Dowdall, D.J. (2000). The impact of trauma memory activation on fear, anger, and perceived emotional control: Implications for the perpetration of violence among Vietnam veterans with combat-related posttraumatic stress disorder. (Doctoral dissertation, State University of New York At Albany, 2000). Dissertation Abstracts International, 60 (8-B), 4217.

Abstract: Although research on emotional dysregulation among individuals with Posttraumatic Stress Disorder has predominantly focused on the experience of fear, studies offer evidence that anger may play a prominent role in the maintenance of post-trauma reactions. Specifically, anger may be an alternative response to fear following exposure to naturalistic trauma-related cues. Further, it is possible that perceptions of a loss of emotional control develop following repeated episodes of anger contributing to the pathological occurrence, as well as recurrence, of this emotion and its associated behavioral action tendencies. In order to investigate whether multiple emotional responses are elicited, and to discern the role of related perceptions of emotional control, the phenomenology of emotional activation was examined in 59 Vietnam veterans with variable symptom levels of combat-related PTSD. Specifically, the impact of priming trauma-related memories on self-reported fear, anger, perceived emotional control (PEC), and verbal and physical aggression was explored. Participants were exposed to standardized neutral (i.e., music) and trauma-related (i.e., combat) sounds in counterbalanced order. Additionally, physiological responses (i.e., blood pressure and heart rate) were recorded and expressed facial affect was emotion coded. Correlational analyses of baseline data revealed that veterans with more severe PTSD reported greater levels of fear, anger, and verbal and physical aggression and lower PEC over fear and anger. Hierarchical regression analyses indicated that these veterans also reported increased anger and recollections of physical acts of violence but not increased recollections of verbal aggression or decreased perceptions of emotional control following the trauma prime. Moreover, although all participants were more autonomically aroused during combat versus neutral priming, only participants with more severe PTSD evidenced greater negatively valenced facial affect. This multimodal, multimethod assessment revealed a complex relationship between the cueing of traumatic memories and emotional reactions to those cues. Although the results point to a mechanism through which anger and aggression may arise, they do not suggest that emotional responses are synchronous across response systems. Additional research on the temporal relationship between fear and anger and their associated features is recommended in the area of trauma. (PsycINFO Database Record (c) 2004 APA, all rights reserved)