Psychology
2013. Vol.4, No.8, 638-644
Published Online August 2013 in SciRes (http://www.scirp.org/journal/psych) http://dx.doi.org/10.4236/psych.2013.48091
638
Mindfulness Based Cognitive Group Therapy vs Cognitive
Behavioral Group Therapy as a Treatment for Driving Anger
and Aggression in Iranian Taxi Drivers
Toktam Kazemeini*, Bahramali Ghanbari-e-Hashem-Abadi, Asieh Safarzadeh
Department of Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
Received November 29th, 2012; revised January 6th, 2013; accepted July 6th, 2013
Copyright © 2013 Toktam Kazemeini et al. This is an open access article distributed under the Creative Com-
mons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, pro-
vided the original work is properly cited.
The frequent experience of anger while driving is associated with great rates of aggressive and dangerous
behaviors. The experience of anger driving can have repercussions that extend beyond the vehicle and can
be harmful to the individual driver and other drivers that are in the same road. Thus, the present research
aims to compare the effectiveness of Mindfulness Based Cognitive Group Therapy (MBCGT) with Cog-
nitive-Behavior Group Therapy (CBGT) on reducing anger and aggression while driving. The experi-
mental design was pretest, posttest and follow up with randomized assignment. The sample of this study
included 20 male taxi drivers who were selected through accessible sampling and participated voluntarily
in the research. Participants were randomly divided into two experimental groups. The first experimental
group received MBCGT and CBGT was conducted in the second experimental group. Both groups were
tested three times (i.e., pretest, posttest, and one-month follow-up). The study tools used were Driving
Anger Scale (DAS) and Driving Anger Expression questionnaire (DAX). Data were analyzed using SPSS
16 software with covariance analysis. The results showed that MBCGT in comparison to CBGT led to
significant reduction in driving anger, aggressive expression of driving anger and significant increase in
adaptive/constructive expression of driving anger. These findings have been discussed theoretically and
their importance in clinical importance.
Keywords: Mindfulness Based Cognitive Group Therapy; Cognitive-Behavior Group Therapy; Driving
Anger and Aggression
Introduction
Over the past several years interest in angry and aggressive
driving behaviors has increased. This interest follows from
numerous national and international surveys, which have all
shown that driving aggressively and becoming angry while
driving is an increasingly frequent and costly phenomenon
(AAA Foundation for Traffic Safety, 1997; NHTSA, 1999;
Parker, Lajunen, & Stardling, 1998; Parkinson, 2001; Rasmus-
sen, Knapp, & Garner, 2000; Underwood, Chapman, Wright, &
Crandall, 1999). So far, researchers have focused a great deal of
their attention on trying to define driving anger and aggression,
(Ellison-Potter, Bell, & Deffenbacher, 2001; Hauber, 1980;
Novaco, 1990), understanding causative factors for driving
anger and aggression (Ellison, Govern, Petri, & Figler, 1995;
Hennessy & Wiesenthal, 1999; Pinto, 2001; Underwood et al.,
1999), the relationship between driving anger and aggression
and risky behaviors and their adverse outcomes (Deffenbacher,
Huff, Lynch, Oetting, & Salvatore, 2000; Novaco, Stokols, &
Milanesi, 1990; Malta, Blanchard, Freidenbreg, Galovski, Karl,
& Holzapfel, 2001; Vandervoort, Ragland, & Syme, 1996). In
fact, research has focused even less on treatment for driving
anger so that there is a relative void in our knowledge of effec-
tive interventions for driving anger and aggression (Diebold,
2003). Most of the treatment studies conducted have focused on
examining the effectiveness of some techniques of cognitive
behavior therapy such as relaxation training, cognitive restruc-
turing, and exposure techniques (Deffenbacher et al., 2000;
Deffenbacher, Filetti, Lynch, Dahlen, & Oetting, 2002; Ga-
lovski & Blanchard, Malta, & Freidenberg, 2003; Richards,
Deffenbacher, Feletti, Lynch, & Kogan, 2001, Rimm, DeGroot,
Boord, Heiman, & Dillow, 1971). Although the effectiveness of
these techniques has been demonstrated using reduction in
measures of driving anger and aggression, the results have not
shown one intervention to be superior over the others. For ex-
ample, one study reported that relaxation training techniques
showed a reduction on certain measures of driving anger and
aggression while the same techniques were not shown to be as
effective in another study (Deffenbacher et al., 2000; Deffen-
bacher et al., 2002). Similar inconsistencies were observed in
cognitive restructuring and exposure techniques (Deffenbacher
et al., 2002; Galovski & Blanchard, 2002; Richards et al., 2001).
Besides to these partial studies, Galovski and Blanchard (2002)
found that a cognitive behavioral treatment helped reduce driv-
ing anger and aggression. To a large degree, cognitive behavior
therapy is based on the assumption that a reorganization of
one’s self-statements will result in a corresponding reorganiza-
*Corresponding author.

T. KAZEMEINI ET AL.
tion of one’s behavior (Corey, 2009). According to Beck’s cog-
nitive view, cognition plays a major role in psychological prob-
lems. He believes that other aspects such as emotional, behav-
ioral and physiologic aspects are raised from this one (Ghase-
mzadeh, 2008). Cognitive change in cognitive-behavior ap-
proach emerges in this way that individuals are taught more
rational thinking skills and they learn to reject their negative
thoughts consciously (Phares, 1992).
On the other hand, there is also direct and indirect evidence
in the literature to suggest that mindfulness may be an effective
intervention for individuals who experience frequent and in-
tense anger while driving (Borders, 2010; Brown, 2003; Die-
bold, 2003; Heppner, 2008; Murphy, 1995; Polizzi, 2007; Wright,
Andrew, & Howells, 2009). Mindfulness is an emerging thera-
peutic technique that combines elements of relaxation with a
unique cognitive component. Mindfulness, as conceptualized
by researchers such as Kabat-Zin and Buddhist monks like
Thich Nhat Hanh, at its most elementary form, is awareness of
each moment as it occurs. Based on ancient Buddhist traditions
from Asia, mindfulness is not a new technique; however, its
systematic application to the treatment of numerous psycho-
logical and physical ills is a relatively recent phenomenon
(Bishop, 2002). Mindfulness from the outset has been a holistic
intervention in the sense that no fundamental distinction is
made between body and mind (Rothwel, 2006) and deal with
totality of one’s existence and personality simultaneously and
consider him/her as a integrated whole (Ataee-e-Nakhaei, 2008).
Mindfulness Based Cognitive Therapy (MBCT) is a therapeutic
approach which uses mindfulness. Cognitive basis of this ap-
proach is Teasdale’s theory of interactive cognitive subsystems
(Teasdale, 1993). In this theory, the relationship between cog-
nitive and emotional processes is complicated and multidimen-
sional. Teasdale refers to two kinds of beliefs: emotional beliefs
(hot cognition) and rational beliefs (cold cognition). Teasdale’s
cognitive therapy is characterized by an emphasis on emotional
beliefs (Teasdale, 1999). In this approach the participants are
taught as soon as negative thoughts or feelings appeared, before
answering to them, let them to remain intact in their mind. Ad-
ditionally, this approach provides patterns for training decen-
tralization skills and utilizes techniques in order to process
information that makes thought-creating cycle’s continuous
(Segal, Williams, & Teasdale, 2002). Mindfulness with the help
of breathing and body, awareness of events, awareness of body,
breathing, sound, and thoughts and accepting thoughts in a
non-judgmentally manner result in changing of effective and
emotional meanings and the individual learns that thoughts are
simple rather than reflection of truth and these negative and
worrying thoughts are not correct essentially. Mindfulness causes
the individual to pay attention to his/her automatic activities
and normal behaviors and obtains an increasing awareness and
consciousness in his/her daily activities. This awareness of
thoughts and feelings leads to change individual connection to
those thoughts and feelings (Kabat-Zinn, 1990). In fact, mind-
fulness changes one’s relationship to thoughts rather than chang-
ing the content of thought (Hayes, Strosahl, & Wilson, 1999).
To date, two studies have investigated effectiveness of
mindfulness based cognitive therapy on improvement of driv-
ing anger and aggression. Diebold (2003) adapted Kabat-Zinn’s
(1990) Mindfulness Based Stress Reduction (MBSR) program
and Segal and colleagues’ (2002) Mindfulness Based Cognitive
Therapy (MBCT) program into a treatment protocol for college
students in order to reduce driving anger. In this study, partici-
pants were 12 graduated students (7 males and 5 females) that
were divided into three groups containing 4 participants. Eleven
participants showed a reduction in driving anger in follow-up.
Twelve participants showed a reduction in driving anger fre-
quency and 9 of 10 participants that reported an intense anger
in baseline, showed a reduction in anger intensity. Reduction in
driving anger and aggression were observed in 9 participants.
After therapy, participants showed reduction in anger expres-
sion that continued commonly until follow-up. In follow-up, 12
participants showed a reduction in verbal anger expression and
11 participants showed an increase in adaptive/constructive ex-
pression. Also, a dissertation conducted by Polizzi (2008) ex-
amined the efficacy of MBCT in reducing driver anger among a
sample of young adults. Support was found for the use of
MBCT to reduce scores on the Driving Anger Scale, reduce the
frequency of anger and aggressive behaviors reported on the
driver logs, reduce scores on the State Anger Scale, and in-
crease scores on Adaptive/Constructive Expression while driv-
ing.
Although the results of CBT and MBCT interventions are
promising, there are inconsistencies and equivocal evidences
for their effectiveness. In addition, no study, as yet, compared
the effectiveness of CBT to MBCT in research literature; there-
fore, the aim of the current study is to compare the effective-
ness of CBGT with MBCGT in the reduction of driving anger
and aggression. The hypothesis of the research was MBCGT
decreases of driving anger and aggression significantly more
than CBGT.
Method
The present study is an experimental research with pretest,
posttest and follow-up design. In this research, independent
variable was group therapy factor with two levels: 1) mind-
fulness based cognitive therapy and 2) cognitive-behavioral ther-
apy that were performed separately in the one of experimental
groups during 6 weeks. Dependent variables in this study in-
cluded: driving anger, aggressive expression of driving anger
and adaptive/constructive expression of driving anger that their
changes were measured in both groups before and after inde-
pendent variable performing and also after 1 month follow-up.
Participants
The population of research included all male taxi drivers of
Mashhad who were selected with accessible sampling and vol-
untarily in September 2011. After approval of taxi-driving or-
ganization and putting advertisement on the bulletin board of
the organization in order to present information about holding
therapeutic sessions for driving anger management, 20 drivers
that had no thought disorder and drug abuse were selected by
means of structural clinical interview (DSM-IV) and assigned
in mindfulness based cognitive group therapy (10 drivers) and
cognitive-behavioral group therapy (10 drivers) randomly. Age
mean of mindfulness based cognitive group therapy and cogni-
tive-behavioral group members were 46.70 ± 11.97 and 45.10 ±
17.86, respectively. History of driving mean in mindfulness
based cognitive group therapy and cognitive-behavioral group
were 23.80 ± 13.35 and 19 ± 10.57 years, respectively. In
mindfulness based cognitive group therapy, 10 percent of group
members had elementary degree, 40 percent primary high
school, 40 percent high school diploma and 10 percent associ-

T. KAZEMEINI ET AL.
ate degree. In cognitive-behavioral group, 30 percent of group
members had elementary education and 70 percent high school
diploma.
Instruments
The study administered three instruments:
1) Driving Anger Scale, Short Form (DAS): The DAS con-
tains 14 driving situations that are rated on a 1 - 5 scale (1 = not
at all, 5 = very much) for amount of anger experienced if they
occurred (Deffenbaccher et al., 1994). Prior to this main study,
validity and reliability of Farsi version of DAS were examined
in a pilot study carried out by researchers. All items of the DAS
were translated into Farsi and back to English by three inde-
pendent translators reaching the final version by consensus.
One hundred taxi drivers (80 men, 20 women) completed DAS
and Driving Log. The correlations between DAS and frequency
and intensity of anger when driving (.65) and between DAS and
frequency of aggressive and risky driving behaviors (.78) were
regarded as indices of convergent validity. They were retested
after one month. The results showed a significant test-retest
reliability quotient (.76) for DAS. The Cronbach’s α coefficient
of this scale at baseline and at follow-up in the present study
were .80 and .82, respectively.
2) Driving Anger Expression Inventory (DAX): The 49
items of the DAX are rated on a 4-point scale (1 = almost never,
4 = almost always), according to how the individual expresses
his/her anger driving (Deffenbaccher et al., 2001; Deffenbac-
cher, Lynch, Oetting, & Swaim, 2002b). The DAX breaks
down into two general dimensions, a 34-item (α = .80) hostile/
aggressive expression and a 15 item (α = .90) adaptive/con-
structive expression, which share a small, native correlation (r
= −.24). Hostile/aggressive expression correlates positively
with roadway anger, aggression, and risky behavior, whereas
adaptive/constructive expression tends to more strongly related
to these variables than adaptive/constructive expression. All
items of the DAX were translated into Farsi and back to Eng-
lish by three independent translators reaching the final version
by consensus. The Cronbach’s α coefficient of this scale at
baseline and at follow-up in the present study were .82 and .86,
respectively.
3) Demographic Questionnaire: A demographic question-
naire was used to collect relevant background information
about each participant. Participants were asked to report their
age, education, and history of driving.
Procedure
The participants were assigned in two experimental groups
randomly. The first experimental group (MBCT) began to per-
form with 10 members by a female therapist and a male assis-
tant therapist. Group therapy included 6 sessions with the
length of 120 minutes (2 hours) which was held in the confer-
ence hall of Homa Hotel of Mashhad in Iran. In this hall, the
chairs were arranged roundly so that all members and therapist
can see each other. In order to present educational and remedial
matters and help to understand them, one board and one Pro-
jector device set were used.
During the first session, demographic questionnaire, Driving
Anger Scale and Driving Anger Expression Inventory were
distributed among group members at the beginning. Then, it
was explained about group structure and aims, ground rules,
concepts of mindfulness and automatic pilot. After initial sum-
marizing, mindful raising exercise, revising and discussing it
were dealt with within a period of 25 minutes. Then body scan
was conducted and it was discussed. Pamphlets and homework
were presented in the final 10 minutes of the first session.
In the second session, firstly, body scan was performed with
the length of 20 minutes. Then, homework revising, discussing
and answering to group members’ questions, reading vignette
of Levine and discuss it, answering to group members’ ques-
tions and solving their problems, sitting meditation with the
length range from 10 to 15 minutes, pleasant event calendar
were dealt with and like the previous session, pamphlets and
homework were presented.
During the third session, 5-minute hearing exercise, 30-
minute sitting meditation and review it, reviewing homework,
3-minute breathing space exercise, walking meditation, and
review it, unpleasant event calendar and presenting pamphlets
and homework were done.
In the fourth session, in addition to review homework, lis-
tening exercise, sitting meditation, 3-minute breathing space
were done; also, driving anger and general anger were spoken
about.
In the fifth session, in addition to review homework, sitting
meditation and breathing space were conducted, the Roman
poem “The Guest House” was read and it was spoken about
problem-focused and emotion-focused coping strategies and
tree in storm analogy.
Finally, in the sixth session, sitting meditation exercises,
breathing space and meditation using mountain imagery were
done; it was dealt with the relationship between mood and
thoughts and to exercise alternative views and procedures that
make changes continue and terminated with meditation of a
stone. It should be noted that in the end of sixth session, driving
anger and driving anger expression questionnaires were distrib-
uted among group members once again and a date was ap-
pointed for one month follow-up session with the consent of the
members. During MBCGT sessions, in order to consistency and
integrity of mind and body and more usefulness of mindfulness
techniques, yoga training films were given to the group mem-
bers.
In the second experimental group (CBT), selection and as-
signment of members, place and holding way of group sessions
were the same as the first experimental group. The period of
conducting intervention in this group was like that of the first
experimental one, i.e. six weeks (each week one 2-hour session).
Meanwhile this group, members had no contact with the first
experimental group during therapy.
In the beginning of the first session, the participants were
given demographic questionnaire, driving anger questionnaire
and driving anger expression. In this session, ground rules re-
garding confidentiality and privacy, orientation of the class,
introduction to interactions between thought, behavior, and
physiology, sequence of A-B-C, saint and suitcase analogy
were spoken about; at last, the group conducted guided imagi-
nary relaxation exercise.
Second session, Homework review, review of previous ses-
sion, most important aspects of cognitive theories of emotions,
characteristics of automatic thoughts ,cognitive distortions,
resistance to cognitive therapy, designing strategies for con-
fronting these resistances and homework assignments were
dealt with.
In the third session, in addition to Homework review, dis-
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T. KAZEMEINI ET AL.
cussion and questions, behavioral and emotional consequences
of thoughts, schemas, relationship between schemas and auto-
matic thoughts and recognizing schemas using vertical arrow
method were raised.
The content of the fourth session included master list of be-
liefs, cognitive map, ranking subjective units of distress (SUD),
objective analysis, utility analysis and consistency analysis.
In the fifth session, logical analysis, providing anger hierar-
chy, rehearsing the counters and perceptive change issues were
posed. Finally in the sixth session, self-punishment methods
and self-rewarding and maintance strategies were spoken about.
In the end of the session, posttest questionnaires were com-
pleted by the group members and a date was appointed for one
month follow-up session with the consent of the members. It
should be noted that homework was presented to the group
members in all sessions.
Results
The mean and standard deviation of driving anger, aggres-
sive expression of driving anger and adaptive/constructive ex-
pression of driving anger scores in two groups in pretest, post-
test and follow-up sessions was shown in Table 1. In order to
compare two groups in age and history of driving and education
variables, independent t and nonparametric Mann-Whitney U
test were used, respectively. The results showed that there was
no significant difference between the two groups in age, history
of driving variables and education (p > .5). Thus, in inferential
analysis for testing hypotheses, it was not necessary to insert
these variables as covariate in statistical model.
In this study, pretest scores were recognized as confounder
variables, therefore their effects on posttest and follow-up
scores using covariance analysis were controlled. Taking into
consideration that covariance analysis is included in parametric
tests, at first defaults of distribution normalization and vari-
ances equality was examined. Kolmogorov-Smirnow Test was
used for studying pretest of normalization assumption and re-
sults showed that scores have normal distribution in two groups.
Also Leven’s test was done in order to examine variances. Re-
sults showed that disparity of pretest scores of driving anger (F
= .83, p = .37), driving anger adaptive/constructive expression
(F = .004, p = .95) and driving anger aggressive expression (F
= .5, p = .48) were the same in two groups. As a result, there
was variances equality condition and taking into consideration
that scores distribution is normal, there was no problem in us-
ing covariance analysis.
In order to compare the effectiveness of two groups in de-
creasing of anger driving, analysis of covariance test (AN-
COVA) was used. Table 2 shows the results of analysis of
covariance. After modifying driving anger scores of pretest
stage using analysis of covariance test, there was a significant
difference between MBCGT and CBGT in the driving anger
scores of posttest stage (F = 15.45, p = .000) and follow-up
stage (F = 7.45, p = .01). Comparing the means of two groups
(Table 1) shows that in posttest stage, driving anger scores in
MBCGT has been decreased more than CBGT significantly and
this difference has been significant in follow-up stage, too.
Impact rate of group therapy type on decrease of driving anger
in posttest was .52 and follow-up .3. In fact, 52 percent of
scores variance in two groups in posttest and 30 percent of
scores variance in two groups in follow-up was due to group
membership.
In order to compare the effectiveness of two groups in im-
Table 1.
Means and standard deviation for anger driving, aggressive expression, and adaptive/constructive expression of all participants.
CBT Group MBCT Group
Variables Time
M* (SD**) M (SD)
Pre 41.80 (4.39) 34.80 (5.27)
Post 35.60 (6.02) 28.70 (3.74) Anger driving
Fallow 34.30 (5.92) 24.40 (3.86)
Pre 52.40 (7.13) 55.20 (5.30)
Post 42.90 (5.66) 40.20 (2.44) Aggressive expression
Fallow 43.30 (4.62) 39.90 (1.96)
Pre 38.60 (7.80) 39.70 (7.57)
Post 44.30 (6.05) 51.30 (5.05) Adaptive/constructive expression
Fallow 45.10 (8.04) 55.50 (4.27)
*Mean; **Standard deviation.
Table 2.
Analysis of covariance to control for the effect size of pre test.
Source Variables Sum of squares Mean square F p Partial eta squared
Posttest of anger driving 281.371 281.371 27.95 .000 .62
Pretest of anger driving
Follow-up of anger driving 228.116 228.116 17.43 .001 .50
Posttest of anger driving 241.353 241.352 15.45 .000 .52
Group
Follow-up of anger driving 75.06 75.06 7.45 .01 .30

T. KAZEMEINI ET AL.
proving of aggressive expression of driving anger and adap-
tive/constructive expression of driving anger, Multivariate
analysis of covariance test (MANCOVA) was used (Table 3).
After modifying aggressive expression and adaptive/construc-
tive expression of driving anger scores of pretest stage, the
results of MANCOVA showed a significant difference between
MBCGT and CBGT in driving anger adaptive/constructive ex-
pression in posttest stage (F(1,18) = 17.90, p = .001, η2 = .52) and
follow-up stage (F(1,18) = 20.73, p = .000, η2 = .56). Comparing
the means of two groups (Table 1) shows that in posttest, driv-
ing anger adaptive/constructive expression scores in MBCGT
has been increased more than CBGT significantly and this dif-
ference has been significant in follow-up too. Impact rate of
group therapy type on driving anger adaptive/constructive ex-
pression improvement in posttest was .52 and follow-up .56,
i.e., 52 percent of scores variance in two groups in posttest and
56 percent of scores variance in two groups in follow-up was
due to group membership.
Also, the result of MANCOVA showed a significant differ-
ence between MBCGT and CBGT in driving anger aggressive
expression in posttest (F(1,18) = 5.22, p = .03, η2 = .24) and fol-
low-up (F(1,18) = 10.13, p = .006, η2 = .38). Comparing the
means of two groups (Table 1) shows that in posttest, driving
anger aggressive expression scores in MBCGT has been de-
creased more than CBGT significantly and this difference has
been significant in follow-up too. Impact rate of group therapy
type on driving anger aggressive expression improvement in
posttest was .24 and follow-up .38, i.e, 24 percent of scores
variance in two groups in posttest and 38 percent of scores
variance in two groups in follow-up was due to group mem-
bership.
Discussion
The results of the present study showed that the effectiveness
of mindfulness based cognitive group therapy in reduction of
driving anger and aggression is more than cognitive-behavioral
group therapy significantly. Although, any research has directly
dealt with comparing the effectiveness of this two therapeutic
approach in improving of driving anger and aggression so far,
results of the present study can be explain regarding cognitive
component of these approaches; Beck’s theory is the cognitive
basis of cognitive-behavioral therapy while mindfulness based
cognitive therapy is based on Teasdale’s interactive cognitive
subsystems. According to Beck, cognition has a main role in
psychopathology. He believes that other aspects such as emo-
tional, behavioral and physiological ones are derived from this
aspect (Ghasemzade, 2008), whereas mindfulness has primarily
been holistic intervention that doesn’t differentiate between
body and mind basically (Rothwell, 2006). This model works
with whole existence and personality of individual simultane-
ously and considers him/her as an integrated whole. Mindful-
ness method which is consistent with interactive cognitive sub-
systems works on physical and sensational effects and individ-
ual’s thoughts, emotions and excitements simultaneously (Ataee-
e-Nakhaei, 2008). Traditional cognitive therapies change intel-
lectual beliefs of individual only and manipulate emotional
beliefs less than intellectual ones, while emphasis on emotional
beliefs is included in Teasdale’s cognitive therapy characteris-
tics. Also, Beck (1975) believes that therapy should be begun
Table 3.
Multivariate analysis of covariance to control for the effect size of pre test.
Source Variables Sum of squaresMean square F p Partial eta
squared
Posttest of adaptive/constructive expression
of driving anger 387.861 387.861 49.56 .000 .75
Follow-up of adaptive/constructive
expression of driving anger 427.122 427.122 23.27 .000 .59
Posttest of driving anger aggressive
expression 71.270 71.270 5.34 .03 .25
Pretest of
adaptive/constructive
expression of driving anger
Follow-up of driving anger aggressive
expression 27.01 27.01 2.00 .1 .15
Posttest of adaptive/constructive expression
of driving anger 69.09 69.09 8.83 .009 .35
Follow-up of adaptive/constructive
expression of driving anger 44.63 44.63 2.43 .3 .13
Posttest of driving anger aggressive
expression 67.48 67.48 5.06 .03 .24
Pretest of driving anger
aggressive expression
Follow-up of driving anger aggressive
expression 61.80 61.80 6.87 .01 .30
Posttest of adaptive/constructive expression
of driving anger 140.101 140.101 17.90 .001 .52
Follow-up of adaptive/constructive
expression of driving anger 380.592 380.592 20.73 .000 .56
Posttest of driving anger aggressive
expression 69.66 69.66 5.22 .03 .24
Group
Follow-up of driving anger aggressive
expression 91.12 91.12 10.13 .006 .38
642

T. KAZEMEINI ET AL.
from automatic negative thoughts levels whereas Teasdale con-
siders that work in the level of these core thoughts and believes
of patients doesn’t appear adequate for therapy. The relation-
ship between cognitive processes and emotion in Teasdale’s
interactive cognitive subsystems is complicated and multidi-
mensional. This new model aims to change schema not to make
specific meanings invalid in patient’s mind. Furthermore, mind-
fulness changes individual’s connection with his/her thoughts
rather than changing thoughts content (Hayes et al., 1999). The
technique’s goal is not to put up negative thoughts from mind
but the goal is to prevent these thoughts strengthening. Mind-
fulness with the help of breathing and using body organs,
awareness of events, awareness of body, breathing, voice and
thoughts and to accept them without judgment about them leads
to change specific sensational and emotional meanings and the
individual learns that thoughts are simple rather than the reflec-
tion of truth and thoughts such as “I am a loser” or “I will not
succeed” are essentially correct no longer. This method causes
the individual to pay attention to his/her automatic and habitual
behaviors and gains increasing awareness and mindfulness in
him/her daily activities (Peterson & Pbert, 2007). Cognitive
change in mindfulness based cognitive therapy is made so that
participants are taught whenever negative thoughts or feelings
emerge in their mind, before responding to them skillfully let
them remain intact in their mind. In addition, it provides pat-
terns for training decentralization skills and utilizes techniques
for information processing that make thinking-creation cycles
permanent (Segal et al., 2002), while cognitive change in cog-
nitive-behavioral approach is made so that the individuals are
taught more logical thinking skills and they learn that oppose
their negative thoughts consciously (Free, 1999).
In addition, mindfulness based cognitive therapy uses tech-
niques such as body scan, sitting meditation, breathing exercise
and so on that help promotion of relaxation response (Shapiro,
Schwartz, & Bonner, 1998, improve regulation of attention and
concentration (Diebold, 2003). Indeed, mindfulness provides
techniques for coping with anger (Berslin, Zack, & McMain,
2002), while less behavioral and relaxation techniques have
been used in cognitive-behavioral approach and emphasized
mostly on recognition of automatic negative thoughts, logical
errors and main negative beliefs.
With regard to the results of this research, it can be con-
cluded that mindfulness based cognitive group therapy can
more curative impacts on driving anger and aggression in com-
parison to cognitive behavioral group therapy and it is better to
prefer this kind of therapy in intervention measures in order to
improve driving anger and aggression.
Limitations and Suggestions: One of the limitations of pre-
sent study was using between-group design; Between-group
research does not allow researchers to understand the charac-
teristics of participants for whom the treatment was or was not
effective. Other limitations included unclear role and mecha-
nism of mindfulness in driving anger and aggression therapy,
performing research on accessible and small sample, short-term
follow-up stage, and using self-report instruments. Although
the used instruments had acceptable reliability and validity, va-
lidity of self-report tools depends on subjects’ truthfulness and
accuracy in answering to test matters totally. Since the sample
was male taxi drivers, the results can only be applied to the
male population.
For future research, it is suggested that the present study to
be performed in the single-subject experimental design frame-
work in order to better understanding characteristics of partici-
pants for whom the treatment was or was not effective. A
longer follow-up phase would provide evidence on the persis-
tence of the changes. Also, in order to increase accuracy of
evaluation of anger and aggression can be used various meth-
ods and tools of measurement. It is recommended that in addi-
tion to self-report questionnaires, clinical interview with par-
ticipant and entourage, clinical examination, and direct obser-
vation of subjects in natural setting to be used for measuring
anger and aggression in different stages (pretest, posttest and
follow-up). Furthermore, it is recommended that effectiveness
of integrating mindfulness based cognitive therapy and cogni-
tive-behavioral therapy on decreasing driving anger and aggres-
sion to be evaluated in future research.
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