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Presentation Slides & Transcript

Biofeedback Training in Reducing Reactive Aggressive among Adolescents
Supervisor Investigator
Dr. Sukhminder Kaur Sandeep Kaur

Aggression is any form of behavior manifested by an individual which usually tend to cause pain, suffering or damage to another person. It is a kind of reaction to the circumstances in which essential requirements of human nature are thwarted. Aggressive behavior during early childhood is considered a part of the normal developmental process (Greydanus, Partt, Greydanus & Hoffman,1992).

Humanistic psychologists such as Maslow (1968) have made this distinction by classing aggression as:
Natural or positive aggression which is aimed largely at self-defence, combating prejudice or social injustice. It is believed that positive aggression takes many forms including self-protection, standing up in the face of negation, pushing for new possibilities, and defending against harm (Jack , 1999).

Pathological aggression  occurs when an individual’s inner nature has become twisted or frustrated. Negative aggression is considered unhealthy because it induces heightened emotions that can in the long-term be damaging to the individual.

The development of aggressive behavior in adolescents is often considered as the result of many factors such as hyperactivity, impulsivity, poor social problem solving skills, low frustration tolerance, harsh parenting and exposure to media violence etc. Aggression leads to more serious problems that appear in the form of learning difficulties, stealing, social adjustment problems and substance abuse in adolescents. Thus, the need of hour is to control the problem of aggression in adolescents in order to prevent more severe problems.

Types of Aggression

Reactive Aggression
Reactive aggression is generally defined as aggression that occurs as an angry response to a perceived provocation or threat (Berkowitz 1993). It is characterized as involving high emotional arousal, hot-blooded anger, impulsivity, and an inability to regulate or control affect (Crick and Grotpeter, 1996; Dodge, 1991; Dodge and Coie, 1987; Schwartz et al.,1998]. It has been uniquely linked with low frustration tolerance, poorly regulated responses to emotional stimuli, increased levels of sadness, unhappiness, depression, and suicidal behavior (Card & Little, 2006; Day, Bream, & Pal, 1992; Fite, Stoppelbein, & Greening, 2009; Miller & Lynam, 2006; Raine et al., 2006; Vitaro, Brendgen, & Tremblay, 2002).

Reactively aggressive individuals are at risk for social isolation, rejection, impulsive behavior and experiencing negative emotions. (Bierman, 2004, Acton, 2003;Moeller & Dougherty, 2002, Hussong & Hicks, 2003; Pardini et al., 2004). It has been proposed that psychiatric disorders serve as a context for suicidal behavior among individuals prone to reactive aggression (Mann et al., 1999)

Physiological basis of aggression
Testosterone is one of the most important, but commonly misrepresented hormones found in the body. Testosterone production is regulated by hormones released from the brain. The hypothalamus and pituitary gland located in the brain produce hormonal signals that ultimately result in the production of testosterone. The hypothalamus is located just above the brain stem, and among its many functions, it produces gonadotrophin releasing hormone (GRH). GRH travels a short distance to the pituitary gland located in the base of the brain stimulating the gland to release FSH (follicle stimulating hormone) and LH (luteinizing hormone).

Empirical Evidence
The concentration of blood testosterone of convicted male criminals who committed violent crimes compared to males without a criminal record or who committed non-aggressive crimes revealed in most cases that men who were judged aggressive/dominant had higher blood concentrations of testosterone than controls (Mazer et al 1998).
Testosterone levels have repeatedly been associated with observer-rated conduct disorder problems and violent reactive aggression in large populations of both males and females ( Dabbs, Carr, Frady, & Riad, 1995; Dabbs & Hargrove,1997; Dabbs & Morris, 1990).

Serotonin is another naturally-occurring chemical in the brain that is known to influence aggression, particularly impulsive aggression. It is called the "feel good" neurotransmitter. If people don’t have enough of it, they deperessed and may therefore behave more aggressively. Although serotonin can act in other parts of the body (e.g., the digestive system), in the brain serotonin is important in modulating a number of emotional and behavioral responses, including anger, mood, and aggression.

Empirical Evidence
Moffitt et al (1998) studied the blood serotonin levels of 781 21-year-old men and women.
The researchers report that, elevated whole blood serotonin was characteristic of violent men." (Low brain levels of serotonin, but high levels of blood serotonin, are associated with behaviour disorders-apparently because of serotonin's different origin and function in blood and brain.)
The violent men's mean serotonin level was .48 standard deviations (SD) above the norm for males as a group, and .56 SD above the mean for non-violent men. Among female subjects, no relationship between serotonin levels and aggression was seen.

Lower serotonin activity is tied specifically to increased impulsivity/aggression (Lesch & Merschdorf, 2000; Verona & Patrick, 2000), which in turn is presumed to enhance the probability of suicide as well as other aggressive behaviors (Mann et al., 1999, 2001).

Cortisol is generally regarded as an indicator of stress reactivity. It is the body's natural stress-fighting hormone, so when a person gets into a stressful situation, cortisol is one of the hormones produced. Low levels of cortisol, rather than high levels, lead to aggression. Several investigations of antisocial adults have analyzed cortisol levels and havefound the cortisol level to be inversely related to the magnitude of behavioral deviation (King et al 1990; Virkkunen 1985; Woodman et al 1978).

Empirical Evidence
Low levels of cortisol have been observed in subjects with high levels of behavioral activation, socialization problems, and violently aggressive antisocial tendencies (McBurnettet al., 1991; Vanyukov et al., 1993; Virkkunen, 1985).
For adolescent boys, having a low resting cortisol level may be related to aggression and a low resting cortisol level has predictive validity for aggression 5 years later (Shoal et al., 2003).
According to Science Daily, low cortisol levels leads to extremely aggressive behavior in boys age 7 to 12.

Biofeedback training
Biofeedback is a non-invasive method in which a person learns to recognize the relationship between mind and bodily changes and with this insight he comes to exert more control over his bodily responses in a more beneficial manner. Researches indicate that it has been an effective tool for treating a number of physical and mental health issues such as generalized anxiety, stress, attention deficit disorder, hypertension and sleep disturbances (Foster, 2004; Niemann et al, 1993, Taylor 1995). It has been found that biofeedback training induce relaxation, increases attention to task and reduce impulsivity (Omizo,1982).Biofeedback techniques train individuals to self-regulate, gain awareness, increase control over their nervous system functioning and improve flexibility in physiological responding (Kessler 2001, Burke 2003).

To determine the therapeutic efficacy of EMG biofeedback therapy on reactive aggression of adolescents.

EMG biofeedback training would be effective in reducing reactive aggression among adolescents.


Sample was comprised of 180 urban male adolescents in the age group of 12 to 19 years, who were high on reactive aggression. Out of which 90 adolescents were included in the experimental group and other 90 were the part of control group. Pre-post experimental control group design was used.

Reactive–proactive aggression questionnaire (Raine et al., 2006) was self-reported measure. It was 3-point scale (0 = never to 2 = often). The scale contains 12 items indexing proactive aggression and 11 items measuring reactive aggression. Their internal consistencies for the reactive (α = .84) and proactive (α = .85) aggression scale was good.

Reactive–proactive aggression questionnaire (Raine et al., 2006) was administered to screen out subjects . After scoring on questionnaire participants those who were high on reactive aggression were divided into two groups (experimental and control). Participants of experimental group were given electromyograph (EMG) Biofeedback training for 10 sessions. Each session was of 30 minutes. On the other hand control group participants were not introduced to electromyograph (EMG) Biofeedback training. However, pre-post intervention scores on reactive aggression of experimental control group scores were compared . Statistical analysis was done with the help of t-test.

Table No.1 Shows the difference between Control & Experimental group
** p<.01

Table No.2 Shows the difference between pre-post scores of both groups
** p<.01
ns= non significant

Findings of the present study are presented in table No.1. Electromyograph (EMG) biofeedback training was given to reduce reactive aggression. Result shows that EMG biofeedback training was effective in reducing reactive aggression among adolescents. Comparison between control group and experimental group on total scores of reactive aggression reveals that experimental group participants showed more extent of change (M= 13.12, SD= 1.87). This difference was statistically significant {t (15.07) = p<.01}.
Thus it can be stated that proposed hypothesis proved to be true in the present study. EMG biofeedback intervention was found to be effective in reducing reactive aggression.

Finding of pre-post comparison is presented in table 2. It can be observed that in control group no significant difference was observed between pre-post scores of reactive aggression. However, post intervention scores of experimental group showed marked decline for reactive aggression scores (M= 13.12) as compared to pre intervention scores (M= 17.94) and this difference was found to be highly significant {t (15.07) = p<.01}.
It can be stated that intervention significantly reduced participants’ tendency to reactive aggression and also investigate the efficacy of utilizing electromyograpic (EMG) feedback training to facilitate control of reactive aggression.

There is ample evidence regarding the effectiveness of alternative systems of medicine like yogic techniques, music therapy and medication on aggressive behavior. On the basis of revealed results it is suggested that EMG biofeedback training helps to reduce muscular tension and arousal states which results in controlling aggressive behaviors among adolescents.

Thank You