Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Anger Self-Management Training for People With Traumatic Brain Injury: A Preliminary Investigation

Hart, Tessa PhD; Vaccaro, Monica J. MS; Hays, Christina BA; Maiuro, Roland D. PhD

Section Editor(s): Caplan, Bruce PhD, ABPP; Bogner, Jennifer PhD, ABPP

Journal of Head Trauma Rehabilitation: March/April 2012 - Volume 27 - Issue 2 - p 113–122
doi: 10.1097/HTR.0b013e31820e686c
Focus on Clinical Research and Practice, Part 1

Objective: To examine the feasibility and gather preliminary data on the efficacy of a fully manualized, 8-session, psychoeducational treatment for irritability and anger after traumatic brain injury (TBI), called anger self-management training (ASMT).

Participants: A total of 10 persons with moderate to severe, chronic TBI with significant cognitive impairment and elevated levels of anger and irritability participated in the study; 8 had significant others (SOs) who participated in portions of the treatment and provided pre- and posttreatment measures; 1 SO provided only data.

Main Outcome Measure: Two subscales of the State-Trait Anger Expression Scale–Revised and Brief Anger-Aggression Questionnaire.

Design: Pre- to posttreatment pilot study.

Results: There was significant improvement on all 3 measures of self-reported anger, with large effect sizes (>1.0), and on 1 of 3 SO-reported scales. Qualitative feedback from participants was positive and dropout rate was low (1 of 11).

Conclusions: The treatment model represented by the ASMT appears worthy of further study in persons with TBI who have both problematic anger and cognitive impairment.

Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania.

Corresponding Author: Tessa Hart, PhD, Moss Rehabilitation Research Institute, Medical Arts Building, 50 Township Line Rd, Elkins Park, PA 19027 (

This research was supported by a seed grant from the Moss Rehabilitation Research Institute and by the TBI Clinical Trials Network, National Institutes of Health grant UO1 HD042738. Jo Ann Brockway, PhD, contributed to the development of the treatment manual described in this project. Christianne Hopwood, PsyD, served as a research therapist and Megan Bartlett, MA, assisted with manuscript preparation. We thank the clinicians at the Drucker Brain Injury Center, Moss Rehabilitation Hospital for referring participants. We also owe a debt of gratitude to the people with TBI and their friends and family members who participated in this study.

The authors declare no conflicts of interest.

© 2012 Lippincott Williams & Wilkins, Inc.