An Examination of Post-Traumatic Stress Symptoms and Aggression among Children with a History of Adverse Childhood Experiences

Exploring the Nexus of Adverse Childhood Experiences and Aggression in Children and Adolescents: A Scoping Review

A strong relation between adverse childhood experiences (ACE) and aggression has been established in adult populations, with less research examining this relation earlier in development. The purpose of this study was to complete a scoping review of the current evidence available on the relation between ACE and aggression and subtypes of aggression within a child and adolescent population. Inclusion criteria for the review included publications in English between 1998 and 2023, use of a child/adolescent population, and peer-review and quantitative publications. Databases searched included PubMed, APA PsycINFO, Scopus, and EBSCO, and search terms included words related to ACE and aggression. Initial selection was based on title and abstract, with 32 papers meeting eligibility criteria for inclusion. Two authors extracted the relevant characteristics of the studies independently and conferred on any disagreements. The overall findings from the scoping review suggest that there is a strong link between aggression and ACE; however, this link may not be as strong for specific subtypes of aggression. Additionally, characteristics of ACE may play role in understanding this relation, but little research is available within a child and adolescent population. A few studies have attempted to examine potential mediators and moderators of this relation; however, none have been replicated within a child and adolescent population. The findings from this review support the need for additional research in this area and identify significant gaps in the literature that need to be addressed within a child and adolescent population.

"Weeding out" violence? Translational perspectives on the neuropsychobiological links between cannabis and aggression

Recent shifts in societal attitudes towards cannabis have led to a dramatic increase in consumption rates in many Western countries, particularly among young people. This trend has shed light on a significant link between cannabis use disorder (CUD) and pathological reactive aggression, a condition involving disproportionate aggressive and violent reactions to minor provocations. The discourse on the connection between cannabis use and aggression is frequently enmeshed in political and legal discussions, leading to a polarized understanding of the causative relationship between cannabis use and aggression. However, integrative analyses from both human and animal research indicate a complex, bidirectional interplay between cannabis misuse and pathological aggression. On the one hand, emerging research reveals a shared genetic and environmental predisposition for both cannabis use and aggression, suggesting a common underlying biological mechanism. On the other hand, there is evidence that cannabis consumption can lead to violent behaviors while also being used as a self-medication strategy to mitigate the negative emotions associated with pathological reactive aggression. This suggests that the coexistence of pathological aggression and CUD may result from overlapping vulnerabilities, potentially creating a self-perpetuating cycle where each condition exacerbates the other, escalating into externalizing and violent behaviors. This article aims to synthesize existing research on the intricate connections between these issues and propose a theoretical model to explain the neurobiological mechanisms underpinning this complex relationship.

The ripple effect of trauma: Evaluating vulnerability, post-traumatic stress symptoms, and aggression within a child and adolescent population

BACKGROUND

The deleterious effects of experiencing adverse childhood experiences (ACEs), especially those associated with child abuse and neglect (CM-ACEs), is well documented. Two common behavioral and emotional concerns observed in children following CM-ACEs is post-traumatic stress and aggression. While support for cognitive models explaining both of these outcomes exists, little is known about any shared cognitive vulnerabilities that may explain the presence of both.

OBJECTIVE

The purpose of the current study was to evaluate a cognitive model of vulnerability/safety as a shared underlying mechanism for the development of post-traumatic stress symptoms (PTSS) and aggression following the occurrence of CM-ACEs in children.

METHODS

Male youth between the ages of 6 and 14 attending school within a residential setting participated in a school-based performance improvement program. As a part of the program, data were collected on the child's history of abuse, PTSS, aggression, and feelings of safety and vulnerability.

RESULTS

The results of the SEM suggested that there was a significant serial indirect effect of vulnerability and PTSS on the relation between CM-ACEs and reactive aggression. This was not true for proactive aggression.

DISCUSSION

The current results suggest that that there may be a shared schema-based model in which feelings of vulnerability and cognitive models promoting the world as an unsafe place may contribute to the maintenance and development of both PTSS and reactive aggression among children who have experienced abuse/neglect.

Adverse childhood experiences and aggression in adulthood: The moderating role of positive childhood experiences

BACKGROUND

Adverse childhood experiences (ACEs) have a significant impact on a person's psychological development and predispose them to various harmful consequences in adulthood, such as different forms of aggression. Contrarily, positive childhood experiences (PCEs) operate as protective factors, buffering against the adverse effects of ACEs and promoting adaptive behaviors and psychological well-being. However, the role of PCEs in the relationship between ACEs and aggression remains relatively unexplored.

OBJECTIVE

To explore the moderation role of PCEs in the relationship between ACEs and aggression and its different components across sexes in a community sample.

METHODS

A sample of 1541 Portuguese adults answered an online protocol with a sociodemographic questionnaire, the Benevolent Childhood Experiences Scale, the Childhood History Questionnaire, and the Buss-Perry Aggression Questionnaire.

RESULTS

ACEs were positively correlated with aggression, including physical and verbal aggression, anger, and hostility, with women reporting a higher prevalence of ACEs and higher levels of anger. Men revealed higher scores in physical and verbal aggression. Furthermore, moderation analyses clarified the moderating effect of PCEs on the relationship between ACEs and aggression in women and between ACEs and anger in both sexes. PCEs attenuate the adverse impact of ACEs, reducing aggression and anger levels.

CONCLUSIONS

This study stresses the complex interplay between childhood experiences and adult aggression, highlighting the differential effects of ACEs and PCEs across men and women. By clarifying these dynamics, interventions can be tailored to bolster protective factors like PCEs. This will ultimately foster healthier developmental trajectories and reduce the prevalence of aggression in adulthood.

Does sports participation affect the mediating role of impulsivity in the association between adverse childhood experiences and aggression?

Introduction

Adverse childhood experiences (ACEs) and self-reported aggression have often been associated, however, the mediating and moderating mechanisms underlying this association are not fully understood. In addition, less is known about potential factors that could serve as protection against the development of aggressive behavior. In this study, we investigated a moderated mediation model of sports participation and five impulsivity traits including positive and negative urgency, sensation seeking, and lack of premeditation and perseverance, in the association between ACEs and two forms of aggression.

Methods and results

The sample comprised 651 (68.5% females) individuals from a Dutch community ranging in age from 18 to 82 years (M = 34.08). Contrary to our expectations, sports participation did not affect the associations of ACEs, the five impulsivity traits, and reactive and proactive aggression, except the association between ACEs and lack of premeditation. Specifically, the detrimental effect of ACEs on the propensity to act without thinking, increases among individuals with lower levels of sports participation. In addition, it was also found that sports participation directly contributed to higher levels of sensation seeking. Finally, after controlling for sociodemographic variables, the positive association between ACEs and reactive aggression was significantly mediated by negative urgency, lack of perseverance, and lack of premeditation, while the positive association between ACEs and proactive aggression was significantly mediated by lack of premeditation and positive urgency.

Conclusion

The findings of this study add to the body of knowledge about the role of sports participation and impulsivity traits in the development of both forms of aggression, however, replication studies among multiple populations are needed before firm conclusions can be drawn.

The impact of childhood maltreatment on aggression, criminal risk factors, and treatment trajectories in forensic psychiatric patients

Introduction

Children's development into healthy well-functioning adults can be negatively affected by adversity. Adverse childhood experiences (ACEs) have been shown to lead to a variety of poor life outcomes, ranging from mental health problems (e.g., anxiety or suicidality) through problematic health behaviors to serious physical diseases and even early death. ACEs can also make people more prone to aggressive behavior, criminality, and recidivism. In this study, we investigated the association between ACEs, specifically childhood maltreatment (CM), and forensically relevant factors; aggression, criminal risk factors, and treatment trajectories, as little is known about these associations in forensic psychiatric patients.

Methods

The study includes data derived from two studies in The Netherlands, of which the first study enrolled 128 patients residing in a Forensic Psychiatric Center (FPC) and the second study included 468 patients who were released unconditionally from FPCs between 2009 and 2013. We expected that more CM would be correlated with higher levels of aggression, higher clinical risk factor scores, and less decrease in clinical risk factor scores over time. To investigate this, we applied correlational analyses and linear growth curve modeling on risk assessment scores and self-report as well as staff report questionnaires on CM and aggression.

Results

Consistent with our first hypothesis, patients with higher CM scores also had higher aggression and risk assessment scores. The effect sizes were small to medium (0.12 to 0.34). Unexpectedly, CM did not influence the course of these treatment trajectories, however, we found that patients with histories of CM had a significantly longer length of stay in a forensic facility than patients without CM (respectively, 10.8 years and 9.3 years on average).

Discussion

This study underlines the importance of carefully examining the history of ACEs and CM in forensic psychiatric patients and considering this in forensic risk assessment and risk guided treatment. More research is needed to draw conclusions about whether and how histories of ACEs should be considered and targeted during treatment trajectories.

Antecedents of sibling aggression and bullying victimization: The parallel and serial contributions of depressive symptoms and substance use

PURPOSE

Sibling aggression has received attention as a common form of family violence. However, further research is needed to elucidate several antecedents of sibling aggression perpetration and bullying victimization, such as substance use and depressive symptoms. Additionally, more studies are needed to identify the mediating paths of depressive symptoms and substance use, which could explain the association between bullying victimization and sibling aggression perpetration on the one hand and the association between sibling aggression victimization and bullying victimization on the other hand, while controlling for exposure to family violence and demographic variables. The current study tested two separate mediational models guided by the displaced aggression theory and self-medication hypothesis.

METHOD

The present study used the Bullying, Sexual, and Dating Violence Trajectories From Early to Late Adolescence in the Midwestern United States, 2007-2013 dataset. The original sample consisted of 1162 middle school students who were initially surveyed and followed into three high schools. For the current study, the first wave was used, which included a sample of 1101 adolescents. Structural equation modeling (SEM) was conducted to first examine whether bullying victimization was associated with sibling aggression perpetration. Then another model was conducted to test whether sibling aggression victimization was associated with bullying victimization.

RESULTS

In the first model, results suggest bullying victimization is positively associated with sibling aggression. Mediation results indicated depressive symptoms and substance use serially mediated the relation between bullying victimization and sibling aggression. In the second model, results suggest that sibling aggression victimization is positively associated with bullying victimization. Parallel mediation results indicated that depressive symptoms alone and not substance use individually explained the association between sibling aggression victimization and bullying victimization. Finally, serial mediation results indicated that depressive symptoms and substance use serially mediate the association between sibling aggression victimization and bullying victimization.

LIMITATIONS

Limitations include self-report measures and cross-sectional design; therefore, we could not estimate casual relationships.

CONCLUSION

The implications of these findings suggest the need for continued attention to school-based bully prevention efforts and family relations interventions. Such efforts might be associated with reductions in bullying victimization and sibling aggression.

Protective Factors Against Aggression and Antisocial Attitudes Among Probation Youth with Childhood Adversity Histories

Childhood adversity is linked to adolescent aggression and antisocial attitudes, which are common predictors of delinquency and violence. Early interruption of these negative trajectories is important for preventing serious criminality. Efforts to bolster protective factors such as social-emotional skills and positive relationships may attenuate this link, but research is needed to clarify salient factors for court-involved youth. Using risk assessment data for a diverse sample of youth on probation (N = 5378), this study investigated the role of adverse childhood experiences in increasing aggression and antisocial attitudes and the degree to which protective factors (self-regulation, future orientation, positive parenting, prosocial connections) mitigated those relationships. Multivariate models controlling for antisocial peers demonstrated that childhood maltreatment was the most salient form of adversity for increasing both aggression and antisocial attitudes. All protective factors were associated with reduced aggression and antisocial attitudes and, in moderation models, muted the impact of childhood adversity on both outcomes. These findings highlight the need for practice efforts geared toward bolstering protective factors for youth on probation, especially among those with child maltreatment histories.

Developmental trauma: Conceptual framework, associated risks and comorbidities, and evaluation and treatment

Children exposed to adverse childhood experiences (ACEs) and pervasive interpersonal traumas may go on to develop PTSD and, in most cases, will further undergo a significant shift in their developmental trajectory. This paper examines contemporary research on Developmental Trauma (DT), which is inextricably linked to disruptions in social cognition, physiological and behavioral regulation, and parent-child attachments. Developmental trauma associated with early experiences of abuse or neglect leads to multi-faceted and longstanding consequences and underscores critical periods of development, complex stress-mediated adaptations, and multilevel, trans-theoretical influences in the diagnostic formulation and treatment of traumatized children, adolescents, and adults. Psychological and medical correlates of Developmental Trauma Disorder are considered, and directions for future research are discussed.

Relationship of parent-rated and objectively evaluated executive function to symptoms of posttraumatic stress and attention-deficit/hyperactivity disorder in homeless youth

Compared to their stably housed peers, homeless, and highly mobile (HHM) youth experience disproportionately greater adversity and risk leading to a wide variety of poor developmental outcomes, and targeted interventions have the potential to mitigate such outcomes. A growing literature highlights the need for accurate diagnosis in high-risk populations given the considerable overlap between posttraumatic symptomology and behaviorally based disorders such as ADHD. Objective testing inferring neurobiological and circuit-based abnormalities in posttraumatic stress disorder (PTSD) and ADHD may provide a useful clinical tool to aid accurate diagnosis and treatment recommendations. This novel, exploratory study examined the relation between executive function (EF) as measured by objective testing and parent ratings with symptoms of posttraumatic stress and ADHD in 86 children (age 9 to 11) living in emergency homeless shelters. Parent-rated EF problems suggested broad impairment associated with ADHD symptoms but specific impairment in emotional/behavioral function associated with posttraumatic stress symptoms. While measures of inhibition and shifting EF were strongly associated with symptomology in bivariate correlations, they explained minimal variance in regression models. Internalizing behavior problems were associated with posttraumatic stress symptoms, while externalizing behavior problems were associated with ADHD symptoms. Implications for clinical practice and future research are discussed.