Appendix 4 Evidence Profile THERAPY TARGETING ANGER CBT- based Individual Study Author’s & Year Shea, Lambert & Reddy, 2013 Design RCT with three month follow-up Intervention (I) and Comparison (C) I: Cognitive behavioural intervention C: Supportive intervention Population Mean age (SD)1 Gender % US veterans (OEF/OIF) Mean age: 36.3 (10.2) Gender: Male Delivered to Individual Dosage (total number of sessions) Twelve weekly 75 minute sessions Primary Outcome domain (Measure(s)) - Anger (OAS-M; STAXI-2) Secondary Outcome domain (Measure(s)) - PTSD (CAPS) - DSM-IV Axis I disorders (SCID-I/P W/PSY) - Anger (DAR7) - Outcomes (OQ) Total sample size N= 25 Participants: I n= 12 12 Participants: C n= 11 Study Participants who received the intervention showed significantly more improvement than controls on the STAXI-2 Anger Expression Index (p=.019), and improvement approached significance on the OAS-M aggression scale (p <.06). There was significantly more improvement for the intervention group on the DAR compared to controls (p=.027). At follow-up, changes for the intervention group were maintained, and on some scales scores had decreased further (STAXI-2 AX and Expression Out,
OAS-M). Overall, participants in both groups rated themselves as being satisfied with treatment that they received. Group Study 1 Study 2 3 Author’s & Year Marshall et al., 2010 Morland et al., 2010 Strom et al., 2013 Design Single group RCT with six month follow-up Single group pre-post with one month- follow-up Intervention (I) and Comparison (C) I: Anger management treatment I1: anger management I2: In-person anger management I: CBT for driving-related anger and aggression Population Mean age (SD)1 Gender % US Veterans (76% Vietnam) Mean age: 55 (8.22) Gender: Male US veterans (76% Vietnam war) In person: Mean age: 54.7 (9.7) Videoconference: Mean age = 54.8 (SD=9.3) Gender: Male US veterans (56% Vietnam war) Mean age: 48.2 (15.3) Gender: Male Delivered to Group
Dosage (total number of sessions) Twelve weekly 90 minute sessions Twelve sessions twice weekly Eight sessions Primary Outcome domain (Measure(s)) - (STAXI-2) - Anger (STAXI-2; NAS-T) - (Driving Anger Scale; Driving Anger Expression Scale; Trait Anger Scale) - Survey of Driving Secondary Outcome domain (Measure(s)) - Conflict tactics (CTS) - Personality (MMPI-II) - PTSD (CAPS, PCL-M) - Comorbidities (SCID) - PTSD (PCL-M) - Depression (CES-D ) Total sample size N= 86 N= 125 N= 9 Participants: I N= 86 n= 61 N= 9 Participants: C N/A n= 64 N/A
Study 1 2 3 Author’s & Year Hermenau et al., 2013 Khoo et al., 2011 Owens, Chard & Cox, 2008 Design RCT with six month Single group pre-post with nine month follow-up Single group pre-post Intervention (I) and Comparison (C) I. Narrative exposure therapy C: Controls I: CBT I: PTSD Residential Rehabilitation Program using CPT at VA medical centre Population Mean age (SD)1 Gender % Congolese (local conflicts) Mean age: 19 (2.02) Gender: Male Australian veterans (68% Vietnam) Mean age: 53 (not reported ) Gender: Male (99.7%) US veterans (68% Vietnam war) Mean age: 52.8 (8.14) Gender: Male (80%) Delivered to and individual Group and individual Group and individual Dosage (total number of sessions) Six sessions over two weeks Six weeks intensive, followed by six weeks of fortnightly sessions Seven weeks intensive Primary Outcome domain (Measure(s)) - PTSD - Aggression (AAS) - PTSD (CAPS, PCL) - PTSD (PCL-M) Secondary Outcome domain (Measure(s)) Integration with civilian life and current contact with combatants (6 questions) - Alcohol use (AUDIT) - Anger (DAR7) - Anxiety and depression (HADS) - Quality of life (WHOQOL-brief) - Depression (BDI-II) - Anger (STAXI-2) Total sample size N= 38 N= 496 N= 99 Participants: I n= 19 N= 496 N= 99