Advanced Anger Assessment Using the STAXI-2 C/A to Identify Anger Profiles

1. Advanced Anger Assessment Using the STAXI-2 C/A to Identify Anger Profiles Thomas M . Brunner, PhD 1

2. -Thomas M. Brunner, PhD- • Developmental/School/Clinical/Forensic Psychologist/Researcher • Specialize in Child/Adolescent Assessment, Treatment, Consultation • Research Associate: Center for Research in Behavioral Medicine and Health Psychology (University of South Florida [USF], Tampa, FL) • Founder and Director: Center for Character Strength Investment (joincsi.com) • Email: solutions@doctorbrunner.com • Website: www.doctorbrunner.com

3. Costa Rican fisherman named Chito with his 17 ft. 980 lb pet crocodile…

5. What can you learn from Chito? • Anger, like crocodiles, populate some habitats • It can be a lethal enemy • It commonly lurks “just below the surface” • If you ignore its presence, it will likely bite you • If you get to know it, you can minimize damage • If you befriend it, you can even use its power

6. Follow-up during and after conference • Psychological Assessment Resources (PAR) -table of materials • After meeting availability • NASP website (slides, handouts) • http://www.doctorbrunner.com/anger-assessment.php • NASP on-site free consultation: -cell: 520-260-0068

7. Learning objectives • Get angrier about anger! • Recognize how anger assessment vital to your role(s) • Internalize a framework to handle varieties of anger • Practice using this framework to spot common profiles • Familiarize yourself with common anger dynamics in learning, bulllying, aggression, suicide, abuse, and threats. • Learn how see red flags that suggest more immediate action is necessary

8. Presentation Organization • Section 1: Anger is in the air…everywhere • Section 2: What have we learned about anger? • Section 3: The STAXI-2 C/A: a “clutch player” for school psychologists • Section 4: Anger’s destiny will go the way of other school impairing conditions • Section 5: Q & A

9. Section 1: Anger is in the air ……everywhere

10. “Age of Anger” • Dominant problem Koop & Lunderberg, 1992 • School shootings • Violence, suicide, bullying, LDs, ADHD, anxiety, • Scientifically/Diagnostically • lack of prominence • Anger “snuck up”

11. Anger is one of the most primary states (like anxiety, sadness) • Cognitive-emotional-behavioral phenomenon • Deeply evolutionary • Darwin talked about fear (anxiety) & rage (anger-based), • Aggression as part of survival instinct • Key phenomenon in personality dynamics • No two people have the same learning style, partly due to idiosyncrasies with emotional regulation

12. Anger is so fundamental, like a “vital sign” Yet, largely ignored…

13. Do you need to take its pulse? Well, how do we better handle what is currently a “suspension bottleneck”?

14. Maybe by assessing the dynamics of anger to answer the following questions, you can do thoughtful triage and relieve the “suspension” revolving door.. -How angry are they “right now”? -Are they ready to explode? -How frequently do they report flg. angry? -How well do they report controlling anger? Note. One of most common reasons youth referred to mental health center – anger!

15. Maybe you come into this talk skeptical about whether need to formally assess anger “Can’t we just ask some questions and not buy yet another measure?”

16. Well, how often must you…. • Work with a chronically angry student • What can you tell teachers/counselors/administration about the danger this anger presents? • Or, how to work with the anger dynamics • Assist with conducting a risk assessment • Counsel students where bullying, low self-esteem, depression, anxiety, suicide, abusive home involved (and yet do not want to get into diagnosis issues) • Work with frustrated LD students • Contribute to a risk assessment protocol • Figure out a way to discuss your concerns with parent?

17. The current and future Zeitgeist: Anger is a deeply school/educational issue • Spectrum range: From irritation (e.g., LD, ADHD, etc.) to rage (bullying, abuse, shooter, threats) • Not clinical issue, it’s an educational issue • Operator even in seemingly solely “cognitive” conditions: e.g., LD, ADHD, TBI, SID, • Brunner, T. M. (2010). Comprehensive assessment of an attention-based learning problem: Capturing the relevance of "psychological vital signs." In N. Mather & L. E. Jaffe (Eds.), Comprehensive evaluations: Case reports for psychologists, diagnosticians, and special educators. New York, NY: Wiley.

18. Main points from Brunner (2010) chapter • No two people have same learning style • Learning process drastically affected by core emotions (e.g., anger, anxiety, mood) • Broad screeners often miss vital dynamics faciliating a truly targeted plan • Use categorical model (>65, then significant) • Screening measures gloss over emotional dynamics • MASC – captures anxiety dynamics • BRIEF – captures dynamics of executive functioning • Learning problems often adjoined by emotional issues (even if sub-clinical)

19. Befriend (and beware) the anger crocodiles, which are breeding prolifically!

20. Section 2: What have we learned about anger?

21. -Anger is complex -Has 3 stages: Experience Expression Control -Has 2 aspects state (“right now”) trait (general tendencies) From 30 years of anger research…

22. Vital anger statistics* • School shooters often are anger internalizers**, until they volcanically erupt • Aggression highly correlated to trait-like anger** and lower anger control** • Bullies often higher in trait-anger** chronically angry • Those who are bullied/teased may tend to have lower trait anger reactivity** • Students with LD’s may tend to angrier more often (higher trait anger**) • School psychologists often struggle with having a reason to refer a child …because saying student is angry is not enough, but STAXI-2 C/A can give you justification • Sometimes it is only milder anger problem, but it could grow worse if left unchecked….so, need a measure that assesses all intensities**, to be preventative (STAXI-2 C/A can help with that) • Gifted students also tend to have anger issues that if even slightly improved, could lead to dramatic improvements (perfectionism, too competitive, or Type A) *Research literature cited in STAXI-2 C/A 2009 Manual **Indicates assessed by the STAXI-2 C/A

23. The Myth - “They just snapped” There are many warning signs Anger expression Threats In fact, targeted violence represents a pattern of thinking and behavior that is understandable and often discernable; likely preceded by a threat. National School Safety Center. (2001). Report on school associated violent deaths. CA. Vossekuil, B., Reddy, M., Fein, R., Borum, R., & Modzeleski, W. (2000) . U.S.S.S. Safe school initiative: An interim report on the prevention of targeted violence in schools. Washington, DC: U.S. Secret Service, National Threat Assessment Center.

24. How many school shootings could have been avoided? Bethel, Alaska Feb 1997 Pearl, Mississippi Oct 1997 West Paducah, Kentucky Dec 1997 Stamps, Arkansas Dec 1997 Jonesboro, Arkansas Mar 1998 Edinboro, Pennsylvania Apr 1998 Fayetteville, Tennessee May 1998 Richmond, Virginia Jun 1998 Littleton, Colorado Apr 1999 Conyers, Georgia May 1999 Demming, New Mexico Nov 1999 Fort Gibson, Oklahoma Dec 1999 Mount Morris, Michigan Feb 2000 Savannah, Georgia Mar 2000 Lake Worth, Florida May 2000 New Orleans, Louisiana Sep 2000 Santee, California Mar 2001 Williamsport, PA Mar 2001 Granite Hills, California Mar 2001 Gary, Indiana Mar 2001 New York, New York Jan 2002 New Orleans, Louisiana Apr 2003 Red Lion, Pennsylvania Apr 2003 Red Lake, Minnesota Mar 2005 Jacksboro, Tennessee Nov 2005 Cazenovia, Wisconsin Sep 2006 Bailey, Colorado Oct 2006 Blacksburg, Virginia Apr 2007 Dover Delaware Sep 2007 Cleveland, Ohio Oct 2007 A Time Line of Recent Worldwide School Shootings. Retrieved online http://www.infoplease.com/ipa/A0777958.html

25. Self-report Ages 9-18 4th grade reading level 5m admin, 5m score Ind. or group adm. Comprehensive but concise Dimensionally, not diagnostically based Section 3: The STAXI-2 C/A: a “clutch player” for school psychologists

26. -Charles D. Spielberger, PhD- Founder & Director: Center for Research in Behavioral Medicine and Health Psychology (USF, Tampa, FL) Distinguished Research Professor, Emeritus, USF Developer of multiple self-report measures used worldwide Major innovation: The “State-trait” distinction E.g., State-Trait Anger Expression Inventory (STAXI, STAXI-2) Adapted into 27 languages Appears most widely used measure of anger in world

27. Why does the STAXI-2 C/A build on the STAXI-2? Robust lineage of validity data with diverse youth populations -See appendix A Over 100 studies have already used these concepts with youth -See Appendix A Concepts correlated with over 20 established anger scales -See Appendix A Spanish youth version of STAXI-2 exemplifies cross-cultural validation Concepts have strong psychometric properties with youth e.g., del barrio (2004); Hagglund et al., 1994 del barrio (2004) Hagglund et al., 1994

28. Why develop the STAXI-2 C/A? Paucity of anger measures for youth Numerous authors (e.g., Feindler, 1992) called for a youth adaptation of the STAXI-2 - most widely used adult anger measure Need for a concise yet comprehensive measure that is developmentally sensitive Need to assess experience, expression, and control of anger while accounting for state and trait aspects of anger Need to create an “anger profile” capturing functional facets of anger that “xray” anger process Need to complement formal risk measures Risk measures do not get into key anger dynamics (e.g., suppressed anger) This is important if want to be preventative

29. STAXI-2 C/A as “clutch school player”, uniquely does the following… • Can spot potential for explosiveness before it occurs • Accounts for widely accepted state-trait distinction • Applicability for youth (e.g., distinguish temporary tantrum vs. trait-like predisposition) • Sensitivity to low scores (like an anger FBA, not a “in the box” clinical yes/no) ) • E.g., sole focus on if score is high enough to meet threshold • Problem: low levels of certain anger facets (e.g., anger control) also significant • Produces an “anger profile”, where the nature of the score is understood as one part of the overall anger process for that individual • Not isolated score or “summary score”

30. STAXI-2 C/A: Conceptual overview • Comprehensive, yet concise • 5 scales, 4 subscales • 1 State Anger scale, 4 Trait Anger scales • 13 “concerning” items that can help screen for risk (possible prelude to or part of risk assessment) • Non-overlapping, conceptually clear scales & subscales • Based on 30 yrs of robust empirically based literature • Each scale/subscale assesses a key functional facet

32. How does the STAXI-2 C/A conceptual structure assist with school risk assessments? -Current risk assessment measures focus more on risk factors, not on the internal or more “hidden” aspects of anger (e.g., suppressed anger) -For example, whether someone internalizes anger may not be assessed by a risk assessment measure, but is assessed by the STAXI-2 C/A -Thus, the STAXI-2 C/A complements current forensic risk measures such as the SAVRY or the PETRA (published by PAR)

33. The Concept of “State” versus “Trait” • State-trait distinction now widely accepted in field of psychology • Many measures confuse states and traits • Definitions: • State: Temporary, often highly transient event (e.g, tantrum) • Trait: Relatively stable, more enduring tendency (e.g., externalizing anger coping style)

34. STAXI-2 CA – Psychometric Overview • Large census matched normative base • State-trait concepts - robust validity correlation data • Strong alphas for control and clinical group • Scales differentiated clinical vs. controls

36. Section 4. Anger’s destiny will go the way of other school impairing conditions

37. What am I really saying? • As science evolves, we develop “types” that we use as references (not rules) and around which research is conducted • ADHD – 3 subtypes • Learning styles – have multiple subtypes • Dyslexia – have multiple types along spectrum

38. …Playfulness

39. Interpretation - Overview • Uniquely comprehensive profile • Recognizes and evaluates anger as a process • The dynamic human anger process: • First we experience, then we express, then we control to some degree • This STAXI-2 C/A anger profile, from left to right, proceeds from experience, to expression, to control

44. Interpretation - Overview • Well-rounded, integrated scoring system • Primarily percentile based chart • Percentiles allow for fine grained sense of persons standing on that scale compared to peers • Augmented by T score chart • T scores allow for comparisons between scales/measures (e.g., to reconfirm magnitude of difference between scale scores)

46. Anger, Depression, and an ADHD-based Learning Problem Brunner, T.M. (in press). Comprehensive Assessment of an Attention-Based Learning Problem: Capturing the Relevance of “Psychological Vital Signs”. In  Mather, N., & Jaffe, L. E. (Eds.), Comprehensive Evaluations: Case Reports for Psychologists, Diagnosticians, and Special Educators. NY: John Wiley & Sons.

47. What would an ADHD profile look like?

48. What would a potential school shooter profile look like? 48

49. Give one example of a bully profile…

50. What would an LD profile look like? 50