Cognitive Behavioral Affective Therapy for Anger

Overseen By Brandon S Perez, M.S.

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: The University of Texas at San Antonio

Disqualifiers: Schizophrenia, Autism, Dementia, others

Approved in 3 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 10

Duration: 4 weeks

100 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new approach called Cognitive Behavioral Affective Therapy (CBAT) to help people manage disruptive anger. Researchers aim to determine if CBAT can effectively reduce anger, particularly when it becomes harmful or leads to risky health issues like high blood pressure. Participants will receive either CBAT or general emotion education to compare results. This trial suits individuals in the U.S. with ongoing anger issues who are not currently receiving treatment. As an unphased trial, it offers a unique opportunity to explore innovative therapy methods that could significantly improve emotional well-being.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, you cannot be undergoing any psychological or psychiatric treatment to participate.

What prior data suggests that Cognitive Behavioral Affective Therapy is safe for anger management?

Research shows that Cognitive Behavioral Affective Therapy (CBAT) is generally safe. Studies on similar therapies, such as Cognitive Behavioral Therapy (CBT) for anger, have found them to be well-tolerated. Participants often experience improvements in self-control and problem-solving without serious side effects.

CBAT has been tested in various groups, including those with substance use issues and long-term pain, and these studies have not reported major negative effects. This suggests that CBAT is safe for managing anger and related issues.

CBAT's strong safety record in other areas indicates it is likely safe for anger management. However, as with any treatment, participants should monitor their feelings and report any concerns to the study team. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Cognitive Behavioral Affective Therapy (CBAT) is unique because it combines traditional cognitive behavioral therapy techniques with a focus on emotional regulation specifically for managing anger. While most treatments for anger, such as anger management classes and standard cognitive behavioral therapy, focus on behavior modification and cognitive restructuring, CBAT emphasizes understanding and managing the emotional processes that lead to anger. Researchers are excited about CBAT because it targets the root emotional triggers of anger, potentially offering a more comprehensive and effective approach to treatment. This focus on emotional regulation could lead to longer-lasting improvements in managing anger compared to existing methods.

What evidence suggests that Cognitive Behavioral Affective Therapy might be an effective treatment for anger?

Research has shown that Cognitive Behavioral Affective Therapy (CBAT), which participants in this trial may receive, can effectively manage anger. Studies have found that methods like CBAT greatly reduce feelings of anger. For instance, one study reported a significant drop in anger levels among people who completed this therapy. Another review highlighted that cognitive-behavioral therapy (CBT) for anger management can lower the risk of violent behavior by 28%. This suggests that CBAT could be a promising choice for those seeking to control and reduce their anger. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for individuals who struggle with excessive anger, such as those with Intermittent Explosive Disorder or related conditions. It's aimed at people whose anger leads to distress and problems in daily life. Participants should be interested in exploring therapy to manage their emotions.

Inclusion Criteria

Live in the United States

Have maladaptive anger (as assessed by the STAXI-2)

Do not currently have any serious psychiatric illnesses (e.g., schizophrenia, autism, dementia, suicidal ideation)

Exclusion Criteria

Is currently undergoing an anger treatment program

Does not live in the United States

Has a current serious psychiatric illness (e.g., schizophrenia, autism, dementia, suicidal ideation)

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 week

1 visit (virtual)

Treatment

Participants receive Cognitive Behavioral Affective Therapy (CBAT) or Emotional Education (EE) through video sessions over 4 weeks

4 weeks

8 video sessions (virtual)

Interim Period

Participants have a 3-week interim period to reflect and implement learned techniques

3 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment, including a final follow-up session

1 week

1 follow-up session (virtual)

What Are the Treatments Tested in This Trial?

Interventions

• Cognitive Behavioral Affective Therapy

Trial Overview The study tests Cognitive Behavioral Affective Therapy (CBAT), a form of 'anger management' therapy designed to reduce anger levels. The effectiveness of CBAT will be measured through various assessments within a community sample.

How Is the Trial Designed?

Group I: Cognitive Behavioral Affective Therapy Experimental Treatment 1 Intervention

Group receiving CBAT.

Group II: Emotional Education Placebo Group 1 Intervention

Group receiving general emotion psychoeducation.

Cognitive Behavioral Affective Therapy is already approved in United States, European Union, Canada for the following indications:

Approved in United States as CBAT for:

• Intermittent Explosive Disorder
• Anxiety Disorders
• Chronic Pain Management
• Chemical Dependence

Approved in European Union as CBAT for:

• Intermittent Explosive Disorder
• Anxiety Disorders
• Mood Disorders

Approved in Canada as CBAT for:

• Intermittent Explosive Disorder
• Anxiety Disorders
• Chronic Pain Management

Who Is Running the Clinical Trial?

The University of Texas at San Antonio

Lead Sponsor

Trials

24

Recruited

7,600+

Published Research Related to This Trial

Acceptance and Commitment Therapy (ACT) was found to be more effective than Cognitive-Behavioral Therapy (CBT) in reducing anger among male students, based on a study involving 30 participants who were randomly assigned to either therapy group.

Both ACT and CBT showed similar effectiveness in improving interpersonal relationships, indicating that while ACT may excel in anger management, CBT remains equally effective for interpersonal issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of Acceptance and Commitment Therapy Compared to Cognitive Behavioral Therapy on Anger and Interpersonal Relationships of Male Students. Masoumian, S., Ashouri, A., Ghomian, S., et al.[2021]

This meta-analysis of 23 studies involving noninstitutionalized adults with measurable anger found medium to large effect sizes for various anger treatments, indicating their effectiveness.

Cognitive therapies were particularly effective for issues like driving anger and trait anger, while relaxation techniques were recommended for managing state anger, suggesting tailored approaches for different types of anger.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of anger treatments for specific anger problems: a meta-analytic review. Del Vecchio, T., O'Leary, KD.[2022]

Anger is defined as a complex emotional response involving cognitive, behavioral, physiological, and social factors, highlighting its significance in understanding and treating this emotion.

The review evaluates various treatment approaches for anger in clinical populations, including aggressive individuals and those with PTSD or cardiovascular issues, emphasizing the need for tailored interventions based on the underlying causes of anger.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Research review on anger in psychotherapy. Mayne, TJ., Ambrose, TK.[2019]

A randomized controlled trial involving 75 adults demonstrated that a brief online cognitive treatment significantly reduced anger levels in participants compared to a waiting list control group after four weeks.

The treatment group experienced a substantial decrease in anger, indicating that internet-based cognitive therapy can be an effective intervention for managing problematic anger in adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of online cognitive treatment for problematic anger: a randomized controlled trial. Howie, AJ., Malouff, JM.[2018]

Anger management methods in cognitive behavioral therapy are generally effective, as supported by meta-analyses and reviews, but treatment readiness is a crucial factor that is often overlooked.

Addressing treatment readiness is essential for improving anger management outcomes, as it can affect the therapeutic alliance and overall effectiveness of the intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Readiness for anger management: clinical and theoretical issues. Howells, K., Day, A.[2019]

The anger self-management training (ASMT) program, consisting of 8 sessions, showed significant improvements in self-reported anger levels among 10 participants with moderate to severe traumatic brain injury (TBI), with large effect sizes greater than 1.0.

Qualitative feedback from participants was positive, and the low dropout rate (only 1 out of 11) suggests that the ASMT is a feasible and potentially effective intervention for managing anger and irritability in individuals with TBI.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Anger self-management training for people with traumatic brain injury: a preliminary investigation. Hart, T., Vaccaro, MJ., Hays, C., et al.[2022]

The review highlights that effective anger treatment should include a comprehensive approach that addresses motivation, physiological arousal, cognitive change, and behavior change, among other components.

Different therapeutic approaches, such as cognitive-behavioral and Buddhist methods, are evaluated against these ideal treatment components, suggesting that a tailored combination of strategies may be most beneficial for managing anger.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

End piece: reflections on the treatment of anger. DiGiuseppe, R.[2019]

A randomized controlled trial involving 92 post-911 veterans with moderate to severe anger issues found that cognitive behavioral therapy (CBI) significantly reduced anger severity and improved social functioning and quality of life compared to supportive therapy.

The effectiveness of CBI was consistent regardless of whether the veterans had a PTSD diagnosis, indicating its broad applicability for treating anger problems in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Treatment of anger problems in previously deployed post-911 veterans: A randomized controlled trial. Shea, MT., Stout, RL., Reddy, MK., et al.[2022]

A systematic review of 42 studies on cognitive behavioral therapy (CBT) for anger found that 60% were randomized controlled trials, indicating a strong methodological approach, and most studies reported statistically significant outcomes.

While CBT for anger appears effective, the presence of social desirability bias (SDB) in one study that corrected for it raises questions about the reliability of the positive results, suggesting that further scrutiny of methodology is needed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

21st Century Cognitive Behavioural Therapy for Anger: A Systematic Review of Research Design, Methodology and Outcome. Fernandez, E., Malvaso, C., Day, A., et al.[2021]

A randomized pilot study involving 25 veterans returning from Iraq or Afghanistan found that an adapted cognitive behavioral intervention (CBI) significantly improved anger and interpersonal functioning compared to a supportive intervention (SI).

The improvements from CBI were maintained at a 3-month follow-up, suggesting its potential effectiveness for treating anger issues in veterans with warzone trauma.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized pilot study of anger treatment for Iraq and Afghanistan veterans. Shea, MT., Lambert, J., Reddy, MK.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7812503/

The Effectiveness of Cognitive-behavioral Therapy on ... The findings of the present study confirm the effectiveness of CBT in reducing the feeling of anger in female students with misophonia.

2. psycnet.apa.org psycnet.apa.org/record/2021-23706-010

Cognitive behavioral therapy for anger management. The main interventions for anger include motivational interviewing, escape and avoidance, progressive muscle relaxation, diaphragmatic breathing, cognitive ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3584580/

The Efficacy of Cognitive Behavioral Therapy: A Review ... CBT has strong support for anxiety, somatoform disorders, bulimia, anger control, and general stress. It showed higher response rates than control conditions ...

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1359178915001263

A systematic review and meta-analysis on the effectiveness ... CBT based anger management achieved a risk reduction of 28% for violent recidivism. •. Treatment completion may result in a 42% risk reduction in general ...

5. brieflands.com brieflands.com/journals/ijpbs/articles/1250

The Effect of Cognitive-Behavioral Group Therapy on ... The aim of the present study was to evaluate the efficacy of cognitive-behavioral group therapy in the reduction of state-trait anger and ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8489050/

Cognitive–behavioral therapy for management of mental ... Cognitive–behavioral therapy (CBT) helps individuals to eliminate avoidant and safety-seeking behaviors that prevent self-correction of faulty beliefs.

7. crowncounseling.com crowncounseling.com/statistics/anger/

Anger Statistics: In the Workplace, Impacts in 2024 The average adult experiences anger approximately 14 times per week. About 30% of adults report trouble controlling their anger.

8. mayoclinic.org mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610

Cognitive behavioral therapy Cognitive behavioral therapy, also called CBT, is a common type of talk therapy. This type of talk therapy is also called psychotherapy.

9. crimesolutions.ojp.gov crimesolutions.ojp.gov/ratedpractices/cognitive-behavioral-therapy-cbt-anger-related-problems-children-and-adolescents

Practice Profile: Cognitive Behavioral Therapy (CBT) for Anger ... The practice is rated Effective for reducing aggression and anger expression, and improving self-control, problem-solving, and social competencies.

10. cdn.clinicaltrials.gov cdn.clinicaltrials.gov/large-docs/17/NCT02233517/Prot_SAP_000.pdf

Study Title: Group Cognitive Behavioral Therapy for Anger ... The proposed research project is a pilot study of the efficacy of Cognitive-Behavioral Therapy for Anger and Aggression in Combat Veterans with PTSD (CBT-A).