Effects of interpretation training on hostile attribution bias and reactivity to interpersonal insult

Concurrent and longitudinal neurostructural correlates of irritability in children

Irritability, or an increased proneness to frustration and anger, is common in youth; however, few studies have examined neurostructural correlates of irritability in children. The purpose of the current study was to examine concurrent and longitudinal associations between brain structure and irritability in a large sample of 9-10-year-old children. Participants included 10,647 children from the Adolescent Brain Cognitive Developmentsm Study (ABCD Study®). We related a latent irritability factor to gray matter volume, cortical thickness, and surface area in 68 cortical regions and to gray matter volume in 19 subcortical regions using structural equation modeling. Multiple comparisons were adjusted for using the false discovery rate (FDR). After controlling for age, sex, race/ethnicity, scanner model, parent's highest level of education, medication use, and total intracranial volume, irritability was associated with smaller volumes in primarily temporal and parietal regions at baseline. Longitudinal analyses showed that baseline gray matter volume did not predict irritability symptoms at the 3rd-year follow-up. No significant associations were found for cortical thickness or surface area. The current study demonstrates inverse associations between irritability and volume in regions implicated in emotional processing/social cognition, attention allocation, and movement/perception. We advance prior research by demonstrating that neurostructural differences associated with irritability are already apparent by age 9-10 years, extending this work to children and supporting theories positing socioemotional deficits as a key feature of irritability.

The relationship between trait anger and reactive aggressive behavior in middle school students: the mediating role and intervention of hostile attribution bias

BACKGROUND

The reactive aggressive behavior in individuals typically shows a rapid growth trend as individuals enter adolescence, and peaks during middle-school period. According to the Comprehensive Cognitive Model of Trait Anger, trait anger and hostile attribution bias play important roles in the development of reactive aggressive behavior. Based on this, current study explored the relationship between trait anger and reactive aggressive behavior in middle school students, as well as the mediating role of hostile attribution bias and interventions.

METHODS

The current study consisted of three sub-studies. Study 1 recruited 87 middle school students with an average age of 12.367 ± 0.889 years, investigated the relationship between trait anger and reactive aggressive behavior, as well as the mediating role of trait hostile attribution bias. Study 2 recruited 62 middle school students with an average age of 13.376 ± 0.963 years, investigated the relationship between trait anger and reactive aggressive behavior, as well as the mediating role of state hostile attribution bias. Study 3 recruited 80 middle school students with an average age of 13.392 ± 0.977 years, implemented an intervention targeting trait hostile attribution bias in middle school students with high trait anger to reduce their reactive aggressive behavior. In current study, data management was performed using SPSS 22.0. Descriptive statistics, independent samples t-test, paired samples t-test, repeated measures analysis of variance (ANOVA), and path analysis were used for statistical analysis.

FINDINGS

The results of Study 1 showed that trait anger predicted reactive aggressive behavior through trait hostile attribution bias. The results of Study 2 indicated that trait and state hostile attribution bias played mediating role intermediary, and trait hostile attribution bias had a stronger mediating effect than state hostile attribution bias. The results of Study 3 suggested that the intervention effectively decreased trait hostile attribution bias and reactive aggressive behavior.

CONCLUSIONS

Trait anger can predict the reactive aggressive behavior of junior high school students, with trait hostility attribution bias and state hostility attribution bias mediating this relationship. Intervening in the hostility attribution bias of high-anger junior high school students can effectively reduce their reactive aggressive behavior.

Association of perceived inequality, relative deprivation and loneliness with the trajectory of anger in university students

OBJECTIVE

To examine the trajectory of anger and its psychosocial predictors (i.e., perceived social inequality, relative deprivation, and loneliness) as well as its association with anxiety and depression.

PARTICIPANTS/METHOD

Students (N = 365) completed an online survey three times over a one-year period.

RESULTS

Three trajectories of anger were identified by growth mixture modeling: low/stable (i.e., a low and stable anger over time; 88.0%), low/increasing (i.e., a low level of anger with an increasing trend; 6.7%), and moderate/decreasing class (i.e., a moderate level of anger with a decreasing trend; 5.3%). A greater perception of relative deprivation, but not of perceived social inequality, was associated with the low/increasing class. A greater level of loneliness was associated with the moderate/decreasing class. Symptoms of depression and anxiety were higher in the moderate/decreasing and low/increasing class than in the low/stable class.

CONCLUSIONS

These results suggest that interventions targeted at anger may benefit from addressing perceptions of relative deprivation and loneliness.

Longitudinal relations between bullying victimization and aggression: The multiple mediation effects of anger rumination and hostile automatic thoughts

Bullying victimization is widely accepted to be associated with aggression. However, the mechanisms underlying this relationship remain unknown. To examine the long-term impact of bullying victimization on aggression, the present study tested the potential mediating effects of both anger rumination and hostile automatic thoughts. A total of 809 undergraduates from four universities across China (74.80% female; Mage = 19.63 years, SD = 0.82 years) completed the survey on three occasions, with a 6-month delay between Time 1 and Time 2 and a 1-year interval between Time 2 and Time 3. A cross-lagged model of anger rumination and hostile automatic thoughts was developed to test whether they predicted one another, and two structural models were constructed to test their mediating roles in bullying victimization and aggression. Findings indicated that anger rumination and hostile automatic thoughts are mutually predictable; the correlation between bullying victimization and aggression is mediated independently by anger rumination and hostile automatic thoughts, and the chain mediation of bullying victimization predicting aggression first through anger rumination and then through hostile automatic thinking was established. In addition, an alternative mediation model is also significant, with hostile automatic thoughts as the primary mediator and anger rumination as the secondary mediator. These results highlight the significance of anger rumination and hostile automatic thoughts in the long-term effects of bullying victimization on aggression. Interventions designed to reduce undergraduate students' anger rumination and hostile automatic thoughts may help reduce their aggression.

Maternal supportive responses to adolescents' negative emotions serve as protective factors for adolescents' hostile attribution bias longitudinally

Existing literature has documented that parenting links to children's hostile attribution biases (HAB). However, little is known about the role played by parental emotion socialization in children's HAB. To address this research gap, the present study investigated the role of parental responses to children's negative emotions (PRCNE) in predicting adolescents' HAB using a longitudinal study. Adolescents (N = 203; Mage  = 13.61 years old at Time 1), who were recruited from a city in mainland China, reported on their mothers' PRCNE and their own HAB at two waves over a year. The results showed that mothers' supportive responses (composed of emotion-focused responses and problem-focused responses) significantly predicted adolescents' reduced HAB over time; however, PRCNE including expressive encouragement, minimization, and nonsupportive responses (composed of punitive responses and parental distress) had no significant relation with adolescents' HAB. These findings add to the existing literature investigating antecedents to adolescents' social information processing deficits and biases.

A systematic review with meta-analysis of cognitive bias modification interventions for anger and aggression

Aggression and anger are associated with interpretation and attention biases. Such biases have become treatment targets for anger and aggressive behavior in cognitive bias modification (CBM) interventions. Several studies have evaluated the efficacy of CBM for the treatment of anger and aggressive behavior, with inconsistent results. The present study meta-analytically analyzed 29 randomized controlled trial studies (N = 2334) published in EBSCOhost and PubMed between March 2013 and March 2023 assessing the efficacy of CBM for anger and/or aggression. Included studies delivered CBMs that addressed either attention biases, interpretation biases, or both. Risk of publication bias and potential moderating effects of several participant-, treatment- and study-related factors were assessed. CBM significantly outperformed control conditions in the treatment of aggression (Hedge's G = -0.23, 95% CI [-0.35, -0.11], p < .001) and anger (Hedge's G = -0.18, 95% CI [-0.28, -0.07], p = .001) independent of treatment dose, participant demographic characteristics, and study quality, though overall effects were small. Follow-up analyses demonstrated that only CBMs targeting interpretation bias were efficacious for aggression outcomes, but not when baseline aggression was accounted for. Findings suggest that CBM demonstrates efficacy for the treatment aggressive behavior and to a lesser extent, anger.

Effects of interpretation bias modification on hostile attribution bias and reactive cyber-aggression in Chinese adolescents: a randomized controlled trial

Highly aggressive individuals tend to interpret others' motives and intentions as hostile in both offline and online social situations. The current study examined whether hostile interpretation bias can be modified to influence cyber-aggression in Chinese middle school students using an interpretation bias modification program. Gender differences and the heterogeneity of cyber-aggression were also investigated since previous studies suggest that they play important roles in determining the intervention effect. One hundred and twenty-one middle school students were randomized to receive either an eight-session interpretation bias modification task (CBM-I; n = 61) or an eight-session placebo control task (PCT; n = 60) over four weeks. Measures of hostile attribution bias and cyber-aggression were administered at baseline, post-training, and at one week follow-up. Results showed that compared to PCT, participants in CBM-I showed a significant reduction in reactive cyber-aggression. However, contrary to our expectation, there was no significant difference between the two groups in the reduction of hostile attribution bias after training. The moderated mediation analysis revealed that the effect of CBM-I on hostile attribution bias and the mediating role of hostile attribution bias in the relationship between CBM-I condition and reactive cyber-aggression was only observed among females, but not among males. These findings provide initial evidence for the potential of CBM-I in reducing hostile attribution bias and cyber-aggression. However, for male students, CBM-I might not be effective enough as expected.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-023-04433-3.

Trait anger and negative interpretation bias in neutral face perception

Introduction

Anger is a basic emotion helping people to achieve goals by preparing the body for action and prompting others to change their behavior but is also associated with health issues and risks. Trait anger, the disposition to experience angry feelings, goes along with an attribution of hostile traits to others. Negative distortions in the interpretation of social information have also been observed in anxiety and depression. The present study examined the associations between components of anger and negative interpretation tendencies in the perception of ambiguous and neutral schematic faces controlling for anxiety, depressed mood, and other variables.

Methods

A sample of 150 young adults performed a computer-based perception of facial expressions task and completed the State-Trait Anger Expression Inventory (STAXI-2) along with other self-report measures and tests.

Results

Trait anger and anger expression correlated with the perception of negative affects in neutral but not in ambiguous faces. More specifically, trait anger was linked to the attribution of anger, sadness, and anxiety to neutral faces. Trait anger predicted perceived negative affects in neutral faces when adjusting for anxiety, depression, and state anger.

Discussion

For neutral schematic faces, the present data support an association between trait anger and negatively biased interpretation of facial expression, which is independent of anxiety and depressed mood. The negative interpretation of neutral schematic faces in trait angry individuals seems not only to comprise the attribution of anger but also of negative emotions signaling weakness. Neutral schematic facial expressions might be useful stimuli in the future study of anger-related interpretation biases.

Development and evaluation of an online intervention for reducing hostile interpretation bias: A randomized controlled trial

Hostility is a trait-level construct characterized by a generally suspicious and cynical view of other people that results in a tendency to interpret ambiguous social situations in hostile or threatening ways. Cognitive behavioral treatments for hostility have high dropout rates, which may be due to hostile beliefs interfering with treatment engagement. As such, there is a need for an alternative approach to prevent dropout and enhance engagement. The current study therefore developed and tested a 1-session, 40-minute online intervention targeting hostility. It was hypothesized that the hostility intervention would be rated as acceptable as indexed by self-report and completion rates. It was also hypothesized that the hostility intervention would be associated with greater reductions in hostility as compared to a control intervention. Finally, it was hypothesized there would be indirect effects of intervention condition on anger and aggression via changes in hostility. Undergraduates (N = 101) who reported elevated hostility and hazardous alcohol use were randomized to complete either the hostility intervention or a control condition targeting physical health habits. Results showed that individuals randomized to the hostility intervention found the intervention to be highly acceptable and all participants completed the intervention in its entirety. The hostility intervention was associated with significantly faster reductions in hostile interpretations than the control condition with medium to large effects. There were significant indirect effects of intervention condition on month one follow-up anger and aggression via changes in hostile cognitions. This proof-of-concept study provides initial evidence that a brief, single-session intervention may be a promising approach for reducing hostility and its correlates.

Attention and interpretation cognitive bias change: A systematic review and meta-analysis of bias modification paradigms

This systematic review and meta-analysis examines the effect of Cognitive Bias Modification for attention (CBM-A) and interpretation (CBM-I) on reducing the targeted biases and investigates moderators of each approach. PsycINFO, PsychArticles, and PubMED databases were searched for randomized-controlled studies published before March 2020 with pre- and post-CBM cognitive bias outcome measures, resulting in 91 CBM-A (n = 5914 individuals) and 70 CBM-I samples (n = 4802 individuals). Random-effects models and Hedge's g calculation showed significant medium overall effects of bias reduction with moderate to high heterogeneity (CBM-A g = 0.49 [0.36, 0.64], I² = 85.19%; CBM-I g = 0.58 [0.48, 0.68], I² = 70.92%). Effect sizes did not differ between approaches and remained significant after trim-and-fill adjustment for possible publication bias. Moderator variables were investigated with meta-regression and subgroup analyses. Participant age, symptom type, control condition and number of trials moderated CBM-A; student and clinical status moderated CBM-I effect size. Results support attention and interpretation modification in controlled laboratory and variable (online) training settings for non-clinical and clinical samples across various symptom types (anxiety, depression, substance use, eating disorders). Further empirical evidence is necessary to determine optimal sample and methodological combinations most strongly associated with adaptive behavioral outcomes.

CBM-I Training and Its Effect on Interpretations of Intent, Facial Expressions, Attention and Aggressive Behavior

There is abundant evidence suggesting that attention and interpretation biases are powerful precursors of aggression. However, little is known how these biases may interact with one another in the development and maintenance of aggression. Using cognitive bias modification of interpretation (CBM-I), the present study examined whether training more pro-social or hostile intent attributions would affect attention bias, interpretation bias of facial expressions, aggression and mood. University students (17–48 years) were assigned to either a positive training (n = 40), negative training (n = 40), or control training (n = 40). Results showed that the positive training successfully changed measures of intent attributions in a pro-social direction compared to the control training. The negative training changed measures of intent attributions in a hostile direction but not more so than the control training. We found no generalization of the training effects to relevant other outcomes. Possible explanations underlying these findings are discussed.

Cognitive Control Processes and Defense Mechanisms That Influence Aggressive Reactions: Toward an Integration of Socio-Cognitive and Psychodynamic Models of Aggression

Research on cognitive processes has primarily focused on cognitive control and inhibitory processes to the detriment of other psychological processes, such as defense mechanisms (DMs), which can be used to modify aggressive impulses as well as self/other images during interpersonal conflicts. First, we conducted an in-depth theoretical analysis of three socio-cognitive models and three psychodynamic models and compared main propositions regarding the source of aggression and processes that influence its enactment. Second, 32 participants completed the Hostile Expectancy Violation Paradigm (HEVP) in which scenarios describe a hostile vs. non-hostile social context followed by a character's ambiguous aversive behavior. The N400 effect to critical words that violate expected hostile vs. non-hostile intent of the behavior was analyzed. Prepotent response inhibition was measured using a Stop Signal task (SST) and DMs were assessed with the Defense Style Questionnaire (DSQ-60). Results showed that reactive aggression and HIA were not significantly correlated with response inhibition but were significantly positively and negatively correlated with image distorting defense style and adaptive defense style, respectively. The present article has highlighted the importance of integrating socio-cognitive and psychodynamic models to account for the full complexity underlying psychological processes that influence reactive aggressive behavior.

The efficacy of incorporating mental imagery in cognitive restructuring techniques on reducing hostility: A randomized controlled trial

BACKGROUND AND OBJECTIVES

Cognitive restructuring (CR) is an effective intervention for hostility. However, the number of patients who fail to benefit suggest that the efficacy of CR can be further improved. The present study investigated whether enhancing CR with mental imagery techniques can increase its efficacy.

METHODS

A high hostility sample (28% male, and 72% female) was randomized over one session of imagery enhanced CR (I-CR) (n = 34), traditional CR (n = 32) or an active control session (AC) (n = 21). Changes in hostile beliefs, aggressive tendencies, state anger and hostility traits were assessed pre- and post-treatment, and at one-week follow-up.

RESULTS

Results showed that both I-CR and CR efficaciously reduced hostile beliefs, aggressive tendencies and anger, to a stronger degree than AC. I-CR was more efficacious and sustainable over time than both CR and AC in reducing hostile beliefs and aggressive tendencies.

LIMITATIONS

This study was conducted using a small, non-treatment seeking sample.

CONCLUSIONS

Findings suggest that implementing imagery techniques in CR for hostile beliefs enhances its' efficacy.

Retaliatory aggressive driving: A justice perspective

Driving anger and roadway aggression have previously been conceptualized using attributional theory, the theory of planned behavior, and the general aggression model (GAM) framework. The current study builds on these findings, testing the applicability of the attribution-of-blame model of perceptions of injustice and expanding existing models of retaliatory driving aggression to include unjust world beliefs and sensitivity to injustice. A sample of 269 participants from a large urban Canadian university viewed five animated driving scenarios (i.e., a queuing violation, a dangerous turn in front of oncoming traffic, selfish parking behavior, misuse of a high occupancy vehicle lane, and a driver failing to stop at a red light). Prior to viewing each scenario, a brief written description of the scenario was provided to each participant and read aloud by the experimenter. After viewing each scenario, participants completed a questionnaire regarding their attributions, emotions, and anticipated behavior in response to the animated scenario. After viewing all animated videos, participants completed a second questionnaire that assessed individual differences and demographic variables. Consistent with the GAM, structural equation and mediation analyses identified a significant path from individual differences (i.e., belief in an unjust world and driving injustice sensitivity), through internal states (i.e., perceptions of injustice and anger), to retaliatory aggressive driving. Results of this study found consistent paths between factors which were significant across all five scenarios and may therefore be generalizable to other driving situations. Other pathways were found to influence only a selection of the five scenarios, suggesting that they may be situation specific. Results provide support for possible intervention strategies that can be employed by driver education programs to reduce aggressive driving.

A Single-Session Combined Cognitive Bias Modification Training Targeting Attention and Interpretation Biases in Aggression

Experimental studies applying cognitive bias modification of attention (CBM-A) and interpretation (CBM-I) to reduce aggression have examined the effect of modifying each cognitive bias in isolation. In order to maximise the potential impact on both biases and symptom reduction, we examined whether a combined bias training procedure targeting both attention and interpretation biases (CBM-AI) in combination would be more effective than targeting interpretation bias (CBM-I) alone. University students (17–35 years) were randomly assigned to either a single session of CBM-AI training (n = 40), CBM-I training (n = 40), or a control condition (n = 40). Contrary to our expectations, participants showed an increase in adaptive attention and pro-social interpretation bias in all training conditions. Additionally, in none of the conditions, we found a significant change on self-reported or behavioural aggression. These findings suggest: (1) that the combined training did not have added effect over single interpretation bias training, (2) that training interpretation bias may lead to changes in attention bias, (3) that elements of the control condition unexpectedly, but interestingly, also affected attention and interpretation biases, and (4) single-session CBM procedures do not produce robust effects on self-report or behavioural measures of aggression in unselected samples.

A cognitive-behavioural intervention to reduce driving anger: Evaluation based on a mixed-method approach

Road anger is an increasing problem that does not only lead to discomfort but is also associated with aggressive driving and an increased risk of crash involvement. Based on a cognitive-behavioural approach, we developed and tested a short group intervention (90 min) that aimed at decreasing road anger among drivers. We used a before-after control group design, surveying people who did (EG) and who did not (CG) participate in the group intervention. The sample (n = 126) consisted of 80 men and 46 women with a mean age of 54 years (SD = 13). In addition, a sub-sample (n = 37) participated in a driving simulator study before and after the intervention. To enrich the survey- and simulator-based findings, we conducted a focus group discussion about post-intervention experiences in traffic. Comparisons of pre and post survey results showed that constructive expression as measured by a slightly revised sub-scale of the Driving Anger Expression Inventory (DAX-short), increased significantly for EG participants but not within the CG. In addition, the involvement in milder forms of road anger (e.g., yelling) decreased significantly in the EG but not in the CG. In the simulator study, we observed that EG participants decreased the extent of aggressive driving, commenting and gesturing - however, none of these differences were statistically significant. EG participants self-assessed the intervention overall positive and 44 % reported that they had changed their way of thinking or reacting in traffic. Overall, results indicate a positive effect of the cognitive-behavioural group intervention. Study limitations, possibilities to improve the intervention and different areas of application are discussed.

Effects of cognitive bias modification for interpretation on hostile interpretation bias and self-reported aggression in juvenile delinquents

BACKGROUND/OBJECTIVE

The social information processing model holds that aggressive behavior is closely related to the hostile interpretation of ambiguous social cues, suggesting the possibility that an intervention that reduces hostile interpretations could reduce aggression. This study in Mainland China evaluated the remediating effects of cognitive bias modification for interpretation (CBM-I) on the hostile interpretation bias and self-reported aggressive behaviors of male juvenile delinquents, taking into account initial hostile interpretation bias as a possible moderator of the intervention effect.

METHOD

Fifty-six male juvenile delinquents aged 16-18 were recruited and randomly assigned to the CBM-I group (n = 28) or the Waiting-List group (n = 28). Interpretation bias and self-reported aggressive behavior were assessed at pre-test and post-test.

RESULTS

The positive interpretations of participants in the CBM-I group were significantly increased compared with participants in the Waiting-List group. The intervention effect of CBM-I on self-reported physical aggression was significant only for juvenile delinquents with high pre-test hostile interpretation bias.

CONCLUSIONS

CBM-I can significantly improve the positive interpretation bias of juvenile delinquents, and reduce the self-reported physical aggression for some male juvenile delinquents. The results have implications for providing low-cost and high-efficiency intervention for juvenile delinquents' self-reported aggression behavior.

The role of genetic and environmental factors in covariation between anxiety and anger in childhood

Higher levels of anger expression, as well as lower levels of anger control, have been reported for adults with anxiety disorders compared to individuals without anxiety disorders. Different to the research on adults, very few studies examined the relationship between anxiety and anger in childhood. In our study, we investigated 398 Italian twin pairs (74 MZ male, 70 MZ female, 134 same-sex dizygotic-53 male, 81 female-, and 120 unlike-sex dizygotic twin pairs), aged 8-17 (mean 13.06 ± 2.59): (i) the heritability of a childhood anger phenotype; (ii) the association between five anxiety domains and anger; (iii) the role of possible common etiological factors in explaining the observed comorbidity and overlap in the risk between anxiety phenotypes and anger. The study demonstrated that anger, assessed by CBCL items, is heritable in children at a similar rate to prior studies (40%). Our research found low to moderate rate of correlation between anger and anxiety (from 0.10 to 0.19). Finally, the present study found that the majority of etiological influences on anxiety and anger are independent of each other. Data showed that shared environmental influences have some small effects on the phenotypic covariation between the anxiety phenotypes and anger (12%); whereas unique environmental influences have an almost negligible effect (1%). Our analyses did not reveal the effect of genetic effects in explaining the covariation between these phenotypes.

Using Interpretation Bias Modification to Reduce Anger in Veterans with Posttraumatic Stress Disorder: A Pilot Study

Difficulty controlling anger is the most commonly reported reintegration concern among veterans with posttraumatic stress disorder (PTSD). One of the mechanisms associated with problematic anger is a tendency to interpret ambiguous interpersonal situations as hostile, known as the hostile interpretation bias (HIB). A computer-based interpretation bias modification (IBM) intervention has been shown to successfully reduce HIB and anger but has not been tested in veterans with PTSD. The current study was a pilot trial of this IBM intervention modified to address problematic anger among veterans with PTSD. Veterans with PTSD and a high level of anger (N = 7) completed eight sessions of IBM treatment over the course of 4 weeks. Participants completed self-report questionnaires at pre- and posttreatment assessment visits, as well as a treatment acceptability interview at posttreatment. Veterans experienced large reductions in hostile interpretation bias and anger from pre- to posttreatment, ds = 1.03-1.96, although these estimates may be unstable due to the small sample size. The feasibility for recruitment, retention, and treatment completion were high. Questionnaire and interview data demonstrated that most participants were satisfied with the treatment and found it helpful and easy to use. Overall, IBM for anger was feasible and acceptable to veterans with PTSD and was associated with reductions in hostile interpretations and self-reported anger outcomes. Further research examining this approach is warranted.

Modification of hostile attribution bias reduces self-reported reactive aggressive behavior in adolescents

Aggressive individuals more readily interpret others' motives and intentions in ambiguous situations as hostile. This hostile attribution bias has been argued to be causally involved in the development and maintenance of aggression, making it a target for interventions. In our current study, adolescents selected for high levels of aggression (N = 39) were assigned to either a test-retest control group or a five-session hostile attribution bias modification training, in which they were trained to make more benign interpretations of ambiguously provocative social situations. Before and after the training, we assessed hostile attribution bias and both reactive and proactive self-reported aggression in both groups. The training not only tended to produce the expected reduction in hostile attribution bias but also crucially led to decreased levels of reactive but not proactive aggression compared with the control group. Our results thus support the idea that hostile attribution bias can be targeted using training techniques and that such training-induced changes in bias may reduce aggression. However, future studies using an active control group and multiple outcome measures are needed to address the long-term effects of training.

The Computations of hostile biases (CHB) model: Grounding hostility biases in a unified cognitive framework

Our behavior is partly a product of our perception of the world, and aggressive individuals have been found to have 'hostility biases' in their perception and interpretation of social information. Four types of hostility biases can be distinguished: the hostile attribution, interpretation, expectation, and perception bias. Such low-level biases are believed to have a profound influence on decision-making, and possibly also increase the likelihood of engaging in aggressive acts. The current review systematically examined extant research on the four types of hostility bias, with a particular focus on the associations between each type of hostility bias and aggressive behavior. The results confirmed the robust association between hostility biases and aggressive behavior. However, it is still unknown how exactly hostility biases are acquired. This is also caused by a tendency to study hostility biases separately, as if they are non-interacting phenomena. Another issue is that current approaches cannot directly quantify the latent cognitive processes pertaining to the hostility biases, thus creating an explanatory gap. To fill this gap, we embedded the results of the systematic review in a state-of-the-art computational framework, which provides a novel mechanistic account with testable predictions.

Translating CBM-I Into Real-World Settings: Augmenting a CBT-Based Psychiatric Hospital Program

Cognitive bias modification for interpretation (CBM-I) is an appealing augmentation to cognitive-behavioral therapy (CBT) because it targets cognitive bias efficiently via computerized training. Few studies have tested the combination of CBM-I and CBT, and none have translated lab-based CBM-I protocols to an acute psychiatric setting. The present study describes the development and implementation of CBM-I as an augmentation to a CBT-based partial hospital. We developed a transdiagnostic CBM-I based on the word-sentence association paradigm (WSAP), which reinforces individuals for endorsing benign interpretations and rejecting negative interpretations of ambiguous sentences. Over two iterations of development, we randomly assigned patients (N = 127; M age = 34.21; 58% female, 40% male, 2% nonbinary) to either CBM-I or a control group (Phase 1: neutral WSAP task; Phase 2: treatment as usual). CBM-I comprised daily sessions (10 minutes) completed during program hours, and number of sessions varied naturalistically according to patient length of stay. Primary outcomes included feasibility, acceptability, and target engagement (interpretation bias). CBM-I was feasible and acceptable to acute psychiatric patients, and successfully shifted interpretation for novel stimuli. Patient feedback suggested that participants viewed CBM-I as bolstering their primary CBT-based care. Exploratory analyses examining clinical benefit revealed a small between-group effect on anxiety severity (d = 0.378), but no group differences on depression outcomes (d = 0.008). Findings indicate that CBM-I is a feasible and acceptable augmentation to CBT-based partial hospital care. Future studies are warranted to determine who is most likely to benefit from this low-intensity approach.

An examination of the relationship between hoarding symptoms and hostility

Hoarding disorder (HD) is a persistent and severe psychiatric condition in which individuals are unable to discard possessions, which results in considerable clutter. Individuals who hoard often endorse interpersonal difficulties and social isolation. However, little research has examined mechanisms that may help to explain this relationship. One possible mechanism is hostility, which is characterized by increased sensitivity to real or perceived social threats. The current study examined the relationship between hoarding symptoms and hostility across two undergraduate samples. In study 1, unselected undergraduates (N = 195) were administered measures of hoarding symptoms, hostile interpretations, and depression and anxiety symptoms. Participants in study 2 (N = 117) were selected for reporting elevated hoarding symptoms. Study 2 participants were administered the same measures as in study 1, and were additionally randomized to an inclusion or exclusion condition in a social exclusion manipulation. Total hoarding symptoms and hostile interpretations were positively associated across both samples, even when controlling for depression and anxiety. Further, greater hoarding symptoms were associated with increased feelings of hostility in response to social exclusion in study 2. Results suggest that increased sensitivity to social threat may confer risk for hoarding. These findings add to a growing body of research implicating interpersonal factors in the development and maintenance of hoarding disorder.

Association of posttraumatic stress disorder and traumatic brain injury with aggressive driving in Iraq and Afghanistan combat veterans

PURPOSE

Aggressive driving contributes to the high rates of postdeployment motor vehicle-related injury and death observed among veterans, and veterans cite problems with anger, aggressive driving, and road rage as being among their most pressing driving-related concerns. Both posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) have been associated with driving-related deficits in treatment-seeking samples of veterans, but the relative contribution of each of these conditions to problems with aggressive driving in the broader population of combat veterans is unclear.

METHOD

χ2 and logistic regression analyses were used to examine the relative association of PTSD, TBI, and co-occurring PTSD and TBI to self-reported problems with road rage in a sample of 1,102 veterans living in the mid-Atlantic region of the United States who had served in Afghanistan or Iraq.

RESULTS

Results indicate that controlling for relevant demographic variables, PTSD without TBI (odds ratio = 3.44, p < .001), and PTSD with co-occurring TBI (odds ratio = 4.71, p < .001) were associated with an increased risk of road rage, but TBI without PTSD was not.

CONCLUSIONS

Our findings suggest that PTSD, with or without comorbid TBI, may be associated with an increased risk of aggressive driving in veterans. Clinical implications for treating problems with road rage are discussed, including use of interventions targeting hostile interpretation bias and training in emotional and physiological arousal regulation skills. (PsycINFO Database Record

The effects of a novel hostile interpretation bias modification paradigm on hostile interpretations, mood, and aggressive behavior

BACKGROUND AND OBJECTIVES

Cognitive theories of aggression propose that biased information processing is causally related to aggression. To test these ideas, the current study investigated the effects of a novel cognitive bias modification paradigm (CBM-I) designed to target interpretations associated with aggressive behavior.

METHODS

Participants aged 18-33 years old were randomly assigned to either a single session of positive training (n = 40) aimed at increasing prosocial interpretations or negative training (n = 40) aimed at increasing hostile interpretations.

RESULTS

The results revealed that the positive training resulted in an increase in prosocial interpretations while the negative training seemed to have no effect on interpretations. Importantly, in the positive condition, a positive change in interpretations was related to lower anger and verbal aggression scores after the training. In this condition, participants also reported an increase in happiness. In the negative training no such effects were found. However, the better participants performed on the negative training, the more their interpretations were changed in a negative direction and the more aggression they showed on the behavioral aggression task.

LIMITATIONS

Participants were healthy university students. Therefore, results should be confirmed within a clinical population.

CONCLUSIONS

These findings provide support for the idea that this novel CBM-I paradigm can be used to modify interpretations, and suggests that these interpretations are related to mood and aggressive behavior.

Modification of Hostile Interpretation Bias in Depression: A Randomized Controlled Trial

Interpretation Bias Modification (IBM) is gaining attention in the literature as an intervention that alters cognitive biases and reduces associated symptoms. Forty, primarily college-aged, non-treatment-seeking adults with major depressive disorder (MDD) were randomly assigned to receive either IBM targeting hostile interpretation bias (IBM-H) or a healthy video control (HVC) condition. Compared to those in HVC, participants in IBM-H reported more benign interpretations and fewer hostile interpretations at posttreatment. No difference in depressive interpretation bias was found between groups at posttreatment. IBM-H led to improved anger control at posttreatment and follow-up compared to HVC, though no effects of condition were found on trait anger or depressive symptoms. The IBM-H group perceived their treatment as less credible than the HVC group. For individuals with high expectancy of treatment success, IBM-H led to lower posttreatment depressive symptoms compared to HVC, while findings trended in the opposite direction for those with low expectancy of success. Overall, these preliminary findings point to boundary conditions for the efficacy of IBM protocols for anger and depression and potential improvements to be made to future IBM protocols.

Relationships Between Hostile Attribution Bias, Negative Urgency, and Reactive Aggression

Abstract. Negative urgency defined as the tendency to act rashly when faced with intense negative emotions and hostile attribution bias (HAB) which refers to the tendency to interpret the intention of others as hostile when social context cues are ambiguous are two key psychological factors underlying reactive aggression. However, the specific associations between these factors in relation to reactive aggression have not been tested yet with competing models. The objective of the study was to test three putative models: (1) negative urgency moderates the association between HAB and reactive aggression; (2) HAB mediates the link between negative urgency and reactive aggression; (3) negative urgency mediates the relation between HAB and reactive aggression. One-hundred seventy-six participants were given self-report questionnaires to assess impulsivity, reactive aggression, as well as vignettes featuring a social situation measuring HAB in response to an ambiguous social provocation. The results showed that negative urgency constitutes a significant mediator in the association between HAB and reactive aggression. These results provide valuable insight into the cognitive processes underlying reactive aggression and may hold implications for diagnosis and intervention on aggressive behaviors.

Hostile interpretation training for individuals with alcohol use disorder and elevated trait anger: A controlled trial of a web-based intervention

High trait anger is associated with more severe alcohol use problems, and alcohol has been found to facilitate aggressive behavior among individuals with high trait anger. Treatments focused on a sample with alcohol use disorder with elevated anger could reduce alcohol use problems, as well as violence and aggression. We sought to examine the efficacy of interpretation bias modification for hostility (IBM-H) in a sample with high trait anger and alcohol use disorder (AUD). Fifty-eight individuals with AUD and elevated trait anger were randomly assigned to eight web-based sessions (two per week) of IBM-H or a healthy video control condition (HVC). Measures of interpretation bias, anger, and alcohol use were administered at pre- and post-treatment and at one-month follow-up. IBM-H led to greater improvements in interpretation bias compared to HVC at post and follow-up. IBM-H also led to greater reductions in trait anger than HVC, though this was an indirect effect mediated by changes in interpretation bias. Further, IBM-H led to lower anger expression than HVC; this was a direct (non-mediated) effect. Lastly, both conditions reported decreases in alcohol use and consequences following treatment, though there were no significant differences between them. These findings provide initial support for the utility of IBM-H as a brief non-confrontational intervention for AUD with elevated trait anger. Limitations and future research directions are discussed.

Pain and multiple facets of anger and hostility in a sample seeking treatment for problematic anger

A number of studies have reported associations between pain and anger in samples with chronic pain, but research has mostly overlooked associations between pain and anger in those with problematic anger. The present study explored associations between pain severity and a variety of anger and hostility constructs in a sample seeking anger treatment (n =131). Zero-order correlations and partial correlations were used to examine associations between pain, anger, and hostility, controlling for depressive symptoms. Hierarchical regression models examined potential interaction effects of gender on associations between pain and these outcomes. Pain severity was positively associated with trait anger, outward anger expression, hostile interpretation bias, hostile ideation, and inability to forgive others. These associations were independent of co-occurring depressive symptoms, with some exceptions. Gender moderated the association between pain and hostile ideation such that pain was positively associated with hostile ideation in women but not men. Pain severity was uniquely associated with multiple outcomes of relevance to individuals undergoing treatment for problematic anger. Clinical implications will be discussed.

Predictors and mediators of trait anger across the psychosis continuum: The role of attachment style, paranoia and social cognition

Anger in the context of psychosis has a significant impact on treatment outcomes and serious implications for risk management. Understanding mechanisms underlying anger will improve interventions and inform strategies for prevention. This study is the first to examine the relationships between anger and key theoretical drivers across different phases of the psychosis continuum. A battery including measures of theory of mind, attachment, hostile attribution bias, paranoia and anger was administered to 174 participants (14 ultra-high risk, 20 first-episode, 20 established psychosis, 120 non-clinical participants). We tested the model that insecure attachment, paranoia, impaired theory of mind and hostile attribution bias would predict trait anger using multiple regression. Attachment avoidance, paranoia and hostile attribution bias were significantly associated with anger but attachment anxiety and theory of mind were not. Mediation analysis showed that paranoia partially mediated the relationship between avoidant attachment and anger but hostile attribution bias did not. Findings emphasise the importance of interventions targeting paranoia to reduce anger and the potential of preventive strategies focused on attachment relationships in early life or adulthood to reduce adult paranoia and anger.

Hostile interpretation bias in depression

BACKGROUND

Research suggests an important relationship between interpretation bias, hostility and Major Depressive Disorder (MDD). Extant literature has yet to examine hostile interpretation bias in clinically depressed samples; the current studies sought to fill this gap.

METHOD

Study 1 participants included undergraduates who met criteria for MDD (n=36) or no anxiety or mood diagnosis (n=35). Each participant completed a structured clinical interview along with measures of depression, hostile interpretation bias, and trait hostility. In Study 2, a sample of treatment-seeking individuals with elevated trait anger completed measures of depression, hostile interpretation bias, and trait anger.

RESULTS

Study 1 demonstrated that, relative to the non-depressed group, individuals with depression displayed greater hostile interpretation bias but comparable levels of trait hostility. In Study 2, greater hostile interpretation bias was associated with greater depressive symptoms, and this relationship was independent of co-occurring trait anger.

LIMITATIONS

The correlational nature of these studies precludes interpretation of causal relationships between constructs. Additionally, replication of these results should be sought in a larger, more diverse sample.

CONCLUSION

Overall, the findings suggest hostile interpretation bias may play a unique role in depression and could be a treatable feature of interpersonal mechanisms maintaining MDD.

Attention and interpretation processes and trait anger experience, expression, and control

This study explored attention and interpretation biases in processing facial expressions as correlates of theoretically distinct self-reported anger experience, expression, and control. Non-selected undergraduate students (N = 101) completed cognitive tasks measuring attention bias, interpretation bias, and Spielberger's State-Trait Anger Expression Inventory (STAXI-2). Attention bias toward angry faces was associated with higher trait anger and anger expression and with lower anger control-in and anger control-out. The propensity to quickly interpret ambiguous faces as angry was associated with greater anger expression and its subcomponent of anger expression-out and with lower anger control-out. Interactions between attention and interpretation biases did not contribute to the prediction of any anger component suggesting that attention and interpretation biases may function as distinct mechanisms. Theoretical and possible clinical implications are discussed.

Approach and avoidance towards aggressive stimuli and its relation to reactive and proactive aggression

This study assessed the association between indirectly measured behavioural approach- and avoidance-related tendencies on the one hand, and reactive versus proactive aggression on the other hand. Reactive aggression (i.e. the impulsive, anger-driven aggression expressed in response to threatening stimuli) was differentiated from proactive aggression (i.e. the more controlled aggression motivated towards obtaining specific goals). A mixed sample of 118 patients and healthy controls filled out a self-report measure to assess their degree of reactive and proactive aggression, and then performed an Approach Avoidance Task in which they were asked to pull or push a joystick in response to a format-feature of a series of pictures, irrespective of their contents. The pictorial stimuli used in this task included attack-related scenes and angry faces, along with neutral, positive and negative control stimuli. The results were controlled for the level of personality disorder pathology, gender, and age. The findings indicated that reactive but not proactive aggression was related to the relative behavioural tendency to approach attack-related scenes, along with positive stimuli. These findings reflect the hyper-reactivity of the approach-related reward system in reactive aggression, and further our knowledge into the distinct correlates and precursors of reactive and proactive aggression.

The relationship between personality disorder traits and reactive versus proactive motivation for aggression

There is a strong link between personality disorders (PDs) and aggression. This is reflected in high prevalence rates of PD diagnoses in forensic samples, and in several diagnostic criteria of PDs directly referring to elevated levels of aggression. Aggression can stem from two distinct types of motivation; reactive or impulsive aggression that serves as a defensive reaction to provocation, and proactive or premeditated aggression used to gain extrinsic benefits. Although some clinical conditions like antisocial, borderline, and narcissistic PDs or PD traits, have been empirically linked to reactive and/or proactive aggression, the current study pioneers assessing the relationship between reactive and proactive aggression and traits of all 10 PDs. A mixed sample of patient and non-patient (N=238) participants were administered with the SCID II to assess the level of PD traits; they also completed the Reactive Proactive Questionnaire to determine levels of reactive and proactive aggression. Results showed that paranoid PD traits were positively related to reactive aggression, whereas proactive aggression was uniquely related to antisocial PD traits. This highlights the importance of differentiating between distinct motivations for aggression in PD samples.

Measuring Hostile Interpretation Bias: The WSAP-Hostility Scale

Hostile interpretation biases are central to the development and maintenance of anger, yet have been inconsistently assessed. The Word Sentence Association Paradigm (WSAP) was used to develop a new measure of hostile interpretation biases, the WSAP-Hostility. Study 1 examined the factor structure and internal consistency of the WSAP-Hostility, as well as its relationship with trait anger. Study 2 provided convergent and divergent validity data by examining its associations with trait anger, aggression, depression, and anxiety. Study 3 examined the relationship between WSAP-Hostility and another measure of hostile interpretation biases, as well as another word sentence association measure, in a sample of community participants. Study 4 also used a sample of community participants to offer further evidence of convergent validity. Across the studies, the WSAP-Hostility demonstrated convergent and divergent validity and internal consistency, supporting its use as a measure of hostile interpretation biases.

Hostility, flooding, and relationship satisfaction: Predicting trajectories of psychological aggression across the transition to parenthood

Psychological aggression has been shown to have harmful effects on both partners, sometimes above and beyond the effects of physical aggression. However, very little is known about psychological aggression during the transition to parenthood. The transition to parenthood is a time where relationship satisfaction often declines and stress increases, which may put the couples at higher risk for psychological aggression. The purpose of this study was to examine if prenatal risk factors related to interpersonal style (specifically, emotional flooding and hostility) predict changes in psychological aggression from pregnancy to 2 years postpartum. Ninety eight couples took part in this study. The couples completed self-report questionnaires during pregnancy, 1 year postpartum, and 2 years postpartum. Both partners were asked about perpetrating and experiencing psychological aggression in their current relationship. Two level Hierarchical Linear Models (HLMs) were used to examine longitudinal associations between hostility, flooding, and psychological aggression. For women, hostility during pregnancy was a significant longitudinal predictor of psychological aggression. For men, flooding was a significant longitudinal predictor of psychological aggression. For both men and women, relationship satisfaction partially mediated the relationship between flooding/hostility and psychological aggression, indicating that women's hostile attitudes and men's tendency to be flooded tend to erode relationship quality, leading to increases in psychological aggression. This may represent a classic demand-withdraw dynamic in couples. The results indicate hostility for women and flooding for men are potential prenatal risk factors for future psychological aggression. Implications and future research directions are discussed. Aggr. Behav. 42:134-148, 2015. © 2014 Wiley Periodicals, Inc.

A Multi-Session Attribution Modification Program for Children with Aggressive Behaviour: Changes in Attributions, Emotional Reaction Estimates, and Self-Reported Aggression

BACKGROUND

Research suggests that aggressive children are prone to over-attribute hostile intentions to peers.

AIMS

The current study investigated whether this attributional style can be altered using a Cognitive Bias Modification of Interpretations (CBM-I) procedure.

METHOD

A sample of 10-12-year-olds selected for displaying aggressive behaviours was trained over three sessions to endorse benign rather than hostile attributions in response to ambiguous social scenarios.

RESULTS

Compared to a test-retest control group (n = 18), children receiving CBM-I (n = 16) were less likely to endorse hostile attributions and more likely to endorse benign attributions in response to a new set of ambiguous social situations. Furthermore, aggressive behaviour scores reduced more in the trained group than in the untrained controls. Children who received attribution training also reported less perceived anger and showed a trend to report more self-control than those in the control group.

CONCLUSIONS

Implications of these findings are discussed.