Editing Anger management (section)

===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>