Anger and associated risk and protective factors among rural American adolescents: Implications for violence prevention.

Background: Adolescent violence in the United States is a prevalent public health problem and is understudied in rural settings. Anger is a significant risk factor for adolescent violence. To better craft adolescent violence interventions, it is important to examine anger and identify its most significant associated factors.

Aims: This study examined (1) self-reported anger changes over time for rural American adolescents; and (2) structural, community, interpersonal, and individual level factors that may contribute to anger.

Methods: We analyzed self-reported survey data from West Virginian middle schoolers ( = 2861) with anger as the outcome. Data was collected twice yearly from October 2020 through April 2023. Independent variables included perceptions of inequality, individual socioeconomic status (SES), neighborhood characteristics, family structure, support from adults at home and school, and harsh parenting.

Analysis: Generalized estimating equation Poisson regression models for main effects and gender interaction were used. Parameter estimates were exponentiated and interpreted as Rate Ratios (RR). Self-reported gender was an effect modifier.

Results: Significant main effects included perceived inequality (RR = 0.98, 95 % CI = 0.97-0.99), SES (RR = 0.99, 95 % CI = 0.98-0.99), supportive adults at school (RR = 0.99, 95 % CI = 0.98-0.99), primary caregiver support (RR = 0.99, 95 % CI = 0.98-0.99), and harsh parenting (RR = 1.10, 95 % CI = 1.05-1.05). Significant gender interaction terms included perceived harsh parenting (RR = 0.98, 95 % CI = 0.97-0.99) and supportive adults at school (RR = 1.01, 95 % CI = 1.00-1.02) for 'other' genders (i.e., participants identifying as neither boy nor girl) compared to boys.

Conclusions: Findings underline the importance of examining rural adolescent anger development and associated risk factors for designing prevention approaches to curb downstream violent behavior.