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Open Access Research article

Anger expression, violent behavior, and symptoms of depression among male college students in Ethiopia

Dale J Terasaki1*, Bizu Gelaye1, Yemane Berhane23 and Michelle A Williams1

Author Affiliations

1 Department of Epidemiology, Multidisciplinary International Research Training Program, University of Washington School of Public Health and Community Medicine, Seattle, Washington, USA

2 Addis Continental Institute of Public Health, Addis Ababa, Ethiopia

3 Department of Community Medicine, Addis Ababa University Medical School, Addis Ababa, Ethiopia

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BMC Public Health 2009, 9:13  doi:10.1186/1471-2458-9-13

Published: 12 January 2009



Depression is an important global public health problem. Given the scarcity of studies involving African youths, this study was conducted to evaluate the associations of anger expression and violent behavior with symptoms of depression among male college students.


A self-administered questionnaire was used to collect information on socio-demographic and lifestyle characteristics and violent behavior among 1,176 college students in Awassa, Ethiopia in June, 2006. The questionnaire incorporated the Spielberger Anger-Out Expression (SAOE) scale and symptoms of depression were evaluated using the Patient Health Questionnaire (PHQ-9). Multivariable logistic regression procedures were used to calculate adjusted odds ratios (OR) and 95% confidence intervals (95%CI).


Symptoms of depression were evident in 23.6% of participants. Some 54.3% of students reported committing at least one act of violence in the current academic year; and 29.3% of students reported high (SAOE score ≥ 15) levels of anger-expression. In multivariate analysis, moderate (OR = 1.97; 95%CI 1.33–2.93) and high (OR = 3.23; 95%CI 2.14–4.88) outward anger were statistically significantly associated with increased risks of depressive symptoms. Violent behavior was noted to be associated with depressive symptoms (OR = 1.82; 95%CI 1.37–2.40).


Further research should be conducted to better characterize community and individual level determinants of anger-expression, violent behavior and depression among youths.