title: Perspective training to treat anger problems after brain injury: Two case studies.
abstract: BACKGROUND
  People with acquired brain injury (ABI) often show increased anger and aggression. Anger has been linked to attributions of hostile intent. The more intentional and hostile the judgments of other's behaviours are, the angrier the responses tend to be. Some people with ABI tend to make harsher attributions than healthy controls (negative attribution bias). Poor perspective-taking may distort assessment of others' intentions, thereby contributing to this bias and subsequent anger responses.
  
  
  OBJECTIVE
  Examine changes in anger and perspective-taking after a Perspectives Group in two participants with ABI.
  
  
  METHODS
  This study is a case report exploring observational changes in anger, hostility, verbal and physical aggression and perspective-taking in two males with ABI and severe emotion dysregulation. Participants and their spouses also provided qualitative feedback through a semi-structured interview following perspectives training. The six-week "Perspectives Group" used hypothetical and real-life situations to teach participants to consider the perspectives of others when determining their intentions.
  
  
  RESULTS
  Both participants showed post-treatment declines in aggression. Although only minimal changes occurred on the perspective-taking measure, spouses described important behavioural changes in their partners that indicated both decreased aggression and better perspective taking.
  
  
  CONCLUSIONS
  These preliminary findings support further investigation of perspectives training for reducing anger after ABI.
authors.affiliation: Oliver Zangwill Centre for Neuropsychological Rehabilitation, Ely, UK.
authors.forename: Jill
authors.initials: J
authors.lastname: Winegardner
authors.affiliation: Oliver Zangwill Centre for Neuropsychological Rehabilitation, Ely, UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Keohane
authors.affiliation: Oliver Zangwill Centre for Neuropsychological Rehabilitation, Ely, UK.
authors.forename: Leyla
authors.initials: L
authors.lastname: Prince
authors.affiliation: Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Dawn
authors.initials: D
authors.lastname: Neumann
mesh_terms: D000328:Adult; D000374:Aggression / Q000523:psychology*; D000786:Anger; D001930:Brain Injuries / Q000523:psychology*; D005260:Female; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy / Q000379:methods*; D012938:Social Perception; D018454:Spouses; D016896:Treatment Outcome
keywords: Brain injury; anger management; attributions; hostility bias; perspective taking; perspectives training