intervention to change attributions that are negative (ican)

Conditions: Trauma, Brain; Brain Injuries; Traumatic Brain Injury; Brain Injuries, Traumatic; Brain, Trauma

Summary: ican is the first treatment to target hostile attributions after tbi, making it a novel anger/ aggression management approach in this population. this is a randomized waitlist control trial. the length of time in the trial is approximately 15 weeks and the intervention is 6 weeks long.

ican is the first treatment to target hostile attributions after tbi, making it a novel anger/ aggression management approach in this population. since the investigator's prior research shows that stronger hostile attributions are associated with poorer perspective taking,39 ican employs a unique perspective-positioning technique to train perspective taking and reduce hostile attributions. after recalling a personal situation in which others' ambiguous actions led to an unpleasant outcome, participants will explore different perspectives: sitting or standing in one position, s/he will explore his or her own thoughts and feelings (self-perspective), then move to a different position to experience the other person's perspective, eliciting their thoughts and feelings. in 40 participants with tbi, we will conduct a phase i, randomized waitlist controlled trial with 4 data collection points: baseline; week 1; week 8 (post-treatment for ican; post-wait period for wlc); week 15 (wlc post-treatment).

Eligibility criteria:
inclusion criteria: * history of complicated mild to severe tbi (injury due to an external physical force), with injury severity being defined either by glasgow coma score at time of injury (≤12), or post-traumatic amnesia (≥1 day), or loss of consciousness (≥30 minutes), or positive head ct scan consistent with tbi. * at least 18 years of age or older; * ≥1 year post-injury; * have adequate vision, hearing, and speech/ language skills to participate in assessments and group therapy (determined based on interaction with the participant at screening) * have adequate reading comprehension (due to the primary assessment involving written scenarios) * have abnormal scores of negative attributions or perspective taking (determined at t0 screening) * have above average aggression (prescreened on telephone, and confirmed t0 screening). * no anticipated medication changes for emotions/ behavior during length of study participation; medications for emotions/ behavior must be stable within last 30 days prior to consent at t0 (screening) * have reliable mode of transportation exclusion criteria: * pre-morbid neurological disorders that could affect mood and cognition (e.g. stroke); does not include controlled seizures * progressive central nervous system disorders (e.g. dementia, parkinson's) * developmental disability (e.g., autism, developmental delay); * major psychiatric disorders (e.g. schizophrenia, borderline personality disorder); * severe depression and/or perceived risk to self or others (mental health resources will be provided and if suicide risk, approved suicide protocol will be utilized); * currently receiving active behavioral therapy for anger. * on drug research study for irritability, anger, aggression

Keywords: anger aggression hostility