TY - JOUR

T1 - Psychological interventions for anger and aggression in people with intellectual disabilities in forensic services

T2 - A systematic review of the literature

AU - Browne, Claire

AU - Smith, Ian Craig

N1 - This is the author’s version of a work that was accepted for publication in Aggression and Violent Behavior. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Aggression and Violent Behavior, 39, 2018 DOI: 10.1016/j.avb.2018.01.002

PY - 2018/3

Y1 - 2018/3

N2 - This systemic review investigates the current evidence for the effectiveness of anger and/or aggression interventions for people with intellectual disabilities (ID) in receipt of forensic mental health services. Due to the prevalence withinthis population of difficulties with anger and aggression, and the associated substantial individual and societal consequences, the provision of psychological interventions has become increasingly common. However, no critical synthesis of the empirical evidence relating to their effectiveness has previously been conducted. Sixteen peerreviewed controlled trials or case series designs published between 2001 and 2016 met the inclusion criteria. The results highlight an emerging evidence base for the use of CBT in improving anger regulation, and for a range of psychological therapies in reducing aggressive behaviour. However, consistent methodological shortcomings limit thegeneralisability of findings and currently preclude firm conclusions on effectiveness. Recommendations are made for future research to address these shortcomings, including clearly-defined adaptations, adequately powered sample sizes, carefully designed baselines and follow-up periods. Despite the current status of evidence, the review provides an accessible and objective foundation to inform decision-making by service commissioners and clinicians providing anger and aggression interventions to people with ID.

AB - This systemic review investigates the current evidence for the effectiveness of anger and/or aggression interventions for people with intellectual disabilities (ID) in receipt of forensic mental health services. Due to the prevalence withinthis population of difficulties with anger and aggression, and the associated substantial individual and societal consequences, the provision of psychological interventions has become increasingly common. However, no critical synthesis of the empirical evidence relating to their effectiveness has previously been conducted. Sixteen peerreviewed controlled trials or case series designs published between 2001 and 2016 met the inclusion criteria. The results highlight an emerging evidence base for the use of CBT in improving anger regulation, and for a range of psychological therapies in reducing aggressive behaviour. However, consistent methodological shortcomings limit thegeneralisability of findings and currently preclude firm conclusions on effectiveness. Recommendations are made for future research to address these shortcomings, including clearly-defined adaptations, adequately powered sample sizes, carefully designed baselines and follow-up periods. Despite the current status of evidence, the review provides an accessible and objective foundation to inform decision-making by service commissioners and clinicians providing anger and aggression interventions to people with ID.

KW - Systematic review

KW - Intellectual disabilities

KW - Forensic

KW - Anger management

KW - Aggression

KW - Psychological interventions

U2 - 10.1016/j.avb.2018.01.002

DO - 10.1016/j.avb.2018.01.002

M3 - Journal article

VL - 39

SP - 1

EP - 14

JO - Aggression and Violent Behavior

JF - Aggression and Violent Behavior

SN - 1359-1789

ER -