have therefore been termed trait anger (Spielberger et al., 1985). When anger
is aroused, trait anger and immediate stressors guide the way in which an individual chooses to respond. Anger
expression is this response to the affective arousal one experiences.
The expression of anger may be directed inward (anger-in) or away from (anger-out) the self. Originally thought to
be extremes of the same continuum (Averill, 1982), research suggests that these are orthogonal constructs (Spielberger
et al., 1985). Anger-in involves an attempt to suppress or deny angry affect and to prevent the outward expression of
anger. As a result, anger may be internalized and/or directed at the self. Anger expressed outwardly (anger-out) may
involve words or noises, facial expressions, physical gestures, or aggressive movements. However, state anger may
also elicit attempts to process or resolve the conflict or frustration with a more cognitive and less impulsive response.
This was identified as anger-control/reflection (Harburg, Blakelock, & Roeper, 1979).
These constructs pertaining to anger experience and expression have been validated in child populations although
they were originally developed from data on anger in adults (e.g., del Barrio, Aluja, & Spielberger, 2004; Hagglund
et al., 1994; Jacobs, Phelps, & Rohrs, 1989). Though often equated in both conversation and in professional writing,
anger expression and aggression are not equivalent constructs. Aggression, which consists of verbal or physical acts
aimed at hurting or upsetting another human being (either directly or indirectly), is a behavior that may be predicted
by anger (e.g., Clay, Hagglund, Kashani, & Frank, 1996). Although the outward expression of anger (anger-out)
may take the form of aggressive acts, it is not limited to them; anger does not necessarily lead to aggression (Averill,
1982). In fact, anger-out can take non-aggressive forms such as stomping one's feet or displaying an angry facial
expression.
2. Possible origins of the awareness and expression of anger
A myriad of factors is thought to contribute to a child's sense of how and when to express or not express anger.
Many of these explanations focus on different aspects of parenting. As with most studies of socialization by parents,
research designs have largely been correlational in nature, which does not permit the delineation of causal relationships
M.A. Kerr, B.H. Schneider / Clinical Psychology Review 28 (2008) 559–577 561
Table 1
Possible origins and the development of anger expression: empirical research articles found in PsycInfo and published after 1985
Authors Child participants Data collection Major Relevant findings
mechanism/modality
Parenting
Cole et al. (2003) N = 85; preschool and Mother–child Parenting – Maternal emotion predicted school
follow-up at Mage = 7 years; observation age conduct problems, particularly for boys
SD = 4 months – Angry exchanges may impact upon boys
and girls conduct problems differently
Snyder et al. (2003) N = 240; Mage = 5.5 years Observation, Parenting – Children were more likely to exhibit anger
teacher/parent when parents' insensitive and negative
report responses cumulated
– Chronic antisocial behavior associated with
parental negative behavior, not child anger.
Zhou et al., (2004) N = 425; 1st and Parent/teacher Parenting – Authoritarian parenting was positively
2nd Grades report associated with anger/frustration
– Dispositional anger/frustration was negatively
associated with social functioning (moderated by
effortful control)
Parent modeling
Fabes et al. (2001) N = 57; preschoolers Observation Parenting – Intensity of negative emotion (anger, sadness,
and fear) and emotional reactivity was associated
with harsh parental coping and parental distress
Mage = 59.2 months Parent/teacher Parent modeling – Children's social competence was negatively
SD = 10.2 months report related to both
Jenkins (2000) N = 71; 4 to 8 years Teacher/parent/ Parent modeling – Anger-based marital conflict was associated
peer report, with others' ratings of childhood aggression
observation (and anger) and short-term anger expressions
Shipman and Zeman N = 25 mother–child Parent and Parenting and – Anger expression more controlled by all
(2001) dyads; maltreating and self-report parental modeling children than sadness
non-maltreating; – Maltreatment associated with poorer
children's aged 6–12 years anger-control and coping
– Anger associated with negative support
expectations
Other factors
Hewitt et al. (2002) N = 114; Mage = 12.3, Self-report Personality – Socially-prescribed perfectionism was
SD = 1.77 years positively associated with anger-out and
negatively associated with anger-suppression
Little and Garber N = 486; 5th and Self-report, Personality and – Angry reactions to stressors were heightened
(2000) 6th Grades peer report environmental when stressors coincided with
stressors corresponding personality orientations.
Ortiz and del Barrio N = 293; Parent and Temperament – Temperamental factors predicted externalized
Gandara (2006) Mage = 11.13 years self-report state and trait anger; rhythmicity predicted
internalized state anger
between variables. It is in fact very possible that children born with a temperament-based proclivity towards irritability
and anger affect the ways in which their parents raise them.
Table 1 is a summary of these studies. Whatever the causal direction, associations between parenting and
children's anger are robust. Socialization by parents is of course invoked regularly as an explanation for many
aspects of children's behavior. It is also possible, however, that parents witness displays of anger more than other
individuals in children's social worlds. Zhou, Eisenberg, Wang, and Resier (2004) found that parents report higher
levels of anger and frustration in their children than do teachers. Children report that they regulate their expression
of anger more so than other negative emotions such as sadness (Shipman & Zeman, 2001), consistent with the
possibility that they display their anger more extensively in specific setting such as their homes. Perhaps children
feel safer expressing anger with their parents or maybe they have learned not to share those feelings outside of close
relationships.
Another possibility is that parents actively contribute to their children's anger expression in the home. In observed
interactions, parents' negative behaviors including criticism, threats, belligerence, and anger tend to elicit anger from
their children, according to a study by Snyder, Stoolmiller, Wilson, and Yamamoto (2003). At the trait level, this
negative parental behavior and expressed anger from the child were highly correlated (r = .60). Although this analysis
failed to account for many other environmental and family factors, it nonetheless suggests that parental anger directed
at the child is associated with children's expression of anger. In fact, during observation, children were four times more
likely to express anger when parents directed negative emotionality toward them than at other times.
Evidence abounds that parenting and family environment are reflected in a child's sense of emotion, including
anger. In a sample of preschoolers, the intensity of observed negative emotions (anger, sadness, fear) was associated
with less punishment of anger displays by parents (Fabes, Leonard, Kupanoff, & Martin, 2001). Teachers rated
emotional reactivity, which reflects a tendency for the child to respond to stressors in overtly emotional ways and with
heightened intensity. Emotional reactivity was also associated with distress experienced by the parents. Parents who
minimized or punished children's expression of negative emotion and who themselves experienced distress were more
likely than others to have children with intense and relatively frequent negative emotional displays. Authoritarian
parenting, marked by coercive control and low responsiveness, has also been associated with higher levels of expressed
anger and frustration by the child and with poor ability to control those feelings (Zhou et al., 2004).
Approaching the extreme of negative parental impact, physical maltreatment appears to have a detrimental effect on
a child's emotional development. In an observational study, children who had been physically maltreated in the past
were less likely than children who had not been maltreated to express emotions, including anger, to their mothers
(Shipman & Zeman, 2001). When anger was aroused, they were less able than non-maltreated children were to use
effective coping strategies. Maltreated children were unable to generate effective solutions for managing their anger
even when removed from and thinking back on the anger-arousing situation. The study showed that the difference
between the ability to effectively solve problems was mediated by the child's mother's lack of appropriate coping
strategies; maltreated children who had difficulty coping with anger often had mothers who lacked effective coping
strategies. When mothers coped effectively with anger their children appeared to do the same regardless of their
maltreatment status.
Parental modeling of inappropriate emotional coping strategies is associated with poor emotional development and
inadequate coping in the child. Children from families with heightened marital conflict demonstrate elevated levels of
externalized anger as evidenced by peer, teacher, and maternal reports (Jenkins, 2000). Specifically, children displayed
more anger when their parents tended to express anger physically and/or aggressively. Deviant anger in the child, coded
as an angry response to a stimulus that is generally considered to be non-anger-arousing, was associated with verbal
anger expression by parents. This verbal expression consisted of parents speaking in sarcastic tones, arguing, shouting,
and insulting one another. Although both physical and verbal anger expression as measured in this longitudinal study
were confounded with aggression, these results suggest that children who live in environments with more inappropriate
displays of anger between their parents may be more likely than others to display heightened and inappropriate anger
responses themselves. In a longitudinal study by Cole, Teti, and Zahn-Waxler (2003), angry distress by mothers
significantly predicted Time 2 externalizing problem behaviors in their children after statistical control for Time 1
externalizing problems. Participants displaying externalizing behaviors tended to display anger for longer periods of
time when interacting with their mothers than did children with few externalizing problem behaviors.
Externalized anger has also been associated with mother-reported child temperament (Ortiz & del Barrio Gandara,
2006). Children with a difficult temperament, including less persistence and low rhythmicity in their behavior displayed
high levels of externalized state and trait anger. A more persistent temperament, characterized by perseverance with tasks
until completed, was associated with ability to cope internally with anger. These results were obtained with a sample of
boys and girls suggesting that the implications of temperament for anger expression may be robust with respect to gender.
Little and Garber (2000) studied how environmental stressors predicted elevations in children's anger when those stressors
were congruent or incongruent with the participating children's pre-existing personality orientation. They found that both
boys and girls with low dispositions towards interpersonal relationships and connectedness were likely to experience
elevated levels of anger when faced with a social stressor. In contrast, social stressors were not associated with anger among
children with a strong interpersonal orientation. Thus, a sociable personality appears to be associated with low levels of
anger in the face of a social stressor; this seems to apply to both boys and girls.
In contrast, a personality characterized by valuing personal achievement predicted high levels of anger for girls, but
only when they were faced with a stressor in that area (Cole et al., 2003). When girls lacked this ingrained need for high
personal achievement, a stressor in this area was not associated with their anger. The fact that association between
achievement stressors, an achievement-oriented personality, and anger was only found in girls suggests gender
differences in potential risk factors and developmental trajectories for anger.
Girls generally display less anger and they tend to have more control of their anger than do boys (Zhou et al., 2004).
This has been linked at least in part to how the emotion is socialized in children of each gender. Mothers have been
observed to be twice as likely to respond positively to anger expressed by boys than by girls (Cole et al., 2003).
Similarly, mothers were five times more likely to respond positively to girls' positive emotions than to their anger,
while a negligible difference existed for boys. Thus, both the expression and the socialization of anger in children
appear to differ significantly between the genders.
3. Assessing anger in children and adolescents
Children's experience and expression of anger have been assessed in three broad ways. First, children and
adolescents are often asked to self-report on their current and/or general experiences and responses to anger using both
standardized measures and study-specific assessment questions. Children's anger expression is also often assessed
using behavioral observations in which verbal and non-verbal behavior is recorded and coded by trained observers.
Lastly, in a smaller number of studies, parents and/or teachers are asked to complete checklists with respect to their
child/student's ‘angry’ behaviors. Although checklists may be most useful in assessing concomitant or
outcome problem behaviors or disorders, anger itself is seldom assessed independently of aggression in these third-
party ratings.
3.1. Self-report measures
The most widely used self-report measure of anger in adults is the well-validated State-Trait Anger Expression
Inventory (STAXI & STAXI-2, Spielberger, 1988, 1999). These tools were derived from the earlier State-Trait Anger
Scale (Spielberger, 1980) and the Anger Expression Scale (AX; Spielberger et al., 1985), both of which assess state-
trait anger, anger expression and anger-control. Some self-report measures of anger in children and adolescents use
these established frameworks, whereas others do not. Published child/youth assessment measures are summarized in
Table 2.
Based on the same model as the AX, the Pediatric Anger Expression Scale (PAES; Jacobs et al., 1989) was
developed as a 15-item self-report measure of anger expression in children. It was designed as a trait-based measure to
assess characteristic ways of expressing anger. Factor analyses yielded four reliable factors. Anger-out (α = .74) reflects
outward verbal and physical displays of anger, both non-aggressive and aggressive in nature. The two aggressive items
“I say mean things” and “I attack whatever it is that makes me angry” had the two lowest factor ratings of the five anger-
out items, which suggests that this factor measures a construct relatively independent of aggression. The items
associated with anger-in produced two factors: anger-suppression (α = .67) and anger-control (α = .68). The two items in
the anger-suppression scale reflect a more negative coping style characteristic of the anger-in concept (see above).
Anger-control in this instance reflects a healthy manner of coping with anger independent of outward expression. Last,
the anger-reflection subscale (α = .63) represents mature coping strategies, relying both on internal cognitive resources
as well as positive interpersonal approaches. Of note is the higher internal consistency for the anger-out scale relative to
the others. This may reflect a heightened awareness of externalized anger, a lower awareness of internalized anger and/
or a greater variability in how children cope with anger when it is not externalized. Overall, boys had higher anger-out
scores and lower anger-reflection scores than did girls. These may reflect genuine gender differences in the
development of anger expression. However, given that there were more girls than boys in the sample used by Jacobs
and colleagues, and no information is given about gender distribution with respect to grade (four or five) this could be
an artefact of sampling. Anger-out was significantly and positively associated with both state and trait anger (Pediatric
Anger Scale) and anxiety (Pediatric Anxiety Scale; Jacobs, 1989), whereas the other forms of anger expression were
inversely related. These correlations held for self-reported and teacher-reported Type-A behavior, which was assessed
using the Hunter–Wolf A–B Rating Scale (Hunter et al., 1982) and the Matthews Youth Test for Health (Matthews &
Angulo, 1980) respectively. Together these results lend support to the validity of the PAES. Unfortunately, limitations
exist for the measure as presented. First, the truncated age range on which the measure was validated (Grades four and
five) leads one to question the validity of the PAES on older children and adolescents. The modest internal
Table 2
Assessing anger in children and adolescents: empirical research articles found on PsycInfo and published after 1985
Authors Measure Modality Sample Dimensions and psychometrics
Self-report questionnaires
del Barrio et al. (2004) State-Trait Anger Expression Self-report 2191 Youth State anger: α = .81
Inventory for Children and (7–17 years)
Adolescents (STAXI-CA) 44 Items Mage = 12 years Trait anger: α = .71
State and trait SD = 2 years Anger expression: α = .53
measure Anger-control: α = .74
Furlong et al. (2002) Multidimensional School Self-report 1166 Adolescents Anger experience: α = .86
Anger Inventory (MSAI) 36 Items (Grades 9–12) Hostility: α = .80
Trait measure Destructive expression: α = .82
Positive coping: α = .68
Hagglund et al. (1994) Pediatric Anger Expression Self-report 136 Children Anger-in: α = .71
Scale—3rd Edition (PAES-III) 15 Items Healthy or chronic Anger-out: α = .72
3-Point scale illness Anger-control: α = .59
Trait measure (7–17 years)
Administered verbally
Jacobs et al. (1989) Pediatric Anger Expression Self-report 284 Children Anger-out: α = .74
Scale (PAES) 15 Items (Grades 4–5) Anger-control: α = .68
3-Point scale Anger-reflection: α = .63
Trait measure Anger-suppression: α = .67
McKinnie-Burney and Adolescent Anger Rating Self-report 792 Adolescents Instrumental anger: α = .83
Komrey (2001) Scale (AARS) 16 Items (12–19 years) Reactive anger: α = .70
5-Point scale Anger-control: α = .80
Reyes et al. (2003) State-Trait Anger Expression Self-report 284 Adolescents State anger: α = .86 to .92
Inventory (STAXI) 44 Items (11–16 years) Trait anger: α = .77–.78
State and trait Mage = 13.48 years, Anger-in: α = .65–.68
measure SD = 1.67 yrs Anger-out: α = .70–.76
Anger-control: α = .81–.83
Smith et al. (1998) Multidimensional School Self-report 202 Adolescent Anger experience: α = .84–.88
Anger Inventory (MSAI) 31 Items males Cynical attitudes: α = .75–.82
4-Point scale (Grades 6–12) Positive coping: α = .68–.73
Trait measure Destructive expression: α = .58–.79
Tangney et al. (1996) Anger Response Inventories– Self-report 307 Children Anger arousal: α = C .90, A .89
Children or Adolescents (Grades 4–6)
(ARI-C and ARI-A) 5-Point scale 434 Adolescents Intentions: α = C .91–.92, A .90–.94
state and trait (Grades 7–11) Maladaptive responses:
measure α = C .71–.83, A .69–.86
Hypothetical Adaptive behaviors:
situations α = C .35–.62, A .47–.76
Escapist-diffusing responses:
α = C .52–.67, A .55–.76
Cognitive reappraisals:
α = C .59–.65, A .74–.80
Long-term consequences:
α = C .90–.93, A .85–.93
von Salisch and Strategies of Anger Self-report 96 Children Confrontation and harming:
Vogelgesang (2005) Regulation in Children (9–13 years) α = C .80, A .80
or Adolescents 4-Point scale Distancing: α = C .67
(SAR-C, SAR-A) Trait measure 85 Adolescents Redirection of attention: A .58
17/18 (C/A) items (14–18 years) Ignoring: A .80
Explanation and reappraisal: α = C .59
Explanation and reconciliation: A .75
Self-blaming reappraisal: A .71
Humor: α = C .61, A .76
consistencies of the subscales are cause for some concern. Similarly, the factor structure differed with respect to gender,
with the PAES yielding only three factors for boys; the anger-control subscale disappeared with those items loading
negatively on the anger-out scale. Combined, these results lend credence to presence in childhood of anger-expression
constructs identified in adults, but also lead to some doubts about the reliability with which the PAES assesses them in
children.
Hagglund et al. (1994) attempted to provide improved psychometric data on the refined PAES-III (Jacobs &
Kronaizl, 1991; Jacobs et al., 1989) using a sample of both healthy and chronically ill children. This new measure
retained eleven and replaced four of the original fifteen items, and, like the original PAES, measures anger expression
relatively independent of aggression. This new constellation of items was expected to correspond to a three-factor
solution: anger-out (α = .72), anger-in (α = .71), and anger-control (α = .59). Measures of internal consistency are
broadly commensurate with those of the PAES. Unlike earlier samples (Jacobs et al., 1989), neither anger-expression
style nor factor structure differed significantly with respect to gender. Anger-out was significantly and positively
associated with other measures of anger and hostility (Differential Emotions Scale-IV; Izard, Dougherty, Blowxom, &
Kotsch, 1974) as well as aggressiveness, as measured by the Child Behavior Checklist (CBCL, Achenbach, 1991),
supporting the validity of this measure. Anger-control was negatively associated with both Anger-Out and Anger-In.
Unfortunately, there were several problematic findings regarding the dimension labelled anger-control. A confirmatory
factor analysis revealed a new factor: anger-distraction and thus a four-factor solution for the PAES-III data. The two
items for this factor came from the anger-control subscale and reflect non-expressive ways to cope with angry affect.
While non-expressive, they seem to coincide with avoidant or non-constructive coping strategies. Reliability or validity
data were not provided for this subscale; thus, use of this subscale is not warranted at this time. However, this factor
loading anomaly suggests that some items in the anger-control subscales may reflect distraction strategies rather than
cognitive appraisal and problem solving. Omitting these two items from the earlier anger-control subscale may result in
greater internal consistency, though this information is not reported. Although the sample used for this study was
somewhat older than the samples used to validate the PAES (mean age ∼ 11 years), it was relatively small and displayed
potentially confounding health problems. Better psychometric data would possibly be gathered from a large sample of
healthy children. Nevertheless, research on the PAES-III provides support for the validity in children of the three types
of anger expression found in adults (anger-in, -out, and -control).
To construct a measure of childhood anger expression equivalent to the adult STAXI, del Barrio et al. (2004)
developed the State-Trait Anger Expression Inventory for Children and Adolescents (STAXI-CA). All of the 32 items
on the STAXI-CA were adapted to the child/adolescent population from items on the adult measure. Both state- and
trait anger are assessed with this measure, as are anger expression (-in and -out; αs = .45 and .62) and anger-control (-in
and -out; αs = .74 and.63). Trait anger is further subdivided into temperament (α = .68) and trait reactions (α = .64),
while state anger is split into both feelings (α = .78) and physical and verbal components (α = .76). Supported by factor
analysis, these subdivisions suggest an added complexity to the anger experience in children beyond what is captured
in other measures, though one that is consistent with findings from the STAXI. Test–re-test reliabilities over a twelve
day period ranged from .18 to .29 for the four subscales, which may not necessarily suggest problems with the items but
perhaps limited temporal stability in children's experience of and reaction to anger. In any case, validation of this
measure and its subscales was established by demonstrating the expected correlations with measures of personality
(Eysenck Personality Questionnaire; Eysenck & Eysenck, 1975), socialization (Socialization Battery; Silva &
Martorell, 1989), aggressiveness (Verbal and Physical Aggressiveness; Caprara & Pastorelli, 1993), and sensation
seeking (Sensation Seeking Scale; Zuckerman, Eysenck, & Eysenck, 1978).
Internal consistency analyses suggest that the state experience of anger is a coherent construct that is readily
identifiable. To a slightly lesser extent, this is also true for trait anger. In contrast, anger expression, as assessed by the
STAXI-CA, appears to be a relatively heterogeneous dimension. Such variability could arise from items that are
inappropriate for measuring the construct. Variability may also be attributable to the complexity of the construct itself.
Although all the items may be attributed in general parlance to reacting to anger in some way, each respondent may
only resonate with some of the items. Of note is the substantially higher internal consistency for the externalized anger
subscale (anger expression-out) than that for internalized anger. Outward displays of anger may be easier to identify
and classify than inward displays; outward displays may also reflect a more unified and coherent outward anger
response in children. Observed heterogeneity in the STAXI-CA subscales may also result from the wide age range of
the participant sample (7 to 17 years). Methods of experiencing, and, particularly expressing anger develop with age
and this may have contributed to the poor internal consistencies of the subscales. Therefore, separate factor analysis by
age group may be important for this measure.
Adolescents (ages 11 to 16 years) completed the 44-item STAXI, which proved to be an appropriate measure of
anger experience and expression in this population (Reyes, Meininger, Liehr, Chan, & Mueller, 2003). Reliability
coefficients for state- and trait anger and anger-control were all higher than those obtained with the STAXI-CA. Age
differences were found with respect to anger-control, with older adolescents scoring significantly higher on this
subscale than younger youth. Internal consistencies were somewhat low for anger-out (α N .70) and anger-in (α N .65)
suggesting again that the items from these subscales measure a more heterogeneous construct. Some possible gender
differences in the experience and expression of anger were also suggested by discrepancies between the genders in the
factor loadings of individual items. For instance, in the measurement of the anger experience, only three items loaded
on the trait-anger factor for girls compared to nine for boys. As with the STAXI-CA, results obtained using the STAXI
with youth suggest that the experience and expression of anger are likely to vary between individuals and with respect
to age and gender.
Other self-report measures were built on alternative frameworks and with alternative methodologies. The Anger
Response Inventories for Children and for Adolescents (ARI-C, ARI-A; Tangney et al., 1996) were developed by
having youth rate age-appropriate scenarios across seven domains. The large number of domains and items relative to
other anger self-report measures suggests that developers of the ARI scales may be attempting to address the
complexity of and the variability in the anger experience and response. The multiple subscales represent state anger
(Anger Arousal) as well as three types of intentions for response (Intentions). Anger expression is assessed across a
range of responses including aggressive, physical, or holding in (Maladaptive Responses), Adaptive Behavioral
responses, Escapist-Diffusing responses, and Cognitive Reappraisal, which is similar to anger-control in the STAXI-
CA. Youth are also asked to rate long-term consequences of their anger. Like other measures, scale reliabilities tended
to be higher for older youth and for more behavioral or observable domains. Many of the Maladaptive Responses facets
were positively associated with aggression, delinquency, and social problems as reported by teachers on the Child
Behavior Checklist–Teacher's Report Form (Achenbach & Edlbrock, 1986). Self-aggression and anger held in were
also predictive of anxiety/depression (CBCL–TRF). Other facets displayed the expected associations with teacher
ratings of variables thought to correlate with anger, also supporting the validity of this measure. Although large parts of
this measure assess aggression, and not anger per se, these sections are clearly distinguishable.
Many measures assess anger expression across several situations, hypothetical or real, including anger expression in
the presence of different audiences. In contrast, the Questionnaire on Strategies of Anger Regulation (SAR; von Salisch
& Vogelgesang, 2005), focuses specifically on anger expression and its regulation with respect to self-identified
friends. Versions for children and for adolescents contain age-appropriate items. Youth are asked to rate frequency with
which they typically engage in each behavior when angry at their friend. Internal consistencies are modest to good, with
higher reliabilities and a more complex factor structure emerging in the adolescent population. Validity of the scales
was ascertained by matching self-reports with those of friends. Construct validity was relatively ignored in the
validation process. The benefit of this measure is that it targets anger expression/control in youth friendships, which has
been shown to differ significantly from anger expression with parents or teachers (e.g. Zeman & Garber, 1996).
Other measures have been designed specifically for the school context. The Multidimensional School Anger
Inventory (MSAI; Furlong, Smith, & Bates, 2002; Smith, Furlong, Bates, & Laughlin, 1998) is a 36-item, four-factor
measure. The School Anger Experience Index and the School Cynicism Index (Hostility) measure the frequency of
anger-provoking experiences and negative thoughts toward school. These two dimensions combined may be roughly
equivalent to trait anger as measured by the STAXI-CA. The expression of anger in school is assessed with the positive-
coping (∼ anger-control) and destructive-expression (∼ anger-out) subscales. Both Anger Experience and Destructive
Expression were positively associated with aggression and with hyperactivity and conduct problems as measured by
the Aggression Questionnaire (Buss & Perry, 1992) and the Conners Teachers Rating Scale (Conners, 1989)
respectively. Scale reliabilities were adequate to good, suggesting the robustness of the measure in assessing the
underlying anger constructs. Although this measure assesses anger specifically within the school context, it neglects
anger-suppression. The MSAI appears to be a reliable and valid measure of anger experience and expression relatively
independent of aggression, with preliminary normative data for youth in that domain. By contrast, the Adolescent
Anger Rating Scale (AARS; McKinnie-Burney & Komrey, 2001) purports to measure instrumental anger, reactive
anger and the control of anger. Unfortunately, it measures these constructs largely in terms of aggression and therefore
it is limited as a measure of anger expression.
Researchers often construct their own study-specific questions when studying anger in younger children. Rather
than focusing on discrete aspects of anger, these questions often ask children to reflect on the general experience of
anger and to rate the intensity of that experience on a Likert-type sale (e.g., Underwood, Hurley, Johanson, & Mosley,
1999). Researchers have also been interested in children's knowledge of how they display their anger (“Did you look
not at all angry, or a little angry, or some angry, or a lot angry?”; Dearing et al., 2002) or if they might be inclined to
display it (“Would you show or not show how mad you feel?”; Zeman & Garber, 1996). Structured questions such as
these have often been qualified by follow-up open-ended questions (e.g., Shipman, Zeman, Nesin, & Fitzgerald, 2003;
Zeman & Garber, 1996). Although questions that are study-specific often appear highly relevant to the research
question in each study, they often are presented and reported with little data as to their validity with respect to either
established constructs of anger expression or those of interest to the researchers. Given that these approaches are
typically used with younger children, limitations in expressive language may interfere with the ability of open-ended
responses to adequately capture a child's experience.
3.2. Behavioral observation
Perhaps the most ecologically valid way in which to assess anger expression in children is to observe and code
‘angry’ words, behaviors, and gestures. Typically used with younger children, behavioral observation is implemented
both in laboratory (e.g., Denham et al., 2002) and naturalistic settings (e.g., Fabes & Eisenberg, 1992). Coding schemes
are typically based on the cultural-informant perspective, which assumes that coders have a baseline of emotional
knowledge based on their own experiences. Some researchers (e.g., Hubbard, 2001) acknowledge the validity and
detail of coding systems such as the Emotion Facial Action Coding System (Friesen & Ekman, 1984) but choose not to
use them due to logistical and/or time limitations. Evidence suggests that there may be little difference between more
and less detailed approaches with respect to coding behaviors on the macro level (Camras et al., 1988).
These study-specific coding criteria have resulted in a myriad of approaches to quantifying children's angry
behaviors. Emerging from various research questions, the target actions of coding systems have ranged from global
reactions to an event to the intensity and duration of a facial expression. Studies that focus on individual behaviors or
gestures tend to rely on coding systems that merely distinguish the expression of anger from that of other emotions. For
instance, Hubbard (2001) developed a system in which observers watched recorded interactions and noted the
frequency with which children displayed angry, happy, and sad facial expressions and rated the intensity of the displays
on a three-point scale. Inter-rater reliability for coding angry facial expressions this way was acceptable (Cohen's
κ = .71 and .81 respectively). Some other researchers have reported similar or greater success at coding anger this
way (Dearing et al., 2002; Denham et al., 2002; Parker et al., 2001) whereas others have done so less reliably
(Underwood et al., 1999; Cohen's κ = .61). Hubbard (2001) also successfully and reliably coded the presence of verbal
displays of anger, based on intonation (Cohen's κ = .82). Angry verbal expression has also been coded based on the
explicit content of the dialogue that was audio recorded during a play activity (Underwood et al., 1999; κ = .71). In
general, study-specific coding systems have been used reliably to decipher facial and verbal expressions of anger from
other emotions.
Other coding systems that focus on more complex expressions are often oriented to differences in reactions to an
angry display or an anger-provoking situation. These reactions are commonly made up of facial, verbal, and physical
expressions of anger. Fabes and Eisenberg (1992) had observers reliably code seven broad behavioral responses
including revenge, active resistance, avoidance and expressing dislike (Cohen's κs = .88–1.00) as they occurred during
live schoolyard interactions. Macro-level behaviors have also been reliably coded with respect to affective valence
(Denham et al., 2002). Overall, the coding of gross behavioral expressions of anger is quite reliable, however this
method obscures the specific components comprising the macro response.
3.3. Summary
Youth self-report measures for anger experience and expression are generally well-validated instruments that reflect
anger constructs previously established in adults. Internal consistencies of questionnaire items range from moderate to
good, with externalized anger (anger-out) being more reliably assessed relative to internalized anger reactions (anger-in
and anger-control). This difference is more pronounced in younger children, which may be a reflection of their lower
awareness of internal processes. Some variability in item factor loadings across gender suggests the possibility of
variability in the underlying constructs of anger expression. However, scale factors tend to be fairly consistent across
measures and populations. Some evidence suggests that ‘trait’ measures of anger experience and expression may not be
stable across re-test periods; these measures appear to be somewhat state or environmentally-dependent. Study-specific
self-report questions do not correspond with established anger-expression constructs, but are usually capture emotional
states and experiences specific to the study paradigm. Similarly, the coding of ‘angry’ behaviors in observational data is
often study-specific in terms of established constructs and their operationalization, but constitutes a reliable way to
quantify macro expressions of anger.
Overall, researchers have assessed anger and its expression quite reliably, both through self-report measures and
through behavioral observation. A shortcoming in the measurement of anger has been that researchers have generally
failed to integrate these two methods of assessment into one research design. Although coding observed behaviors is
descriptively rich, it lacks a well-developed theoretical framework on which to hang. Conversely, psychometrically
sound assessment measures provide little information about how a child is likely to react when angered.
4. Anger expression and interpersonal relationships
Anger expression may also vary according to the relational context in which it takes place. Conversely, anger
expression may also affect the interpersonal relationships of children and adolescents. This research is summarized in
Table 3. Whether or not children express anger outwardly is largely dependent on their age and on the audience.
Overall, younger children are more likely than older children to express their anger (Denham et al., 2002; Shipman
et al., 2003; Underwood et al., 1999; Zeman & Garber, 1996). With increasing age, children may repress their anger
more extensively because they no longer believe that they should express more emotion (Zeman & Shipman, 1996).
When younger children do get outwardly angry, they are more likely to do so with their parents than with peers (Zeman
& Garber, 1996). As children age, expressing anger is seen as less acceptable in general, especially with those outside
of the peer group (Shipman et al., 2003). Although older children are significantly more likely to express anger with
peers than with teachers (Underwood, Coie, & Herbsman, 1992), there seems to be little difference between peers and
parents (Zeman & Shipman, 1996). Discrepancies between anger experienced and expressed across some or all
audiences indicate that children, like adults, do not always express their anger to the extent that it is felt. One line of
research has explored differences between experienced and expressed anger and the manner in which anger is hidden
from any given audience. Given that this experienced affect is often at least partially masked, children must have
motivations for doing so. Highlighting these socially and personally prescribed reasons has been another focal point of
research. Although these two areas have been combined in some studies, for ease and clarity of review they are
summarized separately below.
4.1. Hiding anger
When with others, children often do not visually or verbally convey all of their angry affect. Parker et al. (2001)
read children vignettes in which the main character who was playing a game in which the other child cheated. In the
laboratory, the research has attempted to mirror the stories by having participants engage in a game with another
child (a study confederate) who blatantly cheated. Children reported feeling angrier after the hypothetical vignette
than the live situation. Following the story, they also said that they would express more anger than what was
observed during the live game. There was no association between children's self-reported experience or expression
of anger during the game and the non-verbal behaviors observed by the experimenters. This finding has been
corroborated in other anger-arousing game paradigms (Dearing et al., 2002; Underwood et al., 1999). Children are
more likely to avoid expressing anger in live interactions than in hypothetical situations in order to preserve social
relationships and avoid negative responses from others. The fact that trained observers could not identify angry
expressions when the child reported feeling angry suggests that children are quite proficient at masking their angry
affect.
Children constrict their anger expression in various ways and appear quite likely to express their anger subtly and
non-verbally (Zeman & Shipman, 1996). Underwood et al. (1992) presented children with vignettes of hostile,
ambiguous, or non-hostile encounters with teachers and peers. The participating children reported choosing to mask
their anger more with teachers than with peers. When asked how they would respond to these situations, participants
indicated that they would mask their anger using non-hostile physical behaviors and verbal exchanges. However, this
was partially age-dependent as older but not younger children reported masking their facial expressions as well. During
a laboratory game in which study confederates taunted participants as they lost, children demonstrated facial
expressions that differed depending on whether or not the game was played fairly. In the cheating condition, there were
significantly fewer happy facial expressions but children displayed significantly more angry and neutral facial
Table 3
Anger expression and relationships in children: empirical research articles found on PsycInfo and published after 1985
Authors Participants Relationship to others Relevant findings
Dearing et al. (2002) N = 274; 2nd Grade; ∼8 years old Peer – Non-verbal anger expression mediated the relationship between anger regulation
M.A. Kerr, B.H. Schneider / Clinical Psychology Review 28 (2008) 559–577

and social preference and aggression
Denham et al. (2002) N = 137; Mage = 46 months; Peer – Lower emotion knowledge at age 3 and 4 years was associated with higher anger and
SD = 4.89 months aggression at age 5
Fabes and Eisenberg (1992) N = 69 Peer – Anger-expression style associated with gender, age, social competence and popularity
Mage = 55 months
SD = 7 months
Hubbard (2001) N = 131; 2nd Grade Peer – Social rejection was associated with more expressed anger
African-American – Boys displayed more anger than girls
Jenkins and Ball (2000) N = 108; 6 to 12 years old Hypothetical peer – Expression of anger thought to elicit more anger and aggression from recipients
– Differentiation of anger from sadness and fear greater in older children
Parker et al. (2001) N = 274; 2nd Grade Peer – In a live interactions, children reported feeling and expressed less anger, intended
to hide and dissemble their anger more than in hypothetical situations
– Observed anger expression not related to the child self-report
Shipman et al. (2003) N = 144 Hypothetical peer – Children reported being most likely to express anger verbally or facially
1st and 2nd Grade and 4th – Acceptability of anger expression varies with modality
and 5th Grade
Underwood et al. (1992) N = 85 and 133 Hypothetical peer – Display rules for and masking of anger varied with respect to audience and modality
1st, 3rd, and 7th Grades or teacher of expression
Underwood et al. (1999) N = 382 Peer – Girls and older children displayed less overt anger than did boys or older children
2nd, 4th, and 6th Grade, ∼ 8, 10,
and 12 years old
von Salisch and Vogelgesang N = 85; 9 to 13 years Friend – Complexity and constructiveness of anger response increased with age
(2005) M = 10.5; SD = 1.2; 5 year follow-up
Zeman and Garber (1996) N = 192; 1st, 3rd, and 5th Grades Hypothetical peer – Likelihood of expressing anger associated with age and audience
or parent – Children identified many reasons for and against expressing anger
Zeman and Shipman (1996) N = 137; 2nd and 5th Grades Hypothetical peer – Children less likely to express anger (than sadness or pain) due to fear of
or parent negative consequences
– Mothers deemed by younger children most accepting of anger
569
expressions. This suggests that some angry affect may have been masked facially with neutral expressions. Thus,
children may not display angry faces to the extent that they experience anger.
Strong gender differences exist with respect to how children express and/or mask their anger. Hubbard (2001)
observed that during an anger-arousing game, boys expressed more anger in their facial expressions, verbalizations,
and behavior than did girls (Hubbard, 2001). Whereas girls may opt as often as boys to express their anger verbally in
response to hypothetical vignettes (Shipman et al., 2003; Zeman & Shipman, 1996), observational studies have
indicated that this is less true in live interactions (Underwood et al., 1999). This difference between anger expression in
boys and girls likely arises from the way in which the genders are socialized with respect to anger (Cole et al., 2003).
Although girls may appear to be expressing less anger than boys, they may only be expressing anger in different ways.
Observing playground interactions, Fabes and Eisenberg (1992) noticed that although girls were less likely than boys to
vent their angry feelings in an anger-provoking situation, they were more likely to actively assert themselves. Girls
were also as likely as boys to display angry facial expressions when provoked (Underwood et al., 1999). In addition,
Fabes and Eisenberg observed that older boys tended to display less overt anger than did younger ones. Given that girls
generally express less overt anger than do boys, this age-related inhibition of the display of anger suggests that as
children age, gender differences in how children express anger may lessen.
The research by von Salisch and Vogelgesang (2005) is distinctive because it involved actual friends rather than
hypothetical vignettes or confederates. These researchers studied anger expression in self-selected pairs of close friends
as children, then five years later as adolescents. They corroborated earlier results that expression styles change with
age. Younger children were more likely to use avoidant or confrontational methods of expression, whereas adolescents
more often resorted to both explanation and reconciliation or humor. The adolescents' responses more closely
resembled anger-control rather than anger-out. Strategies used by the adolescents may reflect a heightened desire to
preserve the friend relationship. The results of this study did not support gender differences in expression style. Lack of
gender differences here may result from the nature of the relationship being studied. It is possible that in close
friendships, boys place as much importance on the relationship as do girls and are consequently as likely to try to
preserve the relationship even when expressing their anger.
4.2. Display rules
Saarni (1999) wrote that knowing how to express emotion and, sometimes more importantly, when to express
emotion in a way that is socially acceptable is crucial to the development of the ability to regulate emotion. Given the
discrepancies between experienced and expressed anger in children (see above), it is apparent that learning how and
when to express emotion begins at a young age. Display rules (Saarni, 1979; Underwood et al., 1992) are the
conventions used to govern these important decisions. Socialized through the familial and broader cultural contexts,
these rules dictate when to mask an emotion, either through showing no affect or expressing a more acceptable emotion
(Hochschild, 1979). Children report that they mask anger more often than other feelings, most likely because they
expect others to respond negatively to anger (Underwood, 1997). These expectations are associated not only with the
outward expression of anger itself, but also with the manner in which it is displayed (e.g., verbally, facially, or
behaviorally).
Regardless of the audience, (parent, best friend, or other friend), children expect less support in response to
expressing anger than they do for other negative emotions such as sadness or pain (Zeman & Shipman, 1996). When
asked about hypothetical situations involving peers, children indicated that they expect their own anger expression to
elicit the same from others or to cause peers to distance themselves (Jenkins & Ball, 2000). In fact, when questioning
six to twelve year olds, Jenkins and Ball found that children perceived the goal of expressing anger as getting the
recipient to go away. Fifty percent of the participating children also thought that the child expressing anger would feel
stronger or more dominant than the other child. These effects were strongest among older children, which may explain
in part why older children seem to be less expressive of their anger than are younger children.
If anger expression is perceived by other children as a statement of dominance and interpersonal rejection, it is not
surprising that children report that avoiding trouble and preserving social norms are primary reasons for invoking
display rules (Underwood et al., 1992). When discussing their reasons for not displaying anger in hypothetical
situations, children most frequently reported wanting to avoid interpersonal consequences (60%) and to protect others'
feelings (19%; Zeman & Garber, 1996). Stated reasons for expressing anger included gaining help or a positive benefit
(37%) or being so angry that they would be unable to control it (37%). In addition to the expectation of a negative
interpersonal exchange, they reported the expectation that would not be associated with feeling better (Zeman &
Shipman, 1996). Hence, they may feel that expressing anger in a non-constructive way may jeopardize their
relationships with their peer or broader social group in addition to not helping the individual to feel better. As such,
display rules may constitute an adaptive mechanism that helps preserve crucial relationships with others. Popular boys
and socially-competent girls have observed to have fewer angry conflicts on the school yard than their counterparts
who are less adept socially (Fabes & Eisenberg, 1992). Many display rules may operate at the edge of or outside
consciousness. In a study by Underwood et al. (1992), 41% of children who listened to a hypothetical vignette could
not adequately explain why they reported displaying less anger than they felt. Both conscious and subconscious factors
may well be working at maintaining one's position in its social context.
For some children, however, these processes seem to lack sufficient strength to attenuate angry responses.
Specifically, children who have been rejected by their peer group outwardly express anger to a greater extent and have
fewer discrepancies between their experienced and expressed anger than do non-rejected children. Hubbard (2001)
found that during an observed anger-provoking game, rejected children, as determined by peer nomination, displayed
longer and more intense angry facial expressions and more often had an angry intonation to their voice. Importantly, in
contrast with these social-status differences in anger, there were no social-status differences in aggression in this
particular study: These rejected children were not any more aggressive than their accepted peers. These results suggest
that having fewer display rules for anger may be associated with increased rejection (Dearing et al., 2002). Hence,
researchers tracing the possible causes of social rejection should consider both anger and aggression: Social rejection
may be due to the expression of anger, to the display of aggression (see Schneider, 2000), or to both. This is consistent
with the understanding of anger expression and aggression as separate constructs that may well co-occur.
It is important to remember that, due to the correlational nature of the research in this area, directionality of the
relationship between display rules for anger and peer rejection cannot be known. Children may be rejected first and
subsequently cease to follow display rules for anger in the hope that the behavior change will re-establish a relationship.
Inattention to the display rules may also reflect anger that increases as a result of being rejected. Alternatively, a lack of
established display rules could result in socially-inappropriate anger expression, which, because of how anger is
perceived (Jenkins & Ball, 2000), results in rejection. In a one year longitudinal study by Denham et al. (2002), three
and four year-old children with poor emotional knowledge displayed higher levels of anger and aggression at follow-up
than their proficient peers. Another possibility in regard to the relationship between poor display rules and peer
rejection is that they are associated through a third, unmeasured variable. Many confounding influences are possible,
such as cognitive or learning disabilities, psychopathology, or poor socialization of emotion in the family.
4.3. Summary
As a rule, boys and younger children tend to be more outwardly expressive with their anger than girls or older
children or adolescents. Anger expression by girls and by older children and adolescents, although it may not be less
frequent, appears to be more complex and aimed more specifically at maintaining social relationships. Regardless of
age or gender, children tend to display less anger than they experience. This may result from being socialized to expect
negative outcomes for expressing anger outwardly. Display rules that are used to govern when and how anger should be
expressed appear to be crucial in maintaining one's self in relationship to others. Children who lack and/or violate these
guidelines are often rejected from their peer group. One shortcoming of this area of research is the lack of normative
data on display rules or expression of anger in children. While it is understandably adaptive to restrict emotional
expression at times, doing so too frequently or too intensely may well have many potential negative consequences.
Knowing at what point a child is excessively restricting the display of anger would be useful in this regard because it
would have important implications for diagnosis, intervention and research.
5. Potential outcomes of anger expression
Paralleling the documented negative effects of anger on the physical and mental health in adults, high levels of
experienced anger have been associated with poor health and maladjustment in children and adolescents. While none of
the reviewed studies documented a causal relationship between anger and outcome variables, anger in youth has been
associated with depression, aggression and problem behavior, and negative health status (see Table 4). High levels of
experienced anger have also been associated with specific anger-expression styles. Girls and boys with high self-
572
Table 4
Potential outcomes and associations of anger expression in children: empirical research articles found in PsycInfo and published after 1985
Authors Participants Data collection Design Relevant findings
Clay et al. (1996) N = 84 girls and 84 boys Questionnaires Self-report, current – Anger-expression styles associated with anger level
Mages = 11.15 and 10.08 years – Anger level and expression style predict sadness and aggression
SD = 3.0 and 2.8 years
– Anger-expression style associated with trait anger
M.A. Kerr, B.H. Schneider / Clinical Psychology Review 28 (2008) 559–577

Rice and Howell (2006) N = 1060 Questionnaires Self-report
3 rd to 6th Grades
Depression
Boergers et al. (1998) N = 120 adolescent Interview Self-report, current – Internal and external anger expression (along with depression)
suicide attempters predicted a self-reported wish to die
Mage = 15.1 years Questionnaires
Goldston et al. (1996) N = 225 inpatient Structured interview Self-report, current – Previous suicide attempts were significantly associated with
adolescents; Mage = 14.8 years Questionnaires trait anger
Kashani et al. (1995) N = 22; inpatient boys Questionnaires Self-report – Depression associated with poor cognitive control of anger
6 to 12 years old
Kashani et al. (1997) N = 47 child; 53 adolescent Structured Interview Self and parent – Hopelessness associated with outward, impulsive anger
inpatients report, current
Mages = 9.64 and 14.79 years Questionnaires
Parent interview
Aggression and externalizing behavior

Cole et al. (1996) N = 79 Mood induction Parent-report, current – Extremes of expressing negative affect were associated with
Questionnaires and longitudinal externalizing problem behaviors
Rydell et al. (2003) N = 151; age 5 years, 1.5 and 3 Questionnaires Parent and teacher report, – Level of reactive anger was inversely related to anger regulation
year follow-up current, prospective – Both associated with externalizing and internalizing
problem behaviors
Health
Mueller et al. (2001) N = 167; 14 years Questionnaires Self-report, current – Anger-control negatively associated with percentage body fat
Medical observation
Phipps and Steele (2002) N = 619 Questionnaires Self-report, current – Chronic illness associated with repression of anger
Mage ∼ 12.5; SD = 3 years
Piko et al. (2006) N = 550; Mage = 12.2; SD = 1.2 years Questionnaires Self-report, current – Higher levels of anger were associated with poorer health
and addictive behaviors
Steele et al. (2003) N = 589 Questionnaire Self-report, current – Chronic illness associated with higher repression and lower
anger expression
reported levels of anger were more likely than others to endorse an outward expression style (anger-out) and less likely
to endorse a more cognitive, reflective style (anger-control; Clay et al., 1996). Anger level was also negatively
associated with suppressing anger (anger-in) for boys only. High trait anger was also found to be linked to high levels of
anger-out and low levels of anger-control for both genders (Rice & Howell, 2006). In older children, high levels of
anger-suppression were correlated with low levels of trait anger. Overall, both levels of anger and differences in its
expression have been associated with negative outcomes in children.
5.1. Depression
Hopelessness, a key cognitive component of depression, has been associated with high levels of anger-out and low
levels of anger-control in inpatient youth (Kashani, Suarez, Allan, & Reid , 1997). Of the three expression styles, only
anger-control reliably differentiated between depressed and non-depressed psychiatric inpatients in a study by Kashani,
Dahlmeier, Borduin, Soltys, and Reid (1995). In research by Goldston, Daniel, Reboussin, Kelly, Ievers, and
Brunstetter (1996), trait anger, as measured by the STAXI, was higher in groups of adolescents who had attempted
suicide several times previously rather than only recently or not at all. Boergers, Spirito, and Donaldson (1998)
interviewed adolescents who had been admitted to hospital because of extreme suicidal ideation or attempts. They
found that youth who stated that their reason for wanting to commit suicide was just “to die,” as opposed to more
material or situational reasons, revealed higher overall levels of anger expression. These two findings suggest that high
anger levels in depressed youth may be a particularly stable phenomenon, with highest levels being associated with
more severe psychopathology. In a population of children not diagnosed as depressed, sadness was associated with
anger levels in both boys and girls, and with anger-out in boys (Clay et al., 1996). In a predictive model that considered
other factors, however, anger, overall anger-expression level, and their interaction predicted levels of sadness in girls
only. Thus, there seem to be well-established associations between anger and negative mood in children and
adolescents in studies conducted with children and youth displaying considerable internalizing problems. More
research is needed to confirm this link in less disturbed populations.
5.2. Aggression and externalizing behavior
Rydell, Berlin, and Bohlin (2003) found that reactive, outward expression of anger was predictive of externalizing
problem behaviors at school and at home, whereas anger regulation was predictive of lower levels of externalizing
problems. However, in this study, the externalizing behavior scale was derived from measures of both conduct
problems and of hyperactivity. Thus, although the externalizing problems are probably aggressive in nature to some
extent, the precise degree to which they are is unknown. Low regulation of anger and high anger emotionality were also
predictive of mothers' reports of internalizing behavior problems. Although high expressiveness can be a risk factor for
problem behaviors, being too inexpressive can also place a child at risk. Cole, Zahn-Waxler, Fox, Usher, and Welsh
(1996) found that children who were either too expressive or too inexpressive of negatively valenced emotion,
including anger, experienced more externalizing and total problem behaviors than did children who expressed their
feelings to a moderate degree. In addition, anger emotionality at home and at school was predictive of poor pro-social
behavior (Rydell et al., 2003). In boys, high levels of anger-out and low levels of anger-control have been associated
with aggression (Clay et al., 1996). In a predictive model of aggression, by Clay et al. (1996), anger-expression style
interacted with anger level. This suggests that boys lacking sufficient internal resources to control their anger are likely
to resort to aggressive acts as a means of coping with their affect when levels of anger become too high. For girls,
neither anger level nor expressive style predicted aggression. Given that boys and girls are socialized differently with
respect to anger (e.g., Cole et al., 2003), peers are likely much less tolerant of aggression in girls. However, this could
be an artefact of how aggression is measured. Although girls are certainly less physically aggressive than boys, they
may not differ on other forms of aggression such as verbal or relational aggression (Piko, Keresztes, & Pluhar, 2006).
5.3. Anger and health
Higher levels of anger in youth have been associated with elevated blood pressure and heart rate (Hauber et al.,
1998). State anger, as measured by the STAXI, is predictive of diastolic blood pressure in boys (Mueller, Grunbaum, &
Labarthe, 2001). Elevated anger reactivity has also been historically associated with a Type-A behavior pattern, which
is marked by excessive competitiveness, time urgency, and easily aroused hostility (Heft et al., 1988). Type-A behavior
has been associated with an increased risk for coronary heart disease in adults (Belgian-French Pooling Project, 1984).
It should be noted that in more recent thinking, the Type-A construct has been questioned because its components do
not necessarily co-occur. According to Linden (1987), hostility is probably the salient predictor of poor outcome.
In addition to these longer-term consequences, anger levels have been found to be associated concurrently with
psychosomatic symptoms and poor self-perceived health for both genders (Piko et al. 2006). For girls, anger also
appears to be associated with increased frequencies of tobacco and alcohol consumption as well as poorer diet control.
This coincides with other findings indicating that poor anger-control is predictive of higher percent body fat in girls
(Mueller et al. 2001). Negative health outcomes may be associated with repressed or internalized anger as well as with
anger-out or anger levels. Children diagnosed with either cancer or another chronic illness reported outwardly
expressing less anger than did healthy children (Phipps & Steele, 2002). These sick children were also more likely to
endorse a more repressive emotional style. The finding that chronically ill children endorse increased repression of
affect and less anger expression was corroborated in a later study (Steele, Elliott, & Phipps, 2003). The possibility
exists that these styles of coping with and expressing negative affect resulted from the children's negative health status.
However, whereas internalized or repressed anger may not be a causal factor in chronic illness, repressing anger may
conceivably exacerbate either the physical condition or, more probably, its psychological concomitants.
5.4. Summary
Levels of experienced anger, trait anger, and anger-expression styles are each associated with one another and are
also related to many negative health and behavior problems. Generally, individuals experiencing more anger and/or
those with high trait anger are likely to endorse an outward expressive style and less cognitive control of their anger.
Anger-control and trait anger have been associated with depression, suicidal ideation and attempts, and low mood in
both boys and girls. Children who are excessively reactive and overly expressive with their anger are more likely than
others to exhibit both externalizing and internalizing problem behaviors. Children who are overly restrictive in their
anger expression also seem to behave inappropriately. Poor anger-control and high anger-out is also predictive of
aggression in boys. Lastly, anger levels and internalizing anger has been associated with poor self-perceived health and
with chronic illnesses in children. Overall, the studies in this area were grounded in valid measures of well-established
anger constructs. What would benefit the study of the negative consequences of anger in childhood would be
longitudinal, predictive research designs similar to those found in the adult literature. Although studies of this nature
exist in the area of childhood aggression, understanding the unique role that childhood anger plays in predicting long-
term outcomes, including aggression, seems warranted.
6. Conclusions and future directions
Although it has received far less attention than aggression, research on the awareness and expression of anger by in
youth has produced valuable and insightful information. Constructs of anger expression analogous to those in the adult
literature have been found in youth populations; valid and reliable measures have been developed to assess them.
Anger has also been reliably assessed using observation of both live and recorded interactions. Both self-report and
observational measures have been used to identify possible origins of anger expression during children, to establish
how anger is expressed and the role it plays in interpersonal relationships and to delineate some of the potential
negative consequences of experiencing and/or expressing too much anger.
Despite quality of research in this area, the field as a whole generally lacks coherence, with separate lines of research
appearing to operate independently. Of primary concern is that anger is seldom assessed with more than one modality
in any given study. Rating scales such as the PAES-III or STAXI/STAXI-CA have been used mostly in studies of the
correlates of anger in terms of physical or mental health. Although reliable and valid for the most part, self-report
measures provide little insight into what a child is experiencing and expressing in any given anger-arousing situation.
In other lines of investigation, observational methods and study-specific questionnaires are used. Many of these are of
questionable validity with respect to established anger constructs. Combining observational and rating-scale evaluation
of anger in future research would benefit the field in a number of ways. First, the validity of established self-report
measures could be more firmly established. Given that variability exists in some of these measures with respect to
factor structure and reliability across genders and ages, more psychometric data would enable researchers to better
understand whether this variability is an artefact of the construct or of the assessment tools. Pairing observational and
self-report strategies would also help to establish the construct validity of the observations and their coding. Finally,
using observational research designs alongside self-report assessment would allow behavioral markers to be attached to
construct scale values. Striving to use common assessment tools and strategies in anger research with children would
help to unify the field and allow an easier comparison of results across studies. Further knowledge of how anger
expression is affected by and affects interpersonal relationships should perhaps be an area of focus for future research in
this field. Close, supportive relationships are crucial for healthy emotional and social development; relational support is
a protective factor in mental health. Thus, understanding the role of anger and the manner in which it is expressed in
maintaining and/or dissolving these relationships is crucial. Research focused on developing predictive models for
anger expression would help teachers, parents and clinicians to identify children who may be at risk for negative social,
health, or mental health outcomes. Greater use of longitudinal research designs is essential for the construction and
validations of such models.
As outlined above, the ways in which children display or mask anger in their relationships is based in part on display
rules for anger that are probably socialized both at home and in other social environments. Once scientists are able to
identify at-risk expression styles, researchers can begin to identify the events or interactions between parents and/or
peers that may establish maladaptive display rules or that may fail to establish adaptive display rules in children.
Marked gender differences in the socialization of anger have been identified. Expanding on this, research may reveal
gender normative and non-normative anger-expression styles in children. Very possibly, gender non-normative anger
expression may turn out to be predictive of negative outcomes. Therefore, identifying the processes through which
gender non-normative anger expression originates would be of great importance for parents and for those working with
at risk families.
Studies of anger and its expression might profitably be expanded to include measures of other emotional
experiences in addition to those of anger. This could improve the discriminant validity of the construct and of the
measurement tools. Knowing how the experience and expression of anger is similar to and/or different from other
emotions is necessary to identify and study whatever unique effects that anger plays in the lives of youth. The research
to date has generally not done this.
Anger, though often equated with and subsumed under larger constructs, such as aggression, has been established as
a construct worthy of independent study. Given the long-term negative health outcomes associated with anger in adults,
further exploration of anger expression in children would likely provide information useful in predicting and hopefully
changing the course of psychopathology and general illness across the life span.
References
Achenbach, T. (1991). Manual for the Child Behavior Checklist. Burlington: University of Vermont, Department of Psychiatry.
Achenbach, T., & Edlbrock, C. (1986). Manual for the Teacher's Report Form and teacher version of the Child Behavior Profile.
Averill, J. R. (1982). Anger and aggression: An essay on emotion. New York: Spring-Verlag.
Belgian-French Pooling Project (1984). Assessment of Type A behavior by Bortner scale and ischemic heart disease. European Heart Journal, 5,
440−446.
Boergers, J., Spirito, A., & Donaldson, D. (1998). Reasons for adolescent suicide attempts: Associations with psychological functioning. Journal of
the American Academy of Child and Adolescent Psychiatry, 37, 1287−1293.
Buss, A. H., & Perry, M. (1992). The aggression questionnaire. Journal of Personality and Social Psychology, 63, 452−459.
Camras, L. A., Ribordy, S., Hill, J., Martino, S., Spaccarelli, S., & Stefani, R. (1988). Recognition and posing of emotional expressions by abused
children and their mothers. Developmental Psychology, 18, 776−781.
Caprara, G. V., & Pastorelli, C. (1993). Early emotional instability, prosocial behavior, and aggression: Some methodological aspects. European
Journal of Personality, 7, 19−36.
Clay, D. L., Hagglund, K. J., Kashani, J. H., & Frank, R. G. (1996). Sex differences in anger expression, depressed mood, and aggression in children
and adolescents. Journal of Clinical Psychology in Medical Settings, 3, 79−92.
Cole, P. M., Teti, L. O., & Zahn-Waxler, C. (2003). Mutual emotion regulation and the stability of conduct problems between preschool and early age.
Development and Psychopathology, 15, 1−18.
Cole, P. M., Zahn-Waxler, C., Fox, N. A., Usher, B. A., & Welsh, J. D. (1996). Individual differences in emotion regulation and behavior problems in
preschool children. Journal of Abnormal Psychology, 105, 518−529.
Conners, C. K. (1989). Conners Teacher Rating Scale. Niagara Falls, NY: Multi-Health Systems.
Dearing, K. F., Hubbard, J. A., Ramsden, S. R., Parker, E. H., Relyea, N., & Smithmyer, C. M. (2002). Children's self-reports about anger regulation:
Direct and indirect links to social preference and aggression. Merrill-Palmer Quarterly, 48, 308−336.
del Barrio, V., Aluja, A., & Spielberger, C. (2004). Anger assessment with the STAXI-CA: Psychometric properties of a new instrument for children
and adolescents. Personality and Individual Differences, 37, 227−244.
Denham, S. A., Caverly, S., Schmidt, M., Blair, K., DeMulder, E., Caal, S., et al. (2002). Preschool understanding of emotions: Contributions to
classroom anger and aggression. Journal of Child Psychology and Psychiatry, 43, 901−916.
Eysenck, H. J., & Eysenck, S. B. G. (1975). Manual for the Eysenck Personality Questionnaire. London: Hodder & Stoughton.
Fabes, R. A., & Eisenberg, N. (1992). Young children's coping with interpersonal anger. Child Development, 63, 116−128.
Fabes, R. A., Leonard, S. A., Kupanoff, K., & Martin, C. L. (2001). Parental coping with children's negative emotions: Relations with children's
emotional and social responding. Child Development, 72, 907−920.
Friedman, H., & Booth-Kewley, S. (1987). The “disease-prone personality”: A meta-analytic view of the construct. American Psychologist, 42,
539−555.
Friesen, W., & Ekman, O. (1984). EMFACS: emotion facial action coding system. Available from W. Friesen, Department of Psychiatry, University of
California, San Francisco.
Furlong, M. J., Smith, D. C., & Bates, M. P. (2002). Further development of the multidimensional school anger inventory: Construct validation,
extension to female adolescents, and preliminary norms. Journal of Psychoeducational Assessment, 20, 46−65.
Goldston, D. B., Daniel, S., Reboussin, D. M., Kelly, A., Ievers, C., & Brunstetter, R. (1996). First-time suicide attempters, repeat attempters, and previous
attempters on an adolescent inpatient psychiatry unit. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 631−639.
Hagglund, K. J., Clay, D. L., Frank, R. G., Beck, N. C., Kashani, J. H., & Hewett, J. (1994). Assessing anger expression in children and adolescents.
Journal of Pediatric Psychology, 19, 291−304.
Harburg, E., Blakelock, E. H., Jr., & Roeper, P. R. (1979). Resentful and reflective coping with arbitrary authority and blood pressure: Detroit.
Psychosomatic Medicine, 41, 189−202.
Harburg, E., Julius, M., Kaciroti, N., Gleiberman, L., & Schork, A. (2003). Expressive/suppressive anger-coping responses, gender, and types of
mortality: A 17-year follow-up (Tecumseh, Michigan, 1971–1988). Psychosomatic Medicine, 65, 588−597.
Hauber, R. P., Rice, M. H., Howell, C. C., & Carmon, M. (1998). Anger and blood pressure readings in children. Applied Nursing Research, 11, 2−11.
Heft, L., Thoresen, C. E., Kirmil-Gray, K., Wiedenfeld, S. A., Eagleston, J. R., et al. (1988). Emotional and temperamental correlates of Type A in
children and adolescents. Journal of Youth and Adolescence, 17, 461−475.
Hewitt, P. L., Caelian, C. F., Flett, G. L., Sherry, S. B., Collins, L., & Flynn, C. A. (2002). Perfectionism in children: Associations with depression,
anxiety, and anger. Personality and Individual Differences, 32, 1049−1061.
Hochschild, A. R. (1979). Emotion work, feeling rules, and social structure. American Journal of Sociology, 85, 551−575.
Hubbard, J. A. (2001). Emotion expression processes in children's peer interaction: The role of peer rejection, aggression, and gender. Child
Development, 72, 1426−1438.
Hunter, S. M., Wolf, T. M., Sklov, M. C., Webber, L. S., Watson, R. M., & Berenson, G. S. (1982). Type A coronary-prone behavior pattern and
cardiovascular risk factor variables in children and adolescents: The Bogalusa heart study. Journal of Chronic Diseases, 35, 613−621.
Izard, C.E., Dougherty, B.M., Blowxom, B.M., & Kotsch, W.E. (1974). The differential emotion scale: A method of measuring the subjective
experience of discrete emotions. Unpublished manuscript. Nashville,TN: Vanderbilt University.
Jacobs, G.A. (1989). Brief measures of pediatric anger and anxiety. Unpublished manuscript.
Jacobs, G.A., & Kronaizl, C. (1991). Pediatric anger in rural impoverished communities. Paper presented at the annual meeting of the American
Psychological Association. San Francisco, CA.
Jacobs, G. A., Phelps, M., & Rohrs, B. (1989). Assessment of anger expression in children: The pediatric anger expression scale. Personality and
Individual Differences, 10, 59−65.
Jenkins, J. M. (2000). Marital conflicts and children's emotions: The development of an anger organization. Journal of Marriage and the Family, 62,
723−736.
Jenkins, J. M., & Ball, S. (2000). Distinguishing between negative emotions: Children's understanding of the social-regulatory aspects of emotion.
Cognition and Emotion, 14, 261−282.
Kashani, J. H., Dahlmeier, J. M., Borduin, C. M., Soltys, S., & Reid, J. C. (1995). Characteristics of anger expression in depressed children. Journal
of the American Academy of Child and Adolescent Psychiatry, 34, 322−326.
Kashani, J. H., Suarez, L., Allan, W., & Reid, J. C. (1997). Hopelessness in inpatient youths: A closer look at behavior, emotional expression, and
social support. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1625−1631.
Linden, W. (1987). On the impending death of the Type A construct: Or is there a phoenix rising from the ashes? Canadian Journal of Behavioural
Science, 19, 177−190.
Little, S. A., & Garber, J. (2000). Interpersonal and achievement orientations and specific stressors predicting depressive and aggressive symptoms in
children. Cognitive Therapy and Research, 24, 651−670.
Matthews, K. A., & Angulo, J. (1980). Measurement of the Type A behavior pattern in children: Assessment of children's competitiveness,
impatience-anger, and aggression. Child Development, 51, 466−475.
McKinnie-Burney, D., & Kromrey, J. (2001). Initial development and score validation of the adolescent anger rating scale. Educational and
Psychological Measurement, 61, 446−460.
Mueller, W. H., Grunbaum, J., & Labarthe, D. R. (2001). Anger expression, body fat, and blood pressure in adolescents: Project heartbeat! American
Journal of Human Biology, 13, 531−538.
Ortiz, M. A. C., & del Barrio Gandara, V. (2006). Study on the relations between temperament, aggression, and anger in children. Aggressive
Behavior, 32, 207−215.
Parker, E. H., Hubbard, J. A., Ramsden, S. R., Relyea, N., Dearing, K. F., Smithmyer, C. M., et al. (2001). Children's use and knowledge of display
rules for anger following hypothetical vignettes versus following live peer interaction. Social Development, 10, 528−557.
Phipps, S., & Steele, R. (2002). Repressive adaptive style in children with chronic illness. Psychosomatic Medicine, 64, 34−42.
Piko, B. F., Keresztes, N., & Pluhar, Z. F. (2006). Aggressive behavior in psychosocial health among children. Personality and Individual
Differences, 40, 885−895.
Reyes, L. R., Meininger, J. C., Liehr, P., Chan, W., & Mueller, W. H. (2003). Anger in adolescents. Nursing Research, 52, 2−11.
Rice, M., & Howell, C. (2006). Differences in trait anger among children with varying levels of anger expression patterns. Journal of Child and
Adolescent Psychiatric Nursing, 19, 51−61.
Rydell, A., Berlin, L., & Bohlin, G. (2003). Emotionality, emotion regulation, and adaptation among 5- to 8-year-old children. Emotion, 3, 30−47.
Saarni, C. (1979). Children's understanding of display rules for expressive behavior. Developmental Psychology, 15, 424−429.
Saarni, C. (1999). The development of emotional competence. New York: Guilford Press.
Schneider, B. H. (2000). Friends and enemies: peer relations in childhood. London: Arnold.
Shipman, K. L., & Zeman, J. (2001). Socialization of children's emotion regulation in mother–child dyads: A developmental psychopathology
perspective. Development and Psychopathology, 13, 317−336.
Shipman, K. L., Zeman, J., Nesin, A. E., & Fitzgerald, M. (2003). Children's strategies for displaying anger and sadness: What works with whom?
Merrill-Palmer Quarterly, 49, 100−122.
Silva, F., & Martorell, M. C. (1989). BAS-3. Batería de Socialización (Autoevaluación) Madrid: TEA Ediciones.
Smith, D. C., Furlong, M., Bates, M., & Laughlin, J. D. (1998). Development of the multidimensional school anger inventory for males. Psychology
in the Schools, 35, 1−15.
Snyder, J., Stoolmiller, M., Wilson, M., & Yamamoto, M. (2003). Child anger regulation, parental responses to children's anger displays, and early
child antisocial behavior. Social Development, 12, 335−360.
Spielberger, C. D. (1980). Preliminary manual for the State-Trait Anger Scale (STAS). Tampa, FL: University of South Florida.
Spielberger, C. D. (1988). Manual for the State-Trait Anger Expression Inventory (STAXI). Odessa, FL: Psychological Assessment Resources.
Spielberger, C. D. (1999). STAXI-2: State-Trait Anger Expression Inventory-2: professional manual. Odessa, FL: Psychological Assessment
Resources.
Spielberger, C. D., Johnson, E. H., Russell, S. F., Crane, R. J., Jacobs, G. A., & Worden, T. J. (1985). The experience and expression of anger:
Construction and validation of the Anger Expression Scale. In M. A. Chesney & R. H. Rosenman (Eds.), Anger and hostility in cardiovascular
and behavioral disorders (pp. 5−30). Washington, DC: Hemisphere.
Steele, R. G., Elliott, V., & Phipps, S. (2003). Race and health status as determinants of anger expression and adaptive style in children. Journal of
Social and Clinical Psychology, 22, 40−58.
Tangney, J. P., Hill-Barlow, D., Wagner, P. E., Marschall, D. E., Borenstein, J. K., Sanftner, J., et al. (1996). Assessing individual differences in
constructive versus destructive responses to anger across the lifespan. Journal of Personality and Social Psychology, 70, 780−796.
Thomas, S. P., Groer, M., Davis, M., Droppleman, P., Mozingo, J., & Pierce, M. (2000). Anger and cancer. Cancer Nursing, 23, 344−349.
Underwood, M. K. (1997). Top ten pressing questions about the development of emotion regulation. Motivation and Emotion, 21, 127−146.
Underwood, M. K., Coie, J. D., & Herbsman, C. R. (1992). Display rules for anger and aggression in school-age children. Child Development, 63,
366−380.
Underwood, M. K., Hurley, J. C., Johanson, C. A., & Mosley, J. E. (1999). An experimental, observational investigation of children's responses to
peer provocation: developmental and gender differences in middle childhood. Child Development, 70, 1428−1446.
von Salisch, M., & Vogelgesang, J. (2005). Anger regulation among friends: Assessment and development from childhood to adolescence. Journal of
Social and Personal Relationships, 22, 837−855.
Zeman, J., & Garber, J. (1996). Display rules for anger, sadness, and pain: It depends on who is watching. Child Development, 67, 957−973.
Zeman, J., & Shipman, K. (1996). Children's expression of negative affect: Reasons and methods. Developmental Psychology, 32, 842−849.
Zhou, Q., Eisenberg, N., Wang, Y., & Resier, M. (2004). Chinese children's effortful control and dispositional anger/frustration: Relations to
parenting styles and children's social functioning. Developmental Psychology, 40, 352−366.
Zuckerman, M., Eysenck, S. B. G., & Eysenck, H. J. (1978). Sensation seeking in England and America: Cross-cultural, age, and sex comparisons.
Journal of Consulting and Clinical Psychology, 46, 139−149.

Anger Expression in Children and Adolescents: A Review of The Empirical Literature

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Anger Expression in Children and Adolescents: A Review of The Empirical Literature

Uploaded by

Copyright:

Available Formats

Available online at www.sciencedirect.

Clinical Psychology Review 28 (2008) 559 – 577

Anger expression in children and adolescents:

1. Anger expression in children and adolescents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 560

5.3. Anger and health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 573

1. Anger expression in children and adolescents

1.1. Defining anger

2. Possible origins of the awareness and expression of anger

3. Assessing anger in children and adolescents

3.1. Self-report measures

3.2. Behavioral observation

4. Anger expression and interpersonal relationships

4.1. Hiding anger

M.A. Kerr, B.H. Schneider / Clinical Psychology Review 28 (2008) 559–577

4.2. Display rules

5. Potential outcomes of anger expression

M.A. Kerr, B.H. Schneider / Clinical Psychology Review 28 (2008) 559–577

Aggression and externalizing behavior

5.2. Aggression and externalizing behavior

5.3. Anger and health

6. Conclusions and future directions

You might also like