Exposure-Based Treatment for Angry and Aggressive Adults

描述（由申请人提供）：愤怒的情绪体验及其行为相关性，包括攻击性行为，具有显着的社会，个人和医疗成本。所有有效的愤怒和攻击心理治疗的核心都涉及暴露于挑衅性刺激，这表明暴露是治疗的必要条件。然而，几乎没有研究来检查暴露本身是否是减少愤怒和攻击性的充分条件。如果暴露本身可以减少愤怒和攻击性，这将有助于开发更简约但有效的心理社会治疗方法。拟议的项目涉及一项对照，比较试验的个人管理的10个会话的基于焦虑的治疗，以减少愤怒和攻击行为。大约180名（治疗完成者）通常愤怒和攻击性个体（即，那些在特质愤怒的测量上得分在上四分位数并且报告在过去一年中至少有一次冲动攻击事件的人）将被随机分配到暴露疗法（ET;想象和体内暴露于愤怒激发刺激的组合）、认知放松应对技能（CRCS;针对功能失调的愤怒的经验支持的心理治疗）或无治疗等待名单。据预测，相对于不治疗，ET将导致愤怒和攻击性的临床上有意义的减少（即，将测试ET的绝对功效以确定该治疗是否具有优点）并且将与CRCS相当（即，将测试ET对CRCS的相对功效，以确定ET是否代表已建立的心理社会治疗的可行替代方案）。将在治疗前、治疗后和6个月随访时进行多项结局指标，包括自我报告和关键知情人报告。

DESCRIPTION (provided by applicant): The emotional experience of anger and its behavioral correlates, including aggressive behavior, have significant social, personal, and medical costs. The core of all efficacious psychosocial treatments for anger and aggression involves exposure to provocative stimuli, suggesting that exposure is a necessary condition of treatment. However, almost no research has been conducted to examine whether exposure itself is a sufficient condition for reducing anger and aggression. If exposure alone can be shown to reduce anger and aggression, this would facilitate development of more parsimonious yet effective psychosocial treatments. The proposed project involves a controlled, comparative trial of an individually-administered 10-session exposure-based treatment for the reduction of anger and aggressive behavior. Approximately 180 (treatment completers) generally angry and aggressive individuals (i.e., those who score in the upper quartile on a measure of trait anger and report at least one episode of impulsive aggression in the past year) will be randomly assigned to Exposure Therapy (ET; a combination of imaginal and in vivo exposure to anger arousing stimuli), Cognitive Relaxation Coping Skills (CRCS; an empirically supported psychological treatment for dysfunctional anger), or a no treatment wait list. It is predicted that ET will result in clinically meaningful reductions in anger and aggression relative to no treatment (i.e., the absolute efficacy of ET will be tested to determine whether this treatment has merit) and will be comparable to CRCS (i.e., the relative efficacy of ET to CRCS will be tested to determine if ET represents a viable alterative to an established psychosocial treatment). Multiple outcome measures, including both self-report and key informant report, will be administered at pre-treatment, post-treatment, and 6-month follow-up intervals.