Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-15T11:48:01.014Z Has data issue: false hasContentIssue false

Characteristics of Aggression in Clinically Referred Children

Published online by Cambridge University Press:  07 November 2014

Abstract

Objective

We investigated the phenomenology of aggression in a group of psychiatrically referred children and in a comparison group of children.

Introduction

Children (N=275) were evaluated at a pediatric psychopharmacology clinic in an academic medical center and compared with 100 non-referred children from the community. To assess the influence of several predictors on the child's level of clinical impairment we conducted stepwise regression analyses.

Results

Aggression occurred across many different psychiatric diagnoses in psychiatrically referred children. Aggression in referred children was more frequent, physical, intense, lasted for a longer duration per episode, was more resistant to intervention, and occurred at an earlier age of onset in contrast with comparison children. Controlling for psychiatric diagnosis and demographic variables, family income and number of aggressive episodes in the last 6 months were the only significant predictors of child impairment.

Discussion

Phenomenologically, aggression may be more maladaptive in children with a psychiatric disorder compared with non-referred youths. These phenomenological differences in characteristics of aggression support the concept of an aggressive syndrome in psychiatrically referred children.

Conclusion

Results support the need for development of specific treatment interventions for excessive maladaptive aggression independent of psychiatric diagnosis in referred children and adolescents.

Type
Original Research
Copyright
Copyright © Cambridge University Press 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Connor, DF. Aggression and Antisocial Behavior in Children and Adolescents: Research and Treatment. New York, NY: Guilford Publications, Inc.; 2002.Google Scholar
2.Ferris, CF, Grisso, T. Understanding Aggressive Behavior in Children. vol 794. New York, NY: The New York Academy of Sciences; 1996.Google Scholar
3.Gabel, S, Shindledecker, R. Aggressive behavior in youth: characteristics, outcome, and psychiatric diagnosis. J Am Acad Child Adolesc Psychiatry. 1991;30:982988.Google Scholar
4.Steiner, H, Kamik, N. Child or adolescent antisocial behavior. In: Sadock, BJ, Sadock, VA, eds. Kaplan & Sadok's Comprehensive Textbook of Psychiatry. 8th ed. vol 2. New York, NY: Williams & Wilkins; 2005:49.6.Google Scholar
5.Connor, DF, Melloni, RH Jr, Harrison, RJ. Overt categorical aggression in referred children and adolescents. J Am Acad Child Adolesc Psychiatry. 1998;37:6673.Google Scholar
6.Cunningham, J, Connor, DF, Miller, K, Melloni, RH Jr.Staff survey results and characteristics that predict assault and injury to personnel working in mental health facilities. Aggr Behav. 2003;29:3140.Google Scholar
7.Blader, JC. Symptom, family, and service predictors of children's psychiatric rehospitalization within one year of discharge. J Am Acad Child Adolesc Psychiatry. 2004;43:440451.Google Scholar
8.Connor, DF, Ozbayrak, KR, Kusiak, KA, Caponi, AB, Melloni, RH Jr.Combined pharmacotherapy in children and adolescents in a residential treatment center. J Am Acad Child Adolesc Psychiatry. 1997;36:248254.Google Scholar
9.Edelsohn, GA, Braitman, LE, Rabinovich, H, Sheves, P, Melendez, A. Predictors of urgency in a pediatric psychiatric emergency service. J Am Acad Child Adolesc Psychiatry. 2003;42:11971202.Google Scholar
10.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Press; 1994.Google Scholar
11.Richters, JE, Cicchetti, D. Mark Twain meets DSM-III-R: conduct disorder, development, and the concept of harmful dysfunction. Dev Psychopathol. 1993;5:529.Google Scholar
12.Moffitt, TE, Lynam, D. The neuropsychology of conduct disorder and delinquency: Implications for understanding antisocial behavior. In: Fowles, DC, Sutker, P, Goodman, SH, eds. Progress in Experimental Personality and Psychopathology Research. New York, NY: Springer; 1994:233262.Google Scholar
13.Werry, JS. Severe conduct disorder-some key issues. Can J Psychiatry. 1997;42:577583.Google Scholar
14.Zoccolillo, M, Tremblay, R, Vitaro, F. DSM-III-R and DSM-III criteria for conduct disorder in preadolescent girls: specific but insensitive. J Am Acad Child Adolesc Psychiatry. 1996;35:461470.Google Scholar
15.Coccaro, EF. Intermittent explosive disorder. Curr Psychiatry Rep. 2000;2:6771.Google Scholar
16.Coccaro, EF, Kavoussi, RJ, Berman, ME, Lish, JD. Intermittent explosive disorder-revised: development, reliability, and validity of research criteria. Compr Psychiatry. 1998;39:368376.Google Scholar
17.Leckman, JF, Sholomskas, D, Thompson, WD, Belanger, A, Weissman, M. Best estimate of lifetime psychiatric diagnosis: A methodological study. Arch Gen Psychiatry. 1982;39:879883.Google Scholar
18.Orvaschel, H. Schedule for Affective Disorders and Schizophrenia for school-age children. Epidemiologic version-5. Ft. Lauderdale, FL: Center for Psychological Studies, Nova Southeastern University; 1995.Google Scholar
19.Cohen, J. A coefficient of agreement for nominal scales. Educ Psychol Meas. 1960;20:3746.CrossRefGoogle Scholar
20.Olvera, RL, Pliszka, SR, Konyecsni, WM, Hernandez, Y, Farnum, S, Tripp, RF. Validation of the Interview Module for Intermittent Explosive Disorder (M-IED) in children and adolescents: a pilot study. Psychiatry Res. 2001;101:259267.Google Scholar
21.Shaffer, D, Gould, MS, Brasic, J, et al.A children's global assessment scale (CGAS). Arch Gen Psychiatry. 1983;40:12281231.Google Scholar
22.Rey, JM, Starling, J, Wever, C, Dossetor, DR, Plapp, JM. Inter-rater reliability of global assessment of functioning in a clinical setting. J Child Psychol Psychiatry. 1995;36:787792.Google Scholar
23.Bird, HR, Canino, G, Rubio-Stipec, M, et al.Estimates of the prevalence of childhood maladjustment in a community survey in Puerto Rico. Arch Gen Psychiatry. 1988;45:11201126.CrossRefGoogle Scholar
24.Conners, CK, Barkley, RA. Rating scales and checklists for child psychopharmacology. Psychopharmacol Bull. 1985;21:809843.Google ScholarPubMed
25.Conners, CK, Sitarenios, G, Parker, JD, Epstein, JN. Revision and restandardization of the Conners teacher rating scale (CTRS-R): factor structure, reliability, and criterion validity. J Abn Child Psychol. 1998;26:279291.CrossRefGoogle ScholarPubMed
26.Hinshaw, SP. On the distinction between attentional deficits/hyperactivity and conduct problems/aggression in child psychopathology. Psychol Bull. 1987;101:443463.Google Scholar