chapter  7
Anger Attacks
ByMaurizio Fava
Pages 10

INTRODUCTION Anger attacks are sudden spells of intense anger that resemble panic attacks but lack the predominant affects of fear and anxiety associated with panic attacks. Anger attacks appear to be a form of dysregulated anger, which is a state in which there is an exaggerated angry and aggressive response to provoking or frustrating events. Thus, an anger attack may be viewed as a combination of predisposition-or some enduring state of vulnerability-and provocation. It is possible that this form of dysregulated anger is a response to the fight/flight reaction expressed cognitively and behaviorally as anger and fight instead of fear and flight (1). On the other hand, the predisposition may be related to underlying mood disorder, with anger and irritability being part of a depressive symptomatology (2), or of a hypomanic/manic/mixed state (3). Irritable mood is a core symptom of major depressive disorder in children and adolescents but is emphasized less as a symptom of depression in adults. Nevertheless, Snaith and Taylor (4) report that 37% of depressed inpatients had moderate to severe outwardly directed irritability, and findings from the Epidemiologic Catchment Area surveys indicate that depression is related to violent behavior

in samples taken from the community (5). This chapter discusses the development of the concept of anger attacks, the presence of anger attacks in depression and other psychiatric disorders, and the current treatment of anger attacks.