The experience, expression, and control of anger following traumatic brain injury in a military sample

OBJECTIVE:: To investigate the impact of traumatic brain injury (TBI) on the experience and expression of anger in a military sample. PARTICIPANTS:: A total of 661 military personnel with a history of TBI and 1204 military personnel with no history of TBI. DESIGN:: Cross-sectional, between-group design, using multivariate analysis of variance. MAIN MEASURE:: State-Trait Anger Expression Inventory-2 (STAXI-2). RESULTS:: Participants with a history of TBI had higher scores on the STAXI-2 than controls and were 2 to 3 times more likely than the participants in the control group to have at least 1 clinically significant elevation on the STAXI-2. Results suggested that greater time since injury (ie, months between TBI and assessment) was associated with lower scores on the STAXI-2 State Anger scale. CONCLUSION:: Although the results do not take into account confounding psychiatric conditions and cannot address causality, they suggest that a history of TBI increases the risk of problems with the experience, expression, and control of anger. This bolsters the need for proper assessment of anger when evaluating TBI in a military cohort.