Aggressive Impulse Management (clinical application)

Rationale:
Understanding the causes of human aggression is among the most urgent issues in
modern behavioral science. Aggression takes a tremendous toll on society, by
causing widespread agony and suffering, and through the costs of protecting,
treating, and compensating victims. It is therefore vital to learn how people
may withhold their aggressive impulses.
We propose the Aggressive Impulse Management (AIM) model (Koole, Veenstra, &
Bushman, 2013), which suggests that reducing approach motivation may
down-regulate aggressive impulses. The interventions suggested by the AIM model
require little effort or cognitive skills, and thus these interventions may
reduce aggression when traditional cognitive strategies for anger management
are ineffective. In the current protocol we propose motivational bias
modification (MBM) training for persons with chronic anger management issues.
We hypothesize that regularly repeating avoidance movements towards threatening
stimuli will lower aggression among trait-angry people.

Objective:
This study will investigate if AIM can be trained among people with chronic
anger management processes. According to the AIM model, repeating avoidance
responses to threatening stimuli may reduce aggressive impulses within this
population.

Study design:
We will adapt a computerized training study to investigate if trait-angry
individuals can gain AIM skills. The experiment will repeat daily training-task
sessions over one weeks. Participants with anger management problems will be
assigned randomly to an experimental group (training-task) or one of two
control groups (control-training-task and no-training-task). During the
training-task sessions, the experimental group will respond to angry faces by
pushing a joystick away from themselves (avoidance), and to neutral faces by
pulling a joystick towards themselves (approach). In the control-training-task
group, movement and stimulus type are not linked (counterbalanced right/left
movement toward angry/neutral faces). The control-no-training task group will
not take part in any training-task sessions. To assess training-task effects,
participants their aggression will be measured using a validated computer task
after each training session. In addition, they will keep a diary of their anger
and aggression during the training-task period and up to 1 week afterwards. We
shall also obtain peer reports of participants* aggression (e.g., from partner
or friends).

Intervention (if applicable):
The study contains 5 daily training-task sessions over a period of one week.
Aggression will be measured after each session, with a validated computer task.
In addition, participants will be asked to keep a diary of their anger and
aggression during this week, and up to 1 week afterwards.

Nature and extent of the burden and risks associated with participation,
benefit and group relatedness:
No health risks and only minimal burdens are expected to be associated with
participation. Participants could experience keeping a daily diary as a modest
burden. The training-task will only take around 15 minutes a day and the
previous studies with similar tasks showed that it is generally not experienced
as a burden, but rather fun to do, as it is a computerized task with a
joystick. Subjects can withdraw from the study at any time for any reason if
they wish to do so without any consequences.

This research is part of a larger project including 10 experiments that
systematically test the Aggressive Impulse Model. This present proposed study
is the first to investigate how training motivational tendencies toward
threatening stimuli can lower anger and aggression in people with psychological
problems related to anger regulation, i.e., high trait anger persons. The
present study can have important implications for further development of
instruments to reduce anger and aggression that might benefit anger management
trainings.