Anger and aggression in people with intellectual disabilities: Treatment and follow-up of consecutive referrals and a waiting list comparison

Abstract

Based on the work of Novaco, there have been several reports of case illustrations that develop anger management training for people with intellectual disabilities. Case reports have become increasingly sophisticated, with social validation of aggression and follow-ups of up to 10 years. There have also been three recent outcome studies attesting to the effectiveness of anger management treatment methods. The current report uses more recently developed methods and a larger number of subjects than previous reports and presents a controlled study of these methods. Thirty-three participants made up the treatment condition. Fourteen participants constituted a waiting list control condition, which lasted six months. Participants were assessed using a provocation inventory, anger provoking roleplays, self-report diaries and reports of aggressive incidents. All were assessed pre- and post-experimental conditions and for the treatment condition some had three, nine and 15 months follow-up. For some participants there was a 21 and 30 month follow-up. Control participants all went on to complete treatment. There were significant improvements in anger control on all measures. While there were significant within subject improvements on the provocation inventory, the treatment subjects did not show significant improvement over the control subjects at post-treatment. A significantly greater percentage of control subjects committed further aggressive incidents. Taken together, the results show the positive effect of anger management training and the generalization of these effects to a reduction in the number of reported aggressive incidents. The present study is further evidence of the effectiveness of anger management training for people with intellectual disabilities. These improvements are shown not only in assessments designed to measure the effects of treatment but also in more general socially validated records of incidents of aggression. Copyright © 2004 John Wiley & Sons, Ltd.