Validation of the Dimensions of Anger Reactions Scale (the DAR-5) in non-clinical South Korean adults

BMC Psychology Kim et al. BMC Psychology (2023) 11:74 https://doi.org/10.1186/s40359-023-01084-8 Open Access RESEARCH Validation of the Dimensions of Anger Reactions Scale (the DAR-5) in non-clinical South Korean adults Hae Jin Kim1, Dong Hun Lee1*, Jeong Han Kim2 and Su-Eun Kang1 Abstract Background Posttraumatic anger is a commonly reported emotion among people who have experienced traumatic events. The current study aimed to demonstrate the reliability and validity of the South Korean version of the DAR-5 (DAR-5-K). The DAR-5 is a single scale with 5 items which measures posttraumatic anger. The DAR-5 is composed of five items that measure anger frequency, intensity, duration, aggression, and its interference with social relations. Methods Data were collected from 814 South Korean adults who had experienced traumatic events and participated in the study and analyzed via the combination of exploratory factor analysis (n = 405) and confirmatory factor analysis (n = 409). Results Results supported the one-factor structure, as reported in previous validation studies. The scale demonstrated robust internal reliability and concurrent validity with measures of posttraumatic stress disorder (PTSD) symptoms, depression, anxiety, and self-esteem. The DAR-5 cut-off score of 12 that was established in the original validation study successfully differentiated high from low scorers with regard to PTSD symptoms, depression, anxiety, and self-esteem. Conclusion The results confirm that the DAR-5-K is a brief and psychometrically robust measure of anger that can be used to examine South Korean adults who have experienced traumatic events. Keywords Adults, DAR-5, Posttraumatic anger, South Korea, Validation *Correspondence: Dong Hun Lee 1 Traumatic Stress Center, Department of Education, Sungkyunkwan University, Seoul, Republic of Korea 2 School of Rehabilitation Services and Counseling, University of Texas-Rio Grande Valley, Edinburg, TX, USA Anger is a normal emotion that has functional value, such as facilitating physical and psychological resources or promoting perseverance when faced with difficult situations [1, 2]. However, anger can become maladaptive, and problematic anger can be evaluated by assessing its frequency, intensity, duration, aggression, and interference with social functioning [3]. The presence of anger has been identified in a variety of populations who have experienced traumatic events, including combat veterans [4, 5], Cambodian refugees [6], 9/11 disaster relief workers [7], and those who have faced gross human rights violations [8]. Additionally, populations exposed to individual-level traumas would © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Kim et al. BMC Psychology (2023) 11:74 include victims of domestic violence [9], childhood maltreatment [10], and sexual or nonsexual assault [11]. Anger also increases the risk of developing posttraumatic stress disorder (PTSD) symptoms [12, 13]. Thus, reliable and valid measures of anger can be highly useful for evaluating the presence of maladaptive anger in people who have experienced traumatic events. Several traumatic events have occurred in South Korea recently. In 2003, 192 people lost their lives and 148 were injured due to a fire set by an arsonist in the Daegu Metropolitan Subway. A six-year follow-up study showed that approximately 46.6% of the individuals who were injured in this accident received a PTSD diagnosis and reported adaptive problems in interpersonal relationships and increased vulnerability to stress [14]. A humidifier disinfectant that was potentially lethal when inhaled had been sold widely in South Korea from 1995 to 2011. It took several years for the public to realize the potential danger that the disinfectant’s constituent toxic chemicals posed and for the manufacturer to offer an official apology. Only in 2011 were all the aforementioned disinfectants forcibly recalled by the government. The humidifier disinfectant is reported to have caused serious lung diseases and other medical illnesses in more than 7,000 victims, 1,650 of whom resultantly died [15]. A study that examined 100 families that were harmed by the toxic disinfectant revealed that about 66.6% of them reported a chronic level of posttraumatic embitterment symptoms. In all, 57.5% of the victims reported the emergence of depression/demoralization, 54.3% reported anxiety/nervousness, and 54.3% reported experiencing anger [16]. In 2014, 304 people, 250 of whom were high-school students, lost their lives in one of South Korea’s most distressing maritime tragedies—the Sewol Ferry disaster. Several studies were conducted after the tragedy to identify changes in psychological symptoms among the bereaved families and friends as well as the general public in South Korea, who were indirectly exposed to the event through the media. In addition to the parents of the adolescent victims of the tragedy, the adolescent friends of the deceased students and even middle- and high-school students who did not personally know any of the victims reported emotional changes, which included the emergence of depressive moods and anger [17–19]. In 2017, a 5.4 magnitude earthquake hit Pohang—a mid-sized city located in the southeastern part of South Korea—and resulted in injuries to 135 people. A one-year follow-up study indicated that 13.85% of the 195 survivors who resided in the affected area reported symptoms of posttraumatic stress [20]. More recent traumatic events include a bushfire in a northeastern region of South Korea in 2019, which resulted in two deaths and affected more than 4,000 residents. Numerous studies have been conducted in response to these traumatic events that Page 2 of 12 occurred in South Korea in order to investigate the victims’ posttraumatic symptoms, such as posttraumatic anger. Measurement issues in studies on posttraumatic anger in South Korea Given that a significant number of traumati (...truncated)