Anger & Emotion Regulation

Anger Test (STAXI-2 Guide)

Anger assessment guide covering STAXI-2 expression styles (Anger-In, Anger-Out, Control-In, Control-Out), brief self-reflection questionnaire, and anger-related diagnoses (IED, PTSD, BPD). Spielberger (1999).

An anger test measures anger frequency, intensity, and expression styles. Key tools: STAXI-2 (Spielberger, 1999) with state/trait anger and 4 expression scales; Buss-Perry Aggression Questionnaire (BPAQ) for 4 aggression components; Novaco Anger Scale (NAS) for forensic use.

Understanding Anger Assessment

Anger is a universal human emotion that evolved as a protective response to threat, frustration, or injustice. Anger becomes clinically relevant when it occurs frequently, at high intensity, for extended duration, and when its expression causes harm, to relationships, health, legal standing, or occupational functioning. The distinction between anger (the emotion) and aggression (the behavior) is clinically important: anger does not inevitably lead to aggression, and aggression can occur without significant anger.

The most detailed validated scale is the State-Trait Anger Expression Inventory-2 (STAXI-2) by Spielberger (1999), which distinguishes State Anger (current angry feelings), Trait Anger (general tendency to experience anger), and four Anger Expression/Control styles: Anger-In (suppressed), Anger-Out (expressed outwardly/aggressively), Anger Control-In (internal control), and Anger Control-Out (control over outward expression). The Anger Expression Index (AXI) combines AX-In and AX-Out minus the two control scales.

Clinically significant anger dysregulation is associated with Intermittent Explosive Disorder (IED), characterized by recurrent, impulsive aggressive outbursts disproportionate to provocation, as well as PTSD (irritability and angry outbursts in Criterion E), Borderline Personality Disorder (Criterion 8: inappropriate intense anger), and substance use disorders. Evidence-based treatments include cognitive restructuring, relaxation-based techniques, problem-solving skills, and DBT (particularly interpersonal effectiveness and distress tolerance skills).

Anger Self-Assessment

Rate how often these statements describe you over the past month. This brief reflection tool is based on anger trait dimensions, not a validated clinical tool.

This brief reflection is for educational awareness only and is not a validated clinical tool. For formal anger assessment, the STAXI-2 (Spielberger, 1999) is the criterion-standard self-report tool, available from PAR (psychassessment.com). If anger is causing problems in your life, a mental health professional can help.

STAXI-2 Anger Expression Styles

Spielberger (1999). The four anger expression/control scales capture how individuals typically express and regulate anger, not whether anger itself is pathological. Each scale is scored against T-score norms (mean = 50, SD = 10); scores at or above the 75th percentile are generally considered clinically elevated. The Anger Expression Index (AXI) is a composite derived from the expression and control scales, providing a summary of overall anger management style.

ScaleAbbreviationWhat it measures
Anger Expression-InAX-InTendency to suppress angry feelings inwardly rather than express them
Anger Expression-OutAX-OutTendency to direct anger outwardly toward people or objects
Anger Control-InAC-InTendency to monitor and temper angry feelings internally
Anger Control-OutAC-OutTendency to control outward expression of anger in interactions with others

Several DSM-5 diagnoses involve anger dysregulation as a core or associated feature. Assessment tools such as the STAXI-2 can document baseline severity and monitor treatment progress, but diagnosis requires a structured clinical interview.

ConditionPrimary anger featureDSM-5 reference
Intermittent Explosive Disorder (IED)Recurrent, impulsive aggressive outbursts disproportionate to provocation; verbal or physicalDisruptive, Impulse Control, and Conduct Disorders cluster; A1 (high-frequency/low-intensity) and A2 (low-frequency/high-intensity) subtypes
PTSDIrritability and angry outbursts with little or no provocationCriterion E — alterations in arousal and reactivity (E1)
Borderline Personality Disorder (BPD)Inappropriate, intense anger or difficulty controlling angerCriterion 8 of DSM-5 BPD diagnostic criteria
Substance Use DisordersIrritability and aggression during intoxication or withdrawal, and as a feature of chronic useVariable by substance; anger often diminishes with sustained abstinence

Anger Assessment Tools

Multiple validated self-report tools are available for different clinical contexts. Selection depends on whether the referral question concerns anger experience, aggression, or specific situational provocation.

ToolItemsWhat it measuresTypical use context
STAXI-2 (Spielberger, 1999)57State anger, trait anger, and four expression/control styles (AX-In, AX-Out, AC-In, AC-Out)General clinical, occupational, and research settings
Buss-Perry Aggression Questionnaire (BPAQ; Buss & Perry, 1992)29 (full); 12-item short form (BPAQ-SF)Physical aggression, verbal aggression, anger, and hostility subscalesClinical, forensic, and research settings
Novaco Anger Scale and Provocation Inventory (NAS-PI; Novaco, 2003)NAS: 60 items; PI: 25 itemsCognitive, arousal, and behavioural components of anger; provocation reactivityForensic psychiatric and offender populations

Behavioural Health Outcome Monitoring

PHQ-9, GAD-7, DERS, PCL-5, and anger/aggression outcomes, integrated monitoring for DBT, anger management, forensic, and community mental health programs.

Clinical Use:These results are intended to inform clinical decision-making in licensed practice. They do not replace evaluation by a qualified clinician.

Frequently Asked Questions

Is the STAXI-2 a self-report or clinician-administered tool?

The STAXI-2 is a self-report questionnaire. Respondents rate each item on a frequency or intensity scale, and clinicians then review and interpret the profile against published normative data. It does not require clinician observation during administration.

What does a high Anger-Out score on the STAXI-2 mean?

A high Anger-Out score indicates a person tends to express anger outwardly — through verbally or physically aggressive behaviour directed at other people or objects. Elevated Anger-Out, particularly when combined with low Anger Control-Out, is associated with conflict in relationships and increased risk of aggressive incidents.

Can an anger test diagnose Intermittent Explosive Disorder?

No. Self-report anger questionnaires such as the STAXI-2 are screening and monitoring tools, not diagnostic instruments. A diagnosis of Intermittent Explosive Disorder (IED) requires a structured clinical interview to confirm the DSM-5 criteria, including the frequency, intensity, and disproportionality of aggressive outbursts.

What is the difference between the Anger Expression Index and trait anger?

Trait anger is the stable tendency to experience anger frequently and intensely across many situations. The Anger Expression Index (AXI) reflects how that anger is typically handled — combining Anger-In and Anger-Out (expression) scores and subtracting the two Anger Control scales. A high AXI indicates chronically suppressed or poorly managed anger expression rather than just frequent angry feelings.

References

  1. 1.
    Lievaart M, Franken IH, Hovens JE. Anger Assessment in Clinical and Nonclinical Populations: Further Validation of the State-Trait Anger Expression Inventory-2. J Clin Psychol. 2016;72(3):263-78.View source
  2. 2.
    Coccaro EF, Lee R, McCloskey MS. Validity of the new A1 and A2 criteria for DSM-5 intermittent explosive disorder. Compr Psychiatry. 2014;55(2):260-7.View source
  3. 3.
    Moeller SB, Novaco RW, Heinola-Nielsen V, Hougaard H. Validation of the Novaco Anger Scale-Provocation Inventory (Danish) With Nonclinical, Clinical, and Offender Samples. Assessment. 2016;23(5):624-36.View source
  4. 4.
    Diamond PM, Magaletta PR. The short-form Buss-Perry Aggression Questionnaire (BPAQ-SF): a validation study with federal offenders. Assessment. 2006;13(3):227-40.View source

Bill this assessment

The Anger Test (STAXI-2 Guide) qualifies for reimbursement under these CPT codes (US).

Last reviewed: Jun 3, 2026