Keywords: Anger / Irritability | PTSD Posttraumatic Stress Disorder | Treatment Development
Presentation Type: Symposium
In comparison to those without posttraumatic stress disorder (PTSD), veterans with PTSD report more intense anger and hostility (Novaco & Chemtomb, 2002; Jakupcak et al., 2007; Teten et al., 2010). Notably, high levels of anger are shown to moderate the effectiveness of evidence-based psychotherapy for PTSD, such that veterans with PTSD who exhibit high anger are less likely to show a reduction of PTSD symptoms during cognitive-behavioral PTSD-focused therapy (Forbes et al., 2003; Forbes et al., 2008). There is little to no research on anger management protocols among Veterans with PTSD, and evidence suggests that anger-related difficulties may precipitate early drop-out from PTSD treatment (Taft et al., 2012). The present study is the first empirical evaluation, of which we are aware, of an anger intervention designed specifically for those with PTSD. We will present data from a phase I clinical trial of a novel, 10 session cognitive-behavioral anger, hostility, and aggression (AHA) group intervention. The AHA intervention was informed by I-cubed theory (Finkel & Eckhardt, 2013), and thus includes discussion of processes of risk including: instigation, attentional factors (e.g., tunnel vision on perceived threat), disinhibition, and ways to promote increased inhibition of urges for aggression. Participants were U.S. veterans with PTSD (N=14) recruited from a midwest Veterans Health Administration, and a majority were male (N=12), had experienced combat (N=10), and were from a diverse range of War Eras. Consistent with our hypotheses, clinically reliable reductions were observed in trait anger (d = -.25), anger expression (d = -38), hostility (d= -.57), and aggressive behavior (d = -.66) over the course of AHA treatment. In addition, small to medium effect size decreases in emotion regulation difficulties (d = -21 - -73), and small effect size increases for internal anger control (d = .38) and cognitive reappraisal (d = .29), were observed over time. Participant feedback was positive regarding the AHA intervention and use of graphed anger assessment data over the treatment course, and suggestions for improvement included more role-play of CBT skills and gender-specific groups.
University of Cincinnati College of Medicine
Saturday, November 18
8:30 AM – 10:00 AM
Sunday, November 19
10:15 AM – 11:45 AM
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