Cognitive Bias Modification for Aggression

Phase-Based Estimates
Temple University, Philadelphia, PA
Aggression+2 More
Cognitive Bias Modification - Behavioral
18 - 65
All Sexes
Eligible conditions

Study Summary

This study is evaluating whether a computerized cognitive bias modification program can reduce aggression in people with primary aggression.

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Eligible Conditions

  • Aggression
  • Kleptomania
  • Disruptive, Impulse Control, and Conduct Disorders
  • Intermittent Explosive Disorder

Treatment Effectiveness

Study Objectives

This trial is evaluating whether Cognitive Bias Modification will improve 3 primary outcomes and 2 secondary outcomes in patients with Aggression. Measurement will happen over the course of preatment, post-treatment (4 weeks later) and 1-month follow-up. Total of 2 months.

Month 2
Change in a Aggression from pretreatment to end of treatment (4 weeks later) and 1-month follow-up
Month 2
Change in Emotion Regulation from pretreatment to end of treatment (4 weeks later) and 1-month follow-up
Change in IED diagnosis from pretreatment to end of treatment (4 weeks later) and 1-month follow-up
Change in Social Information Processing from pretreatment to end of treatment (4 weeks later) and 1-month follow-up
Change in a Anger from pretreatment to end of treatment (4 weeks later) and 1-month follow-up

Trial Safety

Trial Design

2 Treatment Groups

Control Condition
Bias Modification
Placebo group

This trial requires 45 total participants across 2 different treatment groups

This trial involves 2 different treatments. Cognitive Bias Modification is the primary treatment being studied. Participants will all receive the same treatment. Some patients will receive a placebo treatment. The treatments being tested are not being studied for commercial purposes.

Bias Modification
Attention (ATT) and interpretation (ITT) bias training. Participants complete the ATT and ITT tasks twice per week for four weeks. The ATT trains attention toward neutral stimuli and away from negative stimuli. On trials with one neutral and one threat word, the probe will always follow the location of the neutral word. Therefore, there is a contingency between the valence of the word and the location of the probe. Participants will be asked to indicate which type of probe had appeared in each trial by pressing a corresponding button as rapidly and accurately as possible. The ITT trains participants to make benign (vs. threatening) interpretations of socially-ambiguous scenarios. For each trial, a word suggesting a socially threatening or benign interpretation is presented then replaced by a sentence describing a socially-ambiguous scenario. Participants indicate if they thought the word and sentence were related. Participants will receive corrective feedback after each trial.
Control Condition
A combination of attention (ATT-C) and interpretation (ITT-C) control tasks These tasks are identical to the experimental tasks (ATT and ITT) with the exceptions that: ATT-C: It is designed to train attention toward neither neutral nor the threat stimuli. This will be achieved by having an equal number of probes follow the location of the threatening word and the neutral word. ITT-C: It is not designed to train benign interpretations of ambiguous social scenarios. Thus, no feedback will be given during the inter-trial interval, rather participants will see a blank screen between trials. Participants will complete both the ATT-C and ITT-C tasks twice per week for four weeks, totaling to eight experimental sessions.
First Studied
Drug Approval Stage
How many patients have taken this drug
Cognitive Bias Modification

Trial Logistics

Trial Timeline

Approximate Timeline
Screening: ~3 weeks
Treatment: Varies
Reporting: pretreatment, posttreatment (4 weeks later) and 1-month follow-up. total of 2 months
This trial has the following approximate timeline: 3 weeks for initial screening, variable treatment timelines, and roughly pretreatment, posttreatment (4 weeks later) and 1-month follow-up. total of 2 months for reporting.

Who is running the study

Principal Investigator
M. M.
Prof. Michael McCloskey, Professor
Temple University

Closest Location

Temple University - Philadelphia, PA

Eligibility Criteria

This trial is for patients born any sex between 18 and 65 years old. There are 3 eligibility criteria to participate in this trial as listed below.

Mark “yes” if the following statements are true for you:
DSM-5 criteria for current IED was met during the phone screen and confirmed during the in-person diagnostic interview conducted during visit one of the study. show original
Have written and verbal English proficiency for understanding consent and study materials
Are able and willing to cooperate with study protocol; i.e show original

Patient Q&A Section

Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.

What causes aggression?

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Aggression may be a function of the genes and/or the early environment—the latter of which may be influenced by genetics—and the brain circuitry responsible for aggression may vary among individuals in a given species. While the brain circuitry for aggression may vary between individuals, some regions of the brain appear to be critical to this form of behavioral disorder. As one example, the amygdala and the basal ganglia appear to be key areas for mediating aggressive behavior in animals. However, more research is needed to better understand the brain circuits that support aggression. In some cases, a disorder such as autism may result when brain connections are disrupted during gestation or during early development.

Unverified Answer

What are common treatments for aggression?

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Aggression is a common problem among children. Different options for managing aggression are needed according to the age of the child. Physical restraint is an excellent technique that is safe and practical for toddlers and preschoolers; however, the technique is not effective or appropriate for preschoolers. Other options should be considered for children aged from 4 to 14 years old. The effectiveness and safety of various techniques must be reviewed in controlled trials.

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How many people get aggression a year in the United States?

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Approximately 1.2 million people are treated for violence annually in the U.S. Through public health and clinical services, combined efforts are needed to support millions of patients in maintaining well-adjusted health in their homes and communities. Public health strategies should target children and adolescents who suffer more bullying and hate crimes.

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Can aggression be cured?

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Aggression is a significant coping mechanism on an individual's life and work-life. The treatment of aggressive behavior is a very controversial issue and is often a difficult and stressful one. The aim of this study was to find possible factors underlying aggression that can influence treatment. We tried to find the following psychologic factors: aggression level, depression, anxiety, body image satisfaction, family functioning, body dissatisfaction, suicidal thoughts, quality of life, and quality of life of the family.

Unverified Answer

What is aggression?

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Findings from a recent study suggest that a significant proportion of women suffer from high levels of aggression. An intervention programme has the potential to have a positive impact on women's mental health, particularly in relation to their physical and mental health.

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What are the signs of aggression?

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It may be concluded that aggression is likely to be characterized by at least three of the following features: negativity, intensity, frequency, hostility and destructive behaviour. It may also be concluded that aggression is more strongly determined as a defensive reaction rather than an aggressive response to a provocation situation. The implication is that aggression is a defensive reaction triggered by provocation with aggressive demands, which is most severe in situations requiring aggressive responses. There may, however, be other more direct aggressive pathways than the defensive reaction which are of great importance in everyday life. The implication is that in situations involving aggression there are a number of possible adaptive mechanisms which are most often used by the offender.

Unverified Answer

Is cognitive bias modification typically used in combination with any other treatments?

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Despite the potential of CBM to lead to reduced anxiety, depressive symptoms, and impulsivity, the current study failed to find a statistically significant difference in overall intervention efficacy when comparing the CBM group to the Control group. While the Control group also received a single-session CBT, this was not found to be beneficial either, and the authors noted that they were unable to adequately address CBM's unique properties. The authors conclude that CBM, when used concurrently with other treatments (such as [surgery] and other pharmacological agents), should be used under controlled conditions with follow-up evaluations as part of the evaluation of any future treatment.

Unverified Answer

What is the latest research for aggression?

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The available research has not conclusively established an etiology, causes or treatment of physical aggression, but some risk factors (including alcohol consumption, smoking and psychosocial factors) have been identified. It will take time to determine the effects of individual therapies. For example, some studies suggest that the use of antidepressants is effective; others indicate a potential protective effect by using statins. Also, the clinical trials and systematic reviews have not consistently confirmed the effectiveness of the different interventions (for example, psychotherapy and cognitive-behaviour therapy).

Unverified Answer

Does cognitive bias modification improve quality of life for those with aggression?

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CBM resulted in immediate improvements in depression, anxiety, and hostility but no effect on psychological flexibility, anger perception, or aggression levels. These preliminary results will need to be replicated in a larger, controlled sample.

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What are the common side effects of cognitive bias modification?

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Significant improvements in cognitive bias were shown in the CBM group, highlighting their clinical validity. Some side effects were reported, with fatigue, headache and general malaise being particularly prevalent in group participants regardless of treatment. The findings of the study add to the growing evidence that CBM may be a successful technique for modifying maladaptive behavior. However, significant methodological limitations in the present study need to be considered.

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Have there been any new discoveries for treating aggression?

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Despite the current research on aggression, there is still no effective medication to cure the aggressive behaviours. Current research suggests that aggression may be prevented. Although there are many theories concerning aggression, currently there is still no known method to cure aggression. In treating aggression, not only psychological, but also medical techniques (drugs or surgery) are needed.

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Is cognitive bias modification safe for people?

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The cognitively-based CBM is safe to use and is compatible with existing guidelines for CBM for depression. Clinicians and therapists should consider using CBM for all patients.

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