Using Anger Management Virtual Reality Cognitive Behavior Therapy to Treat Violent Offenders with Alcohol Dependence in South Korea: A Preliminary Investigation

Abstract

Cognitive Behavior Therapy (CBT) effectively treats impulse/anger attacks and aggressive-impulsive behaviors, frequently conducted concerning domestic violence, among patients with alcohol dependence. CBT combined with virtual reality (VR) is a new and beneficial psychotherapeutic intervention for patients and violent offenders with impulse-anger control problems and alcohol dependence. This clinical study evaluated the effects of the “anger management virtual reality cognitive behavior therapy (AM-VR-CBT)” and motivational interviewing (MI) intervention program on quantitative electroencephalography (QEEG) mapping patterns among violent offenders with alcohol dependence (N = 29) in the National Probation Service. A clinical sample of twenty-nine violent offenders with alcohol dependence, who were evaluated and diagnosed with destructive and impulse-control disorders (DICD), underwent AM-VR-CBT combined with MI. The sessions lasted 150 minutes (AM-VR-CBT: 90 min; MI: 60 min) and were conducted twice a week for three weeks (six sessions). The intervention outcomes were measured using advanced QEEG brain mapping and standardized neurocognitive, emotional, and behavioral inventories, including the Alcohol Dependence Scale (ADS), the Obsessive Compulsive Drinking Scale (OCDS), the Readiness to Change Questionnaire (RTCQ), the Barratt Impulsiveness Scale-II (BIS-II), the Beck Anxiety Inventory (BAI), the Beck Depression Inventory-Second Edition (BDI-2), and the State-Trait Anger Expression Inventory-2 (STAXI-2), to identify neuro-psycho-physiological changes in violent offenders with alcohol dependence. The Wilcoxon signed-rank test was used at p < 0.05. The intervention showed significant improvements and healthy behavioral changes related to obsessive drinking thoughts, compulsive drinking behaviors, attentional control, intrinsic motivation, worry, anxiety, depression, impulse-anger control issues, aggressive behaviors, over-control, interpersonal relationships, self-efficacy, self-reflection, self-inhibition, creativity, mental navigation/imagery, and episodic memory retrieval among violent offenders with alcohol dependence. Therefore, the results demonstrate the efficacy of the novel and promising clinical evidence-based implementation of the AM-VR-CBT + MI program intervention for non-invasive neuromodulation and related neuro-psycho-physiological, neurocognitive, emotional, and behavioral changes among violent offenders demonstrating alcohol dependence, impulse-anger control, and aggressive behaviors.