Anger Management Program Research Articles

Review of Cognitive-Behavioral Therapy for Anger and Aggression in Children, by Denis G. Sukhodolsky and Lawrence Scahill

[Author Affiliation]Joyce Sprafkin. Department of Psychiatry and Behavioral Science, Stony Brook University School of Medicine, Stony Brook, New York.ISBN: 978.1.46.250632.3. New York, NY, The Guilford Press, 2012, 184 pages.Address correspondence to: Joyce Sprafkin, PhD, Department of Psychiatry and Behavioral Science, Stony Brook University School of Medicine, Stony Brook, NY 11794, E-mail: Joyce.Sprafkin@stonybrookmedicine.eduIs it important for child psychiatrists to learn cognitive-behavioral therapy (CBT) strategies in the current climate of efficient service delivery? With our system of care reaching only 20% of children who need mental health services, can we afford to have child psychiatrists engage in nonpharmacologic interventions?Books such as Cognitive-Behavioral Therapy for Anger and Aggression in Children make it possible for child psychiatrists to incorporate CBT strategies into their practices for youth with anger management problems. Disruptive behaviors, including aggression and defiance, are among the most frequent reasons for outpatient mental health referral, and physical aggression is a frequent reason for psychiatric hospitalization. This book fills an important gap in the literature. Although there have been anger management programs for youths in groups (Feindler and Ecton 1986; Nelson and Finch 1996; Lochman et al. 2008), until now there were none for use in individual therapy. This program is for 8-16-year-old youth with significant problems with anger, aggression, and noncompliance. Each of 10 chapters outlines and describes an individual therapy session, each with a set of goals and alternative activities to meet each goal. The clinician is encouraged to select the activities that are most suitable for the developmental level and interests of the individual child. The suggested activities include carefully prepared worksheets and attractive illustrations to present the concepts. There are also three additional chapters that describe the three parent sessions that are part of the program.The anger management program set forth is divided into three major modules, each of which parallels one of three major theoretical models of aggressive behavior. The first module is based on the emotional arousal model which suggests that physiological arousal and the intensity of angry feelings are related to overt aggression. Accordingly, the first session provides psychoeducation about anger and explores the situations that trigger anger for the individual child (which often includes being teased or bothered by a peer, told to do something by a parent while the child is engaged in an enjoyable activity, or being treated unfairly by a teacher), responses that often make the situation worse; that is, increase anger and/or result in a negative outcome (some form of physical or verbal aggression), and simple strategies to reduce angry feelings (i.e., engaging in a distracting activity or calming physical arousal by deep breathing). Session 2 emphasizes the importance of monitoring one's anger intensity by using a Feeling Thermometer and taking steps to prevent anger from getting out of control. Past situations are examined in order to come to the realization that intense anger clouds one's thinking and often results in negative outcomes. The Stop and Think technique is introduced, which is a visualization strategy intended to interrupt behavior (imagining a big stop sign or perhaps more effectively, imagining oneself sitting in the back seat of a police car). Additional calming strategies are introduced, including verbal reminders to calm oneself (Take a deep breath or Take it easy) and relaxation techniques. Session 3 expands on the concept of emotion regulation, introduces strategies to prevent anger-provoking situations from occurring, and further refines the recognition of one's own anger cues.The second module is based on the social-cognitive model of aggression, which explains aggressive behavior as the product of cognitive deficits and distortions on the part of the aggressor. …

Feasibility of the stress and anger management program on children with high functioning autism spectrum disorder in a sample population from Karachi

IntroductionResearch shows that individuals with Autism Spectrum Disorder, struggle with emotional competence as compared to their typically developing counterparts. This leads to internalizing (stress) and externalizing (anger management) problems in the affected population. The stress and anger management program (STAMP) designed by Scarpa et al. is a manualized treatment protocol with good clinical efficacy.ObjectiveThe objective of the present study is to test the feasibility and suitability of STAMP as a systematized treatment protocol in Karachi and to enable the sample population, to become emotionally competent.AimThe aim is to evaluate the effectiveness of STAMP on the reduction of symptoms in the sample population.MethodTen children with high functioning autism spectrum disorder will be selected from various institutes in Karachi, and randomized to experimental and waitlist control group after pre-intervention assessment. Upon completion of the intervention with the experimental group, the waitlist control group will be offered the intervention. Both the groups will be assessed, immediately after the intervention, followed by a one-month follow up assessment.ResultsIt is expected that STAMP will significantly reduce the incidence of problem behaviours as measured by the standardized assessment questionnaires from the manual; as well as significantly reduce the severity of scores on the internalizing and externalizing components of the strength and difficulties questionnaire, in the experimental group as compared to the control group.ConclusionIt is expected that the results of the present study could be utilized to train mental health professionals in Karachi for systematized treatment of ASD and related problems.Disclosure of interestThe authors have not supplied their declaration of competing interest.

An Assessment Instrument for Anger Management in Correctional Settings: The Angry Cognitions Scale-Prison Form

As the rates of both violent crime and prison violence continue to rise, anger management programs have become a common treatment recommendation for prisoners. Several psychology treatment programs have incorporated anger management as core curricula, and many supervisory and probation officers mandate anger management as a post release requirement for probationers. Assessment tools that provide direction in treatment planning and therapeutic will surely be very helpful. The Angry Cognitions Scale (ACS) (Martin and Dahlen in J Ration Emot Cogn Behav Therapy 25:155–173, 2007) was formulated to assess the cognitive antecedents to anger: overgeneralizing, inflammatory labeling, demandingness, catastrophic evaluation, and misattributing causation. Evaluation of adaptive anger was also included. A limitation of that study is its lack of generalization to populations beyond college students and the authors recommended rewriting the scenarios to fit specific clinical populations. Researchers have noticed that prisoners may exhibit unique responses to anger provocations due to their conditions of confinement, potential consequences for acts of violence, and cultural norms of the prison environment (Wydo in Measuring anger in a prison population using the Anger Disorders Scale and the Personality Assessment Inventory, 2003). In the current study, the original scenarios from the Angry Cognitions Scale were reworded or reconstructed to replicate common anger provoking events in jails and prisons. As opposed to events that happen in the general public, such as driving a car or going to the mall, it is posited that inmates will more easily relate to everyday occurrences in jail settings and thus provide more accurate responses to be used in therapy. Two hundred and thirty male inmates completed the Angry Cognitions Scale-Prison Form (ACS-PF) and the State-Trait Anger Expression Inventory-2 (STAXI-2). Results indicated that the five maladaptive subscales of the Angry Cognitions Scale-Prison Form were highly correlated and showed good convergent validity with the STAXI-2, while the adaptive process subscale demonstrated discriminant validity. A factor analysis of all ACS-PF items yielded a three factor solution that offers an alternative scoring method. Results support the hypothesis that the ACS-PF provides information on six distinct cognitive processes that prisoners may experience in response to provocations.

Interprofessional Providers’ Perspectives on the Effectiveness of Anger Management Programs with Court-Mandated Clients

The efficacy of court-mandated anger management treatment has varied reviews in the literature. This study asked counselors their perceptions, and results indicated that anger management treatment was perceived as highly effective. In addition, counselors reported having a moderate level of training preparedness to provide anger management services.

An evaluation of a brief anger management programme for offenders managed in the community using cross-lagged panel models

Purpose – The purpose of this paper is to evaluate the effectiveness of a brief, Cognitive Behaviour Therapy-based group intervention in anger management with male offenders. All participants were the subject of a stipulation to attend the programme under a probation order, and were at the time of the study being managed in the community. Design/methodology/approach – Totally, 105 offenders attended the anger management programme, which was delivered by the Probation Board for Northern Ireland (PBNI), between 2008 and 2010 across a range of centres, representing most regions of the province. Prior to treatment, the offenders completed two measures: The State Trait Anger Expression Inventory (STAXI), and the Stages of Change Scales (SCS). Both these measures were also completed at the end of the programme of treatment. Findings – It was found that the programme significantly reduced the expression of anger as well as state and trait anger among offenders referred to the programme as measured by the STAXI. Both the action and maintenance subscales of the SCS were significant predictors of improvement in anger expression. The action subscale was shown to be a valuable predictor of readiness for change amongst the offenders. Originality/value – Assessing an offender’s readiness to change may enhance selection for specific rehabilitation programs thus reducing drop-out rates leading to a more efficient use of resources. This study demonstrates that those participants who were found to be more ready for change, benefited most from the intervention programme.

Development and Evaluation of a Short Anger Management Group for Special Education Teachers in Greece: A Preliminary Study

This study investigated the efficacy of a psychoeducational group for Greek special education teachers, all but one of whom reported experiencing anger in class. An anger management program was designed, which included a short, four-session package to be given within two weeks. The results of a pretest–posttest comparison revealed reductions in participant-reported indicators of trait anger and hostile interpretations in the anger management group (n = 20) compared to a control sample of teachers not receiving the intervention (n = 24). Mediational analyses also showed that change in hostile attributions mediated change in emotions. These results suggested that the intervention was effective, despite being brief.

Protocol for a systematic review: School‐based interventions for reducing disciplinary school exclusion: A systematic review

Protocol for a systematic review: School‐based interventions for reducing disciplinary school exclusion: A systematic review

A Review of Parent Training in Child Interventions: Applications to Cognitive–Behavioral Therapy for Children with High-Functioning Autism

The number of individuals with autism spectrum disorders (ASD) diagnoses is increasing rapidly, indicating a need for multi-faceted interventions. The addition of a parent training component to cognitive–behavioral therapy (CBT) has been effectively used to treat a variety of psychological disorders in children to support generalization of skills and to reduce the burden of intensive therapy by using parents as co-therapists. We review these treatments as applied to childhood anxiety, oppositional/conduct, and attention-deficit/hyperactivity problems, as well as ASD-specific treatments that combine CBT with a parent component. The Stress and Anger Management Program, a 9-week emotion regulation treatment for school-aged children with high-functioning ASD, is described here as one example of a group CBT intervention that includes parent training.

The Effects of Anger Management Programs on Anger Expression in Psychiatric Inpatients

The Effects of Anger Management Programs on Anger Expression in Psychiatric Inpatients

Effects of an anger management and stress control program on smoking cessation: a randomized controlled trial.

The purpose of this study was to investigate the effects of a cognitive behavioral therapy-oriented anger management and stress control program on smokers' quit rates. Of 2348 smokers, 350 were randomly allocated into study and control groups (n = 175 each). An individualized therapy cessation technique was selected for each participant (combination of behavioral counseling, nicotine replacement therapy, and/or pharmacotherapy). The participants in the control group attended a standard quit program, whereas the study group also received an additional 5-session (90 minutes each) cognitive behavioral therapy-oriented program aimed at improving their anger and stress coping skills. At the beginning of the study, both groups were asked to complete the Trait Anger Scale (TAS) of the State and Trait Anger Scale and the Self-Confident (SCS) and Hopeless (HS) subscales of the Stress Coping Styles Inventory; pretest smoking status of both groups and their coping skills were compared with each other as soon as the program ended (post-test results) and after 3 and 6 months (first and second follow-up tests). Although there was no difference between pretest scores on the TAS (P = .234), SCS (P = .130), and HS (P = .148) subscales, post-test results indicate that the study groups' TAS and HS scores decreased and SCS scores increased (P < .001), whereas there was no change in the control group (P > .05). The study group had a better quit level after 6 months compared with the control group (44% vs 27.4%; P < .001). The anger management and stress control program was found to have a significant effect on cessation (odds ratio, 2.09; 95% confidence interval, 1.14-3.85). The anger and stress coping skills program may increase the success of quitting smoking.

Ceza İnfaz Kurumundaki Erkek Transseksüeller ile Bilişsel Davranışçı Öfke Kontrol Programı Bir Grup Çalışması

Seksüel oryantasyonları nedeniyle reddedilen ya da kötü şaka ve yorumlara maruz kalan transseksüeller, öfke ve saldırganlık başta olmak üzere birçok psikolojik ve sosyal sorunlar yaşamaktadırlar. Ceza infaz kurumlarında kalıyor olmanın verdiği stres de yaşadıkları bu sorunları şiddetlendirmektedir. Yaşadıkları bu stres unsurları transseksüel bireylerde suç davranışlarına varan olumsuz psikososyal sonuçlara neden olmaktadır. Bu bilgiler ışığında bu grup çalışmanın amacı, ceza infaz kurumunda kalan erkek transseksüellerin öfkelerini kontrol etmelerini sağlamak, olumlu duygu ve davranış örüntüleri kazanmalarına aynı zamanda maladaptif davranışlarını minimize etmelerine yardımcı olmaktır. Bu amaç doğrultusunda grup çalışması programı olarak Avrupa Konseyi’ nce desteklenen Yargının Modernizasyonu ve Cezaevi Reformu Projesi kapsamında Adalet Bakanlığı Ceza Tevkifevleri Genel Müdürlüğü’nce geliştirilmiş olan Bilişsel Davranışçı Terapi odaklı Öfke Kontrol Programı kullanılmıştır. Grup çalışması 31.10.2011-31.12.2011 tarihleri arasında Ankara Ceza İnfaz Kurumları Kampüsü' nde kalmakta olan üç transseksüel hükümlüyle yürütülmüştür. Bu makalede BDT odaklı Öfke Kontrol Programının uygulanması, grup süreci ve değerlendirmelerine ilişkin bilgiler verilmiştir. Grup çalışmasının uygulanması sonucunda Öfke Kontrol Programı’ nın etkili bir program olduğu, transseksüel bireylerin öfke ve öfkeye neden olan olaylara ilişkin temel inançlarının değiştiği ve olumlu davranış değişikliğine gittikleri gözlenmiştir.

Effects of the anger management program based on cognitive behavioral techniques on high school students' anger and assertiveness levels

Objective: The study aimed to determine the effects of the anger management program based on cognitive behavioral techniques on adolescents’ anger and assertiveness levels. Methods: The study employed an experimental design with pretest-posttest measures and a control group. State-Trait Anger Expression Inventory (STAXI) and Rathus Assertiveness Inventory (RAI) were applied to 9th grade high school students. Fifty-one students who met the inclusion criteria of the study were randomly matched in terms of gender and their scale scores and assigned to experimental and control groups. At the end of the group work, the scales were reapplied to the students both in the experimental group and in the control group. Results: During the first measurements, there was not a statistically significant difference between the STAXI and RAI scores of the experimental and control groups. The last measurement conducted with STAXI after the program revealed that the mean scores for the trait anger, anger-in, and anger-out subscales were lower in the experimental group than in the control group, and for the anger control subscale, the mean scores were higher in the experimental group than in the control group and the difference was highly significant. After the program, the mean RAI score of the experimental group was higher than that of the control group, and the difference was statistically significant. Conclusion: The results of this study revealed that the anger management program based on cognitive behavioral techniques decreased students’ trait anger levels and helped them express their anger appropriately, manage their anger and develop an assertive behavior.

The Impact of Masculinity on Anger Arousal in Ambiguous Situations

This study aimed to investigate the influence of sex and gender role identity on anger experience at varying levels of provocation in a sample of 585 Australian students. Participants viewed videotaped vignettes of a potentially anger-triggering event where the intent of another person was either ambiguous or unambiguous. Measures of self-predicted anger, trait anger, and gender role identity were then completed. Results supported the hypothesis that it is gender role identity rather than sex that is more closely related to angry emotion. There was, however, no support for the hypothesis that anger arousal would be greater in circumstances in which the intention behind a provoking event is ambiguous when the respondent identifies with a masculine gender role. The implications of these findings for the development of anger management programs are discussed.

Influence of Music Therapy on Coping Skills and Anger Management in Forensic Psychiatric Patients

The effect of music therapy on anger management and coping skills is an innovative subject in the field of forensic psychiatry. This study explores the following research question: Can music therapy treatment contribute to positive changes in coping skills, anger management, and dysfunctional behavior of forensic psychiatric patients? To investigate this question, first a literature review is offered on music therapy and anger management in forensic psychiatry. Then, an explorative study is presented. In the study, a pre- and post-test design was used with a random assignment of patients to either treatment or control condition. Fourteen participants' complete datasets were collected. All participants received "treatment as usual." Nine of the participants received a standardized, music therapy anger management program; the five controls received, unplanned, an aggression management program. Results suggested that anger management skills improved for all participants. The improvement of positive coping skills and diminishing of avoidance as a coping skill were measured to show greater changes in music therapy participants. When controlling for the exact number of treatment hours, the outcomes suggested that music therapy might accelerate the process of behavioral changes.

Depression, self‐esteem and anger expression patterns of Korean nursing students

According to previous studies, nursing students' anger expression patterns, depression and self-esteem significantly affected the physical and mental well-being of patients. It is of utmost importance that the relationship among them is thoroughly investigated in this study. The purpose of this study was to examine the degrees of anger expression patterns, depression and self-esteem of Korean nursing students and to examine the correlations among them. This was a descriptive cross-sectional study. The subjects consisted of 320 Korean nursing students at colleges in S and G city, Korea. The measurements were based on the Korean standard STAXI (State-Trait Anger Expression Inventory), SCL-90-R (Symptom Checklist-90-Revision) and SLCS-R (Self-Liking/Self-Competence Scale-Revised Version). In the analysis of the degrees of variances, the subjects showed lower anger repression, anger expression, control of anger and depression. The degree of self-esteem revealed a higher than the median value. There were significant correlations among anger expression patterns (anger repression, anger expression and anger control), depression and self-esteem. The study limitations were the degree of representativeness of the setting and sample, and its generalizability. Based on the findings of this study, interventions are needed for Korean nursing students in order to promote anger management and improved self-esteem. The development of an anger control programme for nursing students should focus on lowering depression and enhancing self-esteem. One of the policy issues focused on providing anger management programmes for lowering depression and enhancing self-esteem. This study will enable nursing students to recognize the importance of controlling their anger, enhancing their self-esteem, establishing positive emotions and improving their overall well-being as future professional nurses.

학교폭력 예방을 위한 인터넷 기반 분노조절 프로그램의 개발과 효과 검증

Objectives : This study aims to investigate the effectiveness of an internet-based anger management program for school-aged children. Methods : Forty-eight elementary school students took part in an anger management training program; subsequently, participants, their parents, and their teachers answered questionnaires assessing the participants' anger, aggressiveness, and other emotional/behavioral problems, pre- and post-training. Results : At the post-training self-assessment, the participants showed significant reductions in their "anger-out" tendencies and physical aggressiveness. In addition, the effects of the program on "anger-out" tendencies, aggressiveness, anger and peer relational problem were found to be more significant in participants who reported depressive symptoms. Teachers rated the participants' peer-relational problems as having decreased after the training. Conclusion : The proposed internet-based anger management program had a significant effect on the school-aged children's abilities to control their anger.

Evaluation of anger management groups in a high‐security hospital

Anger management programmes for offenders typically aim to improve the management of emotion associated with aggressive and antisocial behaviour. Such programmes have been quite extensively evaluated in prison and probation settings, but there is less published research in forensic mental health settings. This study aimed to evaluate anger management groups in a high-security hospital. Eighty-six patients were referred for a 20-session anger management intervention. Outcomes were self-reported experiences of anger and changes in institutionally documented incidents of aggression. Incident rates were retrospectively reviewed for all group graduates, where data were available, including a comparison group of graduates who acted as their own controls. Group graduates reported sustained reductions in feelings of anger and positive changes in their use of aggression in reaction to provocation. Some reduction in incidents of physical aggression was noted when group completers were compared with non-completers. Incidents of verbal aggression were observed to increase for graduates. There was also a trend towards improvement when treated men were compared with men on the waiting list. Our findings contribute to the growing evidence for anger management groups for aggressive men, although the low-base rate of incidents, typical of such a containing and therapeutic hospital setting, rendered the analysis of behavioural outcomes difficult. Anger management sessions for male forensic psychiatric patients can be effective in reducing incidents of physical aggression in response to provocation. Evaluation of treatments for anger is particularly difficult in secure and protective settings, where the aim is to keep incidents of actual physical aggression to a minimum. Further research of this kind is needed to test the value of self-reported reduction in angry feelings as an indicator of clinically useful progress.

Prevalence of depression, anxiety, stress, and anger in Turkish prisoners.

In Turkey, prison studies are rare and the mental health status of prisoners has not received proper attention. The purpose of this cross-sectional and descriptive study was to assess the prevalence of depression, anxiety, stress, and anger among a group of Turkish prisoners. Two self-reporting instruments (the Depression Anxiety Stress Scale-42 and Multidimensional Anger Scale) were filled out by 685 prisoners. Prisoners in the study group were found to be depressive, anxious, and stressed. Anger symptoms and aggressive behaviors were found to be at a moderate level. Prisoners with a history of being subjected to domestic violence in childhood had higher depression, anxiety, and stress scores than those without such a history. Young prisoners, those who had been previously imprisoned, with substance dependency and higher stress and anxiety levels reported more anger symptoms than others. Psychological support, together with stress and anger management programs, seems to be essential.

The role of anger in offending: a grounded theory analysis of mentally disordered patients

The relationship between anger, violence and offending is not well understood; there is debate in the current literature regarding the nature of this relationship. This issue is of importance because of the widespread use of anger management programmes as a means to reduce anger-mediated offending. This study specifically examined the role of anger in offending behaviour for patients with coexisting problems with anger and psychosis. Grounded theory was used to analyse patients’ file data from an Anger Management and Emotion Regulation programme in a Medium Secure Unit. Grounded theory analysis allowed for a theory of offending to be generated, showing what concepts contribute to offending and thereby determining the role anger plays in offending in mentally disordered patients. Anger, mental illness, substance misuse and social issues were recognised as contributing factors to offending behaviour. This provides justification for managing anger in order to prevent reoffending.

Health and relationships in violence reduction participants: indirect effects of angry temperament

Treatment compliance is a considerable challenge for participants in anger management and violence reduction programs. Participants often exhibit low readiness to change, deficient problem-solving skills, and poor problem awareness. The legal and social consequences of unregulated anger and violence have been well established; however, the personal impact of these behaviors on the functioning of perpetrators has not been as well investigated. We addressed this gap in the literature by examining the relationships between angry temperament, conflict management tactics, social problem-solving, and quality of life factors in participants court-ordered to violence reduction treatment. Bootstrapped mediation models indicated that angry temperament had a significant indirect effect on subjective health through negative problem orientation. These findings have important implications for enhancing readiness to change and the quality of life among violent offenders.