Abstract
Uncontrolled anger is often expressed as verbal and physical aggression. Some people with schizophrenia engage in verbal and physical aggression when they cannot control their anger either through the use of psychotropic medication or psychosocial interventions. In this study, we taught three individuals with long-standing anger management problems the concept of shenpa—the almost instantaneous reaction of the mind to some internal or external stimulus that hooks them to a negative emotion—and a mindfulness-based practice that helped them to intuit this without attachment or anger. In addition, we taught them the mindfulness-based practice of compassionate abiding for dealing with emotionally arousing feelings that follow shenpa. Using a multiple baseline design, we assessed the effects of the two mindfulness-based practices on anger, verbal aggression and physical aggression. The three individuals were able to decrease their anger, greatly reduce verbal aggression, and virtually eliminate physical aggression.
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Adkins, A. D., Singh, A. N., Winton, A. S. W., McKeegan, G. F., & Singh, J. (2010). Using a mindfulness-based procedure in the community: translating research to practice. Journal of Child Family Studies, 19, 175–183.
Allen, M. H., Currier, G. W., Carpenter, D., Ross, R. W., & Docherty, J. P. (2005). The expert consensus guideline series. treatment of behavioral emergencies 2005. Journal of Psychiatric Practice, 11(supplement 1), 5–108.
Allen, M., Bromley, A., Kuyken, W., & Sonnenberg, S. J. (2009). Participants’ experiences of mindfulness-based cognitive therapy: it changed me in just about every way possible. Behavioural and Cognitive Psychotherapy, 37, 413–430.
Barlow, D. H., Nock, M., & Hersen, M. (2009). Single-case experimental designs (3rd ed.). New York: Allyn & Bacon.
Beck, R., & Fernandez, E. (1998). Cognitive-behavioral therapy in the treatment of anger: a meta-analysis. Cognitive Therapy and Research, 22, 63–74.
Bobes, J., Fillat, O., & Arango, C. (2009). Violence among schizophrenia out-patients compliant with medication: prevalence and associated factors. Acta Psychiatrica Scandinavica, 119, 218–225.
Buchanan, R. W., Kreyenbuhl, J., Kelly, D. L., Noel, J. M., Boggs, D. L., Fischer, B. S., & Keller, W. (2010). The 2009 schizophrenia PORT psychopharmacological treatment recommendations and summary statements. Schizophrenia Bulletin, 36, 71–93.
Buckley, P., Citrome, L., Nichita, C., & Vitacco, M. (2011). Psychopharmacology of aggression in schizophrenia. Schizophrenia Bulletin, 37, 930–936.
Chilvers, J., Thomas, C., & Stanbury, A. (2011). The impact of a ward-based mindfulness programme on recorded aggression in a medium secure facility for women with learning disabilities. Journal of Learning Disabilities & Offending Behaviour, 2, 27–41.
Chödrön, P. (2007). Don’t bite the hook: finding freedom from anger, resentment, and other destructive emotions. Boston, MA: Shambhala Audio.
Chödrön, P. (2010). Taking the leap: freeing ourselves from old habits and fears. Boston, MA: Shambhala.
Citrome, L. (2007). Comparison of intramuscular ziprasidone, olanzapine, or aripiprazole for agitation: a quantitative review of efficacy and safety. Journal of Clinical Psychiatry, 68, 1876–1885.
Del Vecchio, T., & O’Leary, K. D. (2004). Effectiveness of anger treatments for specific anger problems: a meta-analytic review. Clinical Psychology Review, 24, 15–34.
DiGiuseppe, R., & Tafrate, R. C. (2003). Anger treatment for adults: a meta-analytic review. Clinical Psychology: Science and Practice, 10, 70–84.
Edmondson, C. B., & Conger, J. C. (1996). A review of treatment efficacy for individuals with anger problems: conceptual, assessment, and methodological issues. Clinical Psychology Review, 16, 251–275.
Fazel, S., Gulati, G., Linsell, L., Geddes, J. R., & Grann, M. (2009). Schizophrenia and violence: systematic review and meta-analysis. PLoS Medicine, 6, e1000120.
Fix, R. L., & Fix, S. T. (2013). The effects of mindfulness-based treatments for aggression: a critical review. Aggression and Violent Behavior, 18, 219–227.
Heppner, W. L., Kernis, M. H., Lakey, C. E., Campbell, W. K., Goldman, B. M., Davis, P. J., & Cascio, E. V. (2008). Mindfulness as a means of reducing aggressive behavior: dispositional and situational evidence. Aggressive Behavior, 34, 486–496.
Hodgins, S. (2008). Violent behavior among people with schizophrenia: a framework for investigations of causes, and effective treatment, and prevention. Philosophical Transactions of the Royal Society B, 363, 2505–2518.
Kabat-Zinn, J. (1990). Full catastrophe living: how to cope with stress, pain and illness using mindfulness meditation. New York, NY: Dell.
Kinney, T. A., Smith, B. A., & Donzella, B. (2001). The influence of sex, gender, self-discrepancies, and self-awareness on anger and verbal aggression among U.S. college students. Journal of Social Psychology, 141, 245–275.
Kongtrül, D. (2008). Light comes through: Buddhist teaching on awakening to our natural intelligence. Boston, MA: Shambhala.
Krakowski, M. I., Czobor, P., Citrome, L., Bark, N., & Cooper, T. B. (2006). Atypical antipsychotic agents in the treatment of violent patients with schizophrenia and schizoaffective disorder. Archives of General Psychiatry, 63, 622–629.
Malterud, K. (2001). Qualitative research: standards, challenges, and guidelines. Lancet, 358, 483–488.
Maron-Katz, A., Ben-Simon, E., Sharon, H., Gruberger, M., & Cvetkovic, D. (2014). A neuroscience perspective on meditation. In N. N. Singh (Ed.), Psychology of meditation (pp. 99–128). New York: Nova.
Parker, R. I., & Vannest, K. (2009). An improved effect size for single-case research: nonoverlap of all pairs. Behavior Therapy, 40, 357–367.
Parker, R. I., Hagan-Burke, S., & Vannest, K. (2007). Percentage of all non-overlapping data (PAND): an alternative to PND. Journal of Special Education, 40, 194–204.
Samuelson, M., Carmody, J., Kabat-Zinn, J., & Bratt, M. A. (2007). Mindfulness-based stress reduction in Massachusetts correctional facilities. Prison Journal, 87, 254–268.
Scheier, M. F., Fenigstein, A., & Buss, A. H. (1974). Self-awareness and physical aggression. Journal of Experimental Social Psychology, 10, 264–273.
Singh, N. N. (2014). Psychology of meditation. New York: Nova.
Singh, N. N., Wahler, R. G., Adkins, A. D., Myers, R. E., & and the Mindfulness Research Group. (2003). Soles of the feet: a mindfulness-based self-control intervention for aggression by an individual with mild mental retardation and mental illness. Research in Developmental Disabilities, 24, 158–169.
Singh, N. N., Lancioni, G. E., Singh, S. D., Winton, A. S. W., Sabaawi, M., Wahler, R. G., & Singh, J. (2007a). Adolescents with conduct disorder can be mindful of their aggressive behavior. Journal of Emotional and Behavioral Disorders, 15, 56–63.
Singh, N. N., Lancioni, G. E., Winton, A. S. W., Adkins, A. D., Singh, J., & Singh, A. N. (2007b). Mindfulness training assists individuals with moderate mental retardation to maintain their community placements. Behavior Modification, 31, 800–814.
Singh, N. N., Lancioni, G. E., Winton, A. S. W., Adkins, A. D., Wahler, R. G., Sabaawi, M., & Singh, J. (2007c). Individuals with mental illness can control their aggressive behavior through mindfulness training. Behavior Modification, 31, 313–328.
Singh, N. N., Lancioni, G. E., Manikam, R., Winton, A. S. W., Singh, A. N. A., Singh, J., & Singh, A. D. A. (2011a). A mindfulness-based strategy for self-management of aggressive behavior in adolescents with autism. Research in Autism Spectrum Disorders, 5, 1153–1158.
Singh, N. N., Lancioni, G. E., Singh, A. D. A., Winton, A. S. W., Singh, A. N. A., & Singh, J. (2011b). Adolescents with Asperger syndrome can use a mindfulness-based strategy to control their aggressive behavior. Research in Autism Spectrum Disorders, 5, 1103–1109.
Singh, N. N., Lancioni, G. E., Karazsia, B. T., Winton, A. S. W., Myers, R. E., Singh, A. N. A., et al. (2013a). Mindfulness-based treatment of aggression in individuals with intellectual disabilities: a waiting list control study. Mindfulness, 4, 158–167.
Singh, N. N., Lancioni, G. E., Winton, A. S. W., Karazsia, B. T., & Singh, J. (2013b). Mindfulness training for teachers changes the behavior of their preschool students. Research in Human Development, 10, 211–233.
Smith, J. A., Flowers, P., & Larkin, M. (2009). Interpretative phenomenological analysis: theory, method and research. Thousand Oaks, CA: Sage.
Suinn, R. (2001). The terrible twos—anger and anxiety: hazardous to your health. American Psychologist, 56, 27–36.
Swanson, J. W., Swartz, M. S., Van Dorn, R. A., Elbogen, E. B., Wagner, H. R., Rosenheck, R. A., et al. (2006). A national study of violent behavior in persons with schizophrenia. Archives of General Psychiatry, 63, 490–499.
Tafrate, R. C. (1995). Evaluation of treatment strategies for adult anger disorders. In H. Kassinove (Ed.), Anger disorders: definition, diagnosis, and treatment (pp. 109–129). Washington, DC: Taylor & Francis.
Tafrate, R. C., Kassinove, H., & Dundin, L. (2002). Anger episodes in high- and low-trait-anger community adults. Journal of Clinical Psychology, 59, 1573–1590.
Torrey, E. F. (2011). Stigma and violence: isn’t it time to connect the dots? Schizophrenia Bulletin, 37, 892–896.
Volavka, J. (2013). Violence in schizophrenia and bipolar disorder. Psychiatria Danubina, 25, 24–33.
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Singh, N.N., Lancioni, G.E., Karazsia, B.T. et al. Shenpa and Compassionate Abiding: Mindfulness-Based Practices for Anger and Aggression by Individuals with Schizophrenia. Int J Ment Health Addiction 12, 138–152 (2014). https://doi.org/10.1007/s11469-013-9469-7
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DOI: https://doi.org/10.1007/s11469-013-9469-7