Abstract
Anger is a common emotion; however, when it is too frequent, too intense, or too prolonged or when it triggers excessive aggression or violence, it becomes a clinical problem. Anger rumination has shown to mediate the link between anger and aggression and is a prevalent clinical problem repeating the activation of aggressive cognitions, increasing anger arousal and the priming and scripting of aggressive behavior.
Rumination-focused cognitive behavioral therapy (Rf-CBT) is a promising treatment of anger rumination to reduce anger and prevent aggression. The chapter presents a case study of Rf-CBT with a patient diagnosed with schizotypal personality disorder (SPD) and suffering from problematic anger and anger rumination. Applying the Rf-CBT theory to anger, anger rumination is triggered when people are angry about perceived insults or frustrations, and the desired mental state is to feel otherwise (e.g., calm or at peace). An individual will continue to ruminate when failing to make progress toward the desired goal and will terminate anger rumination when the goal is either attained or abandoned. Rf-CBT is a principle-driven treatment designed to teach patients to interrupt the mental habit of rumination by identifying triggers of rumination, controlling exposure to these triggers, and acquiring new habits of alternative responses to those cues.
Results of the case study showed Rf-CBT to be a possibly promising approach to reduce anger rumination, anger, and aggression; however, larger studies than a single-case study are necessary to investigate the usefulness of Rf-CBT for anger problems. Using imagery techniques to interrupt anger rumination and thus reduce arousal may be an auspicious strategy, which is in line with advise from meta-analyses for anger treatment to emphasize focus on reducing anger arousal.
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References
Allen JJ, Anderson CA, Bushman BJ (2018) The general aggression model. Curr Opin Psychol 19:75–80. https://doi.org/10.1016/j.copsyc.2017.03.034
Bushman BJ (2002) Does venting anger feed or extinguish the flame? Catharsis, rumination, distraction, anger, and aggressive responding. Personal Soc Psychol Bull 28(6):724–731. https://doi.org/10.1177/0146167202289002
Bushman BJ, Bonacci AM, Pedersen WC, Vasquez EA, Miller N (2005) Chewing on it can chew you up: effects of rumination on triggered displaced aggression. J Pers Soc Psychol 88(6):969
Caselli, G., Offredi, A., Martino, F., Varalli, D., Ruggiero, G. M., Sassaroli, S., . . . Wells, A. (2017). Metacognitive beliefs and rumination as predictors of anger: a prospective study. Aggress Behav, 43(5), 421–429
Csikszentmihalyi M (1990) 1990. Flow. The Psychology of Optimal Experience, New York (HarperPerennial)
Denson TF (2013) The multiple systems model of angry rumination. Personal Soc Psychol Rev 17(2):103–123
Denson TF, Pedersen WC, Friese M, Hahm A, Roberts L (2011) Understanding impulsive aggression: angry rumination and reduced self-control capacity are mechanisms underlying the provocation-aggression relationship. Personal Soc Psychol Bull 37(6):850–862
Fabiansson EC, Denson TF, Moulds ML, Grisham JR, Schira MM (2012) Don‘t look back in anger: neural correlates of reappraisal, analytical rumination, and angry rumination during recall of an anger-inducing autobiographical memory. NeuroImage 59(3):2974–2981. https://doi.org/10.1016/j.neuroimage.2011.09.078
Grisso T, Davis J, Vesselinov R, Appelbaum PS, Monahan J (2000) Violent thoughts and violent behavior following hospitalization for mental disorder. J Consult Clin Psychol 68(3):388
Grodin J, Clark JL, Kolts R, Lovejoy TI (2019) Compassion focused therapy for anger: a pilot study of a group intervention for veterans with PTSD. J Contextual Behav Sci 13:27–33. https://doi.org/10.1016/j.jcbs.2019.06.004
Hardin KM, Contreras IM, Kosiak K, Novaco RW (2022) Anger rumination and imagined violence as related to violent behavior before and after psychiatric hospitalization. J Clin Psychol 78:1878
Hofmann SG, Grossman P, Hinton DE (2011) Loving-kindness and compassion meditation: potential for psychological interventions. Clin Psychol Rev 31(7):1126–1132
Hvenegaard M, Moeller SB, Poulsen S, Gondan M, Grafton B, Austin SF, Watkins ER (2020) Group rumination-focused cognitive-behavioural therapy (CBT) v. group CBT for depression: phase II trial. Psychol Med 50(1):11–19. https://doi.org/10.1017/S0033291718003835
Kirby JN, Doty JR, Petrocchi N, Gilbert P (2017) The current and future role of heart rate variability for assessing and training compassion. Front Public Health 5:40
Kokkinos CM, Voulgaridou I, Despoti G (2021) The indirect effects of anger on relational aggression through anger rumination. J Sch Violence 1-12:511. https://doi.org/10.1080/15388220.2021.1969242
Lee AH, DiGiuseppe R (2018) Anger and aggression treatments: a review of meta-analyses. Curr Opin Psychol 19:65–74
Moeller SB (2019) Cognitive processing in anger and verbal aggression among male forensic inpatients–a case series using metacognitive profiling. J Psychiatry Behav Ther:1–5
Moeller SB, Bech P (2019) The Metacognitive Anger Processing (MAP) scale–validation in a mixed clinical and a forensic in-patient sample. Behav Cogn Psychother 47(1):67–80
Moeller SB, Gondan M, Novaco RW (2017) Violent images, anger and physical aggression among male forensic inpatients. Personal Individ Differ 105:268–274
Moeller SB, Austin SF, Hvenegaard M, Kistrup M, Gran S, Watkins E (2020) Rumination-focused cognitive behaviour therapy for non-responsive chronic depression: an uncontrolled group study. 48:376. Retrieved from https://go.exlibris.link/rxmqqdpq
Moeller SB, Kvist V, Jansen JE, Watkins ER (2021) Clinical case of a schizotypal personality disorder: rumination-focused CBT for anger rumination. J Contemp Psychother 51:1–11
Neff KD, Pommier E (2013) The relationship between self-compassion and other-focused concern among college undergraduates, community adults, and practicing meditators. Self Identity 12(2):160–176
Novaco RW (1976) The functions and regulation of the arousal of anger. Am J Psychiatr 133(10):1124–1128
Novaco RW (2011) Anger dysregulation: driver of violent offending. J Forensic Psychiatry Psychol 22(5):650–668. https://doi.org/10.1080/14789949.2011.617536
Peled M, Moretti MM (2010) Ruminating on rumination: are rumination on anger and sadness differentially related to aggression and depressed mood? J Psychopathol Behav Assess 32(1):108–117
Rivkin W, Diestel S, Schmidt K-H (2018) Which daily experiences can foster Well-being at work? A diary study on the interplay between flow experiences, affective commitment, and self-control demands. J Occup Health Psychol 23(1):99
Salguero JM, García-Sancho E, Ramos-Cejudo J, Kannis-Dymand L (2020) Individual differences in anger and displaced aggression: the role of metacognitive beliefs and anger rumination. Aggress Behav 46(2):162–169
Sezibera V (2010) Intervening on persistent PTSD and co-morbid depression: rumination focused cognitive and behavioral therapy (RFCBT) in a randomized controlled trial (RCT) of young survivors of the 1994 genocide against Tutsi in Rwanda. Rwanda J 21:74–89
Sezibera V, Van Broeck N, Philippot P (2009) Intervening on persistent posttraumatic stress disorder: rumination-focused cognitive and behavioral therapy in a population of young survivors of the 1994 genocide in Rwanda. J Cogn Psychother 23(2):107–113
Simpson C, Papageorgiou C (2003) Metacognitive beliefs about rumination in anger. Cogn Behav Pract 10(1):91–94
Skeem JL, Schubert C, Odgers C, Mulvey EP, Gardner W, Lidz C (2006) Psychiatric symptoms and community violence among high-risk patients: a test of the relationship at the weekly level. J Consult Clin Psychol 74(5):967
Takebe M, Takahashi F, Sato H (2016) Anger rumination as a risk factor for trait anger and anger-in: a longitudinal study. Personal Individ Differ 101:451–455. https://doi.org/10.1016/j.paid.2016.06.038
Topper M, Emmelkamp P, Wakins E, Ehring T (2016) Prevention of anxiety disorders and depression by targeting excessive worry and rumination in adolescents: a randomized controlled trial. Depress Anxiety Disorders:113
Vasquez EA, Pedersen WC, Bushman BJ, Kelley NJ, Demeestere P, Miller N (2013) Lashing out after stewing over public insults: the effects of public provocation, provocation intensity, and rumination on triggered displaced aggression. Aggress Behav 39(1):13–29
Wang X, Yang L, Yang J, Gao L, Zhao F, Xie X, Lei L (2018) Trait anger and aggression: a moderated mediation model of anger rumination and moral disengagement. Personal Individ Differ 125:44–49. https://doi.org/10.1016/j.paid.2017.12.029
Watkins ER (2016) Rumination-focused cognitive-behavioral therapy for depression. The Guilford Press, New York
Watkins ER, Nolen-Hoeksema S (2014) A habit-goal framework of depressive rumination. J Abnorm Psychol 123(1):24
Watkins, E. R., Scott, J., Wingrove, J., Rimes, K., Bathurst, N., Steiner, H., . . . Malliaris, Y. (2007). Rumination-focused cognitive behaviour therapy for residual depression: a case series. Behav Res Ther, 45(9), 2144–2154
Watkins ER, Mullan E, Wingrove J, Rimes K, Steiner H, Bathurst N, Scott J (2011) Rumination-focused cognitive–behavioural therapy for residual depression: phase II randomised controlled trial. Br J Psychiatry 199(4):317–322
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Moeller, S.B. (2023). Review and Case Study: Rumination-Focused Cognitive Behavioral Therapy (CBT) for Anger and Anger Rumination. In: Martin, C.R., Preedy, V.R., Patel, V.B. (eds) Handbook of Anger, Aggression, and Violence. Springer, Cham. https://doi.org/10.1007/978-3-031-31547-3_151
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DOI: https://doi.org/10.1007/978-3-031-31547-3_151
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