Summary: A four-week online anger management program helps reduce anger and aggression and improve emotional regulation in those with aggressive behaviors.
Source: Karolinska Institutet
Anger management problems can have dire consequences for the sufferer and their loved ones.
A new study from the Center for Psychiatric Research at the Karolinska Institute in Sweden shows that four weeks of internet therapy can help people with anger and aggression.
The results were published in the journal Journal of Consulting and Clinical Psychology.
The study, which the researchers chose to call the “anger study,” is the first to compare different Internet-mediated emotion regulation strategies for anger. The results are expected to be important for the understanding of emotion regulation and the dissemination of evidence-based methods.
Attracting participants is easy
“Attracting participants for treatment studies is usually very difficult. And for the anger study, it was too easy and we had to close the recruitment site after a few weeks due to the high number of applicants. This shows that there is a great need for psychological treatment of anger.
“A lot of people with anger issues are embarrassed, and we think the online format is particularly suitable for this group because they don’t have to wait in a waiting room or sit face-to-face with a therapist to talk about their anger. says Johan Bjureberg, associate professor at Karolinska Institutet’s Center for Psychiatric Research and researcher in charge of the study, which was carried out in collaboration with researchers at Örebro University in Sweden.
Anger research evaluated the effects of two emotion regulation strategies: careful emotion education; and cognitive reappraisal. Mindful emotion awareness focuses on one’s ability to notice and accept one’s feelings and thoughts without judging or acting on them. Cognitive reappraisal, in contrast, focuses on the ability to reinterpret thoughts and situations and identify alternative thoughts that do not trigger difficult feelings.
234 participants with significant anger problems were randomly assigned to four weeks of either mindful emotion awareness, cognitive reappraisal, or a combination of the two strategies. All treatments were approximately the same length and were associated with reductions in self-reported anger and aggression at the end of treatment.
Combination therapy is most effective
The combination treatment resulted in significantly lower levels of outward anger expression, aggression, and angry rumination, but not anger suppression, compared with conscious emotion awareness or cognitive reappraisal alone. This combination was particularly effective for participants who experienced very high levels of anger at the beginning of the study.
The findings reinforce research and theories that difficulties in regulating emotions and interpreting events and situations may be a major contributor to anger management problems.
“Our results show that a very short online treatment of just four weeks with minimal therapist support is effective in reducing anger problems. We hope that further studies will support this finding and that the treatment can be widely offered as part of routine care,” explains Johan Bjureberg.
Funding: The research was funded by the Knut and Alice Wallenberg Foundation. No conflict of interest reported.
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Author: Press Service
Source: Karolinska Institutet
Contact: Press service – Karolinska Institute
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Original Research: Closed entrance.
“Targeting Maladaptive Anger with Brief Therapist-Supported Internet-Delivered Emotion Regulation Treatments: A Randomized Controlled Trial” by Johan Bjureberg et al. Journal of Consulting and Clinical Psychology
Targeting maladaptive anger with brief therapist-assisted internet-based emotion regulation treatments: A randomized controlled trial
Purpose: To assess the relative effectiveness of three brief therapist-assisted internet-based emotion regulation treatments for maladaptive anger (mindful emotion awareness) [MEA]cognitive reappraisal [CR]and mindful emotion awareness + cognitive reappraisal [MEA + CR]) and to examine whether baseline levels of anger pathology moderate treatment outcome.
Method: The treatments were evaluated in a randomized controlled trial. In total, 234 participants with maladaptive anger (59% female; mean age = 41.1, SD = 11.6) were randomized to MEA (n = 78), CR (n = 77), or MEA + CR (n = 79) . Self-reported primary and secondary outcomes were monitored at the primary endpoint 3 months after treatment discontinuation (88% retention). Primary outcomes were also assessed weekly during the long-term baseline (4 weeks) and active treatment phase (4 weeks).
Results: On the primary endpoint, MEA + CR was superior for anger expression (d = 0.27 95% confidence interval, CI [0.03, 0.51]), aggression (d = 0.43 [0.18, 0.68]) and angry rumination (d = 0.41 [0.18, 0.63]). MEA + CR was particularly effective in reducing anger expression (d = 0.66 [0.21, 1.11]), aggression (d = 0.90 [0.42, 1.39]) and angry rumination (d = 0.80 [0.40, 1.20]) for those who reported higher outcome values (+1SD) at baseline.
Results: Brief therapist-assisted internet-delivered MEA and CR treatments are effective interventions for maladaptive anger. Combining MEA and CR is particularly effective in reducing anger expression and aggression in individuals reporting higher levels of baseline anger pathology. This study highlights the importance of emotion regulation as an important treatment target for reducing maladaptive anger.