Internet Treatment for Anger Works

Summary: A four-week online anger management program helps reduce anger and aggression and improve emotional regulation in people with aggressive behaviors.

Source: Karolinska Institute

Anger management issues can have serious consequences for the person affected and those close to them.

A new study from the Center for Psychiatry Research at the Karolinska Institutet in Sweden shows that four weeks of therapy delivered over the internet can help angry and aggressive people.

The results were published in the Journal of Consulting and Clinical Psychology.

The study, which the researchers have chosen to call “the anger study”, is the first to compare different strategies for regulating emotions via the Internet against anger. The results should be important for understanding emotion regulation and for the dissemination of evidence-based methods.

Easy recruitment of participants

“It is usually very difficult to recruit participants for treatment studies. For the anger study, on the other hand, it was very easy, and we had to close the recruitment site after a few weeks due to the high number of applications. This suggests that there is a repressed need for the psychological treatment of anger.

“A lot of people who have anger issues are ashamed, and we think the internet format is particularly suited to this group because they don’t have to wait in a reception hall or sit face-to-face with a therapist. and talk about their anger,” says Johan Bjureberg, assistant professor at the Karolinska Institutet Psychiatry Research Center and lead researcher of the study, which was conducted in collaboration with researchers from Örebro University in Sweden.

The anger study assessed the effect of two emotion regulation strategies: conscious emotion sensitization; and cognitive reassessment. Emotional mindfulness focuses on the ability to notice and accept one’s feelings and thoughts without judging them or acting on them. Cognitive reappraisal, on the other hand, focuses on the ability to reinterpret thoughts and situations and identify alternative thoughts that don’t trigger difficult feelings.

The 234 participants, all with significant anger issues, were randomly assigned to four weeks of mindful emotional awareness, cognitive reappraisal, or a combination of these two strategies. All treatments were of approximately the same duration and were associated with lower self-reported anger and aggression at the end of treatment.

The most effective combination therapy

Combination treatment resulted in significantly lower levels of anger outward expression, anger aggression, and anger rumination, but not anger suppression, compared to conscious emotional awareness or cognitive reappraisal alone . The combination was particularly effective for participants who experienced very high levels of anger at the start of the study.

It shows an angry man
The results should be important for understanding emotion regulation and for the dissemination of evidence-based methods. Image is in public domain

The findings reinforce research and theories suggesting that difficulties regulating emotions and interpreting events and situations may be a major contributing factor to anger management issues.

“Our results suggest that a very short treatment of just four weeks administered over the internet with minimal therapist support is effective in reducing anger issues. Our hope is that follow-up studies support this finding and that the treatment can be offered largely as part of regular care,” says Johan Bjureberg.

Funding: The study was funded by the Knut and Alice Wallenberg Foundation. No conflict of interest was reported.

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About this news on anger management and psychology research

Author: Press office
Source: Karolinska Institute
Contact: Press Office – Karolinska Institute
Image: Image is in public domain

Original research: Access closed.
Targeting maladaptive anger with brief, internet-delivered, therapist-supported emotion regulation treatments: A randomized controlled trial” by Johan Bjureberg et al. Journal of Consulting and Clinical Psychology


Targeting maladaptive anger with brief, internet-delivered, therapist-supported emotion regulation treatments: A randomized controlled trial

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

Method: The treatments were evaluated in a randomized controlled trial. A total of 234 participants (59% female; mean age=41.1, SD=11.6) with maladaptive anger were randomized to receive MEA (n=78), CR (n=77) or MEA + CR (n=79). Self-reported primary and secondary outcomes were tracked at the primary endpoint, 3 months after the end of treatment (88% retention). Primary outcomes were also assessed weekly during an extended 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 the expression of anger (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 people who reported high values ​​(+1SD) of the results at baseline.

Conclusion : Brief MEA and CR treatments delivered over the Internet and supported by a therapist are effective interventions for maladaptive anger. The combination of MEA and CR is particularly effective in reducing anger expression and aggression, especially in people 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.

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