Anger in PTSD: Is there a need for a concept of PTSD-related posttraumatic anger?

Despite extensive research on posttraumatic stress disorder (PTSD), anger in PTSD has received little attention. This is surprising, given anger is a key predictor of treatment outcome in PTSD. This paper seeks to build an argument for investigating anger in PTSD as a discrete entity. A key argument is that the capacity to image visual mental phenomena is crucial to the aetiology and maintenance of anger in PTSD. Evidence is reviewed for the influence of visual imagery in anger in PTSD from the perspectives of neuropsychology, psychopathology, anger and PTSD. An argument is advanced for including visual imagery in an integrated (visual–linguistic) cognitive model of anger in PTSD. Directions for research on visual imagery in anger in PTSD and its treatment implications are discussed.

► This paper argues the need to investigate anger in PTSD as a discrete target containing unique characteristics.
► Its key theme is that Visual Imagery (VI) underlies the aetiology and maintenance of anger in PTSD.
► It, accordingly, reviews supporting evidence from the fields of neuropsychology, psychopathology, emotion and PTSD.
► It cautions VI’s role is best understood within an integrated (imaginal-linguistic) cognitive model of anger in PTSD.
► Finally, it highlights requirements for researching VI in anger in PTSD and VI’s treatment implications.