Childhood trauma and anger in adults with and without depressive and anxiety disorders


Childhood trauma (CT) is associated with severe sequelae, including stress-related mental health disorders that can perpetuate long into adulthood. A key mechanism in this relationship seems to be emotion regulation. We aimed to investigate (1) whether childhood trauma is associated with anger in adulthood, and, if so, (2) to explore which types of childhood trauma predominate in the prediction of anger in a cohort that included participants with and without current affective disorders.



In the Netherlands Study of Depression and Anxiety (NESDA), childhood trauma was assessed with a semi-structured Childhood Trauma Interview (CTI) at baseline, and analyzed in relation to anger as measured at a 4-year follow-up with the Spielberger Trait Anger Subscale (STAS), the Anger Attacks Questionnaire, and cluster B personality traits (i.e., borderline, antisocial) of the Personality Disorder Questionnaire 4 (PDQ-4), using analysis of covariance (ANCOVA) and multivariable logistic regression analyses. Post hoc analyses comprised cross-sectional regression analyses, using the Childhood Trauma Questionnaire-Short Form (CTQ-SF) also obtained at a 4-year follow-up.



Participants (n = 2271) were on average 42.1 years (SD = 13.1), and 66.2% were female. Childhood trauma showed a dose–response association with all anger constructs. All types of childhood trauma were significantly associated with borderline personality traits, independently of depression and anxiety. Additionally, all types of childhood trauma except for sexual abuse were associated with higher levels of trait anger, and a higher prevalence of anger attacks and antisocial personality traits in adulthood. Cross-sectionally, the effect sizes were larger compared with the analyses with the childhood trauma measured 4 years prior to the anger measures.



Childhood trauma is linked with anger in adulthood, which could be of particular interest in the context of psychopathology. Focus on childhood traumatic experiences and adulthood anger may help to enhance the effectiveness of treatment for patients with depressive and anxiety disorders. Trauma-focused interventions should be implemented when appropriate.


Significant outcomes

  • Childhood trauma is associated with adulthood anger, including a dose-response relationship.
  • Subtypes of childhood trauma had distinct effects on difficulties with regulating feelings of anger in adulthood.


  • Further exploration is needed to understand the onset and development of anger in adulthood, as the current study only assessed measures of anger at a single time point.
N.J. de Bles, L.E.H. Pütz, N. Rius Ottenheim, A.M. van Hemert, B.M. Elzinga, B.W.J.H. Penninx, E.J. Giltay | 2023
In: Acta Psychiatrica Scandinavica ; ISSN: 1600-0447
Online ahead of print doi: 10.1111/acps.13589
Adults, Anger, Anxiety Disorders, Borderline Personality Disorder, Children, Depressive Disorders, Posttraumatic Stress Disorder, Psychiatric Disorders, Psychotrauma, PTSD (en), Research