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The overall aim of the project is to develop three internet-delivered cognitive behavior therapies for inappropriate anger expression to test the isolated and combined effects of two types of regulation strategies, emotional awareness and cognitive reappraisal. Treatments will be evaluated in a stratified single blind parallel randomized block design, along with a pooled interrupted time series design. Self-recruited adults with elevated levels of anger will be stratified based on baseline level of anger. The particular aims are to examine:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Emotional awareness | Experimental | 4 modules of emotional awareness training |
|
| Cognitive reappraisal | Experimental | 4 modules cognitive reappraisal training |
|
| Awareness + reappraisal | Experimental | 4 modules emotional awareness and cognitive reappraisal training |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Internet-delivered emotional awareness training | Behavioral | Emotional awareness training is delivered via an internet platform during 4 weeks and includes therapist contact several times per week via the platform. |
| Measure | Description | Time Frame |
|---|---|---|
| State-Trait Anger Expression Inventory-2 (Subscales: Anger-out, Anger-in) | Levels of State-trait anger Expression. The subscales Anger Expression-Out (range: 8-32), Anger Expression-In (range: 8-32), and State Anger (range: 15-60) will be used, with higher scores indicating more anger. | Change from baseline, once every week during treatment (0-4 weeks after baseline), and 3 months after treatment has ended. |
| Measure | Description | Time Frame |
|---|---|---|
| Emotion Regulation Questionnaire (Subscale: Reappraisal) | Levels of reappraisal from the subscale Reappraisal (range: 6-35, with higher scores indicating more reappraisal). | Change from baseline, once every week during treatment (0-4 weeks after baseline), and 3 months after treatment has ended. |
| Five Facets Mindfulness Questionnaire (Subscales: Nonreactivity, Non-judging) |
| Measure | Description | Time Frame |
|---|---|---|
| Treatment Credibility Scale | Treatment credibility and expectancy (range: 0-50) with higher scores indicating greater credibility/expectancy. | 1 week after treatment starts |
| Client satisfaction Questionnaire |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Johan Bjureberg, PhD | Karolinska Institutet | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre for Psychiatry Research Karolinska Institutet and Stockholm County Council | Stockholm | 113 64 | Sweden |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36409100 | Derived | Bjureberg J, Ojala O, Berg A, Edvardsson E, Kolbeinsson O, Molander O, Morin E, Nordgren L, Palme K, Sarnholm J, Wedin L, Ruck C, Gross JJ, Hesser H. Targeting maladaptive anger with brief therapist-supported internet-delivered emotion regulation treatments: A randomized controlled trial. J Consult Clin Psychol. 2023 May;91(5):254-266. doi: 10.1037/ccp0000769. Epub 2022 Nov 21. |
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| Internet-delivered Cognitive reappraisal training | Behavioral | Cognitive reappraisal training is delivered via an internet platform during 4 weeks and includes therapist contact several times per week via the platform. |
|
| Internet-delivered awareness and reappraisal training | Behavioral | Emotional awareness and cognitive reappraisal training is delivered via an internet platform during 4 weeks and includes therapist contact several times per week via the platform. |
|
Levels of nonreactivity to inner experiences (range: 6-30; with higher scores indicating more nonreactivity) nonjudging of experience (range: 5-25; with higher scores indicating more nonjudging). |
| Change from baseline, once every week during treatment (0-4 weeks after baseline), and 3 months after treatment has ended. |
| State-Trait Anger Expression Inventory-2 (Subscale: Anger control-in) | Levels of anger control-in (range: 8-32; higher scores indicating more anger control-in). | Change from baseline, once every week during treatment (0-4 weeks after baseline), and 3 months after treatment has ended. |
| State-Trait Anger Expression Inventory-2 (Subscales: Trait anger, Anger control-out, State anger) | Levels of State-Trait Anger Expression. The subscales Trait Anger (range: 10-40; higher scores indicating more trait anger), Anger Control-Out (range: 8-32; higher scores indicating more anger control-out), State Anger (range: 15-60; higher scores indicating more anger control-in). | Change from baseline, 4 weeks after treatment starts, and 3 months after treatment has ended |
| Aggression Questionnaire | Levels of aggression (range 0-87). Higher scores indicate more aggression. | Change from baseline, 4 weeks after treatment starts, and 3 months after treatment has ended. Ranges from 0-87, with higher higher scores indicating more aggression problems. |
| Anger Rumination Scale | Levels of anger rumination (range: 19-76). Higher scores indicate more anger rumination. | Change from baseline, 4 weeks after treatment starts, and 3 months after treatment has ended |
| Five Facets Mindfulness Questionnaire | Levels of mindfulness (range: 29-145). Higher scores indicate more mindfulness. | Change from baseline, 4 weeks after treatment starts, and 3 months after treatment has ended |
| Emotion Regulation Questionnaire (Subscale Suppression) | Levels of suppression (range: 1-28). Higher scores indicate more suppression. | Change from baseline, once every week during treatment (0-4 weeks after baseline), and 3 months after treatment has ended. |
| The Pittsburgh Sleep Quality Index | Sleep quality (range: 0-21). Higher scores indicate worse sleep quality. | Change from baseline, 4 weeks after treatment starts, and 3 months after treatment has ended |
| Perceived Stress Scale 10 item version | Stress (range: 0-40). Higher scores indicate more negative stress. | Change from baseline, once every week during treatment (0-4 weeks after baseline), and 3 months after treatment has ended. |
Levels of client treatment satisfaction (range: 8-32) with higher scores indicating more satisfaction.
| 4 weeks after treatment starts |