Source: Wikipedia

Long-term stress is bad for you. Decades of research demonstrates that when people are over a long period of time, their immune system is suppressed. These individuals experience health problems including heart disease and high blood pressure.

Quite a bit of research has explored the relationship between health and as well. Most of these studies have used American and Western European participants. In these cultures, the people who express anger most often (for example by yelling or slamming doors) are typically the ones who are experiencing the most stress. For these individuals, stress leads to expression of anger, and it also causes health problems. So, Americans and Western Europeans who express their anger also typically have health problems.

A fascinating analysis was reported in the February, 2015 issue of Psychological Science by a research team headed by Shinobu Kitayama. This team examined whether the same relationship between the expression of anger and health problems holds up in a Japanese sample.

Western cultures differ from Japanese culture along many dimensions. One is that Western cultures are relatively flat. That is, there is no strong hierarchy. As a result, there is no powerful social pressure for people to resist anger when they are feeling stress. Japanese culture (like many East Asian cultures) is hierarchical. People low in status have to rein in their emotions when they are in the presence of people more powerful than they are.

These researchers were interested in whether this cultural difference might change the relationship between expressions of anger and health outcomes. In particular, Japanese adults who express anger are likely to be the ones who have relatively more power in the society. Consequently, those individuals who express anger may have more outlets for their stress than those who do not express their anger often.

To test this possibility, the researchers looked at two large-scale studies of adults—one in the United States and one in Japan. These studies collected data both on how often these adults expressed anger as well as a number of measures of health including cholesterol levels, blood pressure and blood measures of inflammation. The studies also collected a number of other demographic variables that might explain the findings.

The results of these surveys suggest that expressing anger is related to very different outcomes across cultures. In the United States, people who express anger often had more symptoms of inflammation and poor health. In contrast, the Japanese participants who expressed anger often actually had fewer biological markers of poor health.

The best way to interpret these findings is that life stress causes health problems. But, people’s behavior in the face of stress differs depending on the culture they belong to. For Americans, expressing anger is strongly related to the amount of stress they experience, because they are free to express their anger. For Japanese, expressing anger is actually a better signal of social status than of stress. In Japan, people can’t generally express their anger unless they are in a social situation in which they have some power or dominance.

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