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Objective: Hostility is a transdiagnostic phenomenon that can have a profound negative impact on interpersonal functioning and psychopathological severity. Evidence suggests that cognitive bias modification for interpretation bias (CBM-I) potentially reduces hostility. However, stringent efficacy studies in people with clinical levels of hostility are currently lacking. Method: The present study investigated the effects of CBM-I in two studies: one feasibility study (Study 1) in a mixed clinical-community sample of men (N = 29), and one randomized clinical study (Study 2) in a mixed-gender sample with clinical levels of hostility (N = 135), pre-registered at https://osf.io/r46jn. We expected that CBM-I would relate to a larger increase in benign interpretation bias and larger reductions in hostile interpretation bias, hostility symptoms and traits, and general psychiatric symptoms at post-intervention compared to an active control (AC) condition. We also explored the beneficial carry-over effects of CBM-I on working alliance in subsequent psychotherapy 5 weeks after finishing CBM-I (n = 17). Results: Results showed that CBM-I increased benign interpretation bias in both studies and partially reduced hostile interpretation bias in Study 2, but not in Study 1. Findings of Study 2 also showed greater reductions in behavioral (but not self-reported) aggression in CBM-I relative to control, but no condition differences were found in self-report hostility measures and general psychiatric symptoms. Conclusions: Overall, we found modest support for CBM-I as an intervention for hostility, with some evidence of its efficacy for hostile interpretation bias and aggression. We discuss study limitations as well as directions for future research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Objective: Numerous provocations cause aggressive behavior. However, different provocation procedures are rarely directly compared. This study examined whether two different provocations (i.e., social exclusion and insult) were equally effective in terms of producing aggressive behavior, negative affective change and threat perception. As psychopathic and narcissistic personality traits may moderate provoked aggression, the current study also explored the differential impact of psychopathic and narcissistic traits on these variables. Method: A male (N = 94) community sample was randomly allocated to receive negative social belonging feedback (i.e., social exclusion) or negative intelligence feedback (i.e., insult) by a confederate. Aggressive behavior was measured using a competitive reaction time task after provocation. Here, aggressive behavior before first provocation (i.e., noise blast) by the opponent reflected unprovoked aggression, whereas aggressive behavior after first provocation reflected provoked aggression. Negative affect was measured pre- and postprovocation, and threat perception was measured postprovocation. Results: Results showed that both provocations were equally effective in producing aggressive behavior, negative affective change, and threat perception. Explorative analysis revealed that increased threat perception suppresses initial aggressive responding under the condition of agentic threat in narcissistic people. Also, decreased negative affective change during provocation suppressed aggressive responding in people with psychopathic traits. Conclusions: The findings suggest that both provocations can interchangeably be implemented to study provoked aggression. Emotional blunting may protect against detrimental provocation effects in people with psychopathic traits. Under conditions of agentic threat narcissistic traits related to withholding aggressive responding after first provocation, lashing out when a new threat emerges.