Anger-Reduction Treatment Reduces Negative Affect Reactivity to Daily Stressors

摘要

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.