Category: Anger

Symposium

Symposium 90 - Treating Dysregulated Anger in Traumatized Populations: Outreach Along the Continuum of Care

Saturday, November 18
12:00 PM - 1:30 PM
Location: Cobalt 501, Level 5, Cobalt Level

Keywords: Anger / Irritability | Treatment-CBT | Technology / Mobile Health
Presentation Type: Symposium

Dysregulated anger is a key symptom and diagnostic criterion for posttraumatic stress disorder (PTSD).  The negative consequences of untreated anger on trauma survivors’ psychological health, and their broader quality of life, are pervasive, disruptive, and chronic (Forbes et al., 2013; Morland et al., 2012).  In civilian and military populations and across different trauma types, research indicates that increased anger following traumatic exposure increases the risk for developing PTSD (Andrews et al., 2009). Moreover, the interpersonal dysfunction related to poor anger control can significantly reduce social support–a key predictor of the maintenance of PTSD (Forbes et al., 2013). In fact, military veterans and their families report anger as a key reason for seeking mental health treatment (Rosen et al., 2013).


Because of these long term consequences of untreated anger, some have suggested that anger treatment should be a top priority for providers, especially among military populations, where unique military experiences can support underlying mechanisms of problematic anger (Morland et al., 2012; Orth & Wiedland, 2006). While treatments are available, research suggests there is limited access to providers offering these treatments , especially in community settings (AVAPL and APA, 2017). Also, uptake may be limited for logistical and stigma-related reasons (Vogt et al., 2006; Whealin et al., 2013). Once in treatment, additional challenges are faced. When EBTs for PTSD are used to treat dysregulated anger as a part of PTSD, many may still have significant elevated anger symptoms following treatment.  Conversely, among those receiving treatment for PTSD, elevated anger at intake predicts more severe PTSD presentations and poorer treatment response (Forbes et al., 2003; Lloyd et al., 2013).  


                This symposium reviews a program of research and intervention development detailing important treatment-related aspects of dysregulated anger among those with PTSD (Greene et al., 2015; Love et al., 2015; Mackintosh et al., 2014; Morland et al., 2010, 2012, 2016).  The first presentation describes results from three studies on the limited effectiveness of evidence-based treatment for PTSD (Pronged Exposure and Cognitive Processing Therapy) in modifying co-occurring problematic anger.  The second talk investigates how dysregulated anger can reduce the effectiveness of Cognitive Processing Therapy for treating PTSD through either disruptions in therapeutic alliance or interference with cognitive restructuring.  The final presentation addresses the need to create additional access points for anger interventions. Results of recent projects and clinical practices for providing anger interventions across digital formats (e.g., telemental health, mobile app and web-based) are presented and future research discussed.

Learning Objectives:

Margaret-Anne Mackintosh

Clinical Research Psychologist
National Center for PTSD

Presentation(s):

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Tara Galovski

Director
National Center for PTSD, VA Boston Healthcare System; Boston University School of Medicine

Presentation(s):

Send Email for Tara Galovski

Leslie Morland

Director of TMH for San Diego VA Health Care System (VASDHCS); Associate Professor of Psychiatry
San Diego VA Health Care System; University of CA, San Diego

Presentation(s):

Send Email for Leslie Morland

Margaret-Anne Mackintosh

Clinical Research Psychologist
National Center for PTSD

Presentation(s):

Send Email for Margaret-Anne Mackintosh

Carolyn J. Greene

Associate Professor
University of Arkansas for Medical Sciences

Presentation(s):

Send Email for Carolyn Greene


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