Aggression in children and adolescents

Cortical volume alterations in the limbic network in adolescents with high reactive aggression

Previous studies show aggression-related structural alterations in frontal and limbic brain regions. Most studies have focused on overall aggression, instead of its subtypes, and on specific regions instead of networks. This study aims to identify both brain networks and regions that are associated with reactive and proactive subtypes of aggression. Structural MRI data were collected from 340 adolescents (125 F/215 M) with a mean age of 16.29 (SD = 1.20). Aggression symptomology was indexed via the Reactive Proactive Aggression Questionnaire (RPQ). Freesurfer was used to estimate Cortical Volume (CV) from seven networks and regions within specific networks associated with aggression. Two multivariate analyses of covariance (MANCOVAs) were conducted on groups for low versus higher reactive and proactive RPQ scores. Our reactive aggression MANCOVA showed a main effect in CV [F(14,321) = 1.935, p = 0.022,ηp2 = 0.078] across all the 7-Networks. Unpacking this main effect revealed significant volumetric differences in the right Limbic Network (LN) (p = 0.029) and the Temporal Pole (p = 0.011), where adolescents in the higher reactive aggression group showed higher cortical volumes. Such findings are consistent with region/voxel-specific analyses that have associated atypical structure within the LN and reactive aggression. Moreover, the temporal pole is highly interconnected with regions important in the regulation and initiation of reactive aggression.

Associations among Parental Phubbing, Self-esteem, and Adolescents' Proactive and Reactive Aggression: A Three-Year Longitudinal Study in China

Parental phubbing, as a new risk factor for adolescents' healthy development, has been noticed by scholars. However, few studies have clarified the associations between parental phubbing and adolescents' proactive and reactive aggression and the potential mediating mechanisms. To address the gaps, the current study explored the longitudinal associations among parental phubbing, self-esteem, and adolescents' proactive and reactive aggression by using the parallel process latent growth curve model and the cross-lagged panel model. The current study involved 2407 Chinese adolescents (girls were 1202, Mage = 12.75, SD = 0.58 at baseline, range = 11-16). Results indicated that parental phubbing significantly positively predicted adolescents' reactive aggression but not proactive aggression. Self-esteem significantly predicted the adolescents' reactive and proactive aggression. Self-esteem significantly mediated the associations between parental phubbing and adolescents' proactive and reactive aggression, respectively. These findings suggest that intervening with parental phubbing is a promising way to reduce adolescents' reactive aggression, and promoting adolescents' self-esteem is an effective approach to prevent their proactive and reactive aggression.

Psychological distress and aggression among adolescents with internet gaming disorder symptoms

The present study aimed to investigate the current situation of internet gaming disorder (IGD) in Chinese adolescents and explore the impact of IGD-related factors on adolescent aggression. We hypothesized that IGD symptoms in adolescents would be associated with aggressive behavior and that risk factors for IGD symptoms could increase the aggressive tendencies of adolescents. To verify the above hypothesis, a cross-sectional survey of junior and senior high school students from southern, southwestern, central, and eastern China was conducted. A total of 9306 valid questionnaires were collected. The results showed that the prevalence of IGD symptoms was 1.78 % among Chinese adolescents. The adolescents in the disordered gamer group had the most severe IGD symptoms, with the highest levels of psychological distress and aggression. Interestingly, adolescents in the casual gamer group had the lowest psychological distress and aggression scores. Linear regression analysis further showed that higher levels of aggression were significantly associated with male sex, younger age, more severe psychological distress and IGD symptoms, and more violent game exposure. Our results suggested that excessive online gaming not only contributes to psychological distress in adolescents but also increases their levels of aggressive behavior. Apart from male sex and younger age, severe IGD symptoms and psychological distress are the most important predictors of the development of aggressive behavior.

Appraising risk factors of aggression in children and adolescents at psychiatric inpatient units

This study examined predictors of aggression and assessed whether different subgroups of children and young people (CYP) display varying risks of aggressive incidents during hospitalization. Data from 10,090 children admitted to the psychiatric inpatient units of Cincinnati Children's Hospital between April 2010 and June 2021 were analysed. Multivariable logistic regression models were used to determine significant predictors associated with aggression, followed by average marginal effects and cluster analyses to rank and establish clusters by the order of predictor importance. About 32.5% reported positive history of an aggressive incident. The mean BRACHA score was doubled compared to those without a prior history. The primary analysis showed that both younger and male CYPs had higher odds of aggressive incidents. We also found that CYP with an African descent, not being able to live with both biological parents, those who reported positive history of psychiatric hospitalisation, and prior externalising behaviours had higher odds of aggressive incidents. These findings have important clinical and public health implications, as they provide valuable knowledge for healthcare professionals to improve prevention strategies for aggression amongst this vulnerable population.

Psychopharmacological treatment of disruptive behavior in youths: systematic review and network meta-analysis

To conduct a systematic review of the comparative efficacy of various psychotropic medications for the treatment of disruptive behavior (DBs) in youths. To this aim, we systematically reviewed randomized clinical trials (RCTs) of various psychotropic medications targeting symptoms of DBs and applied network meta-analysis to investigate their relative efficacy. Fifty-five RCTs meeting the inclusion criteria were selected. To predict and interpret relative treatment efficacy, we compared the efficacy of various psychotropic medications prescribed for DB symptoms based on their mechanism of action. Network meta-analysis revealed that for reducing DBs, second-generation antipsychotics, stimulants, and non-stimulant ADHD medications were more efficacious than placebo, and second-generation antipsychotics were the most efficacious. The dopaminergic modulation of top-down inhibitory process by these medications is discussed in this review. This study offers information on the relative efficacy of various psychotropic medications for the treatment of DB, and insight into a potential neurobiological underpinning for those symptoms. It also illustrates the potential utility of these neurobiological mechanisms as a target for future treatment studies.

The Synergetic Effect of Soft Drinks and Sweet/Salty Snacks Consumption and the Moderating Role of Obesity on Preadolescents' Emotions and Behavior: A School-Based Epidemiological Study

The consumption of ultra-processed foods (UPFs) is high along with the prevalence of emotional and behavioral problems among children and adolescents. The present study sought to investigate the synergetic effect of soft drinks and sweet/salty snacks consumption, and the moderating role of obesity on preadolescents' emotions and behavior. A cross-sectional study was conducted among 1728 Greek preadolescents aged 10-12 and their parents, during the school years 2014-2016. Parental and child characteristics were collected anonymously, through self-administered and validated questionnaires. Among others, soft drinks and sweet/salty snacks consumption was recorded, classifying preadolescents as low or at least moderate consumers, while anthropometric characteristics (height, weight, Body Mass Index (BMI)) were also recorded. Approximately 6 out of 10 preadolescents were characterized by at least moderate consumption of either sweet/salty snacks, or soft drinks, while 22.7% of the participants had at least moderate consumption of both soft drinks and sweet/salty snacks. Boys and preadolescents with a lower level of adherence to the Mediterranean diet, as well as those living in a more obesogenic family environment were more likely to be in the higher consumption groups. When compared to just either the moderate consumption of sweet/salty snacks, or the moderate consumption of soft drinks, the combination of both unhealthy eating habits was associated with significantly higher odds of both aggressiveness and loneliness, while the examined relationships were significantly stronger in overweight/obese children. The positive synergistic effect of soft drinks and sweet/salty snacks consumption on preadolescents' emotions of loneliness and aggressive behavior is even burdened by obesity status highlighting the urgent need for policymakers to take preventive measures to halt the detrimental consequences of UPFs consumption on health outcomes, particularly in overweight/obese children. The importance of the improvement of children's unhealthy eating habits by emphasizing the association between food intake and emotional and behavioral status is highlighted.

Interaction between Sirtuin 1 (SIRT1) polymorphisms and childhood maltreatment on aggression risk in Chinese male adolescents

BACKGROUND

Aggressive behavior is a highly prevalent and serious public health problem among adolescents. However, the etiology and pathogenesis of aggressive behavior remain unclear. Childhood maltreatment is an acknowledged factor for aggressive behavior. SIRT1 is closely related to the occurrence and development of psychiatric disorders. We aimed to reveal the interactive effect between SIRT1 and childhood maltreatment on aggressive behavior among Chinese adolescents.

METHODS

Aggressive behavior and childhood maltreatment were evaluated by the Buss and Warren's Aggression Questionnaire (BWAQ) and short form Childhood Trauma Questionnaire (CTQ-SF), respectively. This study comprised 436 aggression cases and 435 controls. Four SIRT1 tagSNPs were selected for genotyping. Interaction between SIRT1 and childhood maltreatment was estimated by logistic regression models.

RESULTS

Individuals carrying SIRT1 rs4746720 minor allele and TAAC haplotype derived from SIRT1 variants was associated with reduced aggression risk when childhood maltreatment occurred (all P < 0.01). An antagonistic additive interaction between SIRT1 rs4746720 and childhood maltreatment on aggressive behavior (S = 0.421; 95%CI: 0.234 to 0.758) was further testified. No main effect of the SIRT1 SNPs or the haplotype block was observed (all P > 0.05).

LIMITATIONS

Since participants were only males, our findings were unable to be directly extended to females. Cross-sectional design, self-reported measurements and limited sample size were adopted.

CONCLUSION

This study provides the first evidence of SIRT1 × childhood maltreatment interaction on aggressive behavior in male adolescents. The minor allele of SIRT1 rs4746720 presents a protective effect on combination with childhood maltreatment on the risk of aggressive behavior.

Factors Affecting Aggressiveness among Young Teenage Girls: A Structural Equation Modeling Approach

Adolescence is a period of transition for developmental and social domains that may also be accompanied by behavioral problems. Aggressive behavior may be a mental health concern for young teens and is defined as a behavioral and emotional trait that may be distressing for others. This study aimed to understand the factors associated with aggressiveness among young teenage girls. A cross-sectional study was conducted among a sample of 707 female middle school-aged students using multistage random sampling in Tabriz, Iran. The variables of interest were aggressiveness, general health status, happiness, social acceptance, and feelings of loneliness. Structural equation modeling was employed to analyze the data. Low parental support, low satisfaction with body image, high sense of loneliness, and lower perceived social acceptance were found to be the factors influencing aggressiveness. The current study found that the school environment, home environment, individual and interpersonal factors all play a part in aggressiveness. As a result, the contributing elements must be considered when creating and executing successful interventions to improve this population's psychological well-being.

Association between nutritional intake and aggressive behaviors in children and adolescents: The CASPIAN-IV study

OBJECTIVE: This study aims to explore the association of nutritional intake and aggression among a nationally representative sample of Iranian children and adolescents. METHODS: This nationwide cross-sectional study was conducted on a multi-stage sample of 14880 students, aged 6–18 years, living in 30 provinces in Iran. Parents were asked to report the dietary intake of their children as frequency of food groups and/or items. The validated questionnaire of the World Health Organization-Global School-based Health Survey (WHO-GSHS) was used to measure components related to aggression including physical fight, verbal aggression, and being bullied by other students. RESULTS: Participants consisted of 13486 students (90.6% participation rate) with mean age of 12.47 years (95% CI: 12.40, 12.54); 49.2% were girls, and 75.6% lived in urban areas. Physical fighting was more prevalent among urban boys[(48.63%), CI (46.75, 50.5)] while bulling was the most common aggressive behavior among boys [(29.7%), CI (28.03, 31.42)] and girls [(25.26%), CI (23.66, 26.93)] living in urban areas. Daily consumption of fast foods, sweets, soda, salty snacks and fried foods was higher among those participants who reported frequent experience of physical aggression and bullying. Bullying to others increased significantly with consumption of fast food (Odds ratio: 1.43, CI: 1.07, 1.92) and red meat (Odds ratio: 1.14, CI: 1.02, 1.28). Salty snack consumption showed a significant association with physical fighting (Odds ratio: 1.29, CI: 1.15, 1.44). CONCLUSION: The findings of this study suggest that some unhealthy foods might affect the mental health of children and adolescents. Improving dietary habits should be considered for prevention of violence in the vulnerable pediatric age group.

Is Adolescent Alcohol Use Linked to Spikes in Aggressive Behaviour? A Growth Curve Analysis

A relationship between alcohol use and aggression is well-established; however, less is known about how these factors develop and influence each other over time. This study examined the immediate and delayed effects of alcohol use on aggression during adolescence. Alcohol use and aggression were measured in a subset of students (n = 1560) from the Climate and Preventure study, Australia. Participants completed self-report surveys across five assessments (ages 13, 13.5, 14, 15 and 16). In a two-stage analysis, parallel and auto-regressive latent growth curve models were applied to investigate person-specific trajectories (or between-person effects) of alcohol use and aggression and identify the time-varying impact (or within-person effects) of alcohol use on aggression. Average alcohol consumption increased between ages 13 and 16, while average aggression levels decreased over time. Overall growth in alcohol use was positively related to heightened aggression at age 16, and vice versa. Spikes (time-varying increases) in alcohol use were linked to corresponding increases in aggression at each time point. There was evidence of a prospective effect where aggression was associated with hazardous alcohol use a year later, but no evidence that alcohol use was associated with subsequent aggression. Change in hazardous alcohol consumption and aggression beginning early in adolescence are interrelated and are predictive of one another at age 16. The time-varying effects of alcohol on aggression appear to be immediate rather than delayed; however, there is evidence for a prospective relationship where aggression influences later alcohol use. Implications for the timing and nature of novel harm reduction intervention approaches for young people are discussed.

Psychological and neurobiological aspects of suicide in adolescents: Current outlooks

Suicidality is one of the leading causes of death among young adults in the United States and represents a significant health problem worldwide. The suicide rate among adolescents in the United States has increased dramatically in the latest years and has been accompanied by considerable changes in youth suicide, especially among young girls. Henceforth, we need a good understanding of the risk factors contributing to suicidal behavior in youth. An explanatory model for suicidal behavior that links clinical and psychological risk factors to the underlying neurobiological, neuropsychological abnormalities related to suicidal behavior might predict to help identify treatment options and have empirical value. Our explanatory model proposes that developmental, biological factors (genetics, proteomics, epigenetics, immunological) and psychological or clinical (childhood adversities) may have causal relevance to the changes associated with suicidal behavior. In this way, our model integrates findings from several perspectives in suicidality and attempts to explain the relationship between various neurobiological, genetic, and clinical observations in suicide research, offering a comprehensive hypothesis to facilitate understanding of this complex outcome. Unraveling the knowledge of the complex interplay of psychological, biological, sociobiological, and clinical risk factors is highly essential, concerning the development of effective prevention strategy plans for suicidal ideation and suicide.

Genes and Aggressive Behavior: Epigenetic Mechanisms Underlying Individual Susceptibility to Aversive Environments

Over the last two decades, the study of the relationship between nature and nurture in shaping human behavior has encountered a renewed interest. Behavioral genetics showed that distinct polymorphisms of genes that code for proteins that control neurotransmitter metabolic and synaptic function are associated with individual vulnerability to aversive experiences, such as stressful and traumatic life events, and may result in an increased risk of developing psychopathologies associated with violence. On the other hand, recent studies indicate that experiencing aversive events modulates gene expression by introducing stable changes to DNA without modifying its sequence, a mechanism known as “epigenetics”. For example, experiencing adversities during periods of maximal sensitivity to the environment, such as prenatal life, infancy and early adolescence, may introduce lasting epigenetic marks in genes that affect maturational processes in brain, thus favoring the emergence of dysfunctional behaviors, including exaggerate aggression in adulthood. The present review discusses data from recent research, both in humans and animals, concerning the epigenetic regulation of four genes belonging to the neuroendocrine, serotonergic and oxytocinergic pathways—Nuclear receptor subfamily 3-group C-member 1 (NR3C1), oxytocin receptor (OXTR), solute carrier-family 6 member 4 (SLC6A4) and monoamine oxidase A (MAOA)—and their role in modulating vulnerability to proactive and reactive aggressive behavior. Behavioral genetics and epigenetics are shedding a new light on the fine interaction between genes and environment, by providing a novel tool to understand the molecular events that underlie aggression. Overall, the findings from these studies carry important implications not only for neuroscience, but also for social sciences, including ethics, philosophy and law.

Characteristics of Physical Aggression in Children of Immigrant Mothers and Non-immigrant Mothers: A Cross-Sectional Analysis of the Survey of Young Canadians

Physical aggression (PA) is important to regulate as early as the preschool years in order to ensure healthy development of children. This study aims to determine the prevalence and characteristics of PA in children of immigrant and non-immigrant mothers. Secondary data analysis was conducted using the nationwide 2010 Survey for Young Canadians, limited to children 4-9 years of age. Bivariate and multivariable logistic regression was performed, with the outcome, PA, and covariates including maternal, child, household and neighbourhood characteristics. Twenty percent of children of non-immigrant mothers and 16% of children of immigrant mothers reported PA. The only common characteristic of PA between children of non-immigrant (Adj OR 1.44, 95% CI 1.09-1.89) and immigrant mothers (Adj OR 2.08, 95% CI 1.07-4.03) was viewing violent movies/shows. The characteristics of PA differ between children of immigrant versus non-immigrant mothers therefore healthcare providers, policy makers, and researchers should be mindful to address PA in these two groups separately, and find ways to tailor current recommended coping strategies and teach children alternative ways to solve problems based on their needs.

Neural correlates of proactive and reactive aggression in adolescent twins

Verbal and physical aggression begin early in life and steadily decline thereafter in normal development. As a result, elevated aggressive behavior in adolescence may signal atypical development and greater vulnerability for negative mental and health outcomes. Converging evidence suggests that brain disturbances in regions involved in impulse control, emotional regulation, and sensation seeking may contribute to heightened aggression. However, little is known regarding the neural mechanisms underlying subtypes of aggression (i.e., proactive and reactive aggression) and whether they differ between males and females. Using a sample of 106 14-year-old adolescent twins, this study found that striatal enlargement was associated with both proactive and reactive aggression. We also found that volumetric alterations in several frontal regions including smaller middle frontal and larger orbitofrontal cortex were correlated with higher levels of aggression in adolescent twins. In addition, cortical thickness analysis showed that thickness alterations in many overlapping regions including middle frontal, superior frontal, and anterior cingulate cortex and temporal regions were associated with aggression in adolescent twins. Results support the involvement of fronto-limbic-striatal circuit in the etiology of aggression during adolescence. Aggr. Behav. 43:230-240, 2017. © 2016 Wiley Periodicals, Inc.

Joint Association of Active and Passive Smoking with Psychiatric Distress and Violence Behaviors in a Representative Sample of Iranian Children and Adolescents: the CASPIAN-IV Study

BACKGROUND

Mental health and smoking have been receiving increasing attention in adolescents all over the world. Although some studies have assessed the independent association of active/passive smoking with mental health, joint association of active and passive smoking with mental health remains unclear.

PURPOSE

This study was designed to evaluate the joint association of smoking status (active and passive smoking) with psychiatric distress and violent behaviors in Iranian children and adolescents.

METHOD

In this national survey, 13,486 students, aged 6-18 years, living in rural and urban areas of 30 provinces of Iran were selected via multistage, cluster sampling method. Psychiatric distress (including worthless, angriness, worrying, insomnia, confusion, depression, and anxiety), violence behaviors (including bullying, victim, and physical fight), and smoking status (nonsmoker, only passive smoker, only active smoker, and active and passive smoker) were assessed. The questionnaire was prepared based on the World Health Organization Global School-based Student Health Survey (WHO-GSHS). Data were analyzed by the Stata package.

RESULTS

Psychiatric distress and violent behaviors had linearly positive association with smoking status (p trend < 0.001). Compared to "nonsmoker" group, participants who were exposed to passive smoking besides active tobacco use were at increased risk of having angriness (odds ratio (OR) 2.55, 95 % confidence interval (CI) 1.86-3.48), worrying (OR 1.66, 95 % CI 1.24-2.20), and anxiety (OR 1.99, 95 % CI 1.52-2.61) and victim (OR 1.77, 95 % CI 1.34-2.33) and bully behaviors (OR 3.08, 95 % CI 2.33-4.07).

CONCLUSION

The current findings suggest that active and passive tobacco smoking has synergistic effect on psychiatric distress. Since majority of smokers with psychiatric distress do not receive mental health services or counseling on smoking, strategies to address mental health problems and smoking prevention should be included as a part of school health services.

Impact of Irritability and Impulsive Aggressive Behavior on Impairment and Social Functioning in Youth with Cyclothymic Disorder

OBJECTIVE

Research on adults with cyclothymic disorder (CycD) suggests that irritability and impulsive aggression (IA) are highly prevalent among this population. Less is known about whether these behaviors might also distinguish youth with CycD from youth without CycD. Additionally, little is known about how irritability and IA relate to one another, and whether they are associated with different outcomes. This study aimed to compare irritability and IA across diagnostic subtypes to determine whether CycD is uniquely associated with these behaviors, and to assess how irritability and IA relate to youth social and general functioning.

METHODS

Participants (n = 459), 11-18 years of age, were recruited from an urban community mental health center and an academic outpatient clinic; 25 had a diagnosis of CycD. Youth and caregivers completed measures of IA and irritability. Youth and caregivers also completed an assessment of youth friendship quality. Clinical interviewers assessed youth social, family, and school functioning.

RESULTS

Youth with CycD had higher scores on measures of irritability and IA than youth with nonbipolar disorders, but scores were not different from other youth with bipolar spectrum disorders. Measures of irritability and IA were correlated, but represented distinct constructs. Regression analyses indicated that irritability was related to friendship quality (p < 0.005). Both IA and irritability were related to social impairment (ps < 0.05-0.0005) and Child Global Assessment Scale (C-GAS) scores (ps = 0.05-0.005). CycD diagnosis was associated with poorer caregiver-rated friendship quality and social functioning (ps < 0.05).

CONCLUSIONS

We found that irritability and aggression were more severe among youth with CycD than among youth with nonbipolar diagnoses, but did not differ across bipolar disorder subtypes. Among youth seeking treatment for mental illness, irritability and IA are prevalent and nonspecific. Irritability and IA were uniquely related to our outcomes of social and general functioning, suggesting that it is worthwhile to assess each separately, in order to broaden our understanding of the characteristics and correlates of each.