Anger and aggression in people with intellectual disabilities: treatment and follow‐up of consecutive referrals and a waiting list comparison

Abstract

Based on the work of Novaco, there have been several reports of case illustrations that develop anger management training for people with intellectual disabilities. Case reports have become increasingly sophisticated, with social validation of aggression and follow-ups of up to 10 years. There have also been three recent outcome studies attesting to the effectiveness of anger management treatment methods. The current report uses more recently developed methods and a larger number of subjects than previous reports and presents a controlled study of these methods. Thirty-three participants made up the treatment condition. Fourteen participants constituted a waiting list control condition, which lasted six months. Participants were assessed using a provocation inventory, anger provoking roleplays, self-report diaries and reports of aggressive incidents. All were assessed pre-and postexperimental conditions and for the treatment condition some had three, nine and 15 months follow-up. For some participants there was a 21 and 30 month follow-up. Control participants all went on to complete treatment. There were significant improvements in anger control on all measures. While there were significant within subject improvements on the provocation inventory, the treatment subjects did not show significant improvement over the control subjects at posttreatment. A significantly greater percentage of control subjects committed further aggressive incidents. Taken together, the results show the positive effect of anger management training and the generalization of these effects to a reduction in the number of reported aggressive incidents. The present study is further evidence of the effectiveness of anger management training for people with intellectual disabilities. These improvements are shown not only in assessments designed to measure the effects of treatment but also in more general socially validated records of incidents of aggression.

Psychological therapies for people with intellectual disabilities: A systematic review and meta-analysis

“…However, allocation procedures in Rose et al (2008) and Rose et al There are issues associated with the lack of blinding across studies, with only five studies reporting that they attempted to blind the researchers who were responsible for measuring treatment (Benson et al, 1986;Hassiotis et al, In Press;Lindsay et al, 2004;Matson & Senatore, 1981;Willner et al, 2013). Six studies also reported the use of independent raters where masked assessment could not be guaranteed.…”

“…Fourteen studies conducted follow-up measurements within three to six months post treatment, whereas four studies did not collect any follow-up data. Lindsay et al (2004) conducted the longest intervention with approximately forty group sessions of anger treatment over nine months which included up to thirty months of follow-up data for some participants.…”

A cluster randomised controlled trial of a manualised cognitive behavioural anger management intervention delivered by supervised lay therapists to people with intellectual disabilities

“…Another very large effect (Cohen's d = 2.8) was seen using a personal diary-based measure of anger. 40 The PACS-IPT may represent a more suitable self-rating measure than the PI, particularly for people whose intellectual limitations make it difficult to imagine hypothetical situations. Although the PACS-IPT needs further development, it clearly shows potential as an alternative, and perhaps superior, measure of the response to actual provocations that the individual service user encounters.…”

Investigating the Impact of Consultation Based on Acceptance and Commitment to Reduce Anger in Children and Adolescents with Cancer

“…On the implementation of other cognitive interventions, similar results were obtained for anger management (Ahmadi & Abedi, 2002, Shakibayi et al, 2004Ashoori et al, 2008;Akton, 2000;Kellner et al, 2002, Lindsay et al, 2004. Yekta Shokouhi et al (2008) also showed that anger management training on anger reduction and increased use of anger control strategies have a positive impact.…”