anger, hostility and aggression
TRANSCRIPT
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Anger,
Hostility andAggression
By: Jonelle A. Sazon,
Grace V. Agregado
Edbert De Duque
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Anger
Wrath, indignation
a normal human emotion, is astrong, uncomfortable,emotional response to a realor perceive provocation.
Result when a person isfrustrated, hurt or afraid.
Response caused by a distinctchange in your internal and/or external state as aresponse to thoughts orevents that occur in yourexternal environment.
Fight or flight response
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Hostility
Verbalaggression, is anemotionexpressedthrough verbalabuse, lack ofcooperation,violation of rulesor norms, orthreating
behavior
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PhysicalAggression
is behavior inwhich aperson attacksor injuresanotherperson or thatinvolvesdestruction of
property.
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ONSET ANDCLINICALCOURSE
Anger becomesnegative whenexpressinappropriately
Possibleconsequences areproblems such asmigraine, headache,ulcers or coronaryartery disease
Anger can lead tohostility andaggression.
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Stages orPhases
Triggeringphase
Escalation
phase
Crisis phase
Recovery
phase
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Five-Phases Aggression Cycle
Phase Definition Signs, Symptoms, and
behaviors
Triggering Initiates client response-anger or hostility
Restlessness, anxiety,irritability, pacing
Escalation Movement toward a lost ofcontrol
Pale, yelling, swearing,agitated, threatening
Crisis Client loses control Throwing objects, kicking,hitting, spitting, biting
Recovery Regains physical andemotional control
Lowering of voice, decreasedmuscle tension, physicalrelaxation
Postcrisis reconciliation Remorse, apologies, crying,quite
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RelatedDisorders AuditoryHallucinations
Dementia
Delirium
Head Injuries
Intoxication withAlcohol
Intermittentexplosivedisorder-rare
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Acting Out
Is an immature defense mechanism by which the persondeals with the emotional conflicts or stressors throughactions rather than through reflections or feelings.
Verbal or physical aggression, to feel temporarily lesshelpless or powerless.
Act out
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EtiologyNeurobiologicTheoriesLow serotonin=increased
aggressive behavior
Increased dopamine andnorepinephrine =increased impulsiveviolent behavior.
Damage Limbic System
and the frontal andtemporal lobe may causealteration in personsability to modulateaggression
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PsychosocialTheories
Impulse control-ability to delaygratification
Poor Relationships:parents, peers
friends=inconsistentresponses behavior.
Low socioeconomicstatus= increased
risk for failingsocially appropriatebehavior.
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Cultural Considerations In US, women are not permitted to express anger openlyand directly, doing so would not be feminine.
Spector (2001) perceived black patients as being more
dangerous
Bouffee delirante, condition characterized by asudden outburst of agitated and aggressive behavior,
marked confusion and psychomotor excitement.
Amok is a dissociative episode characterized by a periodof brooding followed by an outburst of violent,
aggressive, or homicidal behavior.
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Treatment Treating the underlying or comorbid psychiatricdiagnosis such as schizophrenia or bipolar disorder.
Lithium- effective in aggressive clients
Carbamazepine (Tegretol) and valproate(Depakote)- treat aggression associated withdementia, psychosis, and personality disorders
Benzodiazepines- reduce irritability and agitation in
older adults with dementia
Rapid tranquilization- can be use to decreasedagitation and aggression for clients with psychosis.
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Application of the nursingprocess
Assessment and effective intervention with angry or hostile clientscan often prevent aggressive episodes.
Aggressive behavior is less common and less intense.
The nurse must be familiar with the signs, symptoms andbehaviors associated with the triggering , escalating, crisis,
recovery, and postcrisis of the aggression cycle .