Martijn van Teffelen

General discussion 159 7 one could therefore say that past meta-analyses were comparing apples and oranges. Ignoring the absence of direct comparisons limits the conclusions that can be drawn on what procedure is most provocative for who. An example of how direct comparisons can provide new hypotheses on the nature of provocations and how they impact outcomes is shown in the present dissertation. In chapter 3 explorative findings demonstrated that psychopathic traits are related to reduced affective responding and narcissistic traits are related to increased threat perception in response to provocation. These findings might indicate that psychopathic-related hostility is more affectively based, while narcissistic-related hostility is more cognitively based. As a consequence, hostility interventions may be less effective when they target affective hostility aspects in psychopathic people. Along the same lines, hostility interventions may be attenuated when they target cognitive hostility aspects in narcissistic people. In chapter 4 it was demonstrated that both traditional CR and I-CR reduce hostile beliefs, self-reported anger and aggressive inclinations compared to AC. Moreover, chapter 6 showed that CBM-I reduced hostile interpretation bias and aggressive behavior, but not self-reported anger. Perhaps, people with psychopathic traits show increased benefit from interventions that put less emphasis on affective hostility aspects, such as CBM-I or social skills, problem solving skills or behavioral skills training. Along the same lines, people with narcissistic traits may benefit more from interventions that are more cognitively (but not necessarily less affectively) based, such as CR, I-CR or CBM-I. Hopefully, the present work stimulates provocation research to move forward and conduct randomized studies comparing provocation procedures and how they relate to distinct pathological personality traits, in order to provide new insight into tailored treatment strategies. Extinguishing the Flame: Reducing Hostility The most widely empirically investigated psychological treatment for hostility is cognitive behavioral therapy (CBT). Although treatment studies show support for its’ effectiveness (Hofmann et al., 2012), evidence suggests that there is room for improvement in the treatability of hostility. A promising target for treatability optimization is hostile interpretation bias. The literature suggests that treatment options for hostile interpretation bias may be advanced in two ways: first, by optimizing the efficacy of therapist-provided CR; and second by implementing computerized CBM-I. Optimization of therapist-provided CR One important intervention that has shown to effectively reduce hostility is CR. Previous work showed that enhancing CR with mental imagery may increase its efficacy. In chapter 4 it was investigated whether I-CR outperformed traditional CR. People with high levels of hostility