Impact of Cognitive Control Training on Anger Symptoms and Reactive Aggression

Study Overview
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Brief Summary
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High trait anger is a personality construct characterized by elevations in the frequency, duration, and intensity of anger episodes. According to many social cognitive theories, hostile interpretations of everyday situations contribute to the development and maintenance of anger symptoms. This study will examine the effectiveness of a computer-based cognitive control training task.

Detailed Description
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Difficulties with anger control are reported in a number of psychological conditions and are associated with social problems, such as dating violence and workplace violence. High trait anger is a personality construct characterized by elevations in the frequency, duration, and intensity of anger episodes. However, the cognitive processes contributing to high trait anger are still poorly understood. According to the Integrative Cognitive Model of Anger and Reactive Aggression (ICM), three cognitive processes jointly contribute to the experience of high trait anger and reactive aggression: 1) hostile interpretation biases; 2) cognitive control; and 3) anger rumination. The proposed study will evaluate the validity of this model in relation to cognitive control using a computer-based cognitive control training (CCT) program.

Official Title
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Impact of Cognitive Control Training on Anger Symptoms and Reactive Aggression (Anger Study)

Conditions
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Anger

Intervention / Treatment
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* Behavioral: Cognitive Control Training
* Behavioral: Sham Cognitive Control Training Program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1. Score of 22 or higher on the Trait Anger Scale. Exclusion Criteria: Reports currently receiving psychological treatment or counseling for anger management difficulties. Reports changes in psychiatric medication within the last month. Endorsement of current psychosis or bipolar disorder symptoms. Indicates poor English language proficiency. Reports clinically significant suicidal ideation, intent, or plan.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Cognitive Control Training<br>Participants in this arm will complete a computer-based training program two times in the lab. Participants will complete the first training session in the lab during their initial visit and they will return to the lab one week later to complete the second session. | Behavioral: Cognitive Control Training<br>* A computer-based flanker task that aims to reinforce the recruitment of cognitive control in the presence of hostile/aggressive stimuli.<br>|
| Sham Comparator: Sham Cognitive Control Training Program<br>Participants in this arm will complete a sham training program two times in the lab. The program will look similar in length and design to the experimental training program, but the content of the program will remain affectively neutral. As in the experimental condition, participants will complete the first training session in the lab during their initial visit and they will return to the lab one week later to complete the second session. | Behavioral: Sham Cognitive Control Training Program<br>* A placebo version of the computer-based cognitive control training. Designed to appear similar to the experimental task, but will not reinforce the recruitment of cognitive control in the presence of hostile/aggressive stimuli.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| State-Trait Anger Expression Inventory 2nd Edition | A self-report measure of the experience of anger. | Administered two times over the course of one week. Changes will be examined from visit 1 (before CCT training program) to visit 2 (after CCT training program) | 
| Computer-based cognitive control assessment | A behavioural measure of hostility-primed cognitive control involving aggressive and neutral words. | Administered two times over the course of one week. Changes will be examined from visit 1 (before CCT training program) to visit 2 (after CCT training program) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Anger Rumination Scale | A self-report measure of the degree to individuals focus on experiences with anger. The scale is comprised of four subscales, angry after thoughts (e.g., Whenever I experience anger, I keep thinking about it for a while), angry memories (e.g., I re-enact the anger episode in my mind after it has happened), understanding causes (e.g., When someone provokes me, I keep wondering why this should have happened to me), and thoughts of revenge (e.g. I have difficulty forgiving people who have hurt me.). Participants will be asked to read each item and rate it in terms of how well it reflects their experience on a 4-point scale from 1 (almost never) to 4 (almost always). Totals for each sub scale will be summed to produce a total score (range: 19-76), with higher scores indicating a greater propensity for rumination. | Administered two times over the course of one week. Changes will be examined from visit 1 (before CCT training program) to visit 2 (after CCT training program) | 
| Depression and Anxiety Stress Scale-21 (DASS-21) | A self-report measure of depression, anxiety, and stress symptoms.Items are summed for each subscale to create subscale totals (i.e., depression, anxiety, and stress), with higher scores reflecting more severe emotional distress. Symptom score ranges include: normal (0-4), mild (5-6), moderate (7-10), severe (11-13), and extremely severe (14+). | Administered two times over the course of one week. Changes will be examined from visit 1 (before CCT training program) to visit 2 (after CCT training program) | 
| Dot probe task | A behavioural measure of attentional bias towards angry faces. | Administered two times over the course of one week. Changes will be examined from visit 1 (before CCT training program) to visit 2 (after CCT training program) | 
| Adult Temperament Questionnaire (Effortful Control section) | A self-report measure of one's ability to suppress inappropriate approach behavior, to perform an action when there is a strong tendency to avoid it, and to shift or focus behaviour. | Administered two times over the course of one week. Changes will be examined from visit 1 (before CCT training program) to visit 2 (after CCT training program) | 
| Reactive-Proactive Aggression Questionnaire | A self-report measure of an individual's propensity for reactive aggression. | Administered two times over the course of one week. Changes will be examined from visit 1 (before CCT training program) to visit 2 (after CCT training program) | 
| Taylor Aggression Paradigm | A behavioural measure of reactive aggression. | Administered one time over the course of one week. Participants will be exposed to the paradigm following the second training session.] | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Reactive Aggression, Anger, Cognitive Control Training, Anger Rumination