Clinical Anger Scale

## **What happens if anger is left unchecked?** Anger is one of the most common emotions that a person can feel. Sometimes it is fleeting, meaning it disappears in a few moments or a few hours, but sometimes it can last for a long time. If left to fester, it'll cause a lot of unwanted problems. While anger is an emotion, it can actually cause physical problems. It's one of the emotions that triggers our body's fight-or-flight response, which activates our adrenal glands to produce a surge of stress hormones, such as adrenaline and cortisol. The brain also begins to redirect blood flow from the gut to the muscles. Our heart rate, along with blood pressure, will increase. So will our respiration, perspiration, and temperature (Better Health, 2012). All of these things could lead to problems like hypertension, stroke, heart attacks, abdominal pain, digestive problems, and difficulty sleeping (Cornwell, 2024). It can also cause mental health issues, such as anxiety and depression. Anger can also strain interpersonal relationships, lead to alcohol or substance abuse, and result in violent behavior, too (WebMD Editorial Contributors, 2025). Given all this, mental health professionals need to check on a patient's emotional health and overall well-being, especially when they are confirmed to feel intensely angry at times, and their anger interferes with various aspects of their daily life. It's also important to do this if they have certain disorders, like bipolar disorder, intermittent explosive disorder, oppositional defiant disorder, etc.

## **What is the Clinical Anger Scale?** The Clinical Anger Scale is a 1995 self-report measurement questionnaire created by Snell, Moseley, and Hite. It has 21 objective statements about one's feelings toward different things, situations, or circumstances (Snell et al., 1995). ### **What to expect from the scale** Clients/patients, especially those who are constantly angry, will be asked to rate their behavior, determine how invasive persistent angry feelings are to various aspects of their lives, and identify how much and which aspects make them feel angry. Though the questionnaire is not meant to be used as the sole basis of clinical anger diagnosis, it can still be used as one of the resources or tools for diagnosis and treatment. Examples of self-ratings they can select from include: - My anger does not make me feel anymore tired than usual. - I'm so angry about my life that I've completely lost interest in sex. - My current feelings of anger undermine my interest in sex. - It makes me angry that I feel like such a failure. - I feel irritated a good deal of the time. - My feelings of anger leave me too tired to do anything. I'm so intensely angry and hostile that it completely interferes with my thinking. Each item has a different set of self-ratings based on statements. Your patient/client will answer based on what they believe is applicable to them. ### **Scoring the Clinical Anger Scale** Obtaining useful information from the Clinical Anger Scale requires the practitioner to provide a copy to the patient and get a final score to be interpreted. Here's a quick 101 on how to score and obtain a final score for this anger test: - The letters represent a 4-point Likert scale, with each letter assigned a value: A is zero, B is one, C is two, and D is 3. - You must add up the values depending on the patient's answer. - The final score is the sum of the obtained values. Interpretation, on the other hand, is as follows: - 0 - 13 = Minimal clinical anger - 14 - 19 = Mild clinical anger - 20 - 28 = Moderate clinical anger - 29 - 63 = Severe clinical anger ### **Why should I use this scale?** Practitioners with clients who show symptoms of clinical anger can use this Clinical Anger Scale template to:  - Understand their clients better - Formulate a treatment plan  - Track the progress of the patient  - See the effectiveness of a particular treatment based on the client's response - Identify individuals whose anger is bordering on clinical or those who are at risk of developing this disorder in various settings like schools, prisons, and mental facilities. Based on the constant use and research of the scale's creators, they have determined that the tool they created has adequate internal consistency and test-retest stability. They've also found that clinical anger was associated positively with several anger-related concepts, such as trait anger, state anger, anger-control, and more, but unrelated to social desirability influences. The scale was also found to be related in "predictable ways" to a client/patient's psychopathological symptoms, personality traits, and early family environments (Snell et al., 1995).

## **How to use the Clinical Anger Scale** To help clients manage anger issues through this scale template, here's how it works: ### **Step 1: Download the scale** Access and download our printable Clinical Anger Scale PDF template by clicking on "Use Template" or "Download." ### **Step 2: Explain the questionnaire** Though instructions are provided on the template, it's best to explain how to answer the questionnaire to the client. In addition, you may stay within the vicinity of the patient just in case they have any questions or need clarification. ### **Step 3: Answer the questionnaire** Once they understand how to answer the questionnaire, provide them with a copy. Don't forget to request their honesty and assure them they can take as long as needed.  The template is easy to use. The only thing your patient or client needs to do is to indicate the letter corresponding to the statement that applies to them, per item. There's a field that allows them to write or type the specific letter. ### **Step 4: Compute the score and interpret** After they're done with their part, it's time for you to compute and interpret the score. For a guide on how to do both, refer to the "What is a Clinical Anger Scale?" section. All you need to do is add up the sum and write the total score in the field provided below the questionnaire. You also have an additional notes section to write on, just in case you need to log any comments, insights, or plans you might have for your patient/client. ### **Step 5: Proceed with the next steps** If their score signifies mild to severe clinical anger, we recommend that you talk to your client about the next steps, such as therapy or anger management sessions. 

## **Other anger-related tools you can use** Besides this scale, we have a bunch of tools that can help you with your anger management work, most of them being worksheets, so they're best used when your patients/clients are undergoing anger management/therapy. Here are three of many that we have: - **[Your Anger Cues Worksheet](https://www.carepatron.com/templates/your-anger-cues-worksheet)**: This worksheet is meant to help your patient/client with becoming self-aware and self-reflexive enough to distance themselves from their anger to the point that they can identify what exactly triggers their anger. Being aware of one's anger cues is important when determining how to work through or around them. - **[Weekly Anger Monitor Worksheet](https://www.carepatron.com/templates/weekly-anger-monitor-worksheet):** This worksheet is a take-home worksheet. This will allow your patient/client to monitor themselves and their anger, the intensities of anger they feel from time to time, the physical symptoms they've had, what emotions they've felt, what reactions they've had, and if their reactions had consequences. This is your way of gathering information beyond your clinic. - **[Coping Skills for Anger Handout](https://www.carepatron.com/templates/coping-skills-for-anger-handout)**: You want your patients/clients to develop healthy coping mechanisms for anger instead of engaging in behavior that could potentially endanger them and others. Use this handout to teach them healthy coping mechanisms that they can apply whenever they face their anger triggers.

## **References** Better Health. (2012). Anger - how it affects people. vic.gov.au. https://www.betterhealth.vic.gov.au/health/healthyliving/anger-how-it-affects-people Cornwell, S. (2024, May 29). 5 ways anger affects your health. Everyday Health. https://www.everydayhealth.com/news/ways-anger-ruining-your-health/ Snell, W. E., Gum, S., Shuck, R. L., Mosley, J. A., & Kite, T. L. (1995). The clinical anger scale: Preliminary reliability and validity. Journal of Clinical Psychology, 51(2), 215–226. https://doi.org/10.1002/1097-4679(199503)51:2%3C215::aid-jclp2270510211%3E3.0.co;2-z WebMD Editorial Contributors. (2025, April 14). Mental health and anger management. WebMD. https://www.webmd.com/mental-health/mental-health-managing-anger