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

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).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).Further research should be conducted to better characterize community and individual level determinants of anger-expression, violent behavior and depression among youths.Depression is an important global public health problem, in part, because of its high lifetime prevalence [1], and its association with poverty, malnutrition, and debilitating chronic disorders including angina, arthritis, diabetes, chronic headaches and migraines [1,2]. Several investigators have documented associations between depression and outward anger expression [3-5]. Collectively, available evidence suggest that aggressive, outward violent behavior is associated with an increased risk of symptoms of depression [6,7]. Motivated, in part, by the high prevalence of violence among youths [8] and increasing awareness of the increasing burden of anxiety and depressive disorders among youths [9], investigators have begun to evaluate associations of anger coping styl