The Role of Anger Expression and Control in the Associations between Intimate Partner Violence and Mental Health Outcomes Among Incarcerated Women

Background: An alarming number of women involved in the criminal justice system report histories of intimate partner violence (IPV), which increases their risk of experiencing adverse mental health outcomes. Theories about anger and gender suggest that forms of anger expression (i.e., anger directed toward other persons; suppressing anger) and control (i.e., preventing outward expressions of anger; calming down/reducing anger) may influence the risk for negative mental health outcomes for women who have experienced IPV. The expression and control of anger are critical mechanisms to examine, particularly among incarcerated IPV survivors who may not have the space or choice to fully and safely express their emotions. The current study examined the mediating role of anger expression and control in the association between IPV and mental health symptoms among a sample of incarcerated women.

Methods: A survey was administered to women within a multi-security level state prison and included measures of mental health symptoms, IPV, and anger expression and control. Out of the 832 women (M_age = 38, SD = 11.05) who completed the survey, almost half identified (49.6%) as White/Caucasian, 35% as Black/African American, and 15.4% as Latinx, multiracial, or another race. A mediational path analysis was utilized to examine associations between IPV, anger expression and control, and mental health symptoms, including depression, anxiety, and post-traumatic stress disorder (PTSD). Forms of anger expression and anger control were examined as mediators.

Results: Approximately 70% of women had experienced IPV. Women reported high levels of mental health symptoms (42.8% met the clinical threshold for depression; 28.7% for anxiety; 64.5% for PTSD). A majority of women (74%) tended to suppress their feelings of anger. Path analyses illustrated that IPV was associated with more inward expressions of anger (B = 0.22) and inward control of anger (B = 0.16). Inward expressions of anger were associated with higher levels of depression (B = 0.38), anxiety (B = 0.36), and PTSD (B = 0.38) symptoms. Inward expressions of anger partially mediated the associations between IPV and depression (B = 0.08), anxiety (B = 0.07), and PTSD (B = 0.08) symptoms. Inward control of anger was associated with lower levels of depression (B = -0.12). Outward anger expressions and control were not associated with IPV or mental health symptoms.

Implications: Women involved in the criminal justice system face multiple concerns, including high rates of IPV and mental health symptomatology. Women’s anger expression and control have been under-researched and over-pathologized, especially for socially marginalized women. Findings demonstrated that the suppression of anger expression explained the association between IPV and mental health symptoms. Women who are incarcerated may suppress emotions for fear of punitive responses. However, women’s prisons and social work practice efforts should consider women’s IPV experiences, the role of power while incarcerated and in abuse experiences, and the healthy expression of anger. Future research may explore the complexities of anger for incarcerated women to further develop theory regarding anger, gender, and power.