Editing Anger management (section)

==Affected populations==

===Adults===
One motivation for seeking anger management can be career-related. As both a preventative and corrective tool, anger management is available to help individuals [[Coping (psychology)|cope]] with potentially anger-inducing aspects of their jobs. One such situation applies to caretakers of individuals with [[mental illness]]. The daily stress combined with slow or no progress with the people under their care can create a high level of frustration. Skills training for caretakers of relatives with dementia has been developed to help cope with these feelings of frustration in a positive manner.<ref>{{cite journal|author1=Coon, D.|author2=Thompson, L.|author3=Steffen, A.|author4=Sorocco, K.|author5=Gallagher-Thompson, D.|name-list-style=amp|year=2003|title=Anger and depression management: Psychoeducational skill training interventions for women caregivers of a relative with dementia|journal=Gerontologist|volume=43|issue=5|pages=678–89|pmid=14570964|doi=10.1093/geront/43.5.678|doi-access=free}}</ref>

Anger management is also beneficial in [[law enforcement]]. The role of police officers is to protect civilians, however, conflicts between the police and the general public can develop. The goal of anger management would be to reduce such occurrences like police brutality from negatively impacting the relationship between law enforcement and citizens.<ref>{{cite journal|author1=Abernethy, A. D.|author2=Cox, C.|year=1994|name-list-style=amp|title=Anger management training for law enforcement personnel|journal=Journal of Criminal Justice|volume=22|issue=5|pages=459–466|doi=10.1016/0047-2352(94)90036-1 }}</ref> Anger management programs tailored towards this goal could orient themselves towards these means by focusing on [[conflict resolution]] and including specific law enforcement scenarios in the training. This need was noticed by Novaco, who originally designed an intervention for anger management based on cognitive behavioral therapy, resulting in a specialized skills training program for law enforcement.<ref>{{Cite journal|author=Novaco, R.|year=1977|title= Stress inoculation approach to anger management in training of law-enforcement officers|journal=American Journal of Community Psychology|volume=5|issue=3|pages=327–46|pmid=910754|doi=10.1007/BF00884700|s2cid=46019108}}</ref>

Couples also in the brink of dissolution of their marriage need to understand what to do about [[intimate partner violence]], and the more knowledgeable the individuals are on how to manage their anger, the better prepared they are when confronted with a problem with another person.<ref>{{Cite journal|author1=Shorey, R. C.|author2=Seavey, A. E.|author3=Quinn, E.|author4=Cornelius, T. L.|name-list-style=amp|year=2014|title=Partner-specific anger management as a mediator of the relation between mindfulness and female perpetrated dating violence|journal=Psychology of Violence|volume=4|issue=1|pages=51–64|doi=10.1037/a0033658|pmid=25285239|pmc=4180652}}</ref>

===Children and adolescents===
The ability for young children to understand their emotions and how to react in certain situations can greatly increase their chance of expressing themselves in an appropriate manner. A 2010 study from the ''Journal of Applied School Psychology'' looked at four 4th grade boys who took part in different activities with the [[school psychologist]], ranging from how to deal with emotions to practicing anger reduction strategies. They found a positive correlation between partaking in these meetings and less anger expressing in a multitude of locations (school, home, etc.).<ref name="Sportsman">{{cite journal|author1=Sportsman, E. L.|author2=Carlson, J. S.|author3=Guthrie, K. M.|name-list-style=amp|year=2010|title=Lesson learned from leading an anger management group using the "seeing red" curriculum within an elementary school|journal=Journal of Applied School Psychology|volume=26|issue=4|pages=339–350|doi=10.1080/15377903.2010.518823|s2cid=144343752}}</ref>

Anger management programs with a cognitive-behavioral basis have been modified for children and adolescents. There are three common types of CBT aimed at the youth. First, [[life skills]] development (communication, empathy, assertiveness, etc.) uses modeling to teach appropriate reactions to anger. Second, effective education focuses on identifying the feelings of anger and relaxation. Finally, problem solving conveys a view of cause and effect for situations as an alternative to anger.<ref>{{cite journal|first=P.C|last=Kendall|title=Cognitive-behavioral therapies with youth: Guiding theory, current status, and emerging developments|journal=Journal of Consulting and Clinical Psychology|volume=61|issue=2|pages=235–47|year=1993|pmid=8473577|doi=10.1037/0022-006X.61.2.235|citeseerx=10.1.1.457.2983}}</ref> A wide range of methods can be used to convey these three components, with both age and severity being important factors. For younger children, involvement can be increased by presenting anger management in more of a fun format with educational games and activities being available.<ref>{{cite book|author=Plummer, D. M.|year=2008|title=Anger management games for children|location=London, GBR|publisher=Jessica Kingsley Publishers}}</ref> For adolescents, group therapy can be an effective form given the resemblance to the individual's natural social environment.<ref>{{cite journal|author1=Snyder, K. v.|author2=Kymissis, P.|author3=Kessler, K.|name-list-style=amp|year=1999|title=Anger management for adolescents: Efficacy of brief group therapy|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=38|issue=11|pages=1409–16|pmid=10560228|doi=10.1097/00004583-199911000-00016}}</ref> The severity of expressed anger issues often relates to the intensity of the subsequent anger management program. A few violent outbursts in a classroom setting could result in several sessions with the school's counselor. However, more severe [[juvenile delinquency]] could result in court-mandated anger management sessions in a juvenile correctional facility.

The effectiveness of anger management has been studied in children and adolescents for the purpose of evaluating existing programs and designing more effective programs. In a meta-analyses of 40 studies, an overall effect size of 0.67 was found for CBT anger management treatment, suggesting anger management as a legitimate approach to problematic levels of anger. Skills development (0.79) and problem solving (0.67) both had a higher impact than affective education (0.36). This was believed to be due to behavioral aspects being more easily conveyed than cognitive for children.<ref>{{cite journal|author1=Sukhodolsky, D.|author2=Kassinove, H.|author3=Gorman, B.|name-list-style=amp|year=2004|title=Cognitive-behavioral therapy for anger in children and adolescents: A meta-analysis|journal=Aggression and Violent Behavior|volume= 9|issue=3|pages=247–269|doi=10.1016/j.avb.2003.08.005}}</ref> The true value from early interventions aimed at youths comes from the preventative aspect. Curbing negative behaviors early in life could lead to a more positive outlook as an adult.<ref name=Candelaria>{{cite journal|author1=Candelaria, A. M.|author2=Fedewa, A. L.|author3=Ahn, S.|name-list-style=amp|year=2012|title=The effects of anger management on children's social and emotional outcomes: A meta-analysis|journal=School Psychology International|volume=33|issue=6|pages=596–614|doi=10.1177/0143034312454360|s2cid=146223678}}</ref>

===Individuals with intellectual disabilities===
{{Main|Intellectual disabilities}}
Individuals with intellectual disabilities can struggle with managing anger.<ref>{{cite journal|author1=Kiely, J.|author2=Pankhurst, H.|title=Violence faced by staff in a learning disability service|journal=Disability and Rehabilitation|volume=20|issue=3|pages=81–9|year=1998|pmid=9548019|doi=10.3109/09638289809166060}}</ref> When faced with aggression from individuals with an intellectual disability, caretakers often employ a combination of four different strategies.<ref>{{cite journal|author=Taylor, J.|year=2002|title=A review of the assessment and treatment of anger and aggression in offenders with intellectual disability|journal=Journal of Intellectual Disability Research|volume=46|pages=57–73|pmid=12031019|doi=10.1046/j.1365-2788.2002.00005.x}}</ref> Depending on both the setting and individual, the following strategies for aggression minimization present in different ways.

# '''Reactive strategies''' – Aim to minimize impact of overtly aggressive behavior by using established protocols. E.g., enforced isolation after the start of a violent outburst.
# '''Ecological interventions''' – Attempt to reduce aggression level by changing an aspect of the environment for a more calming effect. E.g., reducing ambient noise to lower irritation.
# '''Contingency management''' – Focuses on modifying behavior through a combination of reinforcement and punishment. E.g., using a token economy to enforce rules concerning behavior.
# '''Positive programming''' – Teaches positive reaction skills as an alternative to aggression. E.g., anger management with a CBT background.

The need for anger management is also evident in situations where individuals with intellectual disabilities are prescribed psychotropic medication as the result of aggressive or self-injurious behavior. The medication's role as a chemical restraint does not help modify the underlying cause of aggression.<ref>{{Cite journal|author1=Matson J. L.|author2=Bamburg J. W.|author3=Mayville E. A.|author4=Pinkston J.|author5=Bielecki J.|author6=Kuhn D.|author7=Smalls Y.|author8=Logan J. R.|name-list-style=amp|year=2000|title=Psychopharmacology and mental retardation: a 10 year review (1990–1999)|journal=Research in Developmental Disabilities|volume=21|issue=4|pages=263–296|doi=10.1016/s0891-4222(00)00042-1|pmid=10983783}}</ref> [[Sedation]] is best used as an emergency measure with skills training as a long-term solution to decreasing the overall rate of violent incidents. In a meta-analysis reviewing 80 studies, behavioral-based interventions were found to be generally effective in modifying behavior.<ref>{{cite journal|first1=Robert|last1=Didden|first2=Hubert|last2=Korzilius|first3=Wietske|last3=van Oorsouw|first4=Peter|last4=Sturmey|first5=James|last5=Bodfish|year=2006|title=Behavioral Treatment of Challenging Behaviors in Individuals With Mild Mental Retardation: Meta-Analysis of Single-Subject Research|journal= American Journal on Mental Retardation|volume=111|pages=290–8|number=4|pmid=16792430|doi=10.1352/0895-8017(2006)111[290:BTOCBI]2.0.CO;2|hdl=2066/56912|hdl-access=free}}</ref> Additionally, cognitive behavioral therapy as administered by lay therapists was found to be effective, which supports the feasibility of such anger management programs.<ref>{{cite journal|author1=Willner, P.|author2=Rose, J.|author3=Jahoda, A.|author4=Kroese, B. S.|author5=Felce, D.|author6=MacMahon, P.|display-authors=etal|year=2013|title=A cluster randomised controlled trial of a manualised cognitive-behavioural anger management intervention delivered by supervised lay therapists to people with intellectual disabilities|journal=Health Technology Assessment|volume=17|issue=21|pages=1–173, v–vi|pmid=23701738|pmc=4781451|doi=10.3310/hta17210}}</ref>

This is a group that a majority of the population might not associate with having AM problems, but research shows over half of the population of Americans with intellectual disabilities displays violent and aggressive actions somewhat regularly. People with a [[learning disability]] tend to express anger and aggression to even those who help them on a daily basis. Adults with intellectual disabilities are at high risk of acting aggressive and being sent to clinics due to their actions.<ref>{{cite book|author1=Willner, P.|author2=Jahoda, A.|author3=Larkin, P.|year=2013|chapter=Management of anger in people with intellectual disabilities|editor=E. Fernandez|title=Treatments for anger in specific populations: Theory, application, and outcome|pages=92–113|location=New York, NY US|publisher=Oxford University Press}}</ref>

The "[[theory of the mind]]" approach states that people with anger management problems tend to be unsteady mentally and are not able to internalize any blame for their actions. One of the main reasons for anger outbursts is externalizing blame and having a quick impulse to lash out. These individuals need to have a better understanding of what their actions mean and that they should understand that blaming themselves for problems can sometimes be the right thing to do.<ref>{{cite journal|author1=Josephs, L.|author2=McLeod, B.|name-list-style=amp|year=2014|title=A theory of mind–focused approach to anger management|journal=Psychoanalytic Psychology|volume=31|issue=1|pages=68–83|doi=10.1037/a0034175|url=https://www.researchgate.net/publication/263922830}}</ref>

=== Violent criminals ===
{{Main|Violence}}
One study found that offenders who were currently in high-security hospitals that went through a self-report 20 class training program had positive results. Results of the self-report showed a decrease in aggression and a lack of responding when angry. There were two issues to keep in mind though; a hospital setting and a setting in which the researchers did not want to provoke much anger due to the instability of the patients.<ref>{{cite journal|author1=Wilson, C.|author2=Gandolfi, S.|author3=Dudley, A.|author4=Thomas, B.|author5=Tapp, J.|author6=Moore, E. |name-list-style=amp|year=2013|title=Evaluation of anger management groups in a high-security hospital|journal=Criminal Behaviour and Mental Health|volume=23|issue=5|pages=356–71|doi=10.1002/cbm.1873|pmid=23881899}}</ref>

In one meta-analysis study composed of studies completed from 1979 to 2010, school-aged children who were identified as having aggressive personalities were given several different anger management classes. Overall, results showed slightly positive results for children receiving the classes (less aggression). The courses aimed at reducing negative emotions in the children and trying to help them with [[self-control]]. While no overarching conclusions could be made, researchers state that children going through anger management courses are more prepared to combat their anger internally and less likely to act out.<ref name=Candelaria/>

=== Substance abusers ===
{{Main|Substance abuse}}
There is no statistical information that shows people who substance abuse also have high rates of aggressive actions. However, researchers believe this is a group of people that should be studied due to their questionable decision-making and typically unstable mental health. Substance abusers could benefit from anger management to prevent potential aggression.{{medcn|date=March 2024}}

=== Post-traumatic stress disorder (PTSD) individuals ===
{{Main|Posttraumatic stress disorder}}
This group can benefit from extended CBT dealing with anger management issues. One study dealing with n=86 war veterans found that during the 12 sessions of training, anger traits slightly dropped as well as small reductions in expressing anger. Research also indicates that their antisocial personality traits upon return can put them behind in society, so finding the right anger management courses is of vital importance. There were not significant enough findings from this study to definitely recommend veterans with PTSD to use CBT anger management courses.<ref>{{cite journal|author1=Marshall, A. D.|author2=Martin, E. K.|author3=Warfield, G. A.|author4=Doron-Lamarca, S.|author5=Niles, B. L.|author6=Taft, C. T.|s2cid=1384881|name-list-style=amp|year=2010|title=The impact of antisocial personality characteristics on anger management treatment for veterans with PTSD|journal=Psychological Trauma: Theory, Research, Practice, and Policy|volume=2|issue=3|pages=224–231|doi=10.1037/a0019890}}</ref>{{primary source inline|date=March 2024}}

=== People with traumatic brain injuries ===
{{Main|Traumatic brain injury}}
People with a traumatic brain injury (TBI) can display impulsive, aggressive and dangerous actions. A study in the ''[[Brain Injury (journal)|Brain Injury]]'' showed that one way to prevent such actions is a community-based treatment of people with TBI. Results indicated that the need to lash out diminished after the 12-week program, and a series of post-treatment testing showed a decline in self-reported frequency of angry actions. Other specific results included: significant decreases in the frequency of experiencing angry feelings and the frequency of outward expression of anger as well as significant increases in the frequency of controlling feelings of anger.<ref>{{cite journal|author1=Walker, A. J.|author2=Nott, M. T.|author3=Doyle, M.|author4=Onus, M.|author5=McCarthy, K.|author6=Baguley, I. J.|name-list-style=amp|year=2010|title=Effectiveness of a group anger management programme after severe traumatic brain injury|journal=Brain Injury|volume=24|issue=3|pages=517–24|doi=10.3109/02699051003601721|pmid=20184408|s2cid=38014905}}</ref>