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

  • Ephrem Fernandez (a1), Catia Malvaso (a2), Andrew Day (a3) and Deepan Guharajan (a1)
Abstract

Background: Past reviews of cognitive behavioural therapy (CBT) for anger have focused on outcome in specific subpopulations, with few questions posed about research design and methodology. Since the turn of the century, there has been a surge of methodologically varied studies awaiting systematic review. Aims: The basic aim was to review this recent literature in terms of trends and patterns in research design, operationalization of anger, and covariates such as social desirability bias (SDB). Also of interest was clinical outcome. Method: After successive culling, 42 relevant studies were retained. These were subjected to a rapid evidence assessment (REA) with special attention to design (ranked on the Scientific Methods Scale) measurement methodology (self-monitored behaviour, anger questionnaires, and others’ ratings), SDB assessment, and statistical versus clinical significance. Results: The randomized controlled trial characterized 60% of the studies, and the State Trait Anger Expression Inventory was the dominant measure of anger. All but one of the studies reported statistically significant outcome, and all but one of the 21 studies evaluating clinical significance laid claim to it. The one study with neither statistical nor clinical significance was the only one that had assessed and corrected for SDB. Conclusions: Measures remain relatively narrow in scope, but study designs have improved, and the outcomes suggest efficacy and clinical effectiveness. In conjunction with previous findings of an inverse relationship between anger and SDB, the results raise the possibility that the favourable picture of CBT for anger may need closer scrutiny with SDB and other methodological details in mind.

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Corresponding author
Correspondence to Ephrem Fernandez, University of Texas at San Antonio – Psychology, One UTSA Circle San Antonio, San Antonio, Texas 78249, USA. Email: ephrem.fernandez@utsa.edu
References
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An asterisk (*) before a reference denotes that it is listed in Table 1.
Beck, R. and Fernandez, F. (1998). Cognitive-behavioral therapy in the treatment of anger: a meta-analysis. Cognitive Therapy and Research, 22, 6374.
Broom, J. (2016). Review: Barriers to physical activity in obese adults: a rapid evidence assessment. Journal of Research in Nursing, 21, 288289.
Burns, J. W., Gerhart, J. I., Bruehl, S., Peterson, K. M., Smith, D. A., Porter, L. S. et al. (2015). Anger arousal and behavioral anger regulation in everyday life among patients with chronic low back pain: relationships to patient pain and function. Health Psychology, 34, 547555.
Burton, E., Butler, G., Hodgkinson, J. and Marshall, S. (2007). Quick but not dirty: rapid evidence assessments (REAs) as a decision support tool in social policy. In Hogard, E., Ellis, R. and Warren, J. (eds), Community Safety: Innovation and Evaluation, pp. 5062. Chester: Chester Academic Press.
*Cahill, S. P., Rauch, S. A., Hembree, E. A. and Foa, E. B. (2003). Effect of cognitive-behavioral treatments for PTSD on anger. Journal of Psychotherapy: An International Quarterly, 17, 113131.
Chereji, S. V., Pintea, S. and David, D. (2012). The relationship of anger and cognitive distortions with violence in violent offenders population: a meta-analytic review. European Journal of Psychology Applied to Legal Context, 4, 198.
*Dahlen, E. R. and Deffenbacher, J. L. (2000). A partial component analysis of Beck's cognitive therapy for the treatment of general anger. Journal of Cognitive Psychotehrapy, 14, 7795.
Day, A., Mohr, P., Howells, K., Gerace, A. and Lim, L. (2012). The role of empathy in anger arousal in violent offenders and university students. International Journal of Offender Therapy and Comparative Criminology, 56, 599613.
Day, A. and Vess, J. (2013). Targeting anger in forensic populations. In Fernandez, E. (ed), Treatments for Anger in Specific Populations: Theory, Application, and Outcome, pp. 158175. Oxford: Oxford University Press.
*Deffenbacher, J. L., Filetti, L. B., Lynch, R. S., Dahlen, E. R. and Oetting, E. R. (2002). Cognitive-behavioral treatment of high anger drivers. Behaviour Research and Therapy, 40, 895910.
*Deffenbacher, J. L., Huff, M. E., Lynch, R. S., Oetting, E. R. and Salvatore, N. F. (2000). Characteristics and treatment of high-anger drivers. Journal of Counseling Psychology, 47, 517.
Delamater, R. J. and McNamara, J. R. (1987). Expression of anger: its relationship to assertion and social desirability among college women. Psychological Reports, 61, 131134.
Del Vecchio, T. and O'Leary, K. D. (2004). Effectiveness of anger treatments for specific anger problems: a meta-analytic review. Clinical Psychology Review, 24, 1534.
DiGiuseppe, R. and Tafrate, R. C. (2003). Anger treatment for adults: a meta-analytic review. Clinical Psychology: Science and Practice, 10, 7084.
Dutton, D. G. and Hemphill, K. J. (1992). Patterns of socially desirable responding among perpetrators and victims of wife assault. Violence and Victims, 7, 2939.
Farrington, D. P., Gottfredson, D. C., Sharman, L. W. and Welsh, B. C. (2002). The Maryland scientific methods scale. In Sherman, L. W., Farrington, D. P., Welsh, B. C. and MacKenzie, D. L. (eds), Evidence-Based Crime Prevention, pp. 1322. New York: Routledge.
*Fernandez, E. and Beck, R. (2001). Cognitive-behavioral self-intervention versus self-monitoring of anger: effects on anger frequency, duration and intensity. Behavioural and Cognitive Psychotherapy, 29, 345356.
Fernandez, E., Day, A. and Boyle, G. J. (2015). Measures of anger and hostility in adults. In Boyle, G. J., Saklofske, D. and Matthews, G. (eds), Measures of Personality and Social Psychological Constructs, pp. 74100. London: Academic Press.
Fernandez, E. and Johnson, S. L. (2016). Anger in psychological disorders: prevalence, presentation, etiology and prognostic implications. Clinical Psychology Review, 46, 124135.
*Fernandez, E. and Scott, S. (2009). Anger treatment in chemically-depended inpatients: evaluation of phase effects and gender. Behavioural and Cognitive Psychotherapy, 37, 431447.
*Fuller, J. R., DiGiuseppe, R., O'Leary, S., Fountain, T. and Lang, C. (2010). An open trial of a comprehensive anger treatment program on an outpatient sample. Behavioural and Cognitive Psychotherapy, 38, 485490.
Garrett, B., Taverner, T., Masinde, W., Gromala, D., Shaw, C. and Negraeff, M. (2014). A rapid evidence assessment of immersive virtual reality as an adjunct therapy in acute pain management in clinical practice. Clinical Journal of Pain, 30, 10891098.
*Goldman, D. B. and Wade, N. G. (2012). Comparison of forgiveness and anger-reduction group treatments: a randomized controlled trial. Psychotherapy Research, 22, 604620.
*Gonzalez-Prendes, A. A., Hernandez Jozeforwicz-Simbeni, D. M. (2009). The effects of cognitive-behavioral therapy on trait anger and paranoid ideation. Research on Social Work Practice, 19, 686693.
*Haddock, G., Barrowclough, C., Shaw, J. J., Dunn, G., Novaco, R.W. and Tarrier, N. (2009) Cognitive-behavioural therapy v. social activity therapy for people with psychosis and a history of violence: randomised controlled trial. British Journal of Psychiatry, 194, 152157.
*Hagiliassis, N., Gulbenkoglu, H., Di Marco, M., Young, S. and Hudson, A. (2005). The Anger Management Project: a group intervention for anger in people with physical and multiple disabilities. Journal of Intellectual and Developmental Disability, 30, 8696.
Hanson, K. and Wallace-Capretta, S. (2000). Predicting Recidivism Among Male Batterers. Canada: Public Works and Government Services.
*Hart, T., Vaccaro, M. J., Hays, C. and Maiuro, R. D. (2012). Anger self-management training for people with traumatic brain injury: a preliminary investigation. Journal of Head Trauma Rehabilitation, 27, 113122.
*Henwood, K., Browne, K. and Chou, S. (2016). A randomized controlled trial exploring the effects of brief anger management on community-based offenders in Malta. International Journal of Offender Therapy and Comparative Criminology, 1–21.
Henwood, K. S., Chou, S. and Browne, K. D. (2015). A systematic review and meta-analysis on the effectiveness of CBT informed anger management. Aggression and Violent Behavior, 25, 280292.
*Heseltine, K., Howells, K. and Day, A. (2010). Brief anger interventions with offenders may be ineffective: a replication and extension. Behaviour Research and Therapy, 48, 246250.
Ho, B. P. V., Carter, M. and Stephenson, J. (2010). Anger management using a cognitive-behavioural approach for children with special education needs: a literature review and meta-analysis. International Journal of Disability, Development and Education, 57, 245265.
Howells, K. and Day, A. (2003). Readiness for anger management: clinical and theoretical issues. Clinical Psychology Review, 23, 319337.
*Howells, K., Day, A., Williamson, P., Bubner, S., Jauncey, S., Parker, A. and Heseltine, K. (2005). Brief anger management programs with offenders: outcomes and predictors of change. Journal of Forensic Psychiatry and Psychology, 16, 296311.
*Howie, A. J. and Malouff, J. M. (2014). Effects of online cognitive treatment for problematic anger: a randomized controlled trial. Cognitive Behaviour Therapy, 43, 310318.
*Hutchinson, G., Willner, P., Rose, J., Burke, I. and Bastick, T. (2017). CBT in a Caribbean context: a controlled trial of anger management in Trinidadian prisons. Behavioural and Cognitive Psychotherapy, 45, 115.
*Hyun, M., Chung, H. C., De Gagne, J. C. and Kang, H. S. (2014). The effect of cognitive-behavioral therapy on depression, anger, and self-control for Korean soldiers. Journal of Psychosocial Nursing and Mental Health Services, 52, 2228.
Izawa, S. and Nomura, S. (2006). The relationship of hostility to health related behaviors, obesity, and hypertension in adolescence. Japanese Journal of Health Psychology, 19, 1119.
Jacobson, N. S. and Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 1219.
*Karahan, T. F., Yalcin, B. M. and Erbas, M. M. (2014). The beliefs, attitudes and views of university students about anger and the effects of cognitive behavioral therapy-oriented anger control and anxiety management programs on their anger management. Educational Sciences: Theory and Practice, 14, 20712082.
Kirchner, T. R. and Shiffman, S. (2013). Ecological momentary assessment. In MacKillop, J., and de Wit, H. (eds), The Wiley-Blackwell Handbook of Addiction Psychopharmacology, pp. 541565. Wiley-Blackwell.
*Korman, L., Collins, J., Littman-Sharp, N., Skinner, W., McMain, S. and Mercado, V. (2008). Randomized control trial of an integrated therapy for comorbid anger and gambling. Psychotherapy Research, 18, 454465.
*Kubiak, S.P., Kim, W. J., Fedock, G. and Bybee, D. (2015). Testing a violence-prevention intervention for incarcerated women using a randomized control trial. Research on Social Work Practice, 25, 334348.
*Lindsay, W. R., Allan, R., Parry, C., Macleod, F., Cottrell, J., Overend, H., and Smith, A. H. W. (2004). Anger and aggression in people with intellectual disabilities. Clinical Psychology and Psychotherapy, 11, 255264.
*Medd, J. and Tate, R. L. (2000). Evaluation of an anger management therapy programme following acquired brain injury: a preliminary study. Nueropsychological Rehabilitation, 10, 185201.
*Morland, L. A., Greene, C. J., Rosen, C. S., Foy, D., Reilly, P., Shore, J., He, Q. and Freuh, C. (2010). Telemedicine for anger management therapy in a rural population of combat veterans with post-traumatic stress disorder: a randomized non-inferiority trial. Journal of Clinical Psychiatry, 71, 855863.
*Naeem, F., Clarke, I. and Kingdon, D. (2009). A randomized controlled trial to assess an anger management group programme. the Cognitive Behaviour Therapist, 2, 2031.
Nicoll, M., Beail, N. and Saxon, D. (2013). Cognitive behavioural treatment for anger in adults with intellectual disabilities: a systematic review and meta‐analysis. Journal of Applied Research in Intellectual Disabilities, 26, 4762.
Novaco, R. W. (2003). The Novaco Anger Scale and Provocation Inventory (NAS-PI). Los Angeles, CA: Western Psychological Services.
Phelps, A. J., Varker, T., Metcalf, O. and Dell, L. (2017). What are effective psychological interventions for veterans with sleep disturbances? A rapid evidence assessment. Military Medicine, 182, e1541–1550.
Prochaska, J. O. and DiClemente, C. C. (1982). Transtheoretical therapy: toward a more integrative model of change. Psychotherapy: Theory, Research and Practice, 19, 276288.
*Resick, P. A., Galovski, T. E., O'Brien Uhlmansiek, M., Scher, C. D., Clum, G. A. and Young-Xu, Y. (2008). A randomized clinical trial to dismantle components of cognitive processing therapy for post-traumatic stress disorder in female victims of interpersonal violence. Journal of Consulting and Clinical Psychology, 76, 243258.
*Rose, J. L. (2013). A preliminary investigation into the influence of therapist experience on outcome of individual anger interventions. Behavioural and Cognitive Psychotherapy, 41, 470478.
*Rose, J. L., Dodd, L. and Rose, N. (2008). Individual cognitive behavioral intervention for anger. Journal of Mental Health Research in Intellectual Disabilities, 1, 97108.
*Rose, J. L., Loftus, M., Flint, B. and Carey, L. (2005). Factors associated with the efficacy of a group intervention for anger in people with intellectual disabilities. British Journal of Clinical Psychology, 44, 305317.
*Rose, J. L., O'Brien, A. and Rose, D. (2009). Group and individual cognitive behavioural interventions for anger. Advances in Mental Health and Learning Disabilities, 3, 4550.
*Shea, M. T., Lambert, J. and Reddy, M. K. (2013). A randomized pilot study of anger treatment for Iraq and Afghanistan veterans. Behaviour Research and Therapy, 51, 607613.
Sherman, L. W., Farrington, D. P., Welsh, B. C. and MacKenzie, D. L. (2002). Evidence-Based Crime Prevention. New York: Routledge.
Sherman, L. W., Farrington, D. P., Welsh, B. C. and MacKenzie, D. L. (2006). Maryland Scientific Methods Scale: Evidence-Based Crime Prevention. London–New York: Routledge.
*Slavin-Spenny, O., Lumley, M. A., Thakur, E. R., Nevedal, D. C. and Hijazi, A. M. (2013). Effects of anger awareness and expression training versus relaxation training on headaches: a randomized trial. Annals of Behavioral Medicine, 46, 181192.
Smedslund, J. (1993). How shall the concept of anger be defined? Theory and Psychology, 3, 533.
*Son, J. and Choi, Y. (2010). The effect of an anger management program for family members of patients with alcohol use disorders. Archives of Psychiatric Nursing, 24, 3845.
*Steffen, A. M. (2000). Anger management for dementia caregivers: a preliminary study using video and telephone interventions. Behavior Therapy, 31, 281299.
Stone, A. A. and Shiffman, S. (1994). Ecological momentary assessment (EMA) in behavorial medicine. Annals of Behavioral Medicine, 16, 199202.
*Strom, T., Leskela, J., Possis, E., Thuras, P., Leuty, M.E., Doane, B.M., Wilder-Schaaf, K. and Rosenzweig, L. (2013). Cognitive-behavioral group treatment for driving-related anger, aggression, and risky driving in combat veterans: a pilot study. Journal of Traumatic Stress, 26, 405408.
Sukhodolsky, D. G., Kassinove, H. and Gorman, B. S. (2004). Cognitive-behavioral therapy for anger in children and adolescents: a meta-analysis. Aggression and Violent Behavior, 9, 247269.
*Tang, M. (2001). Clinical outcome and client satisfaction of an anger amangement group program. Canadian Journal of Occupational Therapy, 68, 228236.
*Taylor, J. L., Novaco, R. W., Gillmer, B. T., Robertson, A. and Thorne, I. (2005). Individual cognitive-behavioural anger treatment for people with mild-borderline intellectual disabilities and histories of aggression: a controlled trial. British Journal of Clinical Psychology, 44, 367382.
Van de Mortel, T. F. (2008). Faking it: social desirability response bias in self-report research. Australian Journal of Advanced Nursing, 25, 4048.
Varker, T., Forbes, D., Dell, L., Weston, A., Merlin, T., Hodson, S. and O'Donnell, M. (2015). Rapid evidence assessment: increasing the transparency of an emerging methodology. Journal of Evaluation in Clinical Practice, 21, 11991204.
*Vassilopoulos, S. P., Brouzos, A., Moberly, N. J. and Tsiligiannis, G. (2015). Development and evaluation of a short anger management group for special education teachers: a preliminary study. International Journal of School and Educational Psychology, 3, 107116.
*Walker, A. J., Nott, M. T., Doyle, M., Onus, M., McCarthy, K. and Baguley, I. J. (2010). Effectiveness of a group anger management programme after severe brain injury. Brain Injury, 24, 517524.
Welte, J. W. and Russell, M. (1993). Influence of socially desirable responding in a study of stress and substance abuse. Alcoholism: Clinical and Experimental Research, 17, 758761.
Williams, J. E. (2010). Anger/hostility and cardiovascular disease. In Potegal, M., Stemmler, G. and Spielberger, C. (eds), International Handbook of Anger: Constituent and Concomitant Biological, Psychological and Social Processes, pp. 435447. New York, NY: Springer Science and Business Media.
Willner, P., Jones, J., Tams, R. and Green, G. (2002). A randomized controlled trial of the efficacy of a cognitive-behavioural anger management group for clients with learning disabilities. Journal of Applied Research in Intellectual Disabilities, 15, 224235.
*Willner, P., Rose, J., Jahonda, A., Stenfert Kroese, B., Felce, D., Cohen, D. et al. (2013a). Group-based cognitive-behavioural anger management for people with mild to moderate intellectual disabilities: cluster randomized controlled trial. British Journal of Psychiatry, 203, 288296.
*Willner, P., Rose, J., Jahoda, A., Stenfert Kroese, B., MacMahon, P., Stimpson, A. et al. (2013b). A cluster randomized controlled trial of a manualised cognitive-behavioural anger management intervention delivered by supervised lay therapists to people with intellectual disabilities. Health Technology Assessment, 17.
*Yalcin, B. M., Unal, M., Pirdal, H. and Karahan, T. F. (2014). Effects of an anger management and stress control program on smoking cessation: a randomized controlled trial. Journal of the American Board of Family Medicine, 27, 645660.
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Behavioural and Cognitive Psychotherapy
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