Cognitive behavioural therapy for aggression among individuals with moderate to severe acquired brain injury: a systematic review and meta-analysis

Iruthayarajah, Jerome; Alibrahim, Fatimah; Mehta, Swati; Janzen, Shannon; McIntyre, Amanda; Teasell, Robert

doi:10.1080/02699052.2018.1496481

Cited by 16 publications

(10 citation statements)

References 28 publications

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“…Psychological interventions appear moderately effective (d = −0.46) in populations with ABI (see Byrne and Coetzer, 2016;Iruthayarajah et al, 2018) and mental health disorders (see Ross et al, 2013;Lee and DiGiuseppe, 2018). The majority of these interventions are based on cognitive behavioral therapy (CBT), which include several limitations.…”

Section: Psychological Interventions For Aggressionmentioning

confidence: 99%

“…Small sample size (e.g., single case studies; n = 1) is a common limitation (Alderman et al, 2013;Ross et al, 2013;Byrne and Coetzer, 2016;Iruthayarajah et al, 2018). Studies in populations with mental health disorders contain larger samples than those with ABI.…”

Section: Psychological Interventions For Aggressionmentioning

confidence: 99%

“…Studies in populations with mental health disorders contain larger samples than those with ABI. Ross et al (2013) reported samples ranging from 3 to 290, while Byrne and Coetzer (2016) and Iruthayarajah et al (2018) reported ABI samples ranging from 1 to 52. While an adequate sample size is necessary for scientific rigor, the inherent nature of recruiting from clinical populations (and especially those with ABI), makes this a challenging limitation to overcome (e.g., see Armstrong et al, 2020).…”

Section: Psychological Interventions For Aggressionmentioning

confidence: 99%

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Shades of Rage: Applying the Process Model of Emotion Regulation to Managing Anger After Brain Injury

2022

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Uncontrollable anger is common following an acquired brain injury (ABI), with impaired emotion regulation (ER) being one of the main contributors. Existing psychological interventions appear moderately effective, though studies typically include limitations such as small sample sizes, issues of long-term efficacy, and standardization of content. While ER has been a popular research field, the study of ER for anger management after ABI is less well investigated, and contains few interventions based on the widely used Process Model of ER. This review surveys the efficacy of ER strategies in individuals with ABI, and proposes a novel research design for future interventions. Recommendations are made about: strategy number and type, shared decision-making, approaches to data analysis, and mode of delivery.

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Section: Psychological Interventions For Aggressionmentioning

confidence: 99%

Section: Psychological Interventions For Aggressionmentioning

confidence: 99%

Section: Psychological Interventions For Aggressionmentioning

confidence: 99%

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Shades of Rage: Applying the Process Model of Emotion Regulation to Managing Anger After Brain Injury

2022

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“…In long-term therapy, antipsychotics have severe side effects such as stroke and increased mortality (58). A review about cognitive behavioural therapy (CBT), a nonpharmacological anger self-management technique, concluded that CBT appears to be an effective tool to control aggression in a population with ABI (59). The results of that review show promise for CBT as a non-pharmacological, safe, psychotherapy alternative to medication use for treatment of aggression after brain injury.…”

Section: Considerations and Implicationsmentioning

confidence: 99%

Prevalence of neuropsychiatric symptoms and psychotropic drug use in patients with acquired brain injury in long-term care: a systematic review

et al. 2018

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Objective: Little is known about the prevalence of neuropsychiatric symptoms (NPS) and psychotropic drug use (PDU) in patients below the age of 65 years with acquired brain injury (ABI) in long-term care. The objective of this study was to review the literature about the prevalence of NPS and PDU. Methods: A systematic literature search of English, Dutch and German articles in Pubmed, EMBASE, PsycINFO and CINAHL was performed with the use of MeSH and free-text terms. Results: Six articles met the inclusion criteria. The place of residence was mainly a nursing home and most studies were conducted in a population of patients with traumatic brain injury. Sample sizes varied from 40 to 26,472 residents and NPS were assessed with different assessment instruments. Depressive symptoms were most common with a prevalence ranging from 13.9% to 39.3%. Two studies reported PDU in which tranquillizers (59%) were the most prevalent psychotropic drugs followed by anticonvulsants (35%) and antidepressants (26-34%). Conclusions: Patients with ABI experience lifelong consequences, regardless the cause of ABI, that have a high impact on them and their surroundings. More insight into the magnitude of NPS and PDU, through prevalence studies, is necessary to achieve suitable provision of care for these patients.

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“…Antipsychotics, which are prescribed for the treatment of psychosis, agitation and aggression, may have adverse effects on cognition and severe side effects in the long-term such as stroke and increased mortality (Ballard, Corbett, Chitramohan, & Aarsland, 2009;Stanislav, 1997). Cognitive behavioural therapy, a non-pharmacological anger self-management technique, appears to be a safe and effective tool to control aggression in a population with ABI as alternative to medication use (Iruthayarajah et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and characteristics of neuropsychiatric symptoms, quality of life and psychotropics in people with acquired brain injury in long‐term care

Kohnen¹,

Lavrijsen²,

Smals³

et al. 2019

Journal of Advanced Nursing

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AimEstablishing the prevalence of neuropsychiatric symptoms (NPS), quality of life and psychotropic drug use in people aged ≤65 years with acquired brain injury in nursing homes.DesignCross‐sectional, observational study among patients aged 18–≤65 years with acquired brain injury admitted to special care units in Dutch nursing homes.MethodsAccording to the Committee on Research Involving Human Subjects in January 2017 this study did not require ethics approval. Nursing homes will be recruited through the national acquired brain injury expertise network for patients with severe brain injury, the regional brain injury teams and by searching the internet. Patient characteristics will be collected through digital questionnaires. Neuropsychiatric symptoms will be assessed with the NeuroPsychiatric Inventory‐Nursing Home version, the Cohen–Mansfield Agitation Inventory and the St. Andrews Sexual Behaviour Assessment; cognition with the Mini‐Mental State Examination, quality of life with the Quality of Life after Brain Injury Overall Scale and activities of daily living with the Disability Rating Scale. Medication will be retrieved from the electronic prescription system. Data collection commenced in 2017 and will be followed by data analysis in 2019. Reporting will be completed in 2020.DiscussionLittle is known about NPS among patients with acquired brain injury in nursing homes. In patients up to the age of 65 years, only six studies were found on prevalence rates of NPS.ImpactPatients with severe acquired brain injury experience lifelong consequences, that have a high impact on them and their environment. Although there is increasing attention for the survival of this vulnerable group of patients, it is also important to enlarge awareness on long‐term consequences, specifically the NPS, quality of life and psychotropic drug use in acquired brain injury. Insight into the magnitude of these issues is necessary to achieve appropriate care for these patients.

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Cognitive behavioural therapy for aggression among individuals with moderate to severe acquired brain injury: a systematic review and meta-analysis

Abstract: The differences in outcomes may be related to the differential management of anger expression and anger suppression. CBT shows promise, but further studies with comparator groups are needed before conclusions about its efficacy can be made.

Cited by 16 publications

References 28 publications

Shades of Rage: Applying the Process Model of Emotion Regulation to Managing Anger After Brain Injury

Shades of Rage: Applying the Process Model of Emotion Regulation to Managing Anger After Brain Injury

Prevalence of neuropsychiatric symptoms and psychotropic drug use in patients with acquired brain injury in long-term care: a systematic review

Prevalence and characteristics of neuropsychiatric symptoms, quality of life and psychotropics in people with acquired brain injury in long‐term care

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