Harburg Ernest, Julius Mara, Kaciroti Niko, Gleiberman Lillian, Schork M Anthony
Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Psychosom Med. 2003 Jul-Aug;65(4):588-97. doi: 10.1097/01.psy.0000075974.19706.3b.
This study examined prospectively (1971-1988) the relationship between anger-coping responses, gender, and mortality (N = 91) in a representative sample of men (N = 324) and women (N = 372), aged 30 to 69, from the Tecumseh Community Health Study.
Anger-coping was measured by responses to hypothetical unfair anger-provoking situations. Cox proportional hazard regressions were used adjusted for seven health risk factors (age, smoking, relative weight, systolic blood pressure (SBP), bronchial problems, FEV1, and cardiovascular (CV) risk).
Men's suppressed anger interacted significantly with SBP and also with bronchial problems to predict both all-cause and CV mortality. Women showed direct relationships between suppressed anger and early mortality (all-cause, CV, and cancer). Women also showed an interaction of spouse-suppressed anger and SBP for all-cause and CV mortality. Data suggest men who expressed their anger died earlier of cancer (N = 16) deaths.
Suppressed anger at the time of an unjust attack may become chronic resentment (intermittent rage or hatred) about which little is known and requires research. The design for future research should experimentally measure both suppressed anger-coping responses (after an unfair attack) and morbidity (eg, blood pressure, bronchitis, immune disorder, etc.) to predict prospectively to earlier mortality.
本研究对来自蒂卡姆西社区健康研究的91名男性（n = 324）和372名女性（n = 372）进行了前瞻性研究（1971 - 1988年），这些参与者年龄在30至69岁之间，旨在探究愤怒应对方式、性别与死亡率之间的关系。
通过对假设的不公平愤怒诱发情境的反应来测量愤怒应对方式。使用Cox比例风险回归模型，并对七个健康风险因素（年龄、吸烟、相对体重、收缩压（SBP）、支气管问题、第一秒用力呼气量（FEV1）和心血管（CV）风险）进行了调整。
男性压抑的愤怒与收缩压以及支气管问题存在显著交互作用，可预测全因死亡率和心血管死亡率。女性中，压抑的愤怒与早期死亡率（全因、心血管和癌症）呈直接关系。女性还显示出配偶压抑的愤怒与收缩压在全因死亡率和心血管死亡率方面的交互作用。数据表明，表达愤怒的男性因癌症死亡（n = 16）的时间更早。
在遭受不公正攻击时压抑的愤怒可能会演变成长期的怨恨（间歇性愤怒或仇恨），对此我们知之甚少，需要进行研究。未来研究的设计应通过实验测量压抑的愤怒应对反应（在遭受不公平攻击后）和发病率（如血压、支气管炎、免疫紊乱等），以期前瞻性地预测更早的死亡率。
