J Korean Acad Psychiatr Ment Health Nurs.  2014 Mar;23(1):38-48.

Gender Specific Role of Anger Expression in Association with Depression and Health Behavior in Community-Dwelling Elders

  • 1College of Nursing Science and East-West Nursing Research Institute, Kyung Hee University, Seoul, Korea. mhjang@khu.ac.kr
  • 2College of Nursing Science, Kyung Hee University, Seoul, Korea.


The purpose of this study was to identify the total, direct, and indirect influence of depression on health behavior (HB); to determine relative magnitudes of specific mediating effects of anger expression in gender specific subgroup among elders.
A cross-sectional correlational survey was conducted in S and G cities with 333 community-dwe1ling elders (male=170, female=163). Data were collected from September 7 to November 7, 2013. Kee's GDSSF-K for depression, Spielberger's STAXI for anger expression and Choi & Kim's health behavior assessment tool were used. Multiple-mediation analyses using Indirect SPSS macros were performed.
Depression had a significant total, direct and indirect effect on HB in both male and female. In women, direct and indirect effect of depression on HB were higher than in men. Specific indirect effects of depression on HB were evidenced via anger-control and anger-out for men and via anger-control and anger-in for women. Among anger expression, anger-control was a more salient mediator for both male and female.
Findings suggest that depression and anger-control should be addressed in tandem for promotion of HB for elders. Tailored interventions for the promotion of HB should be developed considering gender of target population.


Health behavior; Depression; Anger; Elderly

MeSH Terms

Health Behavior*
Health Services Needs and Demand


  • Figure 1 Conceptual model of the study and analytic diagram for the multiple-mediation model proposed.

  • Figure 2 Multiple-mediation bootstrap analysis of relationships between depression and health behavior as mediated by anger-in, anger-out and anger-control (Male/Female estimate).


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