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Anger Treatment in Chemically-Dependent Inpatients: Evaluation of Phase Effects and Gender

Published online by Cambridge University Press:  23 June 2009

Ephrem Fernandez*
Affiliation:
University of Texas at San Antonio, USA
Stephen Scott
Affiliation:
Psychologist in Private Practice, Norman, Oklahoma, USA
*
Reprint requests to Ephrem Fernandez, University of Texas at San Antonio, Department of Psychology, One UTSA Circle, San Antonio, Texas 78249, USA. E-mail: ephrem.fernandez@utsa.edu

Abstract

Background: There is a growing quest for anger management techniques especially in underserved populations. Patients with a substance abuse history often have untreated anger problems. Aims: To test a new comprehensive program for prevention, intervention, and remediation of anger in chemically-dependent patients. A secondary aim was to explore any anger differences between males versus females. Method: Twenty-six participants (13 male, 13 female) completed three phases of treatment plus follow-up. Dependent measures were six subscales of the (STAXI) questionnaire and self-monitored frequency, duration, and intensity of anger. Results: A significant multivariate effect of phase of study accounted for 42% of the variance in STAXI scores. Univariate F-tests confirmed significant changes on all STAXI subscales. Most of these were between pre and post phases of the study, the effect sizes = +0.8 for state anger and +0.99 for trait anger. For self-monitored variables, significant reductions emerged between treatment phases, the average pre-post effect size = +1.02. Gender did not affect STAXI scores although females had more self-monitored anger, particularly anger episodes. Conclusions: Findings suggest cumulative efficacy of the anger treatment program. That trait anger declined more than state anger may indicate characterological change in addition to situational change; anger frequency and duration declined more than intensity in keeping with other reports that intensity peaks suddenly and is less modifiable. That males and females were generally similar in anger is worth noting in relation to other studies. Finally, participant attrition is discussed as a problem and a possible index of treatment outcome.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2009

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References

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th edition). Washington, DC: American Psychiatric Association.Google Scholar
Awalt, R., Reilly, P. M. and Shopshire, M. S. (1997). The angry patient: an intervention for managing anger in substance abuse treatment. Journal of Psychoactive Drugs, 29, 353358.CrossRefGoogle ScholarPubMed
Bain, G. T. and Kornetsky, C. (1989). Ethanol oral self-administration and rewarding brain stimulation. Alcohol, 6, 499503.CrossRefGoogle ScholarPubMed
Beck, R. and Fernandez, E. (1998a). Cognitive-behavioral therapy in the treatment of anger: a meta-analysis. Cognitive Therapy and Research, 22, 6374.CrossRefGoogle Scholar
Beck, R. and Fernandez, E. (1998b). Cognitive-behavioral self-regulation of the frequency, duration, and intensity of anger. Journal of Psychopathology and Behavioral Assessment, 20, 217229.CrossRefGoogle Scholar
Biaggio, M. K. (1987). Therapeutic management of anger. Clinical Psychology Review, 7, 663675.CrossRefGoogle Scholar
Bishop, G. D. and Quah, S. H. (1998). Reliability and validity of measurement of anger/hostility in Singapore: Cook and Medley Ho Scale, STAXI and Buss-Durkee Hostility Inventory. Personality and Individual Differences, 24, 867878.CrossRefGoogle Scholar
Bradbury, K. E. and Clarke, I. (2006). Cognitive behavioural therapy for anger management: effectiveness in adult mental health services. Behavioural and Cognitive Psychotherapy, 35, 201208.CrossRefGoogle Scholar
Craig, R. J. (1985). Reducing the treatment drop out rate in drug abuse programs. Journal of Substance Abuse Treatment, 2, 209219.CrossRefGoogle ScholarPubMed
Deffenbacher, J. L., Oetting, E. R. and DiGiuseppe, R. A. (2002). Principles of empirically supported interventions applied to anger management. Counseling Psychologist, 30, 262280.CrossRefGoogle Scholar
DiGiuseppe, R. and Tafrate, R. C. (2003). Anger treatment for adults: a meta-analytic review. Clinical Psychology: Science and Practice, 10, 7084.Google Scholar
Eckhardt, C., Norlander, B. and Deffenbacher, J. (2004). The assessment of anger and hostility. Aggression and Violent Behavior, 9, 1743.CrossRefGoogle Scholar
Fernandez, E. (1999). Integrating Therapeutic Ttechniques: the case of anger. Paper presented at the Society for Psychotherapy Research Mid-Atlantic Conference. Baltimore, Maryland.Google Scholar
Fernandez, E. (2001). Sequential Integration of Cognitive-Behavioral and Experiential Techniques for Regulating Anger. Workshop conducted at the Annual Conference of the Society for the Exploration of Psychotherapy Integration. Santiago, Chile.Google Scholar
Fernandez, E. (2005). Current Clinical and Methodological Issues in Psychotherapy for Anger. Workshop conducted at the Society for Psychotherapy Research, Lausanne, Switzerland.Google Scholar
Fernandez, E. (in press). Toward an integrative psychotherapy for maladaptive anger. In Potegal, M., Stemmler, G. and Spielberger, C. (Eds.), A Handbook of Anger. New York: Springer.Google Scholar
Fernandez, E. and Beck, R. (2001). Cognitive-behavioural self-intervention versus self-monitoring of anger: effects on anger frequency, duration, and intensity. Behavioural and Cognitive Psychotherapy, 29, 345356.CrossRefGoogle Scholar
Forgays, D. G., Forgays, D. K. and Spielberger, C. D. (1997). Factor structure of the State-Trait Anger Expression Inventory. Journal of Personality Assessment, 69, 497507.CrossRefGoogle ScholarPubMed
Hains, A. A. (1989). An anger-control intervention with aggressive delinquent youths. Behavioral Residential Treatment, 4, 213230.Google Scholar
Howells, K. and Day, A. (2003). Readiness for anger management: clinical and theoretical issues. Clinical Psychology Review, 23, 319337.CrossRefGoogle ScholarPubMed
Karberg, J. C. and James, D. J. (2005). Substance dependence, abuse, and treatment of jail inmates, 2002. National Criminal Justice Reference service 209588. Retrieved December 14 2005, from http://www.ojp.usdoj.gov/bjs/pub/pdf/sdatji02.pdfGoogle Scholar
Kazdin, A. E. (1994). Methodology, design and evaluation in psychotherapy research. In Bergin, A. E. and Garfield, S. L. (Eds.), Handbook of Psychotherapy and Behavior Change (pp.1971). New York: Wiley and Sons.Google Scholar
Loo, H., Poirier-Littre, M.-F, Theron, M., Rein, W. and Fleurot, O. (1997). Amisulpride versus placebo in the medium-term treatment of the negative symptoms of schizophrenia. British Journal of Psychiatry, 170, 1822.CrossRefGoogle ScholarPubMed
Mason, M. J. (1999). A review of procedural and statistical methods for handling attrition and missing data in clinical research. Measurement and Evaluation in Counseling and Development, 32, 111118.CrossRefGoogle Scholar
Merz, W. A. (1994). Placebo response in panic disorder: a review. European Psychiatry, 9, 123127.CrossRefGoogle Scholar
Miczek, K. A. (1987). The psychopharmacology of aggression. In Iversen, L. L., Iverson, S. D. and Snyder, S. H. (Eds.), Handbook of Psychopharmacology. New York: Plenum.Google Scholar
Milovchevich, D., Howells, K., Drew, N. and Day, A. (2001). Sex and gender role differences in anger: an Australian community sample study. Personality and Individual Differences, 31, 117127.CrossRefGoogle Scholar
Reilly, P. M., Clark, H., Westley, M. S., Lewis, E. W. and Sorenson, D. J. (1994). Anger management and temper control: critical components of posttraumatic stress disorder and substance abuse treatment. Journal of Psychoactive Drugs, 26, 401407.CrossRefGoogle ScholarPubMed
Reilly, P. M. and Shopshire, M. S. (2000). Anger management group treatment for cocaine dependence: preliminary outcomes. American Journal of Drug and Alcohol Abuse, 26, 161177.CrossRefGoogle ScholarPubMed
Ross, C. E. and Van Willigen, M. (1996). Gender, parenthood, and anger. Journal of Marriage and Family, 58, 572584.CrossRefGoogle Scholar
Sharkin, B. S. (1993). Anger and gender: theory, research, and implications. Journal of Counseling and Development, 71, 386389.CrossRefGoogle Scholar
Siddle, R., Jones, F. and Awenat, F. (2003). Group cognitive behavior therapy for anger: a pilot study. Behavioural and Cognitive Psychotherapy, 31, 6983.CrossRefGoogle Scholar
Spielberger, C. D. (1988). Manual for the State-Trait Anger Expression Inventory. Odessa, Fl: Psychological Assessment Resources.Google Scholar
Tafrate, R. C. and Kassinove, H. (2006). Anger management for adults: a menu-driven cognitive-behavioral approach to the treatment of anger disorders. In Fiendler, E. L. (Ed.), Anger-Related Disorders: a practitioner's guide to comparative treatments (pp. 115137). New York: Springer.Google Scholar
Taylor, J. L., Novaco, R. W., Gillmer, B. and Thorne, I. (2002). Cognitive-behavioural treatment of anger intensity among offenders with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities. Special Issue: Offenders with Intellectual Disability, 15, 151165.Google Scholar
Timmers, M., Fischer, A. H. and Manstead, S. R. (1998). Gender differences in motives for regulating emotions. Personality and Social Psychology Bulletin, 24, 974985.CrossRefGoogle Scholar
Tivis, L. J., Parsons, O. A. and Nixon, S. J. (1998). Anger in an inpatient treatment sample of chronic alcoholics. Alcoholism: Clinical and Experimental Research, 22, 902907.CrossRefGoogle Scholar
Walfish, S., Massey, R. and Krone, A. (1990). Anxiety and anger among abusers of different substances. Drug and Alcohol Dependence, 25, 253256.CrossRefGoogle ScholarPubMed
Wallen, J. (1992). A comparison of male and female clients in substance abuse treatment. Journal of Substance Abuse Treatment, 9, 243248.CrossRefGoogle ScholarPubMed
Wierzbicki, M. and Pekarik, G. (1993). A meta-analysis of psychotherapy dropout. Professional Psychology: Research and Practice, 24, 190195.CrossRefGoogle Scholar
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