Cognitive Behavioral Affective Therapy for Anger

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: The University of Texas at San Antonio

Disqualifiers: Schizophrenia, Autism, Dementia, others

Approved in 3 Jurisdictions

Trial Summary

What is the purpose of this trial?

This trial aims to test the effectiveness of Cognitive Behavioral Affective Therapy (CBAT) in helping people who struggle with excessive anger. The therapy teaches techniques to manage anger by recognizing triggers and using calming strategies. The goal is to reduce the negative impact of anger on health and behavior.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, you cannot be undergoing any psychological or psychiatric treatment to participate.

What data supports the effectiveness of Cognitive Behavioral Affective Therapy for Anger?

Research shows that cognitive treatments, like Cognitive Behavioral Therapy (CBT), can effectively reduce anger. A study found that people who received online cognitive treatment reported significantly lower anger levels compared to those who did not receive the treatment. ^{1 2 3 4 5}

Is Cognitive Behavioral Affective Therapy for Anger safe for humans?

Research on cognitive behavioral therapy (CBT) for anger, including studies on veterans and individuals with traumatic brain injury, suggests that it is generally safe for humans. These studies have not reported significant safety concerns, indicating that CBT-based treatments for anger are typically well-tolerated. ^{1 4 6 7 8}

How is Cognitive Behavioral Affective Therapy (CBAT) for anger different from other treatments?

Cognitive Behavioral Affective Therapy (CBAT) for anger is unique because it combines traditional cognitive-behavioral techniques with a focus on emotional regulation and motivation, addressing both the cognitive and affective aspects of anger. This approach is more comprehensive than standard anger management therapies, which may not fully integrate these components. ^{3 4 5 9 10}

Research Team

Eligibility Criteria

This trial is for individuals who struggle with excessive anger, such as those with Intermittent Explosive Disorder or related conditions. It's aimed at people whose anger leads to distress and problems in daily life. Participants should be interested in exploring therapy to manage their emotions.

Inclusion Criteria

Speak English

Live in the United States

Have maladaptive anger (as assessed by the STAXI-2)

Exclusion Criteria

Is currently undergoing an anger treatment program

Does not live in the United States

Has a current serious psychiatric illness (e.g., schizophrenia, autism, dementia, suicidal ideation)

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

1 week

1 visit (virtual)

Treatment

Participants receive Cognitive Behavioral Affective Therapy (CBAT) or Emotional Education (EE) through video sessions over 4 weeks

4 weeks

8 video sessions (virtual)

Interim Period

Participants have a 3-week interim period to reflect and implement learned techniques

3 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment, including a final follow-up session

1 week

1 follow-up session (virtual)

Treatment Details

Interventions

• Cognitive Behavioral Affective Therapy (Behavioral Intervention)

Trial Overview The study tests Cognitive Behavioral Affective Therapy (CBAT), a form of 'anger management' therapy designed to reduce anger levels. The effectiveness of CBAT will be measured through various assessments within a community sample.

Participant Groups

Group I: Cognitive Behavioral Affective Therapy Experimental Treatment 1 Intervention

Group receiving CBAT.

Group II: Emotional Education Placebo Group 1 Intervention

Group receiving general emotion psychoeducation.

Cognitive Behavioral Affective Therapy is already approved in Canada for the following indications:

Approved in Canada as CBAT for:

• Intermittent Explosive Disorder
• Anxiety Disorders
• Chronic Pain Management

Who Is Running the Clinical Trial?

The University of Texas at San Antonio

Lead Sponsor

Trials

24

Recruited

7,600+

Findings from Research

The anger self-management training (ASMT) program, consisting of 8 sessions, showed significant improvements in self-reported anger levels among 10 participants with moderate to severe traumatic brain injury (TBI), with large effect sizes greater than 1.0.

Qualitative feedback from participants was positive, and the low dropout rate (only 1 out of 11) suggests that the ASMT is a feasible and potentially effective intervention for managing anger and irritability in individuals with TBI.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Anger self-management training for people with traumatic brain injury: a preliminary investigation. Hart, T., Vaccaro, MJ., Hays, C., et al.[2022]

A randomized controlled trial involving 75 adults demonstrated that a brief online cognitive treatment significantly reduced anger levels in participants compared to a waiting list control group after four weeks.

The treatment group experienced a substantial decrease in anger, indicating that internet-based cognitive therapy can be an effective intervention for managing problematic anger in adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of online cognitive treatment for problematic anger: a randomized controlled trial. Howie, AJ., Malouff, JM.[2018]

The review highlights that effective anger treatment should include a comprehensive approach that addresses motivation, physiological arousal, cognitive change, and behavior change, among other components.

Different therapeutic approaches, such as cognitive-behavioral and Buddhist methods, are evaluated against these ideal treatment components, suggesting that a tailored combination of strategies may be most beneficial for managing anger.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

End piece: reflections on the treatment of anger. DiGiuseppe, R.[2019]

A systematic review of 42 studies on cognitive behavioral therapy (CBT) for anger found that 60% were randomized controlled trials, indicating a strong methodological approach, and most studies reported statistically significant outcomes.

While CBT for anger appears effective, the presence of social desirability bias (SDB) in one study that corrected for it raises questions about the reliability of the positive results, suggesting that further scrutiny of methodology is needed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

21st Century Cognitive Behavioural Therapy for Anger: A Systematic Review of Research Design, Methodology and Outcome. Fernandez, E., Malvaso, C., Day, A., et al.[2021]

Anger is defined as a complex emotional response involving cognitive, behavioral, physiological, and social factors, highlighting its significance in understanding and treating this emotion.

The review evaluates various treatment approaches for anger in clinical populations, including aggressive individuals and those with PTSD or cardiovascular issues, emphasizing the need for tailored interventions based on the underlying causes of anger.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Research review on anger in psychotherapy. Mayne, TJ., Ambrose, TK.[2019]

A randomized pilot study involving 25 veterans returning from Iraq or Afghanistan found that an adapted cognitive behavioral intervention (CBI) significantly improved anger and interpersonal functioning compared to a supportive intervention (SI).

The improvements from CBI were maintained at a 3-month follow-up, suggesting its potential effectiveness for treating anger issues in veterans with warzone trauma.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized pilot study of anger treatment for Iraq and Afghanistan veterans. Shea, MT., Lambert, J., Reddy, MK.[2022]

This meta-analysis of 23 studies involving noninstitutionalized adults with measurable anger found medium to large effect sizes for various anger treatments, indicating their effectiveness.

Cognitive therapies were particularly effective for issues like driving anger and trait anger, while relaxation techniques were recommended for managing state anger, suggesting tailored approaches for different types of anger.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of anger treatments for specific anger problems: a meta-analytic review. Del Vecchio, T., O'Leary, KD.[2022]

A randomized controlled trial involving 92 post-911 veterans with moderate to severe anger issues found that cognitive behavioral therapy (CBI) significantly reduced anger severity and improved social functioning and quality of life compared to supportive therapy.

The effectiveness of CBI was consistent regardless of whether the veterans had a PTSD diagnosis, indicating its broad applicability for treating anger problems in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Treatment of anger problems in previously deployed post-911 veterans: A randomized controlled trial. Shea, MT., Stout, RL., Reddy, MK., et al.[2022]

Acceptance and Commitment Therapy (ACT) was found to be more effective than Cognitive-Behavioral Therapy (CBT) in reducing anger among male students, based on a study involving 30 participants who were randomly assigned to either therapy group.

Both ACT and CBT showed similar effectiveness in improving interpersonal relationships, indicating that while ACT may excel in anger management, CBT remains equally effective for interpersonal issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of Acceptance and Commitment Therapy Compared to Cognitive Behavioral Therapy on Anger and Interpersonal Relationships of Male Students. Masoumian, S., Ashouri, A., Ghomian, S., et al.[2021]

Anger management methods in cognitive behavioral therapy are generally effective, as supported by meta-analyses and reviews, but treatment readiness is a crucial factor that is often overlooked.

Addressing treatment readiness is essential for improving anger management outcomes, as it can affect the therapeutic alliance and overall effectiveness of the intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Readiness for anger management: clinical and theoretical issues. Howells, K., Day, A.[2019]

References

1. United States pubmed.ncbi.nlm.nih.gov

Anger self-management training for people with traumatic brain injury: a preliminary investigation. [2022]

2. England pubmed.ncbi.nlm.nih.gov

Effects of online cognitive treatment for problematic anger: a randomized controlled trial. [2018]

3. United States pubmed.ncbi.nlm.nih.gov

End piece: reflections on the treatment of anger. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

21st Century Cognitive Behavioural Therapy for Anger: A Systematic Review of Research Design, Methodology and Outcome. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

Research review on anger in psychotherapy. [2019]

6. England pubmed.ncbi.nlm.nih.gov

A randomized pilot study of anger treatment for Iraq and Afghanistan veterans. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of anger treatments for specific anger problems: a meta-analytic review. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Treatment of anger problems in previously deployed post-911 veterans: A randomized controlled trial. [2022]

9. Iran pubmed.ncbi.nlm.nih.gov

Efficacy of Acceptance and Commitment Therapy Compared to Cognitive Behavioral Therapy on Anger and Interpersonal Relationships of Male Students. [2021]

10. United States pubmed.ncbi.nlm.nih.gov

Readiness for anger management: clinical and theoretical issues. [2019]