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Anger Self-Management Training for Chronic Moderate to Severe Traumatic Brain Injury: Results of a Randomized Controlled Trial.


ABSTRACT: OBJECTIVE:To test efficacy of 8-session, 1:1 treatment, anger self-management training (ASMT), for chronic moderate to severe traumatic brain injury (TBI). SETTING:Three US outpatient treatment facilities. PARTICIPANTS:Ninety people with TBI and elevated self-reported anger; 76 significant others (SOs) provided collateral data. DESIGN:Multicenter randomized controlled trial with 2:1 randomization to ASMT or structurally equivalent comparison treatment, personal readjustment and education (PRE). Primary outcome assessment 1 week posttreatment; 8-week follow-up. PRIMARY OUTCOME:Response to treatment defined as 1 or more standard deviation change in self-reported anger. SECONDARY OUTCOMES:SO-rated anger, emotional and behavioral status, satisfaction with life, timing of treatment response, participant and SO-rated global change, and treatment satisfaction. MAIN MEASURES:State-Trait Anger Expression Inventory-Revised Trait Anger (TA) and Anger Expression-Out (AX-O) subscales; Brief Anger-Aggression Questionnaire (BAAQ); Likert-type ratings of treatment satisfaction, global changes in anger and well-being. RESULTS:After treatment, ASMT response rate (68%) exceeded that of PRE (47%) on TA but not AX-O or BAAQ; this finding persisted at 8-week follow-up. No significant between-group differences in SO-reported response rates, emotional/behavioral status, or life satisfaction. ASMT participants were more satisfied with treatment and rated global change in anger as significantly better; SO ratings of global change in both anger and well-being were superior for ASMT. CONCLUSION:ASMT was efficacious and persistent for some aspects of problematic anger. More research is needed to determine optimal dose and essential ingredients of behavioral treatment for anger after TBI.

SUBMITTER: Hart T 

PROVIDER: S-EPMC5593756 | biostudies-literature | 2017 Sep/Oct

REPOSITORIES: biostudies-literature

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Anger Self-Management Training for Chronic Moderate to Severe Traumatic Brain Injury: Results of a Randomized Controlled Trial.

Hart Tessa T   Brockway Jo Ann JA   Maiuro Roland D RD   Vaccaro Monica M   Fann Jesse R JR   Mellick David D   Harrison-Felix Cindy C   Barber Jason J   Temkin Nancy N  

The Journal of head trauma rehabilitation 20170901 5


<h4>Objective</h4>To test efficacy of 8-session, 1:1 treatment, anger self-management training (ASMT), for chronic moderate to severe traumatic brain injury (TBI).<h4>Setting</h4>Three US outpatient treatment facilities.<h4>Participants</h4>Ninety people with TBI and elevated self-reported anger; 76 significant others (SOs) provided collateral data.<h4>Design</h4>Multicenter randomized controlled trial with 2:1 randomization to ASMT or structurally equivalent comparison treatment, personal readj  ...[more]

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