Perspective training to treat anger problems after brain injury: Two case studies

Winegardner, Jill; Keohane, Clare; Prince, Leyla; Neumann, Dawn

doi:10.3233/nre-161347

Cited by 14 publications

(7 citation statements)

References 33 publications

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“…Problems with anger are quite typical after traumatic brain injury (TBI). [1][2][3][4][5] Moreover, these problems differ from those of healthy controls in terms of severity and prevalence. A recent study revealed that people with TBI have elevated levels of anger compared to healthy controls.…”

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confidence: 99%

Negative Attribution Bias and Anger After Traumatic Brain Injury

Neumann

Malec

Hammond

2017

Journal of Head Trauma Rehabilitation

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People with TBI may have negative attribution bias, in which they disproportionately judge the intent, hostility, and blameworthiness of others' behaviors. These attributions contributed to their ratings of feeling angry. This suggests that participants with TBI who have anger problems should be evaluated for this bias, and anger treatments should possibly aim to alter negative attributions. However, before implementing clinical practice changes, there is a need for replication with larger samples, and further investigation of the characteristics associated with negative attribution bias.

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confidence: 99%

Negative Attribution Bias and Anger After Traumatic Brain Injury

Neumann

Malec

Hammond

2017

Journal of Head Trauma Rehabilitation

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“…The ICAN intervention was developed based on well-known theories of emotion, such as the appraisal theory (Moors et al, 2013) and hostile attribution style theory (Combs et al, 2007;Dodge, 2006;Jeon et al, 2013), which similarly propose that emotions, particularly anger, are largely influenced by the way in which one evaluates the actions of others. As described earlier, empirical research supports these theories in individuals with TBI (Neumann, Sander, Perkins, et al, 2021;Winegardner et al, 2016). The group facilitators were involved in the final refinement of the intervention protocol and procedures.…”

Section: Journal Of Emotion and Psychopathologymentioning

confidence: 95%

“…To address post-TBI anger and aggression that is associated with negative attributions, an intervention (Perspective Training) was created and initially examined as part of a two-person case study (Winegardner et al, 2016). The treatment taught participants to think about and experience situations from other people's perspectives (perspective-taking) as a way to generate alternative explanations and more benign interpretations (or social inferences) of others' actions.…”

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Intervention to Change Attributions that are Negative: A Feasibility Study on Reducing Anger after Brain Injury

Neumann

Backhaus²,

Jang³

et al. 2023

JEmotionPsychopathol

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Objectives: Explore the early efficacy of a treatment to modify anger, aggression, negative attributions, and perspective-taking in participants with traumatic brain injury (TBI). Design: Randomized waitlist-controlled trial. Participants: Twenty-four adults with a TBI (³ 1-year post-injury) who had above average aggression and either negative attribution bias or poor perspective-taking. Intervention: Intervention to Change Attributions that are Negative (ICAN). Measures: Epps Scenarios (attributions of intent, hostility, blame; anger and aggression responses); Aggression Questionnaire (AQ); PROMIS-Anger; Interpersonal Reactivity Index Perspective-taking; and Participant Global Impression of Change (PGIC) for anger and perspective-taking. Results: Twenty-one participants completed the study (ICAN = 8; Waitlist control [WLC] = 13). Post-treatment, ICAN participants had lower anger responses to Epps Scenarios (p = 0.03) compared to WLC participants who had not yet received treatment. Other between-group comparisons were not significant. Analyses comparing pre/post-intervention changes in the pooled sample (n=21), revealed reduced attributions of intent (p < 0.01) and blame (p = 0.05), and anger (p = 0.01) and aggression responses to Epps scenarios (p < 0.01) after receiving treatment. Post-intervention scores on the AQ and PROMIS-Anger were also significantly reduced (p < 0.01). On the PGIC, 83% and 45% reported noticeable changes in perspective-taking and anger, respectively. Discussion: ICAN may reduce anger and negative attributions after TBI and merits further investigation.

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“…23 The evidence for effective theory of mind training following traumatic brain injury is very scarce and limited to the treatment of general communication problems 25 or confined to case reports. 26 Social skills training for patients with traumatic brain injury focuses exclusively on behavior. It is based upon the assumption that patients lack well-defined social skills or knowledge that can be (re)learned.…”

Section: Treatment Of Social Cognition and Emotion Regulationmentioning

confidence: 99%

Social cognition and emotion regulation: a multifaceted treatment (T-ScEmo) for patients with traumatic brain injury

et al. 2019

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Background: Many patients with moderate to severe traumatic brain injury have deficits in social cognition. Social cognition refers to the ability to perceive, interpret, and act upon social information. Few studies have investigated the effectiveness of treatment for impairments of social cognition in patients with traumatic brain injury. Moreover, these studies have targeted only a single aspect of the problem. They all reported improvements, but evidence for transfer of learned skills to daily life was scarce. We evaluated a multifaceted treatment protocol for poor social cognition and emotion regulation impairments (called T-ScEmo) in patients with traumatic brain injury and found evidence for transfer to participation and quality of life. Purpose: In the current paper, we describe the theoretical underpinning, the design, and the content of our treatment of social cognition and emotion regulation (T-ScEmo). Theory into practice: The multifaceted treatment that we describe is aimed at improving social cognition, regulation of social behavior and participation in everyday life. Some of the methods taught were already evidence-based and derived from existing studies. They were combined, modified, or extended with newly developed material. Protocol design: T-ScEmo consists of 20 one-hour individual sessions and incorporates three modules: (1) emotion perception, (2) perspective taking and theory of mind, and (3) regulation of social behavior. It includes goal-setting, psycho-education, function training, compensatory strategy training, self-monitoring, role-play with participation of a significant other, and homework assignments. Recommendations: It is strongly recommended to offer all three modules, as they build upon each other. However, therapists can vary the time spent per module, in line with the patients’ individual needs and goals. In future, development of e-learning modules and virtual reality sessions might shorten the treatment.

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Perspective training to treat anger problems after brain injury: Two case studies

Abstract: BACKGROUND: People with acquired brain injury (ABI) often show increased

Cited by 14 publications

References 33 publications

Negative Attribution Bias and Anger After Traumatic Brain Injury

Negative Attribution Bias and Anger After Traumatic Brain Injury

Intervention to Change Attributions that are Negative: A Feasibility Study on Reducing Anger after Brain Injury

Social cognition and emotion regulation: a multifaceted treatment (T-ScEmo) for patients with traumatic brain injury

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