Anger Reduction Research Articles

Relaxation and cognitive-relaxation treatments of general anger.

VioLit summary: OBJECTIVE: The purpose of this study by Deffenbacher et al. was to determine whether a combination of relaxation coping skills (RCS) and cognitive coping skills (CCS) interventions might interact synergistically and be more effective than RCS alone. METHODOLOGY: This study was quasi-experimental. The subjects were gathered through a screening instrument questionnaire administered to six introductory psychology classes of approximately 150-200 students per class. Subjects meeting inclusion criteria that focused on admissions of inabilities to control anger and wanting intervention were subsequently assigned in groups of 10-15 by a trained undergraduate assistant. There were 55 participants (27 male and 28 female). These students were randomly assigned to conditions for combined cognitive-relaxation skills and cognitive coping skills (16 students) in an intervention labeled cognitive relaxing coping skills (CRCS). The second intervention group provided relaxation coping skills (RCS) therapy alone to 19 students, and 20 students were placed in the control condition of no intervention aside from taking assessment tests. All participants were rewarded with 3 hours of university laboratory credit. For both CRCS and RCS treatment sessions consisted of eight weekly, 1-hour group meetings led by an advanced doctoral student. Those students who received CRCS intervention attended sessions devoted to cognitive-relaxation coping rationale, progressive relaxation training, and received training in various relaxation coping skills. The students who received RCS intervention attended sessions focused on only relaxation coping skills for anger control. The students in the no-treatment expectancy control condition were given no treatment and simply received credit for assessments. General anger was assessed by Likert-type scales, where increasing scores reflected greater self-reported anger and anger across a range of situations. General-anger expression style, or the ability to suppress anger when provoked, was also measured by a Likert-type scale. Person-specific anger, or anger unique to the individual was assessed by self-reported data, which was later rated by the severity of anger symptoms. State anger and coping were analyzed by a Likert-type scale and a 6-item Coping questionnaire following the presentation of a social provocation through imagery. Lastly, perceived treatment implementation and impact were assessed by evaluation questionnaires drawn from the authors. FINDINGS/DISCUSSION: The authors found that generally CRCS and RCS intervention subjects showed significant anger reduction compared with the control conditions but did not differ significantly from one another. Thus, there was no perceived or measured synergistic effect as both interventions appeared effective. However, the authors also noted that the CRCS intervention subjects attended significantly more sessions than did RCS participants and perceived CRCS as a more helpful intervention overall than did the RCS group. The authors concluded from earlier studies that cognitive coping skills (CCS) were as effective as relaxation coping skills (RCS). The present study supported the earlier findings and showed that RCS remained effective as a single intervention and a CRCS intervention was not significantly better than CCS alone. AUTHORS' RECOMMENDATIONS: The authors recommended that CRCS appeared to be the preferred intervention, though it did not show any statistical superiority over administration of CCS alone. The authors argued that CRCS subjects attended more sessions, reported that treatment engendered greater expectations of success, and rated the treatment as more helpful. Those differences were seen by the authors as having practical implications such as the reduction of premature termination in nonresearch settings. Also, they contended that in a group format in which individualized treatment is more difficult, perhaps the combination of cognitive and relaxation components may better address individual differences among clients. (CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado) KW - Young Adult KW - Anger Management KW - Cognitive Behavioral KW - Anger Treatment KW - Adult Anger KW - Anger Intervention KW - Follow-Up Studies KW - Prosocial Attitudes and Behavior KW - Social Skills Training KW - Coping Skills KW - College Student Research

A Comparison of Cognitive‐Behavioral and Process‐Oriented Group Counseling for General Anger Reduction

Two counseled groups—one using anger reduction for cognitive‐relaxation coping skills and the other using time‐limited, anger‐focused, process‐oriented group counseling—were compared to an uncounseled control group. Both forms of counseling led to significant reductions on a number of trait, state, and person‐specific measures of anger as well as nontargeted general anxiety. Effects were maintained at 5‐week and 15‐month follow‐ups. At no point did counseling conditions differ significantly from one another, suggesting process groups are effective for general anger reduction and as effective as one of the best researched options in the field. Limitations of this conclusion are outlined along with needed research.

Cognitive-relaxation and social skills treatments of anger: A year later.

VioLit summary: OBJECTIVE: The purpose of this study by Deffenbacher was to provide a 12-month follow-up of a general anger reduction program for college students. METHODOLOGY: This study was quasi-experimental. Subjects in the initial study were 49 (26 men and 23 women) introductory psychology students who: a) scored in the upper quartile on the Trait portion of the State-Trait Anger Scale (STAS-T), b) described themselves as having an anger problem and seeking help for it, and c) volunteered when contacted by phone. Of these, 37 returned data for the 12-month follow-up, which resulted in samples of 11 for cognitive relaxation, 12 for social skills, and 14 for control condition. Subjects in the initial study were randomly assigned to conditions and received research credit for their participation. Three measures of anger and one of general anxiety were employed. General anger was measured by the 10-item STAS-T, a Likert scale on which individuals indicated how they generally felt. The Anger Symptom and Anger Situation techniques were utilized in order to measure idiographic, person-specific elements of anger. In other words, the personally most salient aspect of anger-related physiological arousal and anger in the person was measured. The Anger Symptom test assessed self-reported physiological activity when angered. The Anger Situation required the respondents to describe the ongoing situation that provoked the greatest anger experienced. Lastly, a measure of general anxiety (State-Trait Anxiety Inventory, or STAI) was included to assess treatment generalization to nontargeted anxiety. Twelve months after treatment, subjects were sent a letter, the STAS-T, Anger Symptom, Anger Situation, and STAI measures, and a stamped return envelope. Six weeks later the materials were mailed again to nonrespondents. Initial treatments consisted of eight weekly, 1-hour group sessions with 7 or 8 subjects in each group. Two male, advanced graduate students who had extensive training procedures conducted the sessions. Therapists were randomly assigned to one group in each intervention condition. Control subjects were given no expectation of treatment and simply received experimental credit for completing the assessments. FINDINGS/DISCUSSION: Correlations between pretreatment measures were significant between the STAS-T and Anger Situation test, the Anger Symptom and Anger Situation tests, and the Anger Symptom test and the STAI. Those between the Anger Situation test and the STAI were not significant. A one-way multivariate analysis was employed and revealed significant effects for treatment in reducing anger. Post hoc tests of treatment effects were done only on 12-month follow-up data. At the 1-year follow-up, cognitive-relaxation and social skills groups reported significantly less general anger, anger-related psychophysiological arousal, and general anxiety than the control group and did not differ from one another on these measures. AUTHOR'S RECOMMENDATIONS: The author contended that further replicated studies be employed using different populations and different therapists, as well as measures that do not rely totally on self-reported data. (CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado) Cognitive Behavioral Treatment Anger Management Anger Treatment Adult Anger Treatment Program Prosocial Skills Social Skills Training Follow-Up Studies Young Adult College Student Research 09-99

Cognitive-relaxation and social skills interventions in the treatment of general anger.

VioLit summary: OBJECTIVE: The purpose of this study by Deffenbacher et al. was to ascertain if social skills interventions might benefit from greater attention to training in communication skills designed to foster interpersonal understanding. METHODOLOGY: This study was quasi-experimental. Subjects were gathered through a screening instrument questionnaire administered to introductory psychology classes ranging in size from 85 to 210 students. Subjects meeting inclusion criteria that focused on admissions of inabilities to control anger and wanting intervention were assigned into groups of 10-20 by one of the authors. The students were randomly assigned to conditions for cognitive-relaxation therapy (CRT) (14 students), for social skills training (SST) (17 students), and 18 students were placed in the control condition of no intervention aside from taking assessment tests. One student was dropped from the study for not attending pretreatment assessment. All participants were rewarded with 3 hours of university laboratory credit. Treatments consisted of eight weekly, 1-hour group sessions led by two advanced graduate students who had extensive training in cognitive, relaxation, and social skills interventions. Content and procedures for each session followed a written outline and were discussed and role played in weekly 1 1/2 hour supervised sessions. Those students who received CRT intervention attended sessions devoted to cognitive-relaxation coping rationale, progressive relaxation training, and received training in various relaxation coping skills. The students who received SST intervention attended sessions focused on the development of positive, cross-situational skills and interpersonal strategies for minimizing interpersonal antagonism and anger. General anger was assessed by Likert-type scales, in which increasing scores reflected greater self-reported anger and anger across a range of situations. General-anger expression style, or the ability to suppress anger when provoked, was also measured by a Likert-type scale. Person-specific anger, or anger unique to the individual was assessed by self-reported data, which was later rated by the severity of anger symptoms. State anger and coping were analyzed by a Likert-type scale and a 6-item Coping questionnaire following the presentation of a social provocation through imagery. Lastly, perceived treatment implementation and impact were assessed by evaluation questionnaires drawn from the authors. FINDINGS/DISCUSSION: The authors found that generally, CRT and SST intervention subjects showed significant anger reduction compared with the control conditions but did not differ significantly from one another. Thus, both interventions appeared effective. However, the authors also noted that the CRT intervention subjects felt that their program was more helpful than did the SST subjects though the basis of that difference was not clear. AUTHORS' RECOMMENDATIONS: The authors noted that the cognitive-relaxation condition appeared appropriate for general aspects of anger control, though it may have had some social skills deficits. The authors therefore recommended using the broader cognitive-relaxation condition as a primary treatment and targeting social and other skill deficits toward the end of the treatment as needed. (CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado)

Reconceptualizations of Anger: Some Research Perspectives

Implications of current theory and research on anger are considered for two issues of clinical and social import: (1) how anger can be most effectively discharged or modified; (2) the psychological and somatic effects of coping with anger. The shift from an internal-drive model of anger to a stimulus-linked model has major consequences for the reduction of anger. Cognitive features of a frustrating or provocative stimulus, such as expectancies, perceived intentionality, responsibility, and enhancement of self-esteem and the fostering of responses incompatible with anger, provide important avenues for anger intervention without direct anger expression. With regard to the second issue, there is substantial evidence that suppressed anger is linked to elevations in blood pressure, while frequently expressed anger is linked to coronary malfunctioning. However, the absence of anger is seen as having negative psychological consequences. Anger in moderation appears to be the ideal psychosomatic resolution.

High general anger: Correlates and treatment

Two studies on high general anger are reported. In Study 1 high anger Ss reported significantly more general anger, situational anger, anger-related physiological arousal, frequency and intensity of daily anger and general anxiety than low anger Ss. In response to provocation, heart rates (HRs) did not differ, but high anger Ss reported more state anger and tendencies to be verbally and physically antagonistic and lowered tendency to cope constructively. A regression on general anger revealed that general anxiety, coping through verbal antagonism, and average daily level of anger entered the regression and accounted for 70% of the variance. In Study 2, high anger was treated with a relaxation coping skills intervention. Compared to controls, treated Ss reported less general and situational anger, and less state anger, verbal and physical antagonism and greater constructive coping when provoked. These gains were maintained at 5-week and 1-year follow-ups. Groups did not differ on HR when provoked, daily anger ratings or trait anxiety. One-year follow-up, however, revealed significantly lower general anxiety for treated Ss. Results were discussed in terms of the characteristics of high anger Ss, the role of general anxiety in general anger and the usefulness of self-control relaxation approaches for anger reduction.

Anger control: An experimental comparison of three behavioral treatments

The present investigation compared the effectiveness of three behavioral treatment strategies with an attention control group in the reduction of anger. forty male undergraduates who scored above the mean on Novaco's (1975) Anger Inventory were randomly assigned to cognitive stress inoculatio, problem-solving, social skills, or minimal attention groups. The experimental groups received weekly training over a period of 5 weeks stressing their respective anger control treatment strategies. Measures of blood pressure, pulse, self-reported anger, and behavioral measures of assertion and aggression obtained from role-played angerprovoking situations were obtained pre-and posttreatment. Also, all subjects selfmonitored their responses to real life anger-provoking incidents on a daily basis. Cognitively oriented stress inoculation training significantly decreased anger-provoking cognitions but did not increase appropriate assertiveness. The problemsolving and social skills training both reduced anger-provoking cognitions and increased assertive or socially skilled behaviors. Further, the data suggest that the social skills and problem-solving approaches encouraged subjects to interact competently with the social environment whereas the stress inoculation training tended to foster withdrawal from anger-provoking stimuli.

The effect of the ABCs of Rational Emotive Therapy and the empty-chair technique of Gestalt Therapy on anger reduction.

In an analogue study this investigation examined the effect of the ABCs of Rational Emotive Therapy (RET), the empty-chair technique of Gestalt Therapy, and a reflective listening control condition in reducing anger for college females. The repressor-sensitizer response to threat was investigated as a subject characteristic that was hypothesized to influence the effectiveness of the treatment conditions. Both treatment techniques reduced blood pressure and lowered Feeling Questionnaire scores significantly more than the control condition. The repressor-sensitizer measure failed to differentiate between the effectiveness of either treatment. A view championed by Lazarus (1976) is that empirical investigation and validation rather than a dogmatic adherence to theory should govern the choice of treatment methodologies. Goldstein & Stein (1976) assert that treatments should be prescriptive, i.e., modified to meet salient client, therapist, and problem characteristics. In response to these research directions, this study was designed to determine the relative effectiveness of two intervention techniques, the empty-chair technique as described by Gestalt Therapy and the ABC cognitive restructuring technique as described by Rational Emotive Therapy (RET) in reducing anger. These interventions were used with two groups of subjects differing along the continuum of repressionsensitization reaction to threat. The ABCs of RET and the Gestalt emptychair techniques are presently used by coun* Requests for reprints should be sent to Collie W. Conoley, Dept. of Psychology, North Texas State University, Denton, TX 76203. JANE C. CONOLEY Texas Woman's University CAROL EUGENIA KIMZEY North Texas State University selors with no research comparing the effectiveness of the two interventions in reducing anger nor research delineating what client characteristics dictate which intervention. This research is important because both techniques are written about and used extensively by counselors (Ellis & Harper, 1975; Fagan & Shepherd, 1970). Research on the therapeutic use of anger expression indicates that direct aggression against the insulting party causes a faster drop in systolic blood pressure than aggression against another person or no aggression at all (Hokanson & Burgess, 1962; Hokanson, Burgess & Cohen, 1963; Hokanson & Edelman, 1966). This has been interpreted to mean that displaced anger or physical activity is not any more effective than no aggression or activity at all. Aggression needed to be directed toward the source. Feshback (1969) reports a decrease in anger after symbolic expression of feelings. These studies suggest that the empty-chair technique may be effective in anger reduction. The ABCs have a substantial body of research attesting to its efficacy with many problems (DiGiuseppe et al., 1977). However, there appears to be only one study dealing with treatment of frustration where Brody (1974) found that children's tolerance for frustration increased as compared to a control group. While Ellis & Harper (1975) assert the importance of RET in treating anger, there is a dearth of research substantiating Ellis's belief. Writing about RET and Gestalt therapies, Dolliver(1977) suggested that both are similar

Type A behavior, hostility, and coronary atherosclerosis.

Type A behavior pattern was assessed using the structured interview and hostility level was assessed using a subscale of the Minnesota Multiphase Personality Inventory in 424 patients who underwent diagnostic coronary arteriography for suspected coronary heart disease. In contrast to non-Type A patients, a significantly greater proportion of Type A patients had at least one artery with a clinically significant occlusion of 75% or greater. In addition, only 48% of those patients with very low scores (less than or equal to 10) on the Hostility scale exhibited a significant occlusion; in contrast, patients in all groups scoring higher than 10 on the Hostility scale showed a 70% rate of significant disease. The essential difference between low and high scorers on the Hostility scale appears to consist of an unwillingness on the part of the low scorers to endorse items reflective of the attitude that others are bad, selfish, and exploitive. Multivariate analysis showed that both Type A behavior pattern and Hostility score are independently related to presence of atherosclerosis. In this analysis, however, Hostility score emerged as more related to presence of atherosclerosis than Type A behavior pattern. These findings confirm previous observations of increased coronary atherosclerosis among Type A patients. They suggest further that an attitudinal set reflective of hostility toward people in general is over and above that accounted for by Type A behavior pattern. These findings also suggest that interventions to reduce the contribution of behavioral patterns to coronary disease risk might profitably focus especially closely on reduction of anger and hostility.

Collective Stress Syndrome

To the Editor.— In the last few years, we have observed among schoolchildren several outbreaks of acute illness that probably represent instances of In each situation, we have been impressed with the entirely negative and distressing implications of the term hysteria. For the persons involved (and their parents), the term mass is perceived as an affront to personal integrity. For medical personnel and the general public, unfortunate confusion may arise between episodes of hysteria and the psychiatric diagnosis of We therefore propose that the term stress be adopted to describe outbreaks of illness formerly referred to as The use of collective stress syndrome may result in a reduction of defensiveness and anger, thereby facilitating a more reasoned analysis of events and predisposing causes. We believe that enhanced communication will result when the stigma of hysteria is replaced by the generally well-accepted

Motor and cognitive relaxation in the desensitization of anger

Three procedures were assessed to determine their effectiveness in reducing anger. The procedures were: desensitization, desensitization with cognitive relaxation, and desensitization with the absence of relaxation training. Anger was aroused by exposing white males, selected for their reports of anger toward blacks, to black racial stimuli. The desensitization group reported reductions in anxiety and disgust relative to a no-treatment control group. Therapist ratings indicated reductions in anger for Ss in both the desensitization and desensitization with cognitive relaxation groups. In addition the latter group reported reductions in anger concurrently with increases in diastolic and systolic blood pressure. Post-hoc analyses indicated that Ss for whom desensitization was most effective reported less anger after the pretreatment anger arousal procedure, greater depth of relaxation during treatment, and were liked more by their therapists. These Ss also reported a greater reduction in ethnocentrism and a trend toward lower overt hostility following treatment.

Anger and systematic desensitization: a follow-up.

The effect of systematic desensitization on anger in response to treatment related and non-treatment-related items on the Reaction Inventory was studied 6 mo. following systematic desensitization or no treatment. 6 mo. after treatment, the treatment group had maintained reduction in anger, whereas, the no-treatment group showed no change in anger to the treatment and non-treatment-related items.