Cognitive Behavioral Affective Therapy (CBAT) for Anger in Chronic Pain Patients: A Randomized Controlled Trial

This study evaluated an integrative program called Cognitive Behavioral Affective Therapy (CBAT) for maladaptive anger in chronic pain patients. Fifty participants were randomly assigned to either a CBAT group or a comparison group called Emotional Education (EE). Each participant received a 60-minute video-recorded session twice a week for four weeks supplemented with weekly knowledge checks via phone calls. A follow-up session took place one-month post-treatment. Treatment outcomes were measured by the Anger Parameters Scale (APS) comprising five subscales (frequency, duration, intensity, latency, and threshold) as well as daily self-monitored anger logs. As hypothesized, CBAT showed highly significant pre-post reductions in self-monitored anger frequency, duration, and intensity, Hedges' g = 0.71 for frequency, 0.64 for duration, and 0.52 for intensity. At post-treatment, self-monitored anger was lower in CBAT than EE, Hedges' g = 0.42 for frequency, 0.36 for duration, and 0.28 for intensity. The three self-monitored anger outcomes correlated significantly with three corresponding parameters of the APS. These findings demonstrate that CBAT is efficacious in alleviating maladaptive anger in chronic pain sufferers and that this efficacy exceeds that of emotional education. An additional finding of importance is that decreases in self-reported anger were correlated with decreases in anger self-monitored in naturalistic settings. This supports the ecological validity of the present outcomes. Suggestions are made for future research on CBAT using larger samples that are more demographically balanced, the provision of more interactive sessions to supplement online modules, and the addition of a longer follow-up time interval.