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A Pilot Randomized Controlled Trial of Cognitive Bias Modification for Intermittent Explosive Disorder
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2025-08
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Psychology
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https://doi.org/10.34944/mccg-fk53
Abstract
Intermittent Explosive Disorder (IED), characterized by recurrent aggressive outbursts, has a chronic and debilitating course. There are few efficacious treatments for IED, and none that meet the criteria of “empirically supported,” highlighting the need for novel IED interventions. IED is associated with socioemotional information processing difficulties, including over-attentiveness to threatening information (attention bias) and the tendency to attribute hostile intent to others (interpretation bias). Evidence suggests treatment targeting these cognitive biases (cognitive bias modification; CBM) can reduce anger and aggressive behavior, though this has yet to be examined in an IED sample. The present study assessed the efficacy of CBM for the treatment of IED via a pilot randomized controlled trial. Participants diagnosed with IED were randomized into either (1) a four-week (8-session) computerized CBM (n = 22) or (2) a dose-equated computerized placebo intervention (Placebo; n = 22). In the CBM condition, the tasks are aimed at modifying attention and interpretation biases through reinforcing non-hostile responses, whereas in the placebo condition, task contingencies equally favor hostile and non-hostile responses. Participants completed measures of aggression, anger, attention and interpretive biases, emotion regulation, and life satisfaction at pre-, mid-, and post-treatment, as well as a one-month follow-up. Though CBM was superior to placebo in decreasing interpretative biases, CBM did not outperform the Placebo condition in reducing aggression or attention biases. However, only participants in the CBM condition exhibited significant improvements in anger, hostile attribution bias, emotion dysregulation, and life satisfaction over time. These findings provide limited support for the use of CBM in treating anger and related symptoms in IED.
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