Vinson Daniel C, Arelli Vineesha
Department of Family and Community Medicine, University of Missouri-Columbia, Columbia, Mo 65212, USA.
Ann Fam Med. 2006 Jan-Feb;4(1):63-8. doi: 10.1370/afm.390.
Previous studies have examined anger at a given moment (state anger) and proxies for injury, or anger as a trait and injuries per se. Findings have been inconsistent. We sought to define further the relationship between state anger and risk of injury.
We conducted a case-control and case-crossover study in all 3 emergency departments in 1 county in Missouri. Cases were patients seeking care for an acute injury. They were compared with 2 controls: the patient himself or herself 24 hours before, and an individual recruited by telephone from the community and matched for age-group, sex, and time. Self-reported anger was assessed with 3 Likert scale items. Anger just before the injury was compared in case-crossover analyses with the respondent's own level of anger 24 hours before, and in standard case-control analyses with community participants' level of anger at the same hour the same day of the week in a subsequent week.
Of 2,517 patients, 2,446 provided data on anger just before the injury, and 2,117 reported data for 24 hours before injury. Of 1,856 community individuals, 1,533 provided complete data. Anger was prevalent. Of injured patients, 9%, 7%, and 4% reported feeling "quite a bit" or "extremely" "irritable," "angry," and "hostile," respectively, just before injury. Odds ratios for risk of injury were notably higher for greater degrees of anger; for example, for "angry," they were 1.8 (95% confidence interval, 1.1-2.7) for "quite a bit" and 7.2 (3.9-13) for "extremely." Odds ratios in women were substantially lower than those in men. Anger was not associated with fall and traffic injuries, but anger was strongly associated with intentional injuries inflicted by another person in both men and women.
High levels of self-reported state anger increase the risk of injury, especially among men, and specifically the risk of intentional injury in both sexes.
既往研究考察了特定时刻的愤怒情绪（状态愤怒）及其与受伤的关联指标，或者作为一种特质的愤怒情绪与受伤本身的关系。研究结果并不一致。我们试图进一步明确状态愤怒与受伤风险之间的关系。
我们在密苏里州一个县的所有3个急诊科开展了一项病例对照和病例交叉研究。病例为因急性损伤前来就诊的患者。将他们与2名对照进行比较：患者本人24小时前的情况，以及通过电话从社区招募的、在年龄组、性别和时间上相匹配的个体。用3个李克特量表项目评估自我报告的愤怒情绪。在病例交叉分析中，将受伤前的愤怒情绪与受访者自己24小时前的愤怒水平进行比较；在标准病例对照分析中，将其与后续一周中同一周同一天同一时间社区参与者的愤怒水平进行比较。
在2517名患者中，2446名提供了受伤前愤怒情绪的数据，2117名报告了受伤前24小时的数据。在1856名社区个体中，1533名提供了完整数据。愤怒情绪很常见。在受伤患者中，分别有9%、7%和4%的人报告在受伤前感到“相当”或“极其”“易怒”“愤怒”和“敌意”。愤怒程度越高，受伤风险的比值比显著越高；例如，对于“愤怒”，“相当”程度的比值比为1.8（95%置信区间，1.1 - 2.7），“极其”程度的比值比为7.2（3.9 - 13）。女性的比值比显著低于男性。愤怒与跌倒和交通伤无关，但愤怒与他人造成的故意伤害在男性和女性中均密切相关。
自我报告的高水平状态愤怒会增加受伤风险，尤其是在男性中，并且特别是增加两性故意伤害的风险。
