Development of a brief online intervention to address aggression in the context of emotion-related impulsivity: Evidence from a wait-list controlled trial

Johnson, Sheri L.; Zisser, Mackenzie; Sandel, Devon B.; Swerdlow, Benjamin A.; Carver, Charles S.; Sanchez, Amy H.; Fernández, Ephrem

doi:10.1016/j.brat.2020.103708

Cited by 25 publications

(37 citation statements)

References 46 publications

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“…As emotion-related impulsivity is easily assessed, there is potential to screen more widely for these traits, which opens a path towards interventions targeted at emotion-related impulsivity. We have shown that emotion-related impulsivity is reduced after brief, easily accessible interventions involving teaching individuals to recognize emotions, to engage in self-calming techniques in response to emotion states, and to pre-plan coping strategies to cope with highly emotional states ( Johnson et al, 2020 ). Such techniques might be profitably added to mental health approaches typically used for stress reduction, such as mindfulness and techniques for promoting social connection ( Polizzi et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Emotion-related impulsivity predicts increased anxiety and depression during the COVID-19 pandemic

Johnson

Porter

Modavi

et al. 2022

Journal of Affective Disorders

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Introduction Emotion-related impulsivity, defined by poor constraint in the face of emotion, is related to internalizing symptoms, cross-sectionally and longitudinally. Internalizing symptoms, though, are profoundly tied to stress reactivity, and little is known about how emotion-related impulsivity relates to stress reactivity. Method Taking advantage of a sample that had completed measures of depression, anxiety, suicidal ideation, and two forms of emotion-related impulsivity before the pandemic, we asked participants to complete three weekly follow-up internalizing assessments early in the pandemic. Results Among the 150 participants, pre-pandemic emotion-related impulsivity scores predicted higher depression, anxiety, general distress, and suicidal ideation during the COVID-19 pandemic. Controlling for pre-pandemic scores, one form of emotion-related impulsivity (Feelings Trigger Action) predicted increased anxiety and general distress. We also examined how pre-pandemic emotion-related impulsivity was moderated by weekly COVID-related stress. One form of emotion-related impulsivity (Pervasive Influence of Feelings) predicted internalizing symptoms at low stress levels, and a different form (Feelings Trigger Action) predicted internalizing symptoms at higher stress levels. Limitations Limitations include the small sample size, the absence of repeat measures of impulsivity, the attrition of individuals with more internalizing symptoms, and the reliance on self-rated measures. Conclusions Forms of emotion-related impulsivity predict increases in anxiety and distress over time, but the interactions with stress levels appear to vary. Emotion-related impulsivity can be addressed with accessible intervention tools, suggesting promise for broader screening for those at risk for internalizing symptoms during periods of high stress.

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Section: Discussionmentioning

confidence: 99%

Emotion-related impulsivity predicts increased anxiety and depression during the COVID-19 pandemic

Johnson

Porter

Modavi

et al. 2022

Journal of Affective Disorders

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“…According to several clinical studies, Cognitive Anxiety Sensitivity Treatment (CAST) and Dialectical Behavior Therapy (DBT) target anxiety symptoms and suicidality, and have good efficacy in reducing suicidal ideation ( 48 , 49 ). Besides, a brief online intervention is also proved to be efficient to reduce emotion-related impulsivity, which includes emotion recognization, self-calming techniques and pre-plan coping strategies ( 50 ). Retention and engagement of interventions would be challenging ( 51 ), especially considering the high level of impulsivity in MDD patients in our study.…”

Section: Discussionmentioning

confidence: 99%

Trait Anxiety Mediates Impulsivity and Suicidal Ideation in Depression During COVID-19 Pandemic

et al. 2022

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Suicidality in patients with major depressive disorder (MDD) has been an urgent affair during the COVID-19 pandemic. It is well-established that impulsivity and trait anxiety are two risk factors for suicidal ideation. However, literature is still insufficient on the relationships among impulsivity, (state/trait) anxiety and suicidal ideation in individuals with MDD. The present study aims to explore the relationships of these three variables in MDD patients during the COVID-19 pandemic through three scales, including Barrett Impulsivity Scale (BIS), State-Trait Anxiety Scale (STAI) and Self-rating Idea of Suicide Scale (SIOSS). Sixty-three MDD patients (low SIOSS group and high SIOSS group, which were split by the mean score of SIOSS) and twenty-seven well-matched healthy controls were analyzed. Our results showed that the high SIOSS group had higher trait anxiety (p < 0.001, 95% CI = [−19.29, −5.02]) but there was no difference in state anxiety (p = 0.171, 95% CI = [−10.60, 1.25]), compared with the low SIOSS group. And the correlation between impulsivity and suicidal ideation was significant in MDD patients (r = 0.389, p = 0.002), yet it was not significant in healthy controls (r = 0.285, p = 0.167). Further, mediation analysis showed that trait anxiety significantly mediate impulsivity and suicidal ideation in patients with depression (total effect: β = 0.304, p = 0.002, 95% CI = [0.120, 0.489]; direct effect: β = 0.154, p = 0.076, 95% CI = [−0.169, 0.325]), indicating impulsivity influenced suicidal ideation through trait anxiety in MDD patients. In conclusion, our results suggested that trait anxiety might mediate the association of impulsivity and suicidal ideation in MDD patients. Clinicians may use symptoms of trait anxiety and impulsivity for screening when actively evaluating suicidal ideation in MDD patients, especially in the setting of COVID-19 pandemic.

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“…The internet-delivered format was employed because online therapy carries the potential to increase access to evidence-based treatments by decreasing geographical barriers, time constraints, costs, and thresholds to seek help (particularly for individuals with stigmatizing behaviors such as maladaptive anger; Andersson, 2016). A brief four-module format was employed in light of the (partial) success of very brief CBT-based internet-delivered interventions (4–6 modules) for maladaptive anger (Howie & Malouff, 2014; Johnson et al, 2020).…”

Section: Cognitive Behavioral Therapy and Maladaptive Angermentioning

confidence: 99%

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

Bjureberg¹,

Ojala²,

Berg³

et al. 2023

Journal of Consulting and Clinical Psychology

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Objective: To evaluate the relative impact of three brief therapist-supported internet-delivered emotion regulation treatments for maladaptive anger (mindful emotion awareness [MEA], cognitive reappraisal [CR], and mindful emotion awareness + cognitive reappraisal [MEA + CR]) and to test whether baseline levels of anger pathology moderate treatment outcome. Method: Treatments were evaluated in a randomized controlled trial. In total, 234 participants (59% female; mean age = 41.1, SD = 11.6) with maladaptive anger were randomized to MEA (n = 78), CR (n = 77), or MEA + CR (n = 79). Self-reported primary and secondary outcomes were followed up at primary endpoint, 3 months after treatment termination (88% retention). Primary outcomes were also assessed weekly during a prolonged 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 anger expression (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 individuals who reported high values (+1SD) of the outcomes at baseline. Conclusions: Brief therapist-supported internet-delivered MEA and CR treatments are effective interventions for maladaptive anger. Combining MEA and CR is especially effective in reducing anger expression and aggression, particularly, in individuals 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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Development of a brief online intervention to address aggression in the context of emotion-related impulsivity: Evidence from a wait-list controlled trial

Cited by 25 publications

References 46 publications

Emotion-related impulsivity predicts increased anxiety and depression during the COVID-19 pandemic

Emotion-related impulsivity predicts increased anxiety and depression during the COVID-19 pandemic

Trait Anxiety Mediates Impulsivity and Suicidal Ideation in Depression During COVID-19 Pandemic

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

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