Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Aug:167:104344.
doi: 10.1016/j.brat.2023.104344. Epub 2023 Jun 2.

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

Affiliations
Meta-Analysis

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

Nicole K Ciesinski et al. Behav Res Ther. 2023 Aug.

Abstract

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.

Keywords: aggression; anger; cognitive bias modification; meta-analysis; randomized controlled trials.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
PRISMA study screening and selection diagram
Figure 2.
Figure 2.
Random effect of cognitive bias modification on anger
Figure 3.
Figure 3.
Random effect of cognitive bias modification on aggression
Figure 4.
Figure 4.
Doi plots for publication bias in random effects estimates of anger and aggression

References

    1. AlMoghrabi N, Franken IHA, Mayer B, & Huijding J (2022). A Single-Session Combined Cognitive Bias Modification Training Targeting Attention and Interpretation Biases in Aggression. Behaviour Change, 39(1), 1–20.
    1. AlMoghrabi N, Franken IHA, Mayer B, van der Schoot M, & Huijding J (2021). CBM-I Training and Its Effect on Interpretations of Intent, Facial Expressions, Attention and Aggressive Behavior. Europe’s Journal of Psychology, 17(2), 13–27. - PMC - PubMed
    1. AlMoghrabi N, Huijding J, & Franken I (2018). The effects of a novel hostile interpretation bias modification paradigm on hostile interpretations, mood, and aggressive behavior. Journal of Behavior Therapy and Experimental Psychiatry, 58, 36–42. - PubMed
    1. AlMoghrabi N, Huijding J, Mayer B, & Franken I (2019). Gaze-contingent Attention Bias Modification Training and its Effect on Attention, Interpretations, Mood, and Aggressive Behavior. Cognitive Therapy and Research, 43(5), 861–873.
    1. Amir N, Beard C, Burns M, & Bomyea J (2009). Attention modification program in individuals with generalized anxiety disorder. J Abnorm Psychol, 118(1), 28–33. - PMC - PubMed

Publication types

LinkOut - more resources