Anger Research: Staff at the Yale Child Study Center Provide a Helpful Summary Article

David A. Perna, PhD
Licensed Psychologist
Lecturer in Psychiatry
Harvard Medical School

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1 David A. Perna
2 Caitlyn Chappell
3 Heather Corazzini
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"Anger Follows a Developmental
Trajectory"

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"We use the CBT framework for our anger
management
​groups "

​Dr. Perna

Staff at the Yale Child Study Center have provided a helpful summary Article on how to differentiate between anger, irritability, and aggression. I think that it is one of the better summary articles that I have come across in the last year. While it covers a variety of topics that have been discussed in the past, it does so with a sense of clarity that fellow authors seem to lack. 

Here are a list of the points that I think were helpful:

• Anger follows a Developmental Trajectory
• Oppositional Defiant Disorder has three symptoms:
  • Angry/irritable mood
  • Argumentativeness/defiant behavior 
  • Vindictiveness
• ODD has two primary trajectories, one that predicts future mood lability and one that predicts conduct disorder. 
• Parent Management Training (PMT): Focuses on the antecedents to aggression as well as the consequences. The goal is to break the link between the two by focusing on the parent impact on the child.
• Cognitive Behavioral Therapy (CBT) : Focuses on the interaction between cognitions, feelings, and behaviors. 

Sukhodolsky offers his version of treatment which has proven to be clinically effective in a research environment. It is a sophisticated treatment model that is thoughtful and has withstood randomized treatment trials. However, like many of these manual-based, highly structured research protocols one can easily ask, "What is the clinical relevance of this research, when one applies it to a typical outpatient treatment environment?"

I do think that reading this type of research can be helpful in guiding clinicians to adopt "best practices" that help with anger management treatment. However, out-patient treatment of anger is complicated and at times sequentially confusing for both the patient and the inexperienced clinician. 

I do find it surprising that Sukhodolsky comments that CBT is generally implemented on a one-on-one basis. He seems to miss the fact that many models of anger management are based on group models that rely on CBT frameworks. We use the CBT framework for our anger management groups. 

Overall I give the article two thumbs up. Kudos to the staff at Yale!

​Dr. Perna

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