La colère dysfonctionnelle et son évaluation chez l’adulte

Abstract

Anger is an universal and adaptative emotion. However, it has long been relatively neglected and misunderstood compared to depression and anxiety. However, data show that it can have damaging consequences on individual health, as well as on relationships. In particular, the fact that chronic anger leads to heart problems is well documented. However, it is rarely included in diagnostic manuals and/or in psychology courses. Several hypotheses have been put forward to explain the reluctance of health professionals to assess and treat anger. In particular, anger may be a more difficult and unpleasant emotion to deal with, because of the feelings it provokes in professionals (such as intimidation and fear). This is exacerbated by the fact that patients who suffer from it find it difficult to work on themselves to manage it better, preferring to target external triggers. Aggression management was also mainly targeted by social rather than psychological interventions. Moreover, the difficulty of distinguishing it from other constructs such as hostility, irritability and aggression could also play a role in the difficulty of addressing it. To better understand it, it's important to be able to distinguish between normal and pathological anger. The function, outcome, chronicity, intensity and duration of anger episodes are all criteria that can be used as a basis. Spielberger's work provides a robust theoretical framework for identifying the dimensions of anger. Anger trait, for example, would be an element to assess, as it would be predictive of negative consequences. At the same time, numerous studies have pointed to the presence of significant anger in many psychopathological disorders. It is present in certain mood disorders such as depression and bipolar disorder. It is also observed in certain anxiety disorders and in Post-Traumatic Stress Disorder (PTSD). Anger is found in almost 90% of cases of borderline personality disorder. It is also linked to substance abuse and psychotic disorders. Other disorders, particularly for children and adolescents, could benefit from an anger assessment. There are a number of validated psychometric tools available in French for assessing anger, depending on the context. For example, the STAXI-2 is one of the most widely used tools for identifying the trait, state, expression and control of anger. The DAR-5-F is a recently validated short scale that assesses the experience of anger over the past 4 weeks. There are also other scales that assess anger rumination (ARS), aggression (AQ12) and driving anger (DAX). Over the past few years, a field of research has been developing to suggest ways for improving anger management with moderate effect compared to those targeting depression and anxiety. In addition, there are a number of books available for the general public, as well as a handful of clinical cases. However, the interventions and protocols that would be relevant are not available in French. In short, dysfunctional anger is rarely the subject of specific and adapted assessment and treatment. It would benefit from being more systematically assessed and targeted. Clinical research must continue in order to propose appropriate interventions and treatments, taking into account concomitant disorders.