Reducing Aggression in Children and Adolescent on an Inpatient Unit

Phase 1 Study of Anger Control Therapy Augmented With RAGE-Control (Regulate and Gain Emotional-Control)Delivered on an Inpatient Psychiatric Unit

The purpose of this study is to determine whether Anger Control Therapy (ACT) with Regulate and Gain Emotional-Control (RAGE-Control) is a feasible behavioral therapy to provide on a pediatric inpatient psychiatric unit.

Aggression and disruptive behavior are the most common reasons for child and adolescent inpatient psychiatric hospitalization. Aggressive children and adolescents who merit admission to inpatient psychiatric hospitals for treatment typically display dramatic problems with self-regulation that interfere with global adaptive functioning. The goal of this study is to teach self-regulation techniques by combining Cognitive Behavioral Therapy with a biofeedback video game in effort to motivate patients to learn and practice these coping skills, which will translate to decreased feelings of anger and aggression while hospitalized.

Inclusion Criteria:

• consecutive admissions to the psychiatric inpatient unit between the ages of 9 and 17 years of age
• who were not expected to begin or undergo a change >25% to their antipsychotic or mood stabilizing medications
• elevated levels of anger as demonstrated by baseline score on the State Trait Anger Expression Inventory - Child and Adolescent (STAXI-CA) combined State-anger and Trait-anger score greater than 30.

Exclusion Criteria:

• Inability to consent, comprehend, and effectively participate in the study.
• Gross cognitive impairment due to mental retardation, dementia, or intoxication.
• Started on an antipsychotic or mood stabilizing drug within 5 days of beginning the study