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Targeting Maladaptive Anger With Brief Therapist-Supported Internet-Delivered Emotion Regulation Treatments: A Randomized Controlled Trial
Stanford Univ, Dept Psychol, Stanford CA, USA; Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, Solna, Sweden; Reg Stockholm, Stockholm Hlth Care Serv, Stockholm, Sweden.
Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, Solna, Sweden; Reg Stockholm, Stockholm Hlth Care Serv, Stockholm, Sweden.
Linköping Univ, Dept Behav Sci & Learning, Linköping, Sweden.
Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, Solna, Sweden..
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2023 (English)In: Journal of Consulting and Clinical Psychology, ISSN 0022-006X, E-ISSN 1939-2117, Vol. 91, no 5, p. 254-266Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate the relative impact of three brief therapist-supported internet-delivered emotion regulation treatments for maladaptive anger (mindful emotion awareness [MEA], cognitive reappraisal [CR], and mindful emotion awareness + cognitive reappraisal [MEA + CR]) and to test whether baseline levels of anger pathology moderate treatment outcome.

Method: Treatments were evaluated in a randomized controlled trial. In total, 234 participants (59% female; mean age = 41.1, SD = 11.6) with maladaptive anger were randomized to MEA (n = 78), CR (n = 77), or MEA + CR (n = 79). Self-reported primary and secondary outcomes were followed up at primary endpoint, 3 months after treatment termination (88% retention). Primary outcomes were also assessed weekly during a prolonged baseline phase (4 weeks) and an active treatment phase (4 weeks).

Results: At the primary endpoint, the MEA + CR was superior in terms of anger expression (d = 0.27 95% confidence interval, CI [0.03, 0.51]), aggression (d = 0.43 [0.18, 0.68]), and anger 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 anger rumination (d = 0.80 [0.40, 1.20]) for individuals who reported high values (+1SD) of the outcomes at baseline.

Conclusions: Brief therapist-supported internet-delivered MEA and CR treatments are effective interventions for maladaptive anger. Combining MEA and CR is especially effective in reducing anger expression and aggression, particularly, in individuals who report higher levels of initial anger pathology. The present study highlights the importance of emotion regulation as an important treatment target for reducing maladaptive anger.

Place, publisher, year, edition, pages
American Psychological Association Press , 2023. Vol. 91, no 5, p. 254-266
Keywords [en]
maladaptive anger, emotion regulation, cognitive reappraisal, mindful emotion awareness, randomized controlled trial
National Category
Psychology
Identifiers
URN: urn:nbn:se:oru:diva-102480DOI: 10.1037/ccp0000769ISI: 000888033500001PubMedID: 36409100Scopus ID: 2-s2.0-85145845066OAI: oai:DiVA.org:oru-102480DiVA, id: diva2:1715547
Funder
Knut and Alice Wallenberg Foundation, KAW 2018.0426Available from: 2022-12-02 Created: 2022-12-02 Last updated: 2024-01-11Bibliographically approved

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