Skip to main content
Top
Published in: BMC Public Health 1/2009

Open Access 01-12-2009 | Research article

Anger expression, violent behavior, and symptoms of depression among male college students in Ethiopia

Authors: Dale J Terasaki, Bizu Gelaye, Yemane Berhane, Michelle A Williams

Published in: BMC Public Health | Issue 1/2009

Login to get access

Abstract

Background

Depression is an important global public health problem. Given the scarcity of studies involving African youths, this study was conducted to evaluate the associations of anger expression and violent behavior with symptoms of depression among male college students.

Methods

A self-administered questionnaire was used to collect information on socio-demographic and lifestyle characteristics and violent behavior among 1,176 college students in Awassa, Ethiopia in June, 2006. The questionnaire incorporated the Spielberger Anger-Out Expression (SAOE) scale and symptoms of depression were evaluated using the Patient Health Questionnaire (PHQ-9). Multivariable logistic regression procedures were used to calculate adjusted odds ratios (OR) and 95% confidence intervals (95%CI).

Results

Symptoms of depression were evident in 23.6% of participants. Some 54.3% of students reported committing at least one act of violence in the current academic year; and 29.3% of students reported high (SAOE score ≥ 15) levels of anger-expression. In multivariate analysis, moderate (OR = 1.97; 95%CI 1.33–2.93) and high (OR = 3.23; 95%CI 2.14–4.88) outward anger were statistically significantly associated with increased risks of depressive symptoms. Violent behavior was noted to be associated with depressive symptoms (OR = 1.82; 95%CI 1.37–2.40).

Conclusion

Further research should be conducted to better characterize community and individual level determinants of anger-expression, violent behavior and depression among youths.
Appendix
Available only for authorised users
Literature
1.
go back to reference Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B: Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet. 2007, 370: 851-858. 10.1016/S0140-6736(07)61415-9.CrossRefPubMed Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B: Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet. 2007, 370: 851-858. 10.1016/S0140-6736(07)61415-9.CrossRefPubMed
2.
go back to reference Ustun TB, Ayuso-Mateos JL, Chatterji S, Mathers C, Murray CJ: Global burden of depressive disorders in the year 2000. Br J Psychiatry. 2004, 184: 386-392. 10.1192/bjp.184.5.386.CrossRefPubMed Ustun TB, Ayuso-Mateos JL, Chatterji S, Mathers C, Murray CJ: Global burden of depressive disorders in the year 2000. Br J Psychiatry. 2004, 184: 386-392. 10.1192/bjp.184.5.386.CrossRefPubMed
3.
go back to reference Koh KB, Kim DK, Kim SY, Park JK: The relation between anger expression, depression, and somatic symptoms in depressive disorders and somatoform disorders. J Clin Psychiatry. 2005, 66: 485-491.CrossRefPubMed Koh KB, Kim DK, Kim SY, Park JK: The relation between anger expression, depression, and somatic symptoms in depressive disorders and somatoform disorders. J Clin Psychiatry. 2005, 66: 485-491.CrossRefPubMed
4.
go back to reference Richmond M, Spring B, Sommerfeld BK, MeChargue D: Rumination and cigarette smoking: a bad combination for depressive outcomes?. J Consult Clin Psychol. 2001, 69: 836-840. 10.1037/0022-006X.69.5.836.CrossRefPubMed Richmond M, Spring B, Sommerfeld BK, MeChargue D: Rumination and cigarette smoking: a bad combination for depressive outcomes?. J Consult Clin Psychol. 2001, 69: 836-840. 10.1037/0022-006X.69.5.836.CrossRefPubMed
5.
go back to reference Rudnicki SR, Graham JL, Habboushe DF, Ross RD: Social support and avoidant coping: correlates of depressed mood during pregnancy in minority women. Women Health. 2001, 34: 19-34. 10.1300/J013v34n03_02.CrossRefPubMed Rudnicki SR, Graham JL, Habboushe DF, Ross RD: Social support and avoidant coping: correlates of depressed mood during pregnancy in minority women. Women Health. 2001, 34: 19-34. 10.1300/J013v34n03_02.CrossRefPubMed
6.
go back to reference Kaltiala-Heino R, Rimpela M, Marttunen M, Rimpela A, Rantanen P: Bullying, depression, and suicidal ideation in Finnish adolescents: school survey. BMJ. 1999, 319: 348-351.CrossRefPubMedPubMedCentral Kaltiala-Heino R, Rimpela M, Marttunen M, Rimpela A, Rantanen P: Bullying, depression, and suicidal ideation in Finnish adolescents: school survey. BMJ. 1999, 319: 348-351.CrossRefPubMedPubMedCentral
7.
go back to reference Salmon G, James A, Smith DM: Bullying in schools: self reported anxiety, depression, and self esteem in secondary school children. BMJ. 1998, 317: 924-925.CrossRefPubMedPubMedCentral Salmon G, James A, Smith DM: Bullying in schools: self reported anxiety, depression, and self esteem in secondary school children. BMJ. 1998, 317: 924-925.CrossRefPubMedPubMedCentral
8.
go back to reference Krug EG, Dahlberg LL, Mercy JA, Zwi AB, Lozano R: World report on violence and health. 2002, Geneva: World Health Organization Krug EG, Dahlberg LL, Mercy JA, Zwi AB, Lozano R: World report on violence and health. 2002, Geneva: World Health Organization
9.
go back to reference Saluja G, Iachan R, Scheidt PC, Overpeck MD, Sun W, Giedd JN: Prevalence of and risk factors for depressive symptoms among young adolescents. Arch Pediatr Adolesc Med. 2004, 158: 760-765. 10.1001/archpedi.158.8.760.CrossRefPubMed Saluja G, Iachan R, Scheidt PC, Overpeck MD, Sun W, Giedd JN: Prevalence of and risk factors for depressive symptoms among young adolescents. Arch Pediatr Adolesc Med. 2004, 158: 760-765. 10.1001/archpedi.158.8.760.CrossRefPubMed
10.
go back to reference Goodwin RD: Association between coping with anger and feelings of depression among youths. Am J Public Health. 2006, 96: 664-669. 10.2105/AJPH.2004.049742.CrossRefPubMedPubMedCentral Goodwin RD: Association between coping with anger and feelings of depression among youths. Am J Public Health. 2006, 96: 664-669. 10.2105/AJPH.2004.049742.CrossRefPubMedPubMedCentral
11.
go back to reference Lee PS, Sohn JN, Lee YM, Park EY, Park JS: [A correlational study among perceived stress, anger expression, and depression in cancer patients]. Taehan Kanho Hakhoe Chi. 2005, 35: 195-205.PubMed Lee PS, Sohn JN, Lee YM, Park EY, Park JS: [A correlational study among perceived stress, anger expression, and depression in cancer patients]. Taehan Kanho Hakhoe Chi. 2005, 35: 195-205.PubMed
12.
go back to reference Lee WH, Kim CJ: [The relationship between depression, perceived stress, fatigue and anger in clinical nurses]. Taehan Kanho Hakhoe Chi. 2006, 36: 925-932.PubMed Lee WH, Kim CJ: [The relationship between depression, perceived stress, fatigue and anger in clinical nurses]. Taehan Kanho Hakhoe Chi. 2006, 36: 925-932.PubMed
13.
go back to reference Thomas SP, Atakan S: Trait anger, anger expression, stress, and health status of American and Turkish midlife women. Health Care Women Int. 1993, 14: 129-143.CrossRefPubMed Thomas SP, Atakan S: Trait anger, anger expression, stress, and health status of American and Turkish midlife women. Health Care Women Int. 1993, 14: 129-143.CrossRefPubMed
14.
go back to reference Kitamura T, Hasui C: Anger feelings and anger expression as a mediator of the effects of witnessing family violence on anxiety and depression in Japanese adolescents. J Interpers Violence. 2006, 21: 843-855. 10.1177/0886260506288933.CrossRefPubMed Kitamura T, Hasui C: Anger feelings and anger expression as a mediator of the effects of witnessing family violence on anxiety and depression in Japanese adolescents. J Interpers Violence. 2006, 21: 843-855. 10.1177/0886260506288933.CrossRefPubMed
15.
go back to reference Gudlaugsdottir GR, Vilhjalmsson R, Kristjansdottir G, Jacobsen R, Meyrowitsch D: Violent behaviour among adolescents in Iceland: a national survey. Int J Epidemiol. 2004, 33: 1046-1051. 10.1093/ije/dyh190.CrossRefPubMed Gudlaugsdottir GR, Vilhjalmsson R, Kristjansdottir G, Jacobsen R, Meyrowitsch D: Violent behaviour among adolescents in Iceland: a national survey. Int J Epidemiol. 2004, 33: 1046-1051. 10.1093/ije/dyh190.CrossRefPubMed
16.
go back to reference Orpinas PK, Basen-Engquist K, Grunbaum JA, Parcel GS: The co-morbidity of violence-related behaviors with health-risk behaviors in a population of high school students. J Adolesc Health. 1995, 16: 216-225. 10.1016/1054-139X(94)00067-O.CrossRefPubMed Orpinas PK, Basen-Engquist K, Grunbaum JA, Parcel GS: The co-morbidity of violence-related behaviors with health-risk behaviors in a population of high school students. J Adolesc Health. 1995, 16: 216-225. 10.1016/1054-139X(94)00067-O.CrossRefPubMed
17.
go back to reference Kebede D, Ketsela T: Suicide attempts in Ethiopian adolescents in Addis Abeba high schools. Ethiop Med J. 1993, 31: 83-90.PubMed Kebede D, Ketsela T: Suicide attempts in Ethiopian adolescents in Addis Abeba high schools. Ethiop Med J. 1993, 31: 83-90.PubMed
18.
go back to reference Shiferaw S, Fantahun M, Bekele A: Psychosocial problems among students in preparatory school, in Dessie town, north east Ethiopia. Ethiopian Journal of Health Development. 2006, 20: 47-55.CrossRef Shiferaw S, Fantahun M, Bekele A: Psychosocial problems among students in preparatory school, in Dessie town, north east Ethiopia. Ethiopian Journal of Health Development. 2006, 20: 47-55.CrossRef
19.
go back to reference Gelaye B, Philpart M, Goshu M, Berhane Y, Fitzpatrick AL, Williams MA: Anger expression, negative life events and violent behaviour among male college students in Ethiopia. Scand J Public Health. 2008, 36: 538-545. 10.1177/1403494807086916.CrossRefPubMed Gelaye B, Philpart M, Goshu M, Berhane Y, Fitzpatrick AL, Williams MA: Anger expression, negative life events and violent behaviour among male college students in Ethiopia. Scand J Public Health. 2008, 36: 538-545. 10.1177/1403494807086916.CrossRefPubMed
20.
go back to reference Mastrogianni A, Bhugra D: Globalization, cultural psychiatry and mental distress. Int J Soc Psychiatry. 2003, 49: 163-165. 10.1177/00207640030493001.CrossRefPubMed Mastrogianni A, Bhugra D: Globalization, cultural psychiatry and mental distress. Int J Soc Psychiatry. 2003, 49: 163-165. 10.1177/00207640030493001.CrossRefPubMed
21.
go back to reference Bhugra D, Mastrogianni A: Globalisation and mental disorders. Overview with relation to depression. Br J Psychiatry. 2004, 184: 10-20. 10.1192/bjp.184.1.10.CrossRefPubMed Bhugra D, Mastrogianni A: Globalisation and mental disorders. Overview with relation to depression. Br J Psychiatry. 2004, 184: 10-20. 10.1192/bjp.184.1.10.CrossRefPubMed
22.
go back to reference Booker CL, Unger JB, Azen SP, Baezconde-Garbanati L, Lickel B, Johnson CA: A longitudinal analysis of stressful life events, smoking behaviors, and gender differences in a multicultural sample of adolescents. Subst Use Misuse. 2008, 43: 1521-1543. 10.1080/10826080802238009.CrossRefPubMed Booker CL, Unger JB, Azen SP, Baezconde-Garbanati L, Lickel B, Johnson CA: A longitudinal analysis of stressful life events, smoking behaviors, and gender differences in a multicultural sample of adolescents. Subst Use Misuse. 2008, 43: 1521-1543. 10.1080/10826080802238009.CrossRefPubMed
23.
go back to reference Desjarlais R, Eisenberg L, Good B, Kleinman A: World Mental Health: Problems and priorities in low-income countries. 1995, New York: Oxford University Press Desjarlais R, Eisenberg L, Good B, Kleinman A: World Mental Health: Problems and priorities in low-income countries. 1995, New York: Oxford University Press
24.
go back to reference Spitzer RL, Kroenke K, Williams JB: Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. Jama. 1999, 282: 1737-1744. 10.1001/jama.282.18.1737.CrossRefPubMed Spitzer RL, Kroenke K, Williams JB: Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. Jama. 1999, 282: 1737-1744. 10.1001/jama.282.18.1737.CrossRefPubMed
25.
go back to reference Spielberger CD, Sydeman SJ, Owen AE, Marsh BJ: Measuring anxiety and anger with the State-Trait Anxiety Inventory (STAI) and the State-Trait Anger Expression Inventory (STAXI). The use of psychological testing for treatment planning and outcomes assessment. Edited by: Maruish ME. 1999, Mahwah, NJ Lawrence Erlbaum Associates, 1007-1008. Spielberger CD, Sydeman SJ, Owen AE, Marsh BJ: Measuring anxiety and anger with the State-Trait Anxiety Inventory (STAI) and the State-Trait Anger Expression Inventory (STAXI). The use of psychological testing for treatment planning and outcomes assessment. Edited by: Maruish ME. 1999, Mahwah, NJ Lawrence Erlbaum Associates, 1007-1008.
26.
go back to reference Garcia-Leon A, Reyes GA, Vila J, Perez N, Robles H, Ramos MM: The Aggression Questionnaire: a validation study in student samples. Span J Psychol. 2002, 5: 45-53.CrossRefPubMed Garcia-Leon A, Reyes GA, Vila J, Perez N, Robles H, Ramos MM: The Aggression Questionnaire: a validation study in student samples. Span J Psychol. 2002, 5: 45-53.CrossRefPubMed
27.
go back to reference Butcher JN, Spielberger CD: Advances in Personality Assessment. 1983, Hillsdale, NJ: Lawrence Erlbaum Associates Butcher JN, Spielberger CD: Advances in Personality Assessment. 1983, Hillsdale, NJ: Lawrence Erlbaum Associates
28.
go back to reference Honkalampi K, Hintikka J, Haatainen K, Koivumaa-Honkanen H, Tanskanen A, Viinamaki H: Adverse childhood experiences, stressful life events or demographic factors: which are important in women's depression? A 2-year follow-up population study. Aust N Z J Psychiatry. 2005, 39: 627-632. 10.1111/j.1440-1614.2005.01636.x.CrossRefPubMed Honkalampi K, Hintikka J, Haatainen K, Koivumaa-Honkanen H, Tanskanen A, Viinamaki H: Adverse childhood experiences, stressful life events or demographic factors: which are important in women's depression? A 2-year follow-up population study. Aust N Z J Psychiatry. 2005, 39: 627-632. 10.1111/j.1440-1614.2005.01636.x.CrossRefPubMed
29.
go back to reference Silver E, Teasdale B: Mental Disorder and Violence: An examination of Stressful Life Events and Impaired Social Support. Social Problems. 2005, 52: 62-78. 10.1525/sp.2005.52.1.62.CrossRef Silver E, Teasdale B: Mental Disorder and Violence: An examination of Stressful Life Events and Impaired Social Support. Social Problems. 2005, 52: 62-78. 10.1525/sp.2005.52.1.62.CrossRef
30.
go back to reference Ayana AM, Mekonen Z: Khat (Catha edulis Forsk) chewing, sociodemographic description and its effect on academic performance, Jimma University students 2002. Ethiop Med J. 2004, 42: 125-136.PubMed Ayana AM, Mekonen Z: Khat (Catha edulis Forsk) chewing, sociodemographic description and its effect on academic performance, Jimma University students 2002. Ethiop Med J. 2004, 42: 125-136.PubMed
31.
go back to reference Kroenke K, Spitzer RL, Williams JB: The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001, 16: 606-613. 10.1046/j.1525-1497.2001.016009606.x.CrossRefPubMedPubMedCentral Kroenke K, Spitzer RL, Williams JB: The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001, 16: 606-613. 10.1046/j.1525-1497.2001.016009606.x.CrossRefPubMedPubMedCentral
32.
go back to reference Rothman KJ, Greenland S: Modern Epidemiology. 1998, Philadelphia, PA: Lippincott-Raven, 2 Rothman KJ, Greenland S: Modern Epidemiology. 1998, Philadelphia, PA: Lippincott-Raven, 2
33.
go back to reference Zinn-Souza L, Nagai R, Teixeira L, Latorre M, Roberts R, Cooper S, Fischer F: Factors associated with depression symptoms in high school students in Sao Paulo, Brazil. Rev Saude Publica. 2008, 42: 34-40.CrossRefPubMed Zinn-Souza L, Nagai R, Teixeira L, Latorre M, Roberts R, Cooper S, Fischer F: Factors associated with depression symptoms in high school students in Sao Paulo, Brazil. Rev Saude Publica. 2008, 42: 34-40.CrossRefPubMed
34.
go back to reference Sperberg ED, Stabb SD: Depression in women as related to anger and mutuality in relationships. Psychology of Women Quarterly. 1998, 22: 223-238. 10.1111/j.1471-6402.1998.tb00152.x.CrossRef Sperberg ED, Stabb SD: Depression in women as related to anger and mutuality in relationships. Psychology of Women Quarterly. 1998, 22: 223-238. 10.1111/j.1471-6402.1998.tb00152.x.CrossRef
35.
go back to reference Wolke D, Woods S, Bloomfield L, Karstadt L: Bullying involvement in primary school and common health problems. Arch Dis Child. 2001, 85: 197-201. 10.1136/adc.85.3.197.CrossRefPubMedPubMedCentral Wolke D, Woods S, Bloomfield L, Karstadt L: Bullying involvement in primary school and common health problems. Arch Dis Child. 2001, 85: 197-201. 10.1136/adc.85.3.197.CrossRefPubMedPubMedCentral
36.
go back to reference Martin D, Quirino J, Mari J: [Depression among women living in the outskirts of Sao Paulo, Southeastern Brasil]. Rev Saude Publica. 2007, 41: 591-597.CrossRefPubMed Martin D, Quirino J, Mari J: [Depression among women living in the outskirts of Sao Paulo, Southeastern Brasil]. Rev Saude Publica. 2007, 41: 591-597.CrossRefPubMed
37.
38.
go back to reference Mezulis AH, Hyde JS, Abramson LY: The developmental origins of cognitive vulnerability to depression: temperament, parenting, and negative life events in childhood as contributors to negative cognitive style. Dev Psychol. 2006, 42: 1012-1025. 10.1037/0012-1649.42.6.1012.CrossRefPubMed Mezulis AH, Hyde JS, Abramson LY: The developmental origins of cognitive vulnerability to depression: temperament, parenting, and negative life events in childhood as contributors to negative cognitive style. Dev Psychol. 2006, 42: 1012-1025. 10.1037/0012-1649.42.6.1012.CrossRefPubMed
39.
go back to reference Martin SL, Li Y, Casanueva C, Harris-Britt A, Kupper LL, Cloutier S: Intimate partner violence and women's depression before and during pregnancy. Violence Against Women. 2006, 12: 221-239. 10.1177/1077801205285106.CrossRefPubMed Martin SL, Li Y, Casanueva C, Harris-Britt A, Kupper LL, Cloutier S: Intimate partner violence and women's depression before and during pregnancy. Violence Against Women. 2006, 12: 221-239. 10.1177/1077801205285106.CrossRefPubMed
40.
go back to reference Patel V, Kirkwood BR, Pednekar S, Pereira B, Barros P, Fernandes J, Datta J, Pai R, Weiss H, Mabey D: Gender disadvantage and reproductive health risk factors for common mental disorders in women: a community survey in India. Arch Gen Psychiatry. 2006, 63: 404-413. 10.1001/archpsyc.63.4.404.CrossRefPubMed Patel V, Kirkwood BR, Pednekar S, Pereira B, Barros P, Fernandes J, Datta J, Pai R, Weiss H, Mabey D: Gender disadvantage and reproductive health risk factors for common mental disorders in women: a community survey in India. Arch Gen Psychiatry. 2006, 63: 404-413. 10.1001/archpsyc.63.4.404.CrossRefPubMed
41.
go back to reference Adewuya AO, Ola BA, Afolabi OO: Validity of the patient health questionnaire (PHQ-9) as a screening tool for depression amongst Nigerian university students. J Affect Disord. 2006, 96: 89-93. 10.1016/j.jad.2006.05.021.CrossRefPubMed Adewuya AO, Ola BA, Afolabi OO: Validity of the patient health questionnaire (PHQ-9) as a screening tool for depression amongst Nigerian university students. J Affect Disord. 2006, 96: 89-93. 10.1016/j.jad.2006.05.021.CrossRefPubMed
42.
go back to reference Omoro SA, Fann JR, Weymuller EA, Macharia IM, Yueh B: Swahili translation and validation of the Patient Health Questionnaire-9 depression scale in the Kenyan head and neck cancer patient population. Int J Psychiatry Med. 2006, 36: 367-381. 10.2190/8W7Y-0TPM-JVGV-QW6M.CrossRefPubMed Omoro SA, Fann JR, Weymuller EA, Macharia IM, Yueh B: Swahili translation and validation of the Patient Health Questionnaire-9 depression scale in the Kenyan head and neck cancer patient population. Int J Psychiatry Med. 2006, 36: 367-381. 10.2190/8W7Y-0TPM-JVGV-QW6M.CrossRefPubMed
43.
go back to reference Abrahams N, Jewkes R: Effects of South African men's having witnessed abuse of their mothers during childhood on their levels of violence in adulthood. Am J Public Health. 2005, 95: 1811-1816. 10.2105/AJPH.2003.035006.CrossRefPubMedPubMedCentral Abrahams N, Jewkes R: Effects of South African men's having witnessed abuse of their mothers during childhood on their levels of violence in adulthood. Am J Public Health. 2005, 95: 1811-1816. 10.2105/AJPH.2003.035006.CrossRefPubMedPubMedCentral
44.
go back to reference Philpart M, Goshu M, Gelaye B, Williams MA, Berhnae Y: Prevalence and risk factors of gender-based violence committed by male college students in Awassa, Ethiopia. Violence and Victims. 2008 Philpart M, Goshu M, Gelaye B, Williams MA, Berhnae Y: Prevalence and risk factors of gender-based violence committed by male college students in Awassa, Ethiopia. Violence and Victims. 2008
Metadata
Title
Anger expression, violent behavior, and symptoms of depression among male college students in Ethiopia
Authors
Dale J Terasaki
Bizu Gelaye
Yemane Berhane
Michelle A Williams
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2009
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-9-13

Other articles of this Issue 1/2009

BMC Public Health 1/2009 Go to the issue