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The Relationship Between Anger, Childhood Maltreatment, and Emotion Regulation Difficulties in Intimate Partner and Non-Intimate Partner Violent Offenders Frank L. Gardner, Zella E. Moore and Melissa Dettore Behav Modif published online 18 June 2014 DOI: 10.1177/0145445514539346 The online version of this article can be found at: http://bmo.sagepub.com/content/early/2014/06/16/0145445514539346
Published by: http://www.sagepublications.com
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539346 research-article2014
BMOXXX10.1177/0145445514539346Behavior ModificationGardner et al.
Article
The Relationship Between Anger, Childhood Maltreatment, and Emotion Regulation Difficulties in Intimate Partner and NonIntimate Partner Violent Offenders
Behavior Modification 1–22 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0145445514539346 bmo.sagepub.com
Frank L. Gardner1, Zella E. Moore2, and Melissa Dettore1
Abstract Violence is a significant public health problem, which has been linked to the primary emotion of anger. While several theoretical models have attempted to understand the relationship between anger and violence, empirical evidence to support these models and the psychological treatments that follow from them have been lacking. A newer model for understanding the relationship between anger and violence emphasizes the dual diatheses of childhood maltreatment and difficulties in emotion regulation as central to understanding the anger−violence relationship. Investigating the relationship between childhood maltreatment and anger experience and expression among 88 violent offenders referred for intimate partner or non-intimate partner violent offenses, results herein confirm that substantial childhood maltreatment is found among violent offenders, with differing patterns of 1Kean
University, Union, NJ, USA College, Riverdale, NY, USA
2Manhattan
Corresponding Author: Zella E. Moore, Associate Professor, Department of Psychology, Manhattan College, 4513 Manhattan College Parkway, Riverdale, NY 10471, USA. Email: [email protected]
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Behavior Modification
abuse noted across groups. Furthermore, mediational analyses indicate that difficulties in emotion regulation mediate the relationship between childhood maltreatment and various aspects of anger experience and expression among both types of offenders. Keywords anger, emotion regulation, violence, childhood maltreatment, intimate partner Violent behavior is a serious concern resulting in significant interpersonal and societal costs, including judicial, correctional, and public health consequences (Gardner & Moore, 2008; Kassinove & Tafrate, 2002). While exact estimates are difficult to calculate, outcomes of violence translate into billions of dollars in yearly health care expenditures and law enforcement/judicial activities (Piquero, Jennings, & Farrington, 2013). While several explanations for violent behavior have previously been presented (see DiGiuseppe & Tafrate, 2007, for a review), cognitive behavioral models have traditionally emphasized the relationship between the emotion of anger and violent behavior.
Anger and Violence The emotion of anger has its roots in the basic evolutionary motive of species survival, and emotion theorists agree that the emotion of anger serves a variety of basic adaptive functions (Camras, 1992; Izard, 1991). Yet while anger has a clear adaptive function in its ability to prepare human beings to respond to external threat, it can also pose significant problems. The behavioral correlate of anger can have a negative impact on others, and often results in substantial short- and long-term personal and interpersonal costs. Kassinove and Tafrate (2002) found that individuals identified as anger prone (those experiencing high levels of trait anger) are twice as likely to be arrested and three times as likely to have served time in prison compared with those scoring low in trait anger, and most of the offenses among the anger-prone group were related to violent acts. Other lines of research have consistently found that (a) exposure to (and thus the modeling of) violence between parents and (b) the experience of frequent severe punishment by parents, including the use of physically and emotionally abusive behaviors, are significant and consistent predictors of later interpersonal violence (Black, Sussman, & Unger, 2010; Ehrensaft et al., 2003; Krug, Mercy, Dahlberg, & Zwi, 2002). Also, it
Downloaded from bmo.sagepub.com at GEORGIA TECH LIBRARY on October 31, 2014
Gardner et al.
3
has been argued that anger is a mediator of intimate partner violence (IPV) and substance abuse (Barbour, Eckhardt, Davison, & Kassinove, 1998). While not all studies have found a consistent relationship between elevated levels of anger and violent behavior, it has been suggested that the presence of anger, even at moderate levels, is consistently noted among IPV offenders (Eckhardt, Samper, & Murphy, 2008; Murphy, Taft, & Eckhardt, 2007). Consistent with this position, a meta-analysis by Norlander and Eckhardt (2005) found that moderately elevated levels of anger and hostility are notable characteristics of male perpetrators of IPV. To understand the relationship between anger and violent behavior, it is first necessary to distinguish between instrumental aggression and reactive aggression. Instrumental aggression is described as calculated, predatory (i.e., with an emphasis on acquiring other individuals’ possessions and/or asserting control of their behavior for personal benefit), and relatively independent of the experience of anger. Conversely, violence related to reactive aggression is described as impulsive, situation-focused (i.e., emphasizing physical aggression toward others without the primary desire for overt personal gain), and related to the subjective experience of anger (Bushman & Anderson, 2001; DiGiuseppe & Tafrate, 2007; Gardner & Moore, 2008, 2014b). While traditional cognitive behavioral models for understanding the anger−violence relationship differ in some minor respects, they all share some basic core commonalities. These include (a) an emphasis on factors such as cognitive appraisals and attributions of events and (b) aggressive behavioral reactions as a response to the experience of anger and subsequent maintaining/reinforcing consequences (Anderson & Bushman, 2002; Beck, 1999; Berkowitz, 2003; Kassinove & Tafrate, 2002; Novaco, 1975). From traditional cognitive behavioral perspectives, cognitive appraisal is viewed as the essential vehicle by which external events result in the experience of subjective anger, and violent behavior is in turn seen as a frequent consequence of that emotion. To date, however, the data have been at best inconsistent in their support for the various cognitive behavioral models describing the relationship between anger and violence (DiGiuseppe & Tafrate, 2007). Based upon these traditional models, it would be expected that psychological treatments focusing on core components of the models (such as modification of specific cognitions and reduction of physiological arousal) would result in substantial reductions in anger and subsequent violent behavior in clinical populations. However, while a recent review presents a cautious yet relatively promising conclusion about the general efficacy of psychological treatments for anger and violence (Saini, 2009), another review suggested that (a) efficacy data for
Downloaded from bmo.sagepub.com at GEORGIA TECH LIBRARY on October 31, 2014
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Behavior Modification
treatments of anger and violence based upon traditional cognitive behavioral models have been less than compelling and (b) such interventions for anger and violent behavior in clinical populations demonstrate a level of efficacy that is generally consistent with non-specific factors as opposed to specific treatment factors (Olatunji & Lohr, 2005). When looking more specifically at intimate partner violent behavior, a meta-analytic review by Babcock, Green, and Robie (2004) considered 22 studies evaluating treatment efficacy for domestically violent males. The studies included empirical investigations evaluating the relative efficacy of Duluth model interventions, cognitive behavioral therapy (CBT), and other types of interventions on subsequent violence recidivism. For clarity, it should be noted that the goals of Duluth model interventions are as follows: (a) the reduction of paternalistic power and control attitudes and behaviors, (b) the reduction of authoritarian control-/dominance-oriented relationship styles (which the model theorizes to be central to IPV), and (c) the development of more egalitarian relationship styles (Pence & Paymar, 1993). From the Duluth perspective, the discussion of anger and other internal psychological processes is seen as at best secondary to the discussion of paternalistic attitudes and behaviors, and proponents assert that a focus on anger/psychological constructs can allow for the inappropriate pathologizing of violent relational behavior that should instead be understood by its paternalistic, misogynistic, and dominance-oriented features. As such, from this viewpoint, it could be concluded that IPV and non-IPV would be expected to evolve from differing pathways. Overall, results from the Babcock et al. review found that treatment effect sizes for all types of interventions were small (
The Relationship Between Anger, Childhood Maltreatment, and Emotion Regulation Difficulties in Intimate Partner and Non-Intimate Partner Violent Offenders Frank L. Gardner, Zella E. Moore and Melissa Dettore Behav Modif published online 18 June 2014 DOI: 10.1177/0145445514539346 The online version of this article can be found at: http://bmo.sagepub.com/content/early/2014/06/16/0145445514539346
Published by: http://www.sagepublications.com
Additional services and information for Behavior Modification can be found at: Email Alerts: http://bmo.sagepub.com/cgi/alerts Subscriptions: http://bmo.sagepub.com/subscriptions Reprints: http://www.sagepub.com/journalsReprints.nav Permissions: http://www.sagepub.com/journalsPermissions.nav Citations: http://bmo.sagepub.com/content/early/2014/06/16/0145445514539346.refs.html
>> OnlineFirst Version of Record - Jun 18, 2014 What is This?
Downloaded from bmo.sagepub.com at GEORGIA TECH LIBRARY on October 31, 2014
539346 research-article2014
BMOXXX10.1177/0145445514539346Behavior ModificationGardner et al.
Article
The Relationship Between Anger, Childhood Maltreatment, and Emotion Regulation Difficulties in Intimate Partner and NonIntimate Partner Violent Offenders
Behavior Modification 1–22 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0145445514539346 bmo.sagepub.com
Frank L. Gardner1, Zella E. Moore2, and Melissa Dettore1
Abstract Violence is a significant public health problem, which has been linked to the primary emotion of anger. While several theoretical models have attempted to understand the relationship between anger and violence, empirical evidence to support these models and the psychological treatments that follow from them have been lacking. A newer model for understanding the relationship between anger and violence emphasizes the dual diatheses of childhood maltreatment and difficulties in emotion regulation as central to understanding the anger−violence relationship. Investigating the relationship between childhood maltreatment and anger experience and expression among 88 violent offenders referred for intimate partner or non-intimate partner violent offenses, results herein confirm that substantial childhood maltreatment is found among violent offenders, with differing patterns of 1Kean
University, Union, NJ, USA College, Riverdale, NY, USA
2Manhattan
Corresponding Author: Zella E. Moore, Associate Professor, Department of Psychology, Manhattan College, 4513 Manhattan College Parkway, Riverdale, NY 10471, USA. Email: [email protected]
Downloaded from bmo.sagepub.com at GEORGIA TECH LIBRARY on October 31, 2014
2
Behavior Modification
abuse noted across groups. Furthermore, mediational analyses indicate that difficulties in emotion regulation mediate the relationship between childhood maltreatment and various aspects of anger experience and expression among both types of offenders. Keywords anger, emotion regulation, violence, childhood maltreatment, intimate partner Violent behavior is a serious concern resulting in significant interpersonal and societal costs, including judicial, correctional, and public health consequences (Gardner & Moore, 2008; Kassinove & Tafrate, 2002). While exact estimates are difficult to calculate, outcomes of violence translate into billions of dollars in yearly health care expenditures and law enforcement/judicial activities (Piquero, Jennings, & Farrington, 2013). While several explanations for violent behavior have previously been presented (see DiGiuseppe & Tafrate, 2007, for a review), cognitive behavioral models have traditionally emphasized the relationship between the emotion of anger and violent behavior.
Anger and Violence The emotion of anger has its roots in the basic evolutionary motive of species survival, and emotion theorists agree that the emotion of anger serves a variety of basic adaptive functions (Camras, 1992; Izard, 1991). Yet while anger has a clear adaptive function in its ability to prepare human beings to respond to external threat, it can also pose significant problems. The behavioral correlate of anger can have a negative impact on others, and often results in substantial short- and long-term personal and interpersonal costs. Kassinove and Tafrate (2002) found that individuals identified as anger prone (those experiencing high levels of trait anger) are twice as likely to be arrested and three times as likely to have served time in prison compared with those scoring low in trait anger, and most of the offenses among the anger-prone group were related to violent acts. Other lines of research have consistently found that (a) exposure to (and thus the modeling of) violence between parents and (b) the experience of frequent severe punishment by parents, including the use of physically and emotionally abusive behaviors, are significant and consistent predictors of later interpersonal violence (Black, Sussman, & Unger, 2010; Ehrensaft et al., 2003; Krug, Mercy, Dahlberg, & Zwi, 2002). Also, it
Downloaded from bmo.sagepub.com at GEORGIA TECH LIBRARY on October 31, 2014
Gardner et al.
3
has been argued that anger is a mediator of intimate partner violence (IPV) and substance abuse (Barbour, Eckhardt, Davison, & Kassinove, 1998). While not all studies have found a consistent relationship between elevated levels of anger and violent behavior, it has been suggested that the presence of anger, even at moderate levels, is consistently noted among IPV offenders (Eckhardt, Samper, & Murphy, 2008; Murphy, Taft, & Eckhardt, 2007). Consistent with this position, a meta-analysis by Norlander and Eckhardt (2005) found that moderately elevated levels of anger and hostility are notable characteristics of male perpetrators of IPV. To understand the relationship between anger and violent behavior, it is first necessary to distinguish between instrumental aggression and reactive aggression. Instrumental aggression is described as calculated, predatory (i.e., with an emphasis on acquiring other individuals’ possessions and/or asserting control of their behavior for personal benefit), and relatively independent of the experience of anger. Conversely, violence related to reactive aggression is described as impulsive, situation-focused (i.e., emphasizing physical aggression toward others without the primary desire for overt personal gain), and related to the subjective experience of anger (Bushman & Anderson, 2001; DiGiuseppe & Tafrate, 2007; Gardner & Moore, 2008, 2014b). While traditional cognitive behavioral models for understanding the anger−violence relationship differ in some minor respects, they all share some basic core commonalities. These include (a) an emphasis on factors such as cognitive appraisals and attributions of events and (b) aggressive behavioral reactions as a response to the experience of anger and subsequent maintaining/reinforcing consequences (Anderson & Bushman, 2002; Beck, 1999; Berkowitz, 2003; Kassinove & Tafrate, 2002; Novaco, 1975). From traditional cognitive behavioral perspectives, cognitive appraisal is viewed as the essential vehicle by which external events result in the experience of subjective anger, and violent behavior is in turn seen as a frequent consequence of that emotion. To date, however, the data have been at best inconsistent in their support for the various cognitive behavioral models describing the relationship between anger and violence (DiGiuseppe & Tafrate, 2007). Based upon these traditional models, it would be expected that psychological treatments focusing on core components of the models (such as modification of specific cognitions and reduction of physiological arousal) would result in substantial reductions in anger and subsequent violent behavior in clinical populations. However, while a recent review presents a cautious yet relatively promising conclusion about the general efficacy of psychological treatments for anger and violence (Saini, 2009), another review suggested that (a) efficacy data for
Downloaded from bmo.sagepub.com at GEORGIA TECH LIBRARY on October 31, 2014
4
Behavior Modification
treatments of anger and violence based upon traditional cognitive behavioral models have been less than compelling and (b) such interventions for anger and violent behavior in clinical populations demonstrate a level of efficacy that is generally consistent with non-specific factors as opposed to specific treatment factors (Olatunji & Lohr, 2005). When looking more specifically at intimate partner violent behavior, a meta-analytic review by Babcock, Green, and Robie (2004) considered 22 studies evaluating treatment efficacy for domestically violent males. The studies included empirical investigations evaluating the relative efficacy of Duluth model interventions, cognitive behavioral therapy (CBT), and other types of interventions on subsequent violence recidivism. For clarity, it should be noted that the goals of Duluth model interventions are as follows: (a) the reduction of paternalistic power and control attitudes and behaviors, (b) the reduction of authoritarian control-/dominance-oriented relationship styles (which the model theorizes to be central to IPV), and (c) the development of more egalitarian relationship styles (Pence & Paymar, 1993). From the Duluth perspective, the discussion of anger and other internal psychological processes is seen as at best secondary to the discussion of paternalistic attitudes and behaviors, and proponents assert that a focus on anger/psychological constructs can allow for the inappropriate pathologizing of violent relational behavior that should instead be understood by its paternalistic, misogynistic, and dominance-oriented features. As such, from this viewpoint, it could be concluded that IPV and non-IPV would be expected to evolve from differing pathways. Overall, results from the Babcock et al. review found that treatment effect sizes for all types of interventions were small (
