# A Randomized Controlled Trial of the Mobile Anger Reduction Intervention for Veterans

> **NIH VA I01** · DURHAM VA MEDICAL CENTER · 2024 · —

## Abstract

Difficulty controlling anger is the most commonly reported reintegration concern among combat
Veterans, especially those with a diagnosis of posttraumatic stress disorder (PTSD). In Veterans, problematic
anger is associated with numerous negative psychosocial outcomes, including poor functional outcomes (both
social and occupational), family discord, aggression, road rage, and suicide risk. Anger can also impede
successful outcomes from PTSD treatment. Given the high prevalence of anger problems among Veterans
with PTSD and the associated functional impairments, there is a clear need to develop innovative and effective
anger interventions to improve functional outcomes. Use of mobile health (mHealth) technology could provide
a low-cost method to increase the reach of anger management treatments to this high-need group of Veterans.
 One of the mechanisms associated with problematic anger and aggression is hostile interpretation bias,
i.e., a tendency to interpret ambiguous interpersonal situations as hostile. By reducing hostile interpretation
bias, we can reduce problematic anger and aggression and improve functional outcomes. Our team has
developed and piloted a mobile application that uses evidence-based interpretation bias modification
techniques to reduce hostile interpretation bias and anger outcomes. The goal of this project is to evaluate the
efficacy of this mobile application among Veterans with PTSD.
 A randomized controlled trial (RCT) is proposed, in which 150 Veterans with PTSD and problematic
anger will be randomized to either the Mobile Anger Reduction Intervention (MARI) or a health education
condition (HED). The central hypothesis is that participants in the MARI condition will experience greater
anger reductions and functional improvements relative to the HED condition. The proposed research project
will address the following Specific Aims: Aim 1: To evaluate the efficacy of MARI on anger outcomes (e.g.,
hostile interpretation bias, problematic anger) measured at post-treatment, 3-months, and 6-months post
treatment; Aim 2: To evaluate the efficacy of MARI on functional improvements (i.e., psychosocial functioning,
quality of life) and self-harm measured at post-treatment, 3-months, and 6-months post treatment; and
Exploratory Aim: To explore whether changes in hostile interpretation bias (proposed treatment mechanism)
mediate functional improvements.
 If shown efficacious, the public health impact of the MARI application could be enormous. MARI would
provide clinicians and Veterans with an easily accessible treatment option to improve psychosocial functioning
and anger outcomes for Veterans with PTSD. This low-cost, easily implementable, intervention would
significantly increase the reach of evidenced-based treatment for anger.

## Key facts

- **NIH application ID:** 10866230
- **Project number:** 1I01RX004561-01A2
- **Recipient organization:** DURHAM VA MEDICAL CENTER
- **Principal Investigator:** Kirsten Hawkins Dillon
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-02-01 → 2028-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10866230

## Citation

> US National Institutes of Health, RePORTER application 10866230, A Randomized Controlled Trial of the Mobile Anger Reduction Intervention for Veterans (1I01RX004561-01A2). Retrieved via AI Analytics 2026-06-23 from https://api.ai-analytics.org/grant/nih/10866230. Licensed CC0.

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