Emotional dysregulation in childhood, which has been linked to significant social problems in older adolescence, is one of the most common reasons for pediatric mental health treatment and psychiatric hospitalizations. Behavioral approaches to treatment for these disorders are limited, however, resulting in increasing use of restraints and psychotropic drugs. A pilot study was implemented on an inpatient psychiatric unit to evaluate feasibility and provide proof of concept for a novel behavioral intervention comprised of anger control therapy (ACT), a cognitive-behavioraltherapy intervention, augmented by RAGE-Control, a videogame that trains players to regulate physiological arousal in a challenging but controlled situation. Patients (N=18, 9-17 years old) with high levels of anger documented by the State Trait Anger Expression Inventory-Child and Adolescent (STAXI-CA) were enrolled in a 5-session intervention (Experimental group). Changes in STAXI-CA State-Anger and Trait-Anger scores from baseline to Day 5 were compared to those of a demographically comparable treatment as usual (TAU) historic control group (N=19). The Experimental group showed large reductions in STAXI-CA scores, compared to the TAU group. Compliance and satisfaction were high. These findings support the feasibility of the ACT with RAGE-Control intervention. Randomized controlled trials augmenting ACT with the RAGE-Control game are needed to establish efficacy.

Anger, cognitive-behavioral therapy, emotional regulation, videogames

Children’s Hospital Boston, Dept. of Psychiatry, 300 Longwood Avenue, Boston, MA, 02115. USA.