Research Reports - Reducing anger outbursts after a severe TBI

Neuropsychol Rehabil. 2016 Dec 23:1-24. doi: 10.1080/09602011.2016.1270837. [Epub
ahead of print]

Rochat L(1,)(2), Manolov R(3,)(4), Aboulafia-Brakha T(5), Berner-Burkard
C(1,)(6), Van der Linden M(1,)(2,)(7).

Anger outbursts constitute a frequent behavioural issue after a traumatic brain
injury (TBI) and have a strong negative impact on the social outcomes resulting
from the TBI. However, few studies have examined the efficacy of specific
intervention strategies to reduce the frequency and intensity of anger outbursts.
We therefore performed a single-case study on this topic by administering two
successive and complementary psychological interventions with an AB design with
maintenance (first intervention) and an AC design with maintenance plus a
one-month follow-up (second intervention) to a patient with a severe TBI. Whereas
the first intervention focused on improving the recognition and expression of
basic emotions, the second consisted of a self-regulation programme, including
various features such as psychoeducation about self-control strategies,
relaxation and assertiveness training that aimed to establish adequate
behaviours, which were further promoted by an implementation intentions strategy
in the patient's daily life. The results indicated that all interventions
resulted in a reduced frequency and intensity of anger outbursts, and the data
upheld the specificity of these effects. In addition, a meta-analytic integration
of the effects of both interventions on the outcomes indicated a medium effect
size. Further research is needed on other patients who experience long-standing
anger outbursts to examine whether the observed gains can be replicated,
sustained on a longer-term basis and improved. 

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