A systematic review of treatments for problem anger in veteran and military populations with PTSD

Emerging research has highlighted the strong and unique relationship between anger and posttraumatic stress disorder (PTSD) in veteran and military populations, yet traditional treatments for PTSD do not address adequately problem anger. The aim of this systematic review was to map, synthesise and appraise the evidence for promising treatments targeting anger symptoms in veteran and military populations with PTSD. Searches involving PsycInfo, EMBASE, and Medline were undertaken to identify studies of anger treatment for military personnel or veterans with PTSD published until August 2021. There were 25 studies which met the a priori inclusion criteria and which were narratively synthesised. The studies were diverse in nature and were grouped into four categories: standard PTSD treatments (n = 5); anger-focused treatments (n = 5); multi-component treatments, which combined several different treatment approaches for a wide range of issues (n = 10); and mind-body approaches (n = 5). The findings indicate that standard PTSD treatments, as well as mind-body approaches incorporating yoga, meditation, and mindfulness, were largely ineffective in reducing anger. Anger-focused treatments that were trauma-informed, and multi-component intensive treatments held promise. The measurement of anger symptoms was also diverse and often unstandardized. Future research should focus on larger treatment trials that address anger in this population, as well as standard outcome measurement.