AngerNCT06275607
Maladaptive Anger Treatment
A study testing Cognitive Behavioral Affective Therapy and Emotional Discussion in people with Anger and Intermittent Explosive Disorder, run by The University of Texas at San Antonio at 1 site in United States.
Trial summary
From a psychoevolutionary perspective, anger is a universal emotion that can serve the function of making us aware of wrongdoing and motivating us to undo/correct the wrongdoing. Read more about this study
- Who is it for?
- Ages 18 to 65 yearsHealthy volunteers can take part
- Conditions the study is for
- Anger, Intermittent Explosive Disorder, Emotional Distress
- What is being tested?
- Cognitive Behavioral Affective Therapy and Emotional Discussion
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 100 participants
- Where
- 1 siteUnited States
- Study dates
- 7 Feb 2024to 31 Dec 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Live in the United States
- Have maladaptive anger (as assessed by the STAXI-2)
- Do not currently have any serious psychiatric illnesses (e.g., schizophrenia, autism, dementia, suicidal ideation)
- Are not currently undergoing psychological or psychiatric treatment
- Are not currently undergoing an anger treatment program
- Speak English
Who cannot join
- Does not live in the United States
- Does not have maladaptive anger, as assessed by the STAXI-2
- Has a current serious psychiatric illness (e.g., schizophrenia, autism, dementia, suicidal ideation)
- Is currently undergoing psychological or psychiatric treatment
- Is currently undergoing an anger treatment program
- Does not speak English
Trial locations and contacts
1 site in 1 country.
United States1 site, 1 recruiting
- Recruiting
The University of Texas at San Antonio
San Antonio, Texas, 78249
Ephrem Fernandez, Ph.D., ephrem.fernandez@utsa.edu
Brandon S Perez, M.S., brandon.perez3@utsa.edu
About this study
Official title: Cognitive Behavioral Affective Therapy (CBAT) for Maladaptive Anger in a Community Sample: A Randomized Controlled Trial
From a psychoevolutionary perspective, anger is a universal emotion that can serve the function of making us aware of wrongdoing and motivating us to undo/correct the wrongdoing. However, it is well recognized in clinical psychology that anger can be maladaptive, often causing distress and impairment in various areas of day-to-day life; untreated maladaptive anger has been found to raise the risk of certain physical health problems e.g., hypertension and coronary heart disease. At the very extreme, rage has been implicated in aggression and violence. Not surprisingly, there has been a widespread quest for anger treatments or what is popularly called "anger management". One treatment approach that has received increasing empirical support is Cognitive Behavioral Affective Therapy (CBAT), which has been applied to patients with chemical dependence and individuals with chronic pain. To extend this programmatic line of research, the proposed research aims to evaluate the efficacy of CBAT in reducing multiple (psychometric and self-monitored) measures of anger within a community sample.
Read the detailed description
P.I. Dr. Fernandez and Ph.D. student Brandon Perez will train about five undergraduate students in the recruitment procedures. Participants will be recruited by sending electronic announcements and IRB-approved recruitment materials to 1) counseling and psychotherapy clinics, 2) anger management support groups, and 3) social media platforms. Materials will contain study and contact information (study email address and Google Voice number) for potential participants to contact study staff. Interested participants will sign consent forms and be screened for eligibility via an electronic version of the consent form and a brief screening instrument, both presented using an online App (created on Thunkable) for administration of questionnaires. After successfully completing screening, participants will enter their phone number and email address. Participants who do not satisfy screening criteria will be notified accordingly.
Consent and Screening: Participants will first go through the informed consent procedure, where they will be told about the purpose of the study, expectations for them as participants, etc. Informed consent is expected to take approximately 10 minutes. Participants will then be asked to complete a screening questionnaire which is expected to take no more than 3 minutes. These procedures are done via the earlier-mentioned Smart Phone Application. Eligible participants will be randomly assigned to one of two groups: (i) a treatment group receiving Cognitive Behavioral Affective Therapy (CBAT), or (ii) a comparison group receiving Emotional Education (EE). Each group will receive separate links to videos (specific to the content of that group) and pre-recorded by Dr. Fernandez. There will be two videos per week, each lasting about 50 minutes (no more than 8 hours total) over the course of 4 weeks. At 1-month follow-up, each group will be required to view/listen to a final 50-minute videorecording that recaps the specific content for that group.
Questionnaires and other measures: Anger will be screened using the 10-item trait scale of the STAXI-2. At pre-treatment, post-treatment, and follow-up, anger will be assessed using two psychometric instruments, the Anger Parameters Scale and the Anger Expressions Scale. During each of these three phases, anger will also be measured via self-monitoring with reference to a graphical display. These measurement techniques have been effectively used and described in our previous studies.
Online Sessions: The video for session 1 will deal with orientation and self-monitoring. Participants will practice self-monitoring their anger during that first week of orientation. If a participant has no anger on a given day, no monitoring is necessary. Following this week, the comparison group participants will continue to self-monitor their anger for 4 weeks during which they will view/listen to videos on the general topic of emotions (including anger, fear, sadness, as well as positive emotions such as joy). CBAT participants will continue to self-monitor their anger for 4 weeks during which they will view/listen to videos on anger regulation techniques. These videos will cover anger prevention, anger intervention, and anger postvention consecutively. During the prevention phase, an individually tailored behavior contract against anger will be signed by each participant that allows them to reward themselves for adhering to anger reduction goals. Contracts such as these are commonly used in behavior modification. Not legally binding they are formal agreements made collaboratively between provider and participant. They are designed to build motivation and commitment to change. Specifically, both parties agree on the desired or adaptive behaviors, the points to be awarded for such behaviors, and the points to be deducted in the case of maladaptive behaviors. The net number of points is then regularly reviewed by both parties and any appropriate rewards are then "given." In CBAT, rewards are typically watching a favorite movie, dining out at a favorite restaurant, etc. Participants will work with investigators over email to draft and electronically sign their contracts. Research Assistants will review participant progress on their contracts during their regular check-in phone calls. While there is no feasible way to ensure total adherence to the contract - either with in-person or online CBAT training - the phone calls are useful in encouraging participation and self-monitoring. For EE, participants will receive self-monitoring training with an emphasis on the definition of emotion, and types of emotions. Instead of specific skills for regulating anger or other emotions, a range of emotions (e.g., fear, anxiety, sorrow, grief, melancholy, guilt, embarrassment, self-consciousness, pride, contempt, jealousy, surprise, and happiness) will be illustrated with sources from art, literature and the humanities in general. While the comparison group will not receive any skills training for anger regulation, emotional education will receive educational information on negative emotions (such as anger) and positive emotions too.
CBAT participants will also engage in anger prevention techniques such as behavioral rehearsal of anger-provoking situations and stimulus control for discriminating and avoiding situations that are likely to culminate in anger. Intervention techniques include use of thought-stopping, distraction, reappraisal, and replacing maladaptive cognition with coping statements. The postvention phase will train participants in dealing with residual anger through expressive writing and verbal disclosure. Gestalt therapy empty chair dialogue will be used for overcoming unresolved anger. Finally, affective strategies of humor and forgiveness will also be broached.
After the final session (in week 5), participants in both groups will complete the same set of questionnaires previously administered before treatment. This set of questionnaires is expected to take no more than 20 minutes. Participants will then have a 3-week interim waiting period, during which time no action is required on their part, but one intended to serve as a time for participants to reflect and implement techniques that they have learned. This is followed by 1 week of daily anger self-monitoring. Finally, a follow-up session (30-50 minutes) will be held with both groups after this self-monitoring period.
Phone Calls and Knowledge Checks: To ensure that participants comprehend the online videos, RAs will check in with participants twice a week. This also serves to ensure that there are no difficulties with their participation in the study and to verify that the participants are not in any emotional distress. Each semi-weekly phone calls is expected to last approximately 10 minutes, for a total time of 160 minutes over the duration of the study (1 week pre-treatment, 4 weeks of CBAT or EE; and 1 week post-treatment).
Total participant time commitment during the duration of the study is approximately 12 hours.
- Conditions
- Anger, Intermittent Explosive Disorder, Emotional Distress, Aggression, Violence
- Being tested
- Cognitive Behavioral Affective Therapy, Emotional Discussion
- Medical subject headings
- Disruptive, Impulse Control, and Conduct Disorders, Aggression
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Cognitive Behavioral Affective TherapyBehavioural
Active training in regulating anger.
Emotional DiscussionBehavioural
General discussion of emotions; no therapy or training is offered.
| Study group | Role | What they receive |
|---|---|---|
| Cognitive Behavioral Affective Therapy | Experimental | Group receiving CBAT. Receives: Behavioral: Cognitive Behavioral Affective Therapy |
| Emotional Education | Placebo comparator | Group receiving general emotion psychoeducation. Receives: Behavioral: Emotional Discussion |
What is being measured
The primary outcome is the main question the study is designed to answer.
Anger Parameters Scale (APS)
The Anger Parameters Scale taps into five parameters: Frequency, Duration, Intensity, Latency, and Threshold. Scores can range from 0-120 and higher scores imply more maladaptive anger.
The APS is comprised of 30 items rated from 0-4. The total possible score ranges from 0 to 120. A higher score on the APS indicates more maladaptive anger.
Measured: Baseline
Anger Parameters Scale (APS)
The Anger Parameters Scale taps into five parameters: Frequency, Duration, Intensity, Latency, and Threshold. Scores can range from 0-120 and higher scores imply more maladaptive anger.
The APS is comprised of 30 items rated from 0-4. The total possible score ranges from 0 to 120. A higher score on the APS indicates more maladaptive anger.
Measured: One-month
Anger Parameters Scale (APS)
The Anger Parameters Scale taps into five parameters: Frequency, Duration, Intensity, Latency, and Threshold. Scores can range from 0-120 and higher scores imply more maladaptive anger.
The APS is comprised of 30 items rated from 0-4. The total possible score ranges from 0 to 120. A higher score on the APS indicates more maladaptive anger.
Measured: One month after end of treatment program
Anger Expressions Scale (AES)
Measured with the Anger Expressions Scale. The AES is comprised of 60 items rated from 0-4. These items are organized into 12 sub-scales of 5 items each. These sub-scales have a minimum total possible score of 0 and a maximum of 20. Higher scores on each sub-scale (as well as a higher cumulative score) indicates more maladaptive anger.
Measured: Baseline
Anger Expressions Scale (AES)
Measured with the Anger Expressions Scale. The AES is comprised of 60 items rated from 0-4. These items are organized into 12 sub-scales of 5 items each. These sub-scales have a minimum total possible score of 0 and a maximum of 20. Higher scores on each sub-scale (as well as a higher cumulative score) indicates more maladaptive anger.
Measured: One-month
Anger Expressions Scale (AES)
Measured with the Anger Expressions Scale. The AES is comprised of 60 items rated from 0-4. These items are organized into 12 sub-scales of 5 items each. These sub-scales have a minimum total possible score of 0 and a maximum of 20. Higher scores on each sub-scale (as well as a higher cumulative score) indicates more maladaptive anger.
Measured: One month after end of treatment program
Self-Monitored Anger (Anger Log)
Self-monitoring has been successfully implemented for the assessment of anger . The anger log comprises two graphs that range from 12:00 AM to 12:00 PM and 12:00 PM to 12:00 AM, covering a 24-hour period. More specifically, the x-axis represents the time of day, and the y-axis represents the severity of anger. The scale ranges in severity and is broken down into levels: anger, annoyance, and rage.
Measured: Baseline up to 4 weeks
Self-Monitored Anger (Anger Log)
Self-monitoring has been successfully implemented for the assessment of anger . The anger log comprises two graphs that range from 12:00 AM to 12:00 PM and 12:00 PM to 12:00 AM, covering a 24-hour period. More specifically, the x-axis represents the time of day, and the y-axis represents the severity of anger. The scale ranges in severity and is broken down into levels: anger, annoyance, and rage.
Measured: One week after the interim period
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Feb 2024
- Study start7 Feb 2024
- Primary completion31 Dec 2025 (estimated)
- Study completion31 Dec 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (9)Papers the sponsor has linked to this study.
- Other trials for AngerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Parallel Assignment
- Masking
- None (open label)
- Enrolment
- 100 participants (estimated)
Sponsor and investigators
- Lead sponsor
- The University of Texas at San Antonio
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06275607
- Sponsor's protocol ID
- FY23-24-93
- Status last verified
- Feb 2024
- First submitted
- 7 Feb 2024
- Last updated
- 23 Feb 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Fernandez, E. (2008). The angry personality: A representation on six dimensions of anger expression. https://doi.org/10.4135/9781849200479
Fernandez, E., Arevalo, I., Torralba A., & Vargas, R. (2014). Norms for Five Parameters of Anger: How Do Incarcerated Adults Differ From the Community?. International Journal of Forensic Mental Health. 13. 18-24. https://doi.org/10.1080/14999013.2014.889256
Fernandez, E. & Beck, R. (2001). Cognitive-Behavioral Self-Intervention Versus SelfMonitoring of Anger: Effects on Anger Frequency, Duration, and Intensity. Behavioural and Cognitive Psychotherapy, 29(3). 345-356. http://doi.org/10.1017/S1352465801003071
Fernandez E, Pham TM, Kolaparthi K, Sun R, Perez BS, Iwuala EC, Wu W, Shattuck EC. Parameters of anger as related to sensory-affective components of pain. Scand J Pain. 2022 Dec 9;23(2):284-290. doi: 10.1515/sjpain-2022-0131. Print 2023 Apr 25.
PubMed 36490215Fernandez E, Perez B, Sun R, Kolaparthi K, Pham T, Iwuala E, Garza R, Shattuck EC, Wu W. Anger treatment via CBAT delivered remotely: Outcomes on psychometric and self-monitored measures of anger. Clin Psychol Psychother. 2024 Jan-Feb;31(1):e2907. doi: 10.1002/cpp.2907. Epub 2023 Sep 12.
PubMed 37699599Fernandez E, Scott S. Anger treatment in chemically-dependent inpatients: evaluation of phase effects and gender. Behav Cogn Psychother. 2009 Jul;37(4):431-47. doi: 10.1017/S1352465809990075. Epub 2009 Jun 23.
PubMed 19545479Fernandez E, Woldgabreal Y, Guharajan D, Day A, Kiageri V, Ramtahal N. Social Desirability Bias Against Admitting Anger: Bias in the Test-Taker or Bias in the Test? J Pers Assess. 2019 Nov-Dec;101(6):644-652. doi: 10.1080/00223891.2018.1464017. Epub 2018 May 9.
PubMed 29741402Henderson, M. M. (2016). The anger parameters scale and the anger expressions scale: A psychometric study. The University of Texas at San Antonio.
Spielberger, C. D., Sydeman, S. J., Owen, A. E., & Marsh, B. J. (1999). Measuring anxiety and anger with the State-Trait Anxiety Inventory (STAI) and the State-Trait Anger Expression Inventory (STAXI). In M. E. Maruish (Ed.), The use of psychological testing for treatment planning and outcomes assessment (2nd ed., pp. 993-1021). Lawrence Erlbaum Associates Publishers.
Study at a glance
From the registry record, last updated by the sponsor on 23 Feb 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Cognitive Behavioral Affective Therapy (CBAT) for Maladaptive Anger in a Community Sample: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT06275607
- Acronym / sponsor ID
- FY23-24-93
- Conditions
- Anger, Intermittent Explosive Disorder, Emotional Distress, Aggression, Violence
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 100 participants (estimated)
- Lead sponsor
- The University of Texas at San AntonioUniversity, hospital or other
- Study start
- 7 Feb 2024 (actual)
- Primary completion
- 31 Dec 2025 (estimated)
- Study completion
- 31 Dec 2025 (estimated)
- First posted
- 23 Feb 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
From a psychoevolutionary perspective, anger is a universal emotion that can serve the function of making us aware of wrongdoing and motivating us to undo/correct the wrongdoing. However, it is well recognized in clinical psychology that anger can be maladaptive, often causing distress and impairment in various areas of day-to-day life; untreated maladaptive anger has been found to raise the risk of certain physical health problems e.g., hypertension and coronary heart disease. At the very extreme, rage has been implicated in aggression and violence. Not surprisingly, there has been a widespread quest for anger treatments or what is popularly called "anger management". One treatment approach that has received increasing empirical support is Cognitive Behavioral Affective Therapy (CBAT), which has been applied to patients with chemical dependence and individuals with chronic pain. To extend this programmatic line of research, the proposed research aims to evaluate the efficacy of CBAT in reducing multiple (psychometric and self-monitored) measures of anger within a community sample.
Detailed description
P.I. Dr. Fernandez and Ph.D. student Brandon Perez will train about five undergraduate students in the recruitment procedures. Participants will be recruited by sending electronic announcements and IRB-approved recruitment materials to 1) counseling and psychotherapy clinics, 2) anger management support groups, and 3) social media platforms. Materials will contain study and contact information (study email address and Google Voice number) for potential participants to contact study staff. Interested participants will sign consent forms and be screened for eligibility via an electronic version of the consent form and a brief screening instrument, both presented using an online App (created on Thunkable) for administration of questionnaires. After successfully completing screening, participants will enter their phone number and email address. Participants who do not satisfy screening criteria will be notified accordingly.
Consent and Screening: Participants will first go through the informed consent procedure, where they will be told about the purpose of the study, expectations for them as participants, etc. Informed consent is expected to take approximately 10 minutes. Participants will then be asked to complete a screening questionnaire which is expected to take no more than 3 minutes. These procedures are done via the earlier-mentioned Smart Phone Application. Eligible participants will be randomly assigned to one of two groups: (i) a treatment group receiving Cognitive Behavioral Affective Therapy (CBAT), or (ii) a comparison group receiving Emotional Education (EE). Each group will receive separate links to videos (specific to the content of that group) and pre-recorded by Dr. Fernandez. There will be two videos per week, each lasting about 50 minutes (no more than 8 hours total) over the course of 4 weeks. At 1-month follow-up, each group will be required to view/listen to a final 50-minute videorecording that recaps the specific content for that group.
Questionnaires and other measures: Anger will be screened using the 10-item trait scale of the STAXI-2. At pre-treatment, post-treatment, and follow-up, anger will be assessed using two psychometric instruments, the Anger Parameters Scale and the Anger Expressions Scale. During each of these three phases, anger will also be measured via self-monitoring with reference to a graphical display. These measurement techniques have been effectively used and described in our previous studies.
Online Sessions: The video for session 1 will deal with orientation and self-monitoring. Participants will practice self-monitoring their anger during that first week of orientation. If a participant has no anger on a given day, no monitoring is necessary. Following this week, the comparison group participants will continue to self-monitor their anger for 4 weeks during which they will view/listen to videos on the general topic of emotions (including anger, fear, sadness, as well as positive emotions such as joy). CBAT participants will continue to self-monitor their anger for 4 weeks during which they will view/listen to videos on anger regulation techniques. These videos will cover anger prevention, anger intervention, and anger postvention consecutively. During the prevention phase, an individually tailored behavior contract against anger will be signed by each participant that allows them to reward themselves for adhering to anger reduction goals. Contracts such as these are commonly used in behavior modification. Not legally binding they are formal agreements made collaboratively between provider and participant. They are designed to build motivation and commitment to change. Specifically, both parties agree on the desired or adaptive behaviors, the points to be awarded for such behaviors, and the points to be deducted in the case of maladaptive behaviors. The net number of points is then regularly reviewed by both parties and any appropriate rewards are then "given." In CBAT, rewards are typically watching a favorite movie, dining out at a favorite restaurant, etc. Participants will work with investigators over email to draft and electronically sign their contracts. Research Assistants will review participant progress on their contracts during their regular check-in phone calls. While there is no feasible way to ensure total adherence to the contract - either with in-person or online CBAT training - the phone calls are useful in encouraging participation and self-monitoring. For EE, participants will receive self-monitoring training with an emphasis on the definition of emotion, and types of emotions. Instead of specific skills for regulating anger or other emotions, a range of emotions (e.g., fear, anxiety, sorrow, grief, melancholy, guilt, embarrassment, self-consciousness, pride, contempt, jealousy, surprise, and happiness) will be illustrated with sources from art, literature and the humanities in general. While the comparison group will not receive any skills training for anger regulation, emotional education will receive educational information on negative emotions (such as anger) and positive emotions too.
CBAT participants will also engage in anger prevention techniques such as behavioral rehearsal of anger-provoking situations and stimulus control for discriminating and avoiding situations that are likely to culminate in anger. Intervention techniques include use of thought-stopping, distraction, reappraisal, and replacing maladaptive cognition with coping statements. The postvention phase will train participants in dealing with residual anger through expressive writing and verbal disclosure. Gestalt therapy empty chair dialogue will be used for overcoming unresolved anger. Finally, affective strategies of humor and forgiveness will also be broached.
After the final session (in week 5), participants in both groups will complete the same set of questionnaires previously administered before treatment. This set of questionnaires is expected to take no more than 20 minutes. Participants will then have a 3-week interim waiting period, during which time no action is required on their part, but one intended to serve as a time for participants to reflect and implement techniques that they have learned. This is followed by 1 week of daily anger self-monitoring. Finally, a follow-up session (30-50 minutes) will be held with both groups after this self-monitoring period.
Phone Calls and Knowledge Checks: To ensure that participants comprehend the online videos, RAs will check in with participants twice a week. This also serves to ensure that there are no difficulties with their participation in the study and to verify that the participants are not in any emotional distress. Each semi-weekly phone calls is expected to last approximately 10 minutes, for a total time of 160 minutes over the duration of the study (1 week pre-treatment, 4 weeks of CBAT or EE; and 1 week post-treatment).
Total participant time commitment during the duration of the study is approximately 12 hours.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- Parallel Assignment
| Arm | Type | Receives |
|---|---|---|
| Cognitive Behavioral Affective Therapy | Experimental | Behavioral: Cognitive Behavioral Affective TherapyGroup receiving CBAT. |
| Emotional Education | Placebo comparator | Behavioral: Emotional DiscussionGroup receiving general emotion psychoeducation. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Live in the United States
- Have maladaptive anger (as assessed by the STAXI-2)
- Do not currently have any serious psychiatric illnesses (e.g., schizophrenia, autism, dementia, suicidal ideation)
- Are not currently undergoing psychological or psychiatric treatment
- Are not currently undergoing an anger treatment program
Key exclusion criteria (6 listed)
- Does not live in the United States
- Does not have maladaptive anger, as assessed by the STAXI-2
- Has a current serious psychiatric illness (e.g., schizophrenia, autism, dementia, suicidal ideation)
- Is currently undergoing psychological or psychiatric treatment
- Is currently undergoing an anger treatment program
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Cognitive Behavioral Affective TherapyActive training in regulating anger. | Behavioural | Cognitive Behavioral Affective Therapy |
| Emotional DiscussionGeneral discussion of emotions; no therapy or training is offered. | Behavioural | Emotional Education |
Primary outcome
Anger Parameters Scale (APS)
Time frame: Baseline
The Anger Parameters Scale taps into five parameters: Frequency, Duration, Intensity, Latency, and Threshold. Scores can range from 0-120 and higher scores imply more maladaptive anger. The APS is comprised of 30 items rated from 0-4. The total possible score ranges from 0 to 120. A higher score on the APS indicates more maladaptive anger.
Anger Parameters Scale (APS)
Time frame: One-month
The Anger Parameters Scale taps into five parameters: Frequency, Duration, Intensity, Latency, and Threshold. Scores can range from 0-120 and higher scores imply more maladaptive anger. The APS is comprised of 30 items rated from 0-4. The total possible score ranges from 0 to 120. A higher score on the APS indicates more maladaptive anger.
Anger Parameters Scale (APS)
Time frame: One month after end of treatment program
The Anger Parameters Scale taps into five parameters: Frequency, Duration, Intensity, Latency, and Threshold. Scores can range from 0-120 and higher scores imply more maladaptive anger. The APS is comprised of 30 items rated from 0-4. The total possible score ranges from 0 to 120. A higher score on the APS indicates more maladaptive anger.
Anger Expressions Scale (AES)
Time frame: Baseline
Measured with the Anger Expressions Scale. The AES is comprised of 60 items rated from 0-4. These items are organized into 12 sub-scales of 5 items each. These sub-scales have a minimum total possible score of 0 and a maximum of 20. Higher scores on each sub-scale (as well as a higher cumulative score) indicates more maladaptive anger.
Anger Expressions Scale (AES)
Time frame: One-month
Measured with the Anger Expressions Scale. The AES is comprised of 60 items rated from 0-4. These items are organized into 12 sub-scales of 5 items each. These sub-scales have a minimum total possible score of 0 and a maximum of 20. Higher scores on each sub-scale (as well as a higher cumulative score) indicates more maladaptive anger.
Anger Expressions Scale (AES)
Time frame: One month after end of treatment program
Measured with the Anger Expressions Scale. The AES is comprised of 60 items rated from 0-4. These items are organized into 12 sub-scales of 5 items each. These sub-scales have a minimum total possible score of 0 and a maximum of 20. Higher scores on each sub-scale (as well as a higher cumulative score) indicates more maladaptive anger.
Self-Monitored Anger (Anger Log)
Time frame: Baseline up to 4 weeks
Self-monitoring has been successfully implemented for the assessment of anger . The anger log comprises two graphs that range from 12:00 AM to 12:00 PM and 12:00 PM to 12:00 AM, covering a 24-hour period. More specifically, the x-axis represents the time of day, and the y-axis represents the severity of anger. The scale ranges in severity and is broken down into levels: anger, annoyance, and rage.
Self-Monitored Anger (Anger Log)
Time frame: One week after the interim period
Self-monitoring has been successfully implemented for the assessment of anger . The anger log comprises two graphs that range from 12:00 AM to 12:00 PM and 12:00 PM to 12:00 AM, covering a 24-hour period. More specifically, the x-axis represents the time of day, and the y-axis represents the severity of anger. The scale ranges in severity and is broken down into levels: anger, annoyance, and rage.
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 23 Feb 2024.
- BackgroundFernandez, E. (2008). The angry personality: A representation on six dimensions of anger expression. https://doi.org/10.4135/9781849200479
- BackgroundFernandez, E., Arevalo, I., Torralba A., & Vargas, R. (2014). Norms for Five Parameters of Anger: How Do Incarcerated Adults Differ From the Community?. International Journal of Forensic Mental Health. 13. 18-24. https://doi.org/10.1080/14999013.2014.889256
- BackgroundFernandez, E. & Beck, R. (2001). Cognitive-Behavioral Self-Intervention Versus SelfMonitoring of Anger: Effects on Anger Frequency, Duration, and Intensity. Behavioural and Cognitive Psychotherapy, 29(3). 345-356. http://doi.org/10.1017/S1352465801003071
- Background: PubMed 36490215Fernandez E, Pham TM, Kolaparthi K, Sun R, Perez BS, Iwuala EC, Wu W, Shattuck EC. Parameters of anger as related to sensory-affective components of pain. Scand J Pain. 2022 Dec 9;23(2):284-290. doi: 10.1515/sjpain-2022-0131. Print 2023 Apr 25.
- Background: PubMed 37699599Fernandez E, Perez B, Sun R, Kolaparthi K, Pham T, Iwuala E, Garza R, Shattuck EC, Wu W. Anger treatment via CBAT delivered remotely: Outcomes on psychometric and self-monitored measures of anger. Clin Psychol Psychother. 2024 Jan-Feb;31(1):e2907. doi: 10.1002/cpp.2907. Epub 2023 Sep 12.
- Background: PubMed 19545479Fernandez E, Scott S. Anger treatment in chemically-dependent inpatients: evaluation of phase effects and gender. Behav Cogn Psychother. 2009 Jul;37(4):431-47. doi: 10.1017/S1352465809990075. Epub 2009 Jun 23.
- Background: PubMed 29741402Fernandez E, Woldgabreal Y, Guharajan D, Day A, Kiageri V, Ramtahal N. Social Desirability Bias Against Admitting Anger: Bias in the Test-Taker or Bias in the Test? J Pers Assess. 2019 Nov-Dec;101(6):644-652. doi: 10.1080/00223891.2018.1464017. Epub 2018 May 9.
- BackgroundHenderson, M. M. (2016). The anger parameters scale and the anger expressions scale: A psychometric study. The University of Texas at San Antonio.
- BackgroundSpielberger, C. D., Sydeman, S. J., Owen, A. E., & Marsh, B. J. (1999). Measuring anxiety and anger with the State-Trait Anxiety Inventory (STAI) and the State-Trait Anger Expression Inventory (STAXI). In M. E. Maruish (Ed.), The use of psychological testing for treatment planning and outcomes assessment (2nd ed., pp. 993-1021). Lawrence Erlbaum Associates Publishers.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Cognitive Behavioral Affective Therapy and Emotional Discussion in people with Anger and Intermittent Explosive Disorder, run by The University of Texas at San Antonio at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 23 Feb 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Ephrem Fernandez, Ph.D. ((210) 458-5755, ephrem.fernandez@utsa.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Anger Parameters Scale (APS) (time frame: Baseline). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06275607, which also lists 9 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Feb 2024; AzTrials last refreshed its copy on 27 Oct 2026.