Journal List > J Korean Acad Nurs > v.39(1) > 1002513

J Korean Acad Nurs. 2009 Feb;39(1):145-156. Korean.
Published online February 28, 2009.
Copyright © 2009 Korean Society of Nursing Science
Development and Evaluation of a School-based Anger Management Program (SAMP) for Adolescents
Young-Joo Park,1 Ho-Sihn Ryu,1 Keum-Sun Han,1 Jung Hye Kwon,2 HanKyeom Kim,3 Yoon Jung Cho,4 Hyun-Cheol Kang,5 Suk-Hee Cheon,6 and Ji-Won Yoon7
1Professor, College of Nursing, Korea University, Seoul, Korea.
2Professor, Department of Psychology, Korea University, Seoul, Korea.
3Professor, Department of Pathology, Korea University, Seoul, Korea.
4Professor, Department of Laboratory Medicine, Korea University, Seoul, Korea.
5Associate Professor, Department of Informational Statistics, Hoseo University, Cheonan, Korea.
6Full-time Instructor, Department of Nursing, Sangji University, Wonju, Korea.
7Part-time Instructor, College of Nursing, Korea University, Seoul, Korea.

Address reprint requests to: Yoon, Ji-Won. College of Nursing, Korea University, 126-1 Anam-dong 5-ga, Seongbuk-gu, Seoul 136-705, Korea. Tel: 82-2-3290-4910, Fax: 82-2-927-4676, Email:
Received October 17, 2008; Accepted January 31, 2009.



This study was done to develop a school-based anger management program (SAMP) of 4 sessions and examine its effects on the anger, anger expression, psychosomatic responses, psychosocial responses, and immunologic responses in adolescents.


A quasi-experimental study using a nonequivalent control group, pre-post design with repeated measures was used. Chi-square test, t-test, paired t-test, and Fisher's exact test were used to analyze the data.


There were no differences between the experimental and control groups in outcome variables except for lymphocytes. However, following additional analyses, statistically significant differences by time point were observed for pain sensitivity, T cell, Helper T (Th) cell, Suppressor (Ts) cell and Natural Killer (NK) cell post-treatment, entrapment and psychosomatic symptoms at the 4-week follow-up, and resilience at the 10-week follow-up for the experimental group.


Although some modifications in contents and administration will be required to increase the effectiveness of the program for anger management, SAMP can be used to promote anger management ability in adolescents.

Keywords: Anger; Adolescent; School


Figure 1
Research design.

Exp.=experimental group; Cont.=control group; X=SAMP (school-based anger management program); O1=general characteristics, anger, anger expression psychosomatic response (psychosomatic symptom, pain sensitivity), psychosocial response, immunologic response; O2=anger, anger expression psychosomatic response (psychosomatic symptom, pain sensitivity), psychosocial response, immunologic response; O3, O4=anger, anger expression, psychosomatic response (psychosomatic symptom), psychosocial response.

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Table 1
General Characteristics and Homogeneity between Experimental and Control Group (N=55)
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Table 2
Homogeneity of Outcome Variables between Experimental and Control Group (N=55)
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Table 3
Effects of SAMP on Outcome Variables (N=55)
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Table 4
Effects of SAMP for the Experimental Group (N=32)
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This work was supported by the Management Center for Health Promotion (MCHP) Grant funded by the Korean Government (KIHASA) (05-84).

1. Adelson J, Doehrman MJ. The psychodynamic approach to adolescence. In: Adelson J, editor. Handbook of Adolescency psychology. New York, NY: Wiley; 1980. pp. 99-116.
2. Beck R, Fernandedz E. Cognitive-behavioral therapy in the treatment of anger: A meta-analysis. Cognitive Therapy and Research 1998;22:63–74.
3. Berk LS, Felten DL, Tan SA, Bittman BB, Westengard J. Modulation of neuroimmune parameters during the eustress of humor-associated mirthful laughter. Alternative Therapies in Health & Medicine 2001;7:62–76.
4. Boergers J, Spirito A, Donaldson D. Reasons for adolescent suicide attempts: Associations with psychological functioning. Journal of the American Academy of Child & Adolescent Psychiatry 1998;37:1287–1293.
5. Bruehl S, Burns JW, Chung OY, Ward P, Johnson B. Anger and pain sensitivity in chronic low back pain patients and pain-free controls: The role of endogenous opioids. Pain 2002;99:223–233.
6. Choi CJ. In: The effects of meditation programs in the reduction of school life maladjustment and anger of junior high school students. Seoul: Chungang University; 2006.
Unpublished master's thesis.
7. Chon KK, Hahn DU, Lee JO, Spielberg CD. Korean adaptation of the state-trait anger expression inventory: anger and blood pressure. Korean Journal of Health Psychology 1997;2:60–78.
8. Chon KK, Lee MK. Preliminary development of Korean version of CES-D. Korean Journal of Clinical Psychology 1992;11:65–75.
9. Crockenberg SB. Infant irritability, mother responsiveness, and social support influences on the security of infant-mother attachment. Child Development 1981;52:857–865.
10. Gilbert P, Allan S. The role of defeat and entrapment (arrested flight) in depression: An exploration of an evolutionary view. Psychological Medicine 1998;28:585–598.
11. Gilbert P, Gilbert J, Irons C. Life events, entrapments and arrested anger in depression. Journal of Affective Disorders 2004;79:149–160.
12. Hong YS. In: The effects of the stress and psychosocial resources for adolescent suicidal behaviors. Seoul: Yonsei University; 2004.
Unpublished doctoral dissertation.
13. Ishihara S, Makita S, Imai M, Hashimoto T, Nohara R. Relationship between natural killer activity and anger expression in patients with coronary heart disease. Heart and Vessels 2003;18:85–92.
14. Ju JY. In: The study on the relationship among anger expression mode, depression, and aggression in high school students. Seoul: Seoul Women's University; 2005.
Unpublished master's thesis.
15. Kadner KD. Resilience. Responding to adversity. Journal of Psychological Nursing and Mental Health Services 1989;27(7):20–59.
16. Kim HS, Kim HS. Development of instrument for measuring personality factor related to juvenile delinquency. Journal of Korean Academy of Psychiatric and Mental Health Nursing 1999;8:190–201.
17. Lazarus RS, Kranner AD, Folkman S. An etiological assessment of emotion. In: Plutchik R, Kellerman H, editors. Emotion: Theory, research and experience. vol. 1. New York, NY: Academic Press; 1980. pp. 198-201.
18. Lutgendorf SK, Sood AK, Anderson B, McGinn S, Maiseri H, Dao M, et al. Social support, psychological distress, and natural killer cell activity in ovarian cancer. Journal of Clinical Oncology 2005;23:7105–7113.
19. Na SI, Ma SJ. Discriminating variables between vocational high school students and academic high school students. Journal of Agricultural Education and Human Resource Development 2005;37:61–80.
20. Park ES, Park YJ, Ryu HS, Han KS, Hwang RI, Im YJ, et al. A nationwide survey on current conditions of school health education. Journal of Korean Academy of Nursing 2006;36:381–388.
21. Park HS. In: The effect of emotion expression technique and cognitive relaxation by anger expression. Busan: Pusan University; 2004.
Unpublished master's thesis.
22. Park YJ, Baik SI, Shin HJ, Yoon JW, Cheon SH, Moon SH. Anger, cardiovascular health and depression in middle-aged Korean men: The mediating effect of social support. Journal of Korean Academy of Nursing 2006;36:863–871.
23. Park YJ, Han KS, Shin HJ, Kang HC, Chun SH, Moon SH, et al. Prediction on the negative outcomes of anger in female adolescents. Journal of Korean Academy of Nursing 2004;34:172–181.
24. Piko B. Gender differences and similarities in adolescents' ways of coping. The Psychological Record 2001;51:223–235.
25. Seo SG. In: Cognitive factors related to anger and their therapeutic implications. Seoul: Seoul National University; 2002.
Unpublished doctoral dissertation.
26. Spielberg CD. In: Professional manual for the State-Trait Anger Expression Inventory (STAXI). Tampa, FL: Psychological Assessment Resources, Inc.; 1988.
27. Suh JY. In: A study on the influence of parental divorce on children's adaptation: Focusing on resilience. Seoul: Yonsei University; 2002.
Unpublished master's thesis.
28. Suk MH. In: Effects of guided imagery on psychological resources and stress responses of adolescents. Seoul: Yonsei University; 2001.
Unpublished doctoral dissertation.
29. Williams JE, Paton CC, Siegler IC, Eigenbrodt ML, Nieto FJ, Tyroler HA. Anger proneness coronary heart disease risk: Perspective analysis from the atherosclerosis risk in communities (ARIC) study. Circulation 2000;101:2034–2039.
30. Yarcheski A, Mahon NE, Yarcheski TJ. Anger in early adolescent boys and girls with health manifestations. Nursing Research 2002;51:229–236.