Kathleen M McIntyre1, Jacqueline A Mogle2, Jennifer M Scodes3, Martina Pavlicova4, Peter A Shapiro5, Ethan E Gorenstein1, Felice A Tager1, Catherine Monk1, David M Almeida6, Richard P Sloan1. 1. Department of Psychiatry, Columbia University Medical Center. 2. College of Nursing, Pennsylvania State University. 3. Division of Biostatistics, New York State Psychiatric Institute. 4. Department of Biostatistics, Mailman School of Public Health, Columbia University Medical Center. 5. Department of Psychiatry, Division of Consultation-Liaison Psychiatry, Columbia University Medical Center. 6. Department of Human Development and Family Studies, Pennsylvania State University.
Abstract
OBJECTIVE: Negative affect (NA) reactivity to daily stressors may confer health risks over and above stress exposure, especially in chronically angry adults. This randomized controlled trial tests the hypothesis that a 12-week cognitive-behavioral therapy (CBT) anger-reduction treatment would decrease NA reactivity to daily stressors assessed via ambulatory diary for those in treatment, but not on a wait-list for treatment. METHOD: Healthy adults (N = 158, aged 20-45 years, 53.20% women) scoring high on Spielberger's (1988) Trait Anger, a scale from the State-Trait Anger Expression Inventory, were randomly assigned to a CBT treatment or wait-list control group, and completed 24 hr of prerandomization and postintervention ecological momentary assessment (EMA) of NA intensity and stress events every 20 ± 5 min. A longitudinal model using a generalized estimating equation examined whether stressor exposure and NA reactions to momentary stressors changed from pre- to posttreatment in the CBT group. RESULTS: There was a significant 3-way interaction (t28 = 2.29, p = .03) between stressor, treatment group, and EMA day, indicating that NA reactivity decreased for the treatment group 1.60 points more than for the wait-list group (a 379.38% greater change in NA reactivity). NA during stressors was 1.18 points lower (a 28.42% decrease) for the treatment group at EMA Day 2 (p = .04), whereas wait-list NA during stressors nonsignificantly increased. CONCLUSION:CBT to decrease chronic anger is associated with lower NA reactivity to daily stressors in this sample and could be a promising treatment to mitigate the health impact of stress in this clinical population. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
RCT Entities:
OBJECTIVE: Negative affect (NA) reactivity to daily stressors may confer health risks over and above stress exposure, especially in chronically angry adults. This randomized controlled trial tests the hypothesis that a 12-week cognitive-behavioral therapy (CBT) anger-reduction treatment would decrease NA reactivity to daily stressors assessed via ambulatory diary for those in treatment, but not on a wait-list for treatment. METHOD: Healthy adults (N = 158, aged 20-45 years, 53.20% women) scoring high on Spielberger's (1988) Trait Anger, a scale from the State-Trait Anger Expression Inventory, were randomly assigned to a CBT treatment or wait-list control group, and completed 24 hr of prerandomization and postintervention ecological momentary assessment (EMA) of NA intensity and stress events every 20 ± 5 min. A longitudinal model using a generalized estimating equation examined whether stressor exposure and NA reactions to momentary stressors changed from pre- to posttreatment in the CBT group. RESULTS: There was a significant 3-way interaction (t28 = 2.29, p = .03) between stressor, treatment group, and EMA day, indicating that NA reactivity decreased for the treatment group 1.60 points more than for the wait-list group (a 379.38% greater change in NA reactivity). NA during stressors was 1.18 points lower (a 28.42% decrease) for the treatment group at EMA Day 2 (p = .04), whereas wait-list NA during stressors nonsignificantly increased. CONCLUSION: CBT to decrease chronic anger is associated with lower NA reactivity to daily stressors in this sample and could be a promising treatment to mitigate the health impact of stress in this clinical population. (PsycINFO Database Record (c) 2019 APA, all rights reserved).