(PS2-D90) Identifying the Best Cognitions to Target in Anger Management: It Is the Honor Code

Anger can be dysregulated and lead to dysfunctional behaviors and consequences, negatively influencing one’s well-being and increasing health problems, occupational difficulties, aggression, violence, substance abuse, and weakened social support. No diagnostic category exists for anger disorders in DSM5. However, CBT has emerged as an efficacious treatment for anger. CBT hypothesize that when patients experience undesirable activating events, they experience irrational, unhealthy, maladaptive cognitions. In therapy, clinicians aim to change these cognitions through cognitive and behavioral techniques to reduce dysfunctional anger. However, little consensus exists concerning which cognitive constructs are most influential in eliciting clinical anger. This lack of consensus makes anger harder to treat. The Anger Cognitions Scale – 2nd Edition assesses an individual’s endorsement of seven cognitive processes commonly discussed in CBT treatments of anger. Some cognitions predict dysfunctional anger better than others do, and some have only shared but no significant unique variance in predicting dysfunctional anger. Although the ACS-R provides robust evidence on the cognitions related to dysfunctional anger, evidence suggests two additional cognitions involved in anger were not included in the ACS-R. These include self-condemnation and the honor code. This study develops ACS-3rd measures to add these constructs to the others. The ACS3 assesses the cognitions of hostile attributions, overgeneralization, inflammatory labeling, demandingness, catastrophic evaluation, honor code, self-condemnation, frustration intolerance, and negative consequences of anger to determine the most influential constructs related to dysfunctional anger.

All of the cognitions significantly predicted dysfunctional anger. Only the measures for hostile attributions, negative consequences of anger, frustration intolerance, and honor code had significant shared variance. The honor code emerged as the strongest predictor of dysfunctional anger by far. Including it in the regression reduced the unique variance in predicting dysfunctional anger of all the other cognition subscales. The honor code comes from social psychology and has not been studied in a clinical context. It involves elements of self-worth, self-preservation, and revenge. It has not been included in most CBT approaches for treating anger. This has important implications for treating anger to include the assessment of the honor code. Also, we have not yet explored the best ways to change this cognition.