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A Brief Measure for the Assessment of Anger and Aggression

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A brief, six-item measure was developed for the rapid screening and identification of anger and aggression levels in violence-prone men. Four studies were conducted to examine the reliability and validity of the measure using a clinical data base of 401 men. Analyses indicated a satisfactory degree of internal consistency, test-retest reliability, and a significant relationship between the brief measure and Buss-Durkee Hostility Inventory total scores. Significantly higher scores were observed for three types of assault samples, including a group of domestic batterers, a group of generally assaultive men, and a mixed assault group, when compared to nonviolent controls. A cutting score for violent versus nonviolent group classification was determined via discriminant analysis. Significant differences observed at post-test between an anger management treatment group and waiting-list control subjects further illustrated the measure's sensitivity to changes in psychological status and provided additional support for its clinical validity and utility.
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Violence
Journal of Interpersonal
http://jiv.sagepub.com/content/2/2/166
The online version of this article can be found at:
DOI: 10.1177/088626087002002003
1987 2: 166J Interpers Violence
ROLAND D. MAIURO, PETER P. VITALIANO and TIMOTHY S. CAHN
A Brief Measure for the Assessment of Anger and Aggression
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... A modified version of the 6-item Brief Anger-Aggression Questionnaire (BAAQ, Maiuro, Vitaliano, & Cahn, 1987) was used to assess anger during the past 2 weeks. This measure is brief, fairly widely used, and has satisfactory reliability and validity (Maiuro et al., 1987). ...
... A modified version of the 6-item Brief Anger-Aggression Questionnaire (BAAQ, Maiuro, Vitaliano, & Cahn, 1987) was used to assess anger during the past 2 weeks. This measure is brief, fairly widely used, and has satisfactory reliability and validity (Maiuro et al., 1987). ...
Technical Report
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Problem: For crews of naval ships, effective decision-making during stressful situations is essential to successful performance of their operational missions. Recent mishaps at sea have shown that fatigue, communication deficits, and other factors can have deleterious consequences for decision-making during unexpected or emergency events. One strategy for improving safety and readiness at sea involves identifying minimally intrusive methods to increase resilience among crew members, enhance their ability to make optimal decisions effectively during urgent situations, and improve their ability to manage stress during normal operations. Purpose: The purpose of this study was to deliver an enhanced version of an existing Stress Resilience Training System (SRTS) and to evaluate its effects on cognitive performance, stress-related physiology, and psychological health. As delivered in this study, SRTS involves an initial 2-hr in-person classroom training, augmented by ongoing use of an SRTS mobile app, and continued mentoring by selected crew members who received additional training in SRTS. This system has been previously used to teach stress management and self-regulation strategies in other military, first responder, and elite athlete populations. We hypothesized that SRTS would improve resilience, psychological health, decision-making, and other areas of executive functioning among shipboard Sailors. Method: Using a single-group, time series design, 92 crew members from a single naval vessel received the SRTS intervention, and were measured at three different time points: baseline, 8-week follow-up, and 10-week follow-up. Study assessments measured cognitive performance, heart rate variability (HRV), and self-reported psychological health. Findings: At the 8-week follow-up, relative to baseline, participants demonstrated increased information processing speed and improved decision-making, and reported decreased depression and anxiety. Furthermore, there was a marginally significant increase in resilience across the study period. Overall, Sailors perceived increased stress at the 8-week follow-up relative to baseline; however, these changes were not sustained at the 10-week follow-up. Increases in perceived stress were statistically significant only among Sailors reporting low levels of app usage, suggesting that using the SRTS app component may have protective effects on perceived stress. There was also a positive relationship between training-related HRV coherence and a relative increase in cognitive processing speed among those reporting higher use of the self-regulation techniques taught in the intervention. However, neither app utilization nor self-reported use of the self-regulation techniques taught in the intervention were related to any other outcome found significant in the current study. Furthermore, no significant changes over time were found in the HRV-based physiological measures, in cognitive assessments of sustained attention or planning, or in self-reported psychological outcomes in sleep, anger, social support, or coping styles. Conclusions: In this pilot study, some methodological challenges were encountered, which will be remedied in subsequent administrations of the training and evaluation. In addition, statistical power was limited by relatively high rates of attrition between baseline and follow-up. Nonetheless, initial findings were encouraging. This study showed that a command can feasibly integrate a resilience intervention into its training schedule and command culture for the purposes of improving the resilience and well-being of its crew. The results indicated that SRTS has promise as a foundation for enhancing decision-making and resilience among shipboard Sailors to ultimately enhance their readiness and ability to successfully complete their missions.
... Three scales measuring negative emotions (anger, disgust, and anxiety) were included to determine the association of these emotions with the experience of misophonia and to determine differences between people with self-reported misophonia and those without. Anger was measured with the 6-item Brief Anger and Aggression Questionnaire (Maiuro et al., 1987), with all items measured on a 5-point Likert scale (extremely unlikely to very likely). Disgust was measured with the 6-item Propensity subscale of the revised Disgust Propensity and Sensitivity scale (Fergus and Valentiner, 2009), with all items measured on a 5point Likert scale (never to always). ...
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Aims This longitudinal study examined the role of anger, disgust, and anxiety in the experience of misophonia, the quality of life of those with self-reported misophonia in comparison to those without misophonia, and the association of misophonia and quality of life over time. Methods An online longitudinal survey was conducted, with misophonia, anger, disgust, anxiety, depression, self-esteem, and quality of life measured at two time points (6-months apart) in two groups of people (those with self-reported misophonia and those without misophonia). Results Anger and disgust emerged as the primary predictors of misophonic responses. Anxiety and depression were not significantly associated with misophonia over time. Differences in quality of life were observed between those with and without self-reported misophonia in the current study, with lower scores across the SF-36 domains of role limitations due to emotional problems, energy/fatigue, emotional wellbeing, social functioning, and general health for those with misophonia compared to those without misophonia. Compared with other studies, scores for those with self-reported misophonia were lower than those with long-term physical conditions, similar to those with tinnitus, but higher than those with obsessive compulsive disorder. Misophonia was predictive of quality of life over time but only on two domains: role limitations due to emotional problems (predictors: avoidance, emotional responses, and impact on participation in life) and pain (predictor: impact on participation in life). Depression remained a strong predictor of quality of life over time. Conclusion Anger and disgust are more strongly associated with the experience of misophonia than anxiety. Quality of life in people with self-reported misophonia is lower than in the general population and may be similar to those with tinnitus. Depression, avoiding triggers, the extent of the emotional response, and perceived impact on participation in life are associated with perceptions of lower quality of life over time for people with self-reported misophonia.
... 26 Prior work has suggested emotions associated with aggression include anger, irritation and feeling anxious; errors were therefore correlated between these items as this may reflect an underlying latent construct of anger-related emotions. 51,52 Further, disgust and avoidance (a need to leave) are associated with each other, with emotions associated with disgust and avoidance, including distraction, anger and irritation; errors between these items were also correlated, as they may reflect an underlying latent construct of disgust-related emotions. 53,54 With the physiological items, sweating, heart palpitations, pain, and tingling were linked, as they may reflect an underlying latent construct related to the experience of an increased heart rate in response to triggers. ...
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Objective Most current Misophonia scales are not validated, do not include both emotional and physiological responses to triggers, and/or focus only on auditory triggers. This research aimed to develop and validate a measure of the magnitude of the Misophonic response that addressed these omissions. Method Three studies were carried out with individuals with self-diagnosed Misophonia. In study 1, expert opinion and participants commented on initial items to determine both face and content validity. In study 2, scale structure, reliability, and convergent and discriminant validity were determined using correlations, principal component analysis (PCA), and reliability analysis. In study 3, factor structure was confirmed in another sample of participants using confirmatory factor analysis (CFA). Results The final 22-item scale assesses the magnitude of responses to triggers across any sensory modality. There are three subscales (emotional, physiological, and participation in life), with three additional items measuring frequency of triggers, avoidance of triggers, and time taken to recover from the triggers. The final scale showed suitable discriminant and convergent validity, with good internal consistency (Cronbach's alphas range 0.77 to 0.89). The three-component solution extracted using PCA explained 53.97% of variance, with all items loading between 0.45 and 0.84. The structure was confirmed with CFA (χ² = 269.01, p < .001; CFI = 0.96; TLI = 0.96 and RMSEA = 0.045 (CI 0.037–0.053). Conclusion The Misophonia Response Scale, which is valid and reliable, will facilitate understanding of Misophonia as it is short and easy to use for self-report in research.
... In brief, participants were aged 18-65, were at least 6 months post moderate/ severe TBI, and acknowledged anger that was new, or worse, since injury. Problematic anger was verified by a score ≥ 1 standard deviation above the demographically adjusted mean on the Trait Anger (TA) or Anger Expression-Out (AX-O) subscales of the State-Trait Anger Expression Inventory-2 (STAXI-2; Spielberger, 2000), or a score of ≥ 9 on the Brief Anger-Aggression Questionnaire (Maiuro, Vitaliano, & Cahn, 1987). Trial participants were contacted for a treatment enactment interview unless they had attended fewer than half of their treatment sessions (n = 4), were lost to follow-up in the parent study (n = 4), or could not be reached thereafter (n = 2). ...
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Objectives Treatment enactment, a final stage of treatment implementation, refers to patients’ application of skills and concepts from treatment sessions into everyday life situations. We examined treatment enactment in a two-arm, multicenter trial comparing two psychoeducational treatments for persons with chronic moderate to severe traumatic brain injury and problematic anger. Methods Seventy-one of 90 participants from the parent trial underwent a telephone enactment interview at least 2 months (median 97 days, range 64–586 days) after cessation of treatment. Enactment, quantified as average frequency of use across seven core treatment components, was compared across treatment arms: anger self-management training (ASMT) and personal readjustment and education (PRE), a structurally equivalent control. Components were also rated for helpfulness when used. Predictors of, and barriers to, enactment were explored. Results More than 80% of participants reported remembering all seven treatment components when queried using a recognition format. Enactment was equivalent across treatments. Most used/most helpful components concerned normalizing anger and general anger management strategies (ASMT), and normalizing traumatic brain injury-related changes while providing hope for improvement (PRE). Higher baseline executive function and IQ were predictive of better enactment, as well as better episodic memory (trend). Poor memory was cited by many participants as a barrier to enactment, as was the reaction of other people to attempted use of strategies. Conclusions Treatment enactment is a neglected component of implementation in neuropsychological clinical trials, but is important both to measure and to help participants achieve sustained carryover of core treatment ingredients and learned material to everyday life.
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Only one meta‐analysis was conducted for fathers, showing a statistically significant short‐term improvement in parental stress. There was no significant different in effects according to the type of programme or intervention duration. Abstract BACKGROUND Parental psychosocial health can have a significant effect on the parent‐child relationship, with consequences for the later psychological health of the child. Parenting programmes have been shown to have an impact on the emotional and behavioural adjustment of children, but there have been no reviews to date of their impact on parental psychosocial wellbeing. OBJECTIVES To address whether group‐based parenting programmes are effective in improving parental psychosocial wellbeing (for example, anxiety, depression, guilt, confidence). SEARCH METHODS We searched the following databases on 5 December 2012: CENTRAL (2011, Issue 4), MEDLINE (1950 to November 2011), EMBASE (1980 to week 48, 2011), BIOSIS (1970 to 2 December 2011), CINAHL (1982 to November 2011), PsycINFO (1970 to November week 5, 2011), ERIC (1966 to November 2011), Sociological Abstracts (1952 to November 2011), Social Science Citation Index (1970 to 2 December 2011), metaRegister of Controlled Trials (5 December 2011), NSPCC Library (5 December 2011). We searched ASSIA (1980 to current) on 10 November 2012 and the National Research Register was last searched in 2005. SELECTION CRITERIA We included randomised controlled trials that compared a group‐based parenting programme with a control condition and used at least one standardised measure of parental psychosocial health. Control conditions could be waiting‐list, no treatment, treatment as usual or a placebo. 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Overall, we found that group‐based parenting programmes led to statistically significant short‐term improvements in depression (standardised mean difference (SMD) ‐0.17, 95% confidence interval (CI) ‐0.28 to ‐0.07), anxiety (SMD ‐0.22, 95% CI ‐0.43 to ‐0.01), stress (SMD ‐0.29, 95% CI ‐0.42 to ‐0.15), anger (SMD ‐0.60, 95% CI ‐1.00 to ‐0.20), guilt (SMD ‐0.79, 95% CI ‐1.18 to ‐0.41), confidence (SMD ‐0.34, 95% CI ‐0.51 to ‐0.17) and satisfaction with the partner relationship (SMD ‐0.28, 95% CI ‐0.47 to ‐0.09). However, only stress and confidence continued to be statistically significant at six month follow‐up, and none were significant at one year. There was no evidence of any effect on self‐esteem (SMD ‐0.01, 95% CI ‐0.45 to 0.42). None of the trials reported on aggression or adverse effects. The limited data that explicitly focused on outcomes for fathers showed a statistically significant short‐term improvement in paternal stress (SMD ‐0.43, 95% CI ‐0.79 to ‐0.06). We were unable to combine data for other outcomes and individual study results were inconclusive in terms of any effect on depressive symptoms, confidence or partner satisfaction. AUTHORS' CONCLUSIONS The findings of this review support the use of parenting programmes to improve the short‐term psychosocial wellbeing of parents. Further input may be required to ensure that these results are maintained. More research is needed that explicitly addresses the benefits for fathers, and that examines the comparative effectiveness of different types of programme along with the mechanisms by which such programmes bring about improvements in parental psychosocial functioning. Plain language summary PARENT TRAINING FOR IMPROVING PARENTAL PSYCHOSOCIAL HEALTH Parental psychosocial health can have a significant effect on the parent‐child relationship, with consequences for the later psychological health of the child. Some parenting programmes aim to improve aspects of parental wellbeing and this review specifically looked at whether group‐based parenting programmes are effective in improving any aspects of parental psychosocial health (for example, anxiety, depression, guilt, confidence). We searched electronic databases for randomised controlled trials in which participants had been allocated to an experimental or a control group, and which reported results from at least one scientifically standardised measure of parental psychosocial health. We included a total of 48 studies that involved 4937 participants and covered three types of programme: behavioural, cognitive‐behavioural and multimodal. Overall, the results suggested statistically significant improvements in the short‐term for parental depression, anxiety, stress, anger, guilt, confidence and satisfaction with the partner relationship. However, only stress and confidence continued to be statistically significant at six month follow‐up, and none were significant at one year. There was no evidence of effectiveness for self‐esteem at any time point. None of the studies reported aggression or adverse outcomes. Only four studies reported the outcomes for fathers separately. These limited data showed a statistically significant short‐term improvement in paternal stress but did not show whether the parenting programmes were helpful in terms of improving depressive symptoms, confidence or partner satisfaction. This review shows evidence of the short‐term benefits of parenting programmes on depression, anxiety, stress, anger, guilt, confidence and satisfaction with the partner relationship. The findings suggest that further input may be needed to support parents to maintain these benefits. However, more research is needed that explicitly addresses the benefits for fathers, and that provides evidence of the comparative effectiveness of different types of programme and identifies the mechanisms involved in bringing about change.
Chapter
Traumatic brain injury (TBI) is associated with a variety of behavioral consequences, including symptoms of depression, anxiety, aggression, and impulse control and overlaps with many of the symptoms of posttraumatic stress and posttraumatic stress disorder. There are many challenges to researchers and clinicians, including heterogeneity of the injury, distinguishing premorbid characteristics from the consequences of the TBI, lack of specificity in diagnostic criteria, and the absence of systematic therapeutic trials. In this chapter, we present an overview of the literature on psychiatric and behavioral consequences of TBI, highlighting those studies that investigate the incidence of these conditions, contribution of premorbid functioning to subsequent symptoms, and characteristics of mild TBI (frequently referred to as concussion) that provide clues to distinguishing it from other psychiatric comorbidities. Our analysis of the available literature suggests that in some but not all cases, TBI may diminish inhibitory control over certain behaviors, while in others there may be an exacerbation of clinical expression of psychiatric symptoms. Potential treatments need to consider the possibility of adverse events in patients who have suffered a TBI, and prospective trials should be encouraged.
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Objective The aim of this systematic review was to assess the efficacy and safety of pharmacological agents in the management of agitated behaviours following traumatic brain injury (TBI). Methods We performed a search strategy in PubMed, OvidMEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library, Google Scholar, Directory of Open Access Journals, LILACS, Web of Science and Prospero (up to 10 December 2018) for published and unpublished evidence on the risks and benefits of 9 prespecified medications classes used to control agitated behaviours following TBI. We included all randomised controlled trials, quasi-experimental and observational studies examining the effects of medications administered to control agitated behaviours in TBI patients. Included studies were classified into three mutually exclusive categories: (1) agitated behaviour was the presenting symptom; (2) agitated behaviour was not the presenting symptom, but was measured as an outcome variable; and (3) safety of pharmacological interventions administered to control agitated behaviours was measured. Results Among the 181 articles assessed for eligibility, 21 studies were included. Of the studies suggesting possible benefits, propranolol reduced maximum intensities of agitation per week and physical restraint use, methylphenidate improved anger measures following 6 weeks of treatment, valproic acid reduced weekly agitated behaviour scale ratings and olanzapine reduced irritability, aggressiveness and insomnia between weeks 1 and 3 of treatment. Amantadine showed variable effects and may increase the risk of agitation in the critically ill. In three studies evaluating safety outcomes, antipsychotics were associated with an increased duration of post-traumatic amnesia (PTA) in unadjusted analyses. Small sample sizes, heterogeneity and an unclear risk of bias were limits. Conclusions Propranolol, methylphenidate, valproic acid and olanzapine may offer some benefit; however, they need to be further studied. Antipsychotics may increase the length of PTA. More studies on tailored interventions and continuous evaluation of safety and efficacy throughout acute, rehabilitation and outpatient settings are needed. PROSPERO registration number CRD42016033140
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This paper described the construction of an inventory consisting of the following scales: Assault, Indirect Hostility, Irritability, Negativism, Resentment, Suspicion, Verbal Hostility, and Guilt. The first and second versions of the scale were item analyzed, and the final revision consists of 75 items. The hostility items were scaled for social desirability, and social desirability was correlated with probability of endorsement. The r's of .27 and .30 for college men and women, respectively, were considerably smaller than those of previous studies. Factor analyses of college men's and women's inventories revealed two factors: An attitudinal component of hostility (Resentment and Suspicion) and a "motor' component (Assault, Indirect Hostility, Irritability, and Verbal Hostility).