Cognitive-Behavioral Therapy in the Treatment of Anger: A Meta-Analysis

Abstract

Anger has come to be recognized as a significantsocial problem worthy of clinical attention andsystematic research. In the last two decades,cognitive-behavioral therapy (CBT) has emerged as themost common approach to anger management. Theoverall efficacy of this treatment has not beenascertained, and therefore, it was decided to conduct ameta-analysis of this literature. Based on 50 studiesincorporating 1,640 subjects, it was found that CBT produceda grand mean weighted effect size of .70, indicatingthat the average CBT recipient was better off than 76%of untreated subjects in terms of anger reduction. This effect was statistically significant,robust, and relatively homogeneous across studies. Thesefindings represent a quantitative integration of 20years of research into a coherent picture of theefficacy of CBT for anger management. The results alsoserve as an impetus for continued research on thetreatment of anger.

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REFERENCES

  1. Abikoff, H., & Klein, R. G. (1992). Attention-deficit hype ractivity and conduct disorder: Comorbidity and implications for treatment. Journal of Consulting and Clinical Psychology, 60, 881–892.

    Google Scholar 

  2. Actor, R. G., & During, S. M., (1992). Preliminary results of aggression management training for aggressive parents. Journal of Interpersonal Violence. 7, 410–417.

    Google Scholar 

  3. Barth, R. P., Blythe, B. J., Schinke, S. P., & Schilling R. F. (1983). Self-control training with maltreating parents. Child Welfare. 62, 313–324.

    Google Scholar 

  4. Benson, B. A., Rice, C. J., & Miranti, S. V. (1986). Effects of anger management training with mentally retarded adults in group treatment. Journal of Counseling and Clinical Psychology, 54,728–729.

    Google Scholar 

  5. Boswell, J. W. (1984). Effects of a multimodal counseling program and of a cognitive-behavioral counseling program on the anger management skills of pre-adolescent boys within an elementary school setting (Doctoral dissertation, Pennsylvania State University, 1984). Dissertation Abstracts International, 45,372.

    Google Scholar 

  6. Cain, J. A. (1987). Anger control: A comparison of cognitive-behavioral and relaxation training, with post-treatment follow-up (Doctoral dissertation, United States International University, 1987). Dissertation Abstracts International , 48,1804–1805.

    Google Scholar 

  7. Dangle, R. F., Deschner, J. P., & Rasp, R. R. (1989). Anger control training for adolescents in residential treatment. Behavior Modification, 13,447–458.

    Google Scholar 

  8. Deffenbacher, J. L. (1995). Ideal treatment package for adults with anger disorders. In H. Kassinove (Ed.), Anger disorders: Definition, diagnosis, and treatment(pp 151–172). Washington DC: Taylor & Francis.

    Google Scholar 

  9. Deffenbacher, J. L., Story, D. A., Stark, R. S., Hogg, J. A., & Brandon, A. D. (1987). Cognitive-relaxation and social skills interventions in the treatment of anger. Journal of Counseling Psychology, 34,171–176.

    Google Scholar 

  10. Deffenbacher, J. L., Story, D. A., Brandon, A. D., Hogg, J. A., & Hazaleus, S. L. (1988). Cognitive and cognitive-relaxation treatments of anger. Cognitive Therapy and Research, 12,167–184.

    Google Scholar 

  11. Deffenbacher, J. L., Lynch R. S., Oetting, E. R., and Kemper, C. C. (1996). Anger reduction in early adolescents. Journal of Counseling Psychology, 43, 149–157.

    Google Scholar 

  12. Deffenbacher, J. L., McNamara, K., Stark, R. S., & Sabadell, P. M. (1990a). A comparison of cognitive-behavioral and process-oriented group counseling for general anger reduction. Journal of Counseling and Development, 69, 167–172.

    Google Scholar 

  13. Deffenbacher, J. L., McNamara, K., Stark, R. S., & Sabadell, P. M. (1990b). A combination of cognitive, relaxation, and behavioral coping skills in the reduction of general anger. Journal of College Student Development, 31,351–358.

    Google Scholar 

  14. Deffenbacher, J. L., & Stark, R. S. (1992). Relaxation and cognitive-relaxation treatments of general anger. Journal of Counseling Psychology, 39,158–167.

    Google Scholar 

  15. Deffenbacher, J. L., Thwaites, G. A., Wallace, T. L., & Oetting, E. R. (1994). Social skills and cognitive-relaxation approaches to general anger. Journal of Counseling Psychology, 41, 386–396.

    Google Scholar 

  16. Deschner , J. P., & McNeil, J. S. (1986). Results of anger control training for battering couples. Journal of Family Violence, 1,111–120.

    Google Scholar 

  17. Dobson, K. S. (1989). A meta-analysis of the efficacy of cognitive therapy for depression. Journal of Consulting and Clinical Psvchology, 57,414–419.

    Google Scholar 

  18. Dodge, K. A. (1993). Social cognitive mechanisms in the development of conduct disorder and depression. Annual Review of Psvchology, 44, 559–584.

    Google Scholar 

  19. Eckhardt, C. l., & Deffenbacher, J. L. (1995). Diagnosis of anger disorders. In H. Kassinove (Ed.), Anger disorders: Definition, diagnosis, and treatment(pp 27–48). Washington DC: Taylor & Francis.

    Google Scholar 

  20. Faulkner, K., Stoltenberg, C. D., Cogen, R., Nolder, M., & Shooter, E. (1992). Cognitive-behavioral group treatment for male spouse abusers. Journal of Family Violence, 7,37–55.

    Google Scholar 

  21. Feindler, E. L., Ecton, R. B., Kingsley, D., & Dubey, D.R. (1986). Group anger control training for institutionalized psychiatric male adolescents. Behavior Therapy, 17,109–123.

    Google Scholar 

  22. Feindler, E. L., Marriott, S. A., & Iwata, M. (1984). Group anger-control training for junior high school delinquents. Cognitive Therapy and Research, 8,299–311.

    Google Scholar 

  23. Fernandez, E., & Boyle, G.J. (1996). Meta-analytic procedure and interpretation of treatment outcome and test validity for the practitioner psychologist. In M. Smith & V. Sutherland (Eds.), International review of professional issues in selection and assessment(Vol. 2, pp. 109–125). Chichester, UK: Wiley.

    Google Scholar 

  24. Fernandez, E., & Turk, D. C. (1989). The utility of cognitive coping strategies for altering pain perception: A meta-analysis. Pain, 38, 123–135.

    Google Scholar 

  25. Fernandez, E., & Turk, D. C. (1993). Anger in chronic pain patients: A neglected target of attention. American Pain Society Bulletin, 3,5–7.

    Google Scholar 

  26. Fernandez, E., & Turk, D. C. (1995). The scope and significance of anger in the experience of chronic pain. Pain, 61,165–175.

    Google Scholar 

  27. Gaertner, G. P. (1984). A component analysis of stress inoculation training for the development of anger management skills in adult male offenders (Doctoral dissertation, Pennsylvania State University, 1983). Dissertation Abstracts International, 44,2359.

    Google Scholar 

  28. Glass, G. V., McGaw, B., & Smith, M. L. (1981). Meta-analvsis in social research.Beverly Hills, CA: Sage.

    Google Scholar 

  29. Glick, B., & Goldstein, A. P. (1987). Aggression replacement training. Journal of Counseling and Development, 65,356–362.

    Google Scholar 

  30. Hinshaw, S. P., Henker, B., & Whalen, C. K. (1984). Self-control in hyperactive boys in anger-inducing situations: Effects of cognitive-behavioral training and of methylphenidate. Journal of Abnormal Child Psychology, 12,55–77.

    Google Scholar 

  31. Jackson, N. C. (1992). Anger control training for adolescents in acute inpatient psychiatric treatment (Doctoral dissertation, Mississippi State University, 1991). Dissertation Abstracts International, 53,407.

    Google Scholar 

  32. Kassinove, H., & Sukhodolsky, D. G. (1995). Anger disorders: Basic science and practice issues. In H. Kassinove (Ed.), Anger disorders: Definition, diagnosis, and treatment(pp. 1–26). Washington DC: Taylor & Francis.

    Google Scholar 

  33. Kennedy, S. M. (1992). Anger management training with adult prisoners (Doctoral dissertation, University of Ottawa, 1990). Dissertation Abstracts International, 52,6087.

    Google Scholar 

  34. Koop, C. E., & Lundberg, G. D., (1992). Violence in America: A public health emergency. Journal of the American Medical Association, 267,3075–3076.

    Google Scholar 

  35. Larson, J. D. (1991). The effects of a cognitive-behavioral anger-control intervention on the behavior of at risk middle school students (Doctoral dissertation, Marquette University, 1990). Dissertation Abstracts International, 52,117.

    Google Scholar 

  36. Lochman, J. E. (1985). Effects of different treatment lengths in cognitive-behavioral interventions with aggressive boys. Child Psychiatry and Human Development, 16,45–56.

    Google Scholar 

  37. Lochman, J. E., Lampron, L. B., Gemmer, T. C., Harris, S. T., & Wyckoff, G. M. (1989). Teacher consultation and cognitive-behavioral interventions with aggressive boys. Psychology in the Schools, 26,179–188.

    Google Scholar 

  38. Lochman, J. E., Burch, P. R., Curry, J. F., & Lampron, L. B. (1984). Treatment and generalization effects of cognitive-behavioral and goal-setting interventions with aggressive boys. Journal of Consulting and Clinical Psychology, 52,915–916.

    Google Scholar 

  39. Lochman, J. E., & Curry, J. F. (1986). Effects of social problem-solving training and self-instruction training with aggressive boys. Journal of Clinical Child Psychology, 15,159–164.

    Google Scholar 

  40. Lochman, J. E., & Lenhart, L. A. (1993). Anger coping intervention for aggressive children: conceptual models and outcome effects. Clinical Psychology Review, 13, 785–805.

    Google Scholar 

  41. Lochman, J. E., Nelson, W. M., & Sims, J. P. (1981). A cognitive-behavioral program for use with aggressive children. Journal of Clinical Child Psychology, 10,146–148.

    Google Scholar 

  42. Macpherson, S. L. (1986). An investigation of the components of anger management as applied to an incarcerated population (Doctoral dissertation, Pennsylvania State University, 1986). Dissertation Abstracts International, 47,1731.

    Google Scholar 

  43. Mahoney, M. (1993). Theoretical developments in the cognitive psychotherapies. Journal of Consulting and Clinical Psychology, 61,187–193.

    Google Scholar 

  44. Mandel, S. M. (1991). Cognitive behavioral anger control training with aggressive adolescent male s in a special education high school (Doctoral dissertation, Temple University, 1991). Dissertation Abstracts International, 52,2471.

    Google Scholar 

  45. McDougall, C., Boddis, S., Dawson, K., & Hayes, R. (1990). Developments in anger control training. Issues in Criminological and Legal Psychology, 15,39–44.

    Google Scholar 

  46. Meichenbaum, D. H. (1975). Stress inoculation training.New York: Pergamon Press.

    Google Scholar 

  47. Meichenbaum, D. H. (1976). A cognitive-behavior modification approach. In M. Hersen & A. Bellack (Eds.), Behavioral assessment: A practical handbook.New York: Pergamon Press.

    Google Scholar 

  48. Moon, J. R., & Eisler, R. M. (1983). Anger control: An experimental comparison of three behavioral treatments. Behavior Therapy, 14,493–505.

    Google Scholar 

  49. Moore, K. J., & Shannon, K. K., (1993). The development of superstitious beliefs in the effectiveness of treatment of anger: Evidence for the importance of experimental program evaluation in applied settings. Behavioral Residential Treatment, 8,147–161.

    Google Scholar 

  50. Napolitano, S. (1992). Evaluation of prison anger control training (PACT): A group treatment program for incarcerated murderers and violent offenders (Doctoral dissertation, California School of Professional Psychology, 1991). Dissertation Abstracts International, 53,1071.

    Google Scholar 

  51. Novaco, R. W. (1975). Anger control: The development and evaluation of an experimental treatment.Lexington, MA: D.C. Health.

    Google Scholar 

  52. Novello, A., Shosky, S., & Froehlke, R. (1992). From the Surgeon General, U.S. Public Health Service: A medical response to violence. Journal of the American Medical Association, 267,3007.

    Google Scholar 

  53. Olson, M. L. (1987). The effect of a cognitive-behavioral anger management program on hostility among clinically anger clients (Doctoral dissertation, Western Conservative Baptist Seminary, 1986). Dissertation Abstracts International, 48,885.

    Google Scholar 

  54. Omizo, M. M., Hershberger, J. M., & Omizo, S. A. (1988). Teaching children to cope with anger. Elementary School Guidance and Counseling, 22,241–245.

    Google Scholar 

  55. Pascucci , N. J. (1991). The efficacy of anger control training in reducing chronic aggressive behavior among emotionally disturbed/learning disabled African-American male pre-adolescents and adolescents (Doctoral dissertation, St. John's University, 1991). Dissertation Abstracts International, 51,3678.

    Google Scholar 

  56. Rhoades, G. F. (1988). The effects of stress inoculation and relative dogmatism upon anger management with forensic inpatients (Doctoral dissertation, Western Conservative Baptist Seminary, 1982). Dissertation Abstracts International, 48,3694.

    Google Scholar 

  57. Rokach, A. (1987). Anger and aggression control training: Replacing attack with interaction. Psychotherapy, 24,353–362.

    Google Scholar 

  58. Rosengren, D. B. (1987). The program of anger control (PACT): An intervention for angry adolescents (Doctoral dissertation, University of Montana, 1986). Dissertation Abstracts International, 48,1819.

    Google Scholar 

  59. Rosenthal, R. (1991). Meta-analytic procedures for social research,Newbury Park, CA: Sage.

    Google Scholar 

  60. Rosenthal, R. (1995). Writing meta-analytic reviews. Psychological Bulletin, 118,183–192.

    Google Scholar 

  61. Saylor, C. F., Benson, B., & Einhaus, L. (1985). Evaluation of an anger management program for aggressive boys in inpatient treatment. Journal of Child and Adolescent Psychotherapy, 2,5–15.

    Google Scholar 

  62. Schlichter, J. K., & Horan, J. J. (1981). Effects of stress inoculation on the anger and aggression management skills of institutionalized juvenile delinquents. Cognitive Therapy and Research, 5,359–365.

    Google Scholar 

  63. Shivrattan, J. L. (1988). Social interactional training and incarcerated juvenile delinquents. Canadian Journal of Criminology, 30,145–163.

    Google Scholar 

  64. Smith, L., & Beckner, B. M. (1993). An anger management workshop for inmates in a medium security facility. Journal of Offender Rehabilitation, 19,103–111.

    Google Scholar 

  65. Steele, H. V. (1991). Social skills and anger control training with juvenile, mentally retarded felony offenders (Doctoral dissertation, University of South Florida, 1990). Dissertation Abstracts International, 51,5593.

    Google Scholar 

  66. Stermac, L. E. (1986). Anger control treatment for forensic patients. Journal of Interpersonal Violence, 1,446–457.

    Google Scholar 

  67. Tafrate, R. C. (1995). Evaluation of treatment strategies for adult anger disorders. In H. Kassinove (Ed.), Anger disorders: Definition, diagnosis, and treatment(pp 109–130). Washington, DC: Taylor & Francis.

    Google Scholar 

  68. Van Balkom, A. J. L. M., van Oppen, P., Vermeulen, A. W. A., van Dyck, R., Nauta, M. C. E., & Vorst, H. C. M. (1994). A meta-analysis on the treatment of obsessive compulsive disorder: A comparison of antidepressants, behavior, and cognitive therapy. Clinical Psychology Review, 14,359–381.

    Google Scholar 

  69. Whiteman, M., Fanshel, D., & Grundy, J. F. (1987). Cognitive-behavioral interventions aimed at anger of parents at risk of child abuse. Social Work, 32, 469–474.

    Google Scholar 

  70. Wilcox, D., & Dowrick, P. W. (1992). Anger management with adolescents. Residential Treatment for Children and Youth, 9,29–39.

    Google Scholar 

  71. Wu, S. F. (1990). The efficacy of cognitive-behavioral interventions in facilitating griefwork, decreasing attachment, and anger management: A comparative study of post-divorce adjustment groups (Doctoral dissertation, University of South Florida, 1989). Dissertation Abstracts International, 51,2080.

    Google Scholar 

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Beck, R., Fernandez, E. Cognitive-Behavioral Therapy in the Treatment of Anger: A Meta-Analysis. Cognitive Therapy and Research 22, 63–74 (1998). https://doi.org/10.1023/A:1018763902991

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  • ANGER
  • COGNITIVE-BEHAVIORAL THERAPY
  • META-ANALYSIS