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Anger in Multiple Sclerosis Patients Linked to Nervous System Damage

Multiple Sclerosis Symptoms
According to a study, multiple sclerosis patients experience more than twice as much withheld anger as the general population.

Researchers assessed 195 patients with multiple sclerosis, using a range of scales that measure anger, depression and anxiety, and then compared them with the general population. The results showed that while multiple sclerosis patients experienced almost twice the normal level of withheld anger and exerted low levels of control on their anger, their expressed anger levels were similar to the general population. This, together with the fact that the elevated withheld anger levels were not related to the severity of the patients' multiple sclerosis, suggests that these inconsistent changes were caused by nervous system damage, rather than an emotional reaction to the stress of the disease.

The patients who took part in the study comprised 150 with relapsing-remitting multiple sclerosis and 45 with progressive multiple sclerosis. More than two-thirds (68 per cent) were women, the average age of the participants was 40 and the average time since diagnosis was 11 years.

The study found that multiple sclerosis patients:
  • Were more than twice as likely to experience high levels of withheld anger, with 60 per cent of patients recording the same high levels as the top 25 per cent of the general population.
  • Exerted a low level of control on their anger, with just 11 per cent of patients reporting the same high levels of control compared to the top 25 per cent of the general population.
  • Were about the same as non multiple sclerosis patients when it came to expressed anger, with 30 per cent of patients reporting the same high levels as the top 25 per cent of the general population.
"We believe that the higher levels of withheld anger shown by the study subjects is due to demyelination, loss of the substance in the white matter that insulates the nerve endings and helps people receive and interpret messages from the brain" explains lead researcher Dr Ugo Nocentini.

"Our findings clearly show that anger characteristics in multiple sclerosis patients differ from those observed in the general population and the overall results surprised the research team" concludes Dr Nocentini.

"Anger disrupts interpersonal relationships and this is particularly true for withheld anger, which might go unrecognized by other people" says Dr Nocentini. "Withheld anger has been reported to be associated with physical problems, in particular high blood pressure and vascular disorders, and may have a negative effect on the general health of multiple sclerosis patients.

"Because withheld anger has no, or few, overt manifestations, and is unlikely to be recognized by clinicians or reported by patients, it is important that multiple sclerosis patients are asked if they experience abnormal anger."
References:
1. Nocentini et al. An exploration of anger phenomenology in multiple sclerosis. European Journal of Neurology. 16, 1312-1317. (December 2009). DOI: 10.1111/j.1468-1331.2009.02727.x

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