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Acceptability and Feasibility of the Anger and Irritability Management Skills Mobile App Among Veterans with Posttraumatic Stress Disorder: A Mixed-Methods Pilot Study

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Abstract

Problematic anger as a symptom of posttraumatic stress disorder (PTSD) is prevalent in military populations, including Veterans. Existing anger management programs may be underutilized due to barriers to accessing standard care. Mobile applications (apps) for anger management could increase access to care while using minimal resources. The current mixed-methods pilot study evaluated the satisfaction and helpfulness of the Anger and Irritability Management Skills (AIMS) app, a self-manageable mobile app developed by the VA’s National Center for PTSD for individuals struggling with anger. Veterans (N = 23) were recruited from the women’s (n = 6) and men’s (n = 15) residential Trauma Recovery Program at the VA Palo Alto Health Care System. Participants completed the Anger Expression Index (AEI) before and after using AIMS in a self-directed manner for 3 weeks. After 3 weeks, they also completed a satisfaction survey and participated in a qualitative focus group to share experiences and opinions about the app to inform future app updates. Paired samples t-tests were used to examine changes in AEI scores. Descriptive statistics were used to examine the perceived helpfulness of AIMS. Qualitative data were examined using Rapid Qualitative Analysis and themes were identified using matrix analysis. Perceived helpfulness of the AIMS app was rated, on average, between moderately to very helpful, and app satisfaction was rated between moderately to very satisfied. AEI scores significantly reduced from pre- to post-app use. Qualitative results revealed four themes: (1) symptom monitoring, (2) tailoring app use to fit users’ needs, (3) potential as a self-management resource, and (4) potential as a supplement to care. Participants generally perceived AIMS to be helpful for managing their anger and they were satisfied with the app, indicating preliminary acceptability and helpfulness of the app. Future studies with a larger sample size to explore novel ways to increase app dissemination efforts and explore using AIMS in other healthcare settings are warranted.

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Data Availability

Data is available upon request sent to Carmen.McLean4@va.gov.

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Acknowledgements

The authors would like to acknowledge Dr. Robert Jenkins, Men’s Trauma Recovery Program Coordinator, and Dr. Jean Cooney, Women’s Trauma Recovery Program Coordinator, at VA Menlo Park, for assisting us with participant scheduling and recruitment.

Funding

This material is the result of work supported with resources and the use of facilities at the VA Palo Alto Health Care System.

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Authors and Affiliations

  1. National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System, 795 Willow Road, Bldg. 334, Menlo Park, CA, 94025, USA

    Nadia Malek, Shilpa Hampole, Margaret-Anne Mackintosh & Carmen P. McLean

  2. Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, USA

    Carmen P. McLean

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  1. Nadia Malek
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  2. Shilpa Hampole
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  3. Margaret-Anne Mackintosh
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  4. Carmen P. McLean
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Contributions

Carmen McLean contributed to study conception and design. Material preparation and data collection were performed by Nadia Malek. All authors contributed to data analysis and interpretation. The draft of the manuscript was written by Nadia Malek and all authors contributed to manuscript revisions. All authors read and approved the final manuscript.

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Correspondence to Carmen P. McLean.

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Approval for this study was granted by the Stanford University Institutional Review Board.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no conflict of interests.

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The views expressed in this article are solely those of the authors and do not reflect an endorsement by, or the offical policy of the Department of Veteran Affairs (VA) or the U.S. Government. This material is the result of work supported with resources and the use of facilities at the VA Palo Alto Health Care System.

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Malek, N., Hampole, S., Mackintosh, MA. et al. Acceptability and Feasibility of the Anger and Irritability Management Skills Mobile App Among Veterans with Posttraumatic Stress Disorder: A Mixed-Methods Pilot Study. J. technol. behav. sci. (2024). https://doi.org/10.1007/s41347-024-00426-6

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