Clinicians’ diagnosis of a case with anger problems

The comorbidity of anger symptoms with personality disorders in psychiatric outpatients

“…Lachmund et al (2005) found that BPD was over diagnosed in their study of clinicians diagnosing angry patients. This diagnosis was overused most often with women.…”

“…Among practicing clinicians, it is common to see clients for whom anger is a problem (Lachmund, DiGiuseppe, & Fuller, 2005). Indeed, an investigation of state anger (anger and aggression at the time of treatment initiation) in psychiatric outpatients showed that half of the participants reported moderate to severe levels of anger, and that the level of anger was equivalent to the levels of depression and anxiety at intake (Posternak & Zimmerman, 2002).…”

“…Despite the frequency with which clinicians report seeing angry clients, clinical proficiency in understanding and diagnosing anger problems remains inadequate (Lachmund et al, 2005). The problem of adequately diagnosing angry clients stems from the fact that anger in the DSM-IV is a symptom that is secondary to other psychiatric problems, such as explosive outbursts in someone with posttraumatic stress disorder (PTSD).…”

“…However, some clients can best be described as having a primary anger disorder, i.e., their anger is not simply an offshoot of another primary problem (e.g., mania, generalized anxiety disorder [GAD], PTSD, major depressive disorder [MDD]). Among clinicians in routine practice, considerable confusion exists concerning how to diagnose these angry patients (Lachmund et al, 2005).…”

“…Similarly, Baumeister et al (1996) posited that high narcissism might be expressed with high aggression when there is a perceived ego threat. Lachmund et al (2005) found that clinicians frequently assigned PD diagnoses to hypothetical cases of angry patients. In their study, clinicians assigned a PD diagnosis 80% of the time when they were asked for primary and secondary diagnoses for case vignettes describing angry patients.…”