The effectiveness of psychological interventions for aggressive behavior following acquired brain injury: A meta-analysis and systematic review

BACKGROUND: The consequences of aggressive behavior following ABI have an impact at both an individual and systemic level. In contrast to other ABI sequelae, aggressive behavior has been shown to increase over time without appropriate timely interventions. OBJECTIVE: The current meta-analysis aimed to systematically review the current literature examining psychological interventions for aggressive behavior following ABI. The meta-analysis also aimed to provide a statistical synthesis of the available evidence. METHOD: Following the PRISMA guidelines, an electronic and ancestral search of the available literature identified eleven studies (N = 123) that met the inclusion criteria for the review. Non-overlap effect sizes (Tau-U) were calculated to synthesize the available evidence from single case experimental design studies (SCEDs; N = 7). Standardized mean difference effect sizes (d) were calculated to synthesize the available evidence from group studies (N = 4). RESULTS: A medium omnibus effect size (weighted d = –0.46, 95% CI: –0.69 <> –0.24) was found for group studies. Similarly, the overall effect size (Tau-U) for SCEDs was –0.59 (95% CI: –0.72 <> –0.46), indicating a 59% reduction in aggressive behaviour compared to baseline. CONCLUSION: The findings of the meta-analysis suggest that psychological interventions for aggressive behavior are at least moderately effective at reducing aggressive behavior following ABI.