Expressing anger linked with better health in some cultures

"Many of us in Western societies naively believe that anger is bad for health, and beliefs like these appear to be bolstered by recent scientific findings," says psychological scientist Shinobu Kitayama of the University of Michigan. "But our study suggests that the truism linking anger to ill health may be valid only within the cultural boundary of the 'West,' where anger functions as an index of frustration, poverty, low status and everything else that potentially compromises health."

"These findings show how socio-cultural factors go under the skin to influence vital biological processes," explains Kitayama.

In other words, it's the circumstances that elicit anger, and not anger itself, that seem to be bad for health. In previous work, Kitayama and colleagues found that anger can function as a signal of high status and privilege in Asia -- drawing on this, they hypothesized that greater expression of anger might be associated with better health among Asian participants.

A recent incident on a Korean Air flight bound for Seoul illustrates this point, says Kitayama. Heather Cho, former vice president of Korean Air and daughter of Korean Air Chairman Cho Yang-ho, apparently flew into a rage when she was improperly served a bag of macadamia nuts by the chief flight attendant. In an angry outburst, Ms. Cho ordered the pilot to take the plane back to the gate so that the flight attendant could be kicked off the flight.

This expression of anger, which may seem disproportionate to the circumstance, is a typical display of privilege and power, says Kitayama, and may, therefore, be linked with better rather than worse health.

To explore the link, the researchers examined data from American participants drawn from the Midlife in the United States (MIDUS) survey and data from Japanese participants drawn from the Midlife in Japan (MIDJA) survey.

To measure health, the researchers looked at biomarkers for inflammation and cardiovascular functioning, both of which have been linked to anger expression in previous research. The combination of these two factors served as a measure of overall biological health risk.

The researchers also looked at measures that gauged various aspects of anger, including how often participants expressed angry feelings through verbally or physically aggressive behaviors (e.g., "I slam doors," "I say nasty things").

The data revealed that greater anger expression was associated with increased biological health risk among American participants, as previous studies have shown.

But greater anger expression was associated with reduced biological health risk among Japanese participants. And the association was not explained by other potentially related factors -- such as age, gender, chronic health conditions, smoking and alcohol consumption, social status, and experience of negative emotions more generally.

"The association between greater anger and compromised biological health, taken for granted in the current (Western) literature, was completely reversed so that greater anger was associated with better biological health among Japanese," explains Kitayama.

The researchers did not find a link between other facets of anger, such as chronic propensity toward anger or the extent to which participants suppressed feelings of anger, and health outcomes.

Together, these findings suggest that the link between anger expression and health reflects different experiences across cultural contexts. In the US, expressing anger seems to reflect the degree to which people experience negative events, while in Japan it may reflect the degree to which people feel empowered and entitled.

"Our point is that anger expression is a complex phenomenon likely motivated by a variety of factors, many of which could be culture-specific. These cultural factors must be taken into account to achieve a full understanding of the link between anger and health," the researchers write.

Kitayama and colleagues hope that future longitudinal research that follows participants over time will help to shed light on the relationship:

"Such research will help us address whether improving personal and social life styles so as to reduce anger may entail long-term health benefits."