**6. Conclusion**

This review has elucidated the linkages between anger in PTSD and advanced various propositions underscoring the role of imagery as an underlying mechanism in their relationship. Based on that exposition, guidelines and an algorithm for the efficacious treatment of anger in PTSD have been proposed. That algorithm and those guidelines underscore the importance of appreciating the limits of imagery-based interventions in the context of PTSD and recognising the influence of individual differences and circumstances on imagery in PTSD. They also stress the need to apply evidence-supported anger-specific treatments to anger in PTSD and locate angerwork within a phased PTSD treatment model. This represents the first articulation of such guidance and it is, accordingly, best understood as prototypical in nature.

PTSD is a disorder of recovery and there are significant, positive treatment outcomes associated with evidence-based, gold standard psychological interventions like exposure treatment. This particularly the case where anxiety is the predominant

emotion experienced by those with PTSD. Many individuals, however, are likely to be troubled by enduring PTSD characterised by posttraumatic anger. A significant minority of this group are either slow or fail to benefit from the receipt of first rank PTSD treatments, like imaginal exposure. This group is the logical target for increased conceptual and empirical research and descriptive and explanatory theoretical models of anger in PTSD and its treatment are much required. It is also important, given the imagery-based connections between anger and PTSD identified in this review, that such theoretical models attend to the role of imagery. Poor imagery control is the law of poor anger control. This is particularly so in anger in PTSD.

To better account for and treat anger in PTSD, the theoretical models developed need to be multi-representational in nature and attend to affective, physiological, behavioural and account for both linguistic and imaginal cognitive processes. Such an approach is entirely consistent with the observation of Aaron T Beck that "effective cognitive therapy depends greatly on moving beyond purely verbal exchanges to encouraging patients and therapists to resort to their auditory or visual imagery capacities" (page 107) [216].
