Understanding aggressive behaviour across the lifespan

Daily life affective dynamics as transdiagnostic predictors of mental health symptoms: An ecological momentary assessment study

BACKGROUND

Affective dynamics have been identified as a correlate of a broad span of mental health issues, making them key candidate transdiagnostic factors. However, there remains a lack of knowledge about which aspects of affective dynamics - especially as they manifest in the course of daily life - relate to a general risk for mental health issues versus specific symptoms.

METHODS

We leverage an ecological momentary assessment (EMA) study design with four measures per day over a two-week period to explore how negative affect levels, inertia, lability, and reactivity to provocation and stress in the course of daily life relate to mental health symptoms in young adults (n = 256) in the domains of anxiety, depression, psychosis-like symptoms, behaviour problems, suicidality, and substance use.

RESULTS

Dynamic structural equation modelling (DSEM) suggested that negative affect levels in daily life were associated with depression, anxiety, indirect and proactive aggression, psychosis, anxiety, and self-injury; negative affective lability was associated with depression, physical aggression, reactive aggression, suicidal ideation, and ADHD symptoms; negative affective inertia was associated with depression, anxiety, physical aggression, and cannabis use; and emotional reactivity to provocation was related to physical aggression.

LIMITATIONS

The cross-sectional design, the limited span of mental health issues included, and the convenience nature and small size of the sample are limitations.

CONCLUSIONS

Findings suggest that a subset of mental health symptoms have shared negative affective dynamics patterns. Longitudinal research is needed to rigorously examine the directionality of the effects underlying the association between affective dynamics and mental health issues.

Examining profiles of convergence and divergence in reports of parental warmth: Links to adolescent developmental problems

Parental warmth during the transition from childhood to adolescence is a key protective factor against a host of adolescent problems, including substance use, maladjustment, and diminished well-being. Moreover, adolescents and parents often disagree in their perceptions of parenting quality, and these discrepancies may confer risk for problem outcomes. The current study applies latent profile analysis to a sample of 687 mother-father-6th grade adolescent triads to identify patterns of adolescent-parent convergence and divergence in perceptions of parental warmth. Five profiles were identified, and associations with adolescent positive well-being, substance use, and maladjustment outcomes in 9th grade were assessed. Patterns of divergence in which adolescents had a pronounced negative perception of parental warmth compared to parents, as well as those wherein pronounced divergence was present in only one adolescent-parent dyad, were associated with diminished positive well-being compared to adolescents who had more positive perceptions of warmth than parents. Having more negative perceptions of warmth compared to parents was also associated with elevated risk for alcohol and marijuana initiation, but only when the divergence was pronounced rather than more moderate. These findings add nuance to findings from previous between-family investigations of informant discrepancies, calling for further family-centered methods for investigating multiple perspectives.

Factors affecting intent to perpetrate violence against nurses: Theory of Planned Behavior approach

BACKGROUND

The Theory of Planned Behavior (TPB) has been found to predict target behaviors. The literature examining this model lacks attention to violence toward nurses.

PURPOSE

To explore the association between the public's exposure to violence and intention to employ violence toward nurses, under the TPB framework.

METHODS

A cross-sectional study (705 participants) employed a self-report questionnaire. Path analysis assessed TPB variables' mediation between prior exposure to violence and violent intent toward nurses.

DISCUSSION

The TPB variables, that is attitudes, subjective norms, and perceived control, mediated only the association between exposure to physical violence and intention to act violently. Subjective norms were the strongest mediator. The explained variance was 31%.

CONCLUSION

When addressing violence against nurses, policymakers must consider attitudes, subjective norms, and perceived control among patients and their attendants. Violence directed at nurses and health care workers reflects societal violence and the "upstream approaches" needed to mitigate violence in health care settings.

Associations Between Parenting Behaviors and Behavioral Problems in Young Children With Developmental Delays

Children with developmental delays (DD) are at heightened risk for developing behavior problems, which contribute to parenting stress and caregiving burden. There is an established relation between parenting behaviors and child developmental outcomes with less known about parent-child interactions in young children with DD. The present study examined the associations between parenting behaviors and child behavior in a sample of 180 families with preschool-aged children with DD. Results indicated that caregivers' harsh and coercive behaviors were associated with observed challenging behavior in children. Child age, as well as the number of commands issued by caregivers were associated with noncompliance in children. The significance and limitations of these findings are discussed, as well as recommendations for interventions and future research.

Association of greenness surrounding school with aggression among adolescents: A multi-site study in China

Association of greenness surrounding school with aggression among adolescents was not well understood. This study aimed to investigate the associations of greenness surrounding school with adolescents' total and sub-types of aggression and explore potential mediators underlying these associations. A multi-site study of 15,301 adolescents aged 11-20 years were recruited through a multistage, random cluster sampling across 5 representative provinces in mainland China. Satellite-derived Normalized Difference Vegetation Index (NDVI) values within circular buffers of 100 m, 500 m, and 1000 m surrounding school were used to indicate the adolescents' greenness exposure. We used the Chinese version of Buss and Warren's Aggression Questionnaire to assess total and sub-types of aggression. Daily concentrations of PM2.5, and NO2 were obtained from the China High Air Pollutants datasets. Per IQR increment of NDVI 100 m and 500 m surrounding school was associated with lower odds of total aggression; odds ratio [OR] with 95% CI was 0.958 (0.926-0.990) for the 100 m buffer and 0.963 (0.932-0.996) for the 500 m buffer, respectively. Similar associations can be observed in two sub-types of aggression, including verbal (NDVI 100 m: 0.960 (0.925-0.995); NDVI500m: 0.964 (0.930-0.999)) and indirect aggression (NDVI 100 m: 0.956 (0.924-0.990); NDVI500m: 0.953 (0.921-0.986)). There were no sex and age differences in the associations of school surrounding greenness with aggression, except that the beneficial associations of greenness exposure with total aggression (0.933(0.895-0.975) vs.1.005(0.956-1.056)), physical aggression (0.971(0.925-1.019) vs.1.098(1.043-1.156)), and hostility (0.942(0.901-0.986) vs.1.016(0.965-1.069)) were greater among participants aged ≥16 years than those aged<16 years. PM2.5 (proportion mediated estimates: 0.21; 95% CI: 0.08, 0.94) and NO2 (-0.78, 95% CI: -3.22, -0.37) mediated the association of NDVI 500 m surrounding school with total aggression. Our data indicated that exposure to greenness in school surroundings was associated with reduced aggression, particularly in verbal and indirect aggression. The presence of PM2.5 and NO2 partially mediated these associations.

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.

Effects of Animated Movies on the Aggression and Behavior Performance of Primary School Students and Their Control Using a Cognitive Behavioral Anger-Control Training (CBACT) Program

This work is a combination of two studies, Study I and Study II, which aimed to examine the impact of animated movies on the aggression and behavioral performance of primary school students, as well as their control using the CBACT program. In Study I, the influence of animated movies on 300 students from ten primary schools in Pakistan with gender differences (50% male), family systems, and viewing time duration was examined. This study was performed on 7- to 9-year-old children on four subscales of the Buss-Perry aggression questionnaire (BPAQ), three subscales of the child behavior questionnaire (CBQ), and toy selection. Following that, in Study II the CBACT intervention was applied to aggressive students (n = 46) selected from Study I. Students were randomly divided into CBACT treatment (50%) and control groups. The results of Study I indicated that violent animated movies had a greater impact on the aggressive behavior of male students than on that of females, while girls were more affected by watching nonviolent movies. Furthermore, male viewers from nuclear families and females from joint families showed more aggressive problems. It was also observed that aggression in students significantly increased (p < 0.001) with increasing viewing animation time duration (10 to 30 min). The results of Study II showed that aggression in the treatment group was significantly reduced (p = 0.000) with the CBACT program but remained constant for the control group. The findings of Study I showed that violent animation is strongly linked with aggression and behavioral performance in primary school students. The CBACT program in Study II indicates that students may not be completely eliminated from watching violent movies, but their aggression levels were reduced when they watched animated movies. Therefore, the CBACT program opens a new window into behavioral problem treatment, which is casually influenced by violent media.

Unveiling common psychological characteristics of proneness to aggression and general psychopathology in a large community youth cohort

Elevated aggression in individuals with psychiatric disorders is frequently reported yet aggressive acts among people with mental illness are often intertwined with proneness to aggression and other risk factors. Evidence has suggested that both general psychopathology and proneness to aggression may share common psychological characteristics. This study aims to investigate the complex relationship between general psychopathology, proneness to aggression, and their contributing factors in community youth. Here, we first examined the association between proneness to aggression and the level of general psychopathology in 2184 community youths (male: 41.2%). To identify common characteristics, we trained machine learning models using LASSO based on 230 features covering sociodemographic, cognitive functions, lifestyle, well-being, and psychological characteristics to predict levels of general psychopathology and proneness to aggression. A subsequent Gaussian Graph Model (GGM) was fitted to understand the relationships between the general psychopathology, proneness to aggression, and selected features. We showed that proneness to aggression was associated with a higher level of general psychopathology (discovery: r = 0.56, 95% CI: [0.52-0.59]; holdout: r = 0.60, 95% CI: [0.54-0.65]). The LASSO model trained on the discovery dataset for general psychopathology was able to predict proneness to aggression in the holdout dataset with a moderate correlation coefficient of 0.606. Similarly, the model trained on the proneness to aggression in the discovery dataset was able to predict general psychopathology in the holdout dataset with a correlation coefficient of 0.717. These results suggest that there is substantial shared information between the two outcomes. The GGM model revealed that isolation and impulsivity factors were directly associated with both general psychopathology and proneness to aggression. These results revealed shared psychological characteristics of general psychopathology and proneness to aggression in a community sample of youths.

Bidirectional association between sleep quality or duration and aggressive behaviour in early adolescents: A cross-lagged longitudinal study

BACKGROUND

Several cross-sectional studies have suggested a strongly positive link between sleep and aggressive behaviour; however, longitudinal studies reporting the relationship between sleep and aggressive behaviour are lacking. This study aimed to examine whether a bidirectional relationship exists between sleep quality or duration and aggressive behaviour in early adolescents.

METHODS

A total of 1579 early adolescents (60.9 % boys) from the Chinese Early Adolescents Cohort study were included in this study. Data on sleep quality, sleep duration and aggressive behaviour collected at two time points (September 2019 and September 2021) were used, and the bidirectional relationship between sleep quality or duration and aggressive behaviour was examined using a cross-lagged model.

RESULTS

The results revealed a bidirectional relationship between low sleep quality and highly aggressive behaviour. A shorter sleep duration did not predict highly aggressive behaviour, whereas only highly aggressive behaviour predicted a shorter sleep duration.

CONCLUSIONS

Sleep quality and aggressive behaviour were interrelated over time among adolescents. However, sleep duration did not predict aggressive behaviour, suggesting that sleep quality, instead of sleep duration, should be the primary target for managing aggressive behaviour.

Cecal microbiota transplantation: unique influence of cecal microbiota from divergently selected inbred donor lines on cecal microbial profile, serotonergic activity, and aggressive behavior of recipient chickens

BACKGROUND

Accumulating evidence from human trials and rodent studies has indicated that modulation of gut microbiota affects host physiological homeostasis and behavioral characteristics. Similarly, alterations in gut microbiota could be a feasible strategy for reducing aggressive behavior and improving health in chickens. The study was conducted to determine the effects of early-life cecal microbiota transplantation (CMT) on cecal microbial composition, brain serotonergic activity, and aggressive behavior of recipient chickens.

METHODS

Chicken lines 6₃ and 7₂ with nonaggressive and aggressive behavior, respectively, were used as donors and a commercial strain Dekalb XL was used as recipients for CMT. Eighty-four 1-d-old male chicks were randomly assigned to 1 of 3 treatments with 7 cages per treatment and 4 chickens per cage (n = 7): saline (control, CTRL), cecal solution of line 6₃ (6₃-CMT), and cecal solution of line 7₂ (7₂-CMT). Transplantation was conducted via oral gavage once daily from d 1 to 10, and then boosted once weekly from week 3 to 5. At weeks 5 and 16, home-cage behavior was recorded, and chickens with similar body weights were assigned to paired aggression tests between the treatments. Samples of blood, brain, and cecal content were collected from the post-tested chickens to detect CMT-induced biological and microbiota changes.

RESULTS

6₃-CMT chickens displayed less aggressive behavior with a higher hypothalamic serotonergic activity at week 5. Correspondingly, two amplicon sequence variants (ASVs) belonging to Lachnospiraceae and one Ruminococcaceae UCG-005 ASV were positively correlated with the levels of brain tryptophan and serotonin, respectively. 7₂-CMT chickens had lower levels of brain norepinephrine and dopamine at week 5 with higher levels of plasma serotonin and tryptophan at week 16. ASVs belonging to Mollicutes RF39 and GCA-900066225 in 7₂-CMT chickens were negatively correlated with the brain 5-hydroxyindoleacetic acid (5-HIAA) at week 5, and one Bacteroides ASV was negatively correlated with plasma serotonin at week 16.

CONCLUSION

Results indicate that CMT at an early age could regulate aggressive behavior via modulating the cecal microbial composition, together with central serotonergic and catecholaminergic systems in recipient chickens. The selected CMT could be a novel strategy for reducing aggressive behavior through regulating signaling along the microbiota-gut-brain axis.

"My [Search Strategies] Keep Missing You": A Scoping Review to Map Child-to-Parent Violence in Childhood Aggression Literature

Child-to-parent violence is often referred to as one of the most 'under-researched' forms of family violence. However, it is closely associated with one of the most widely researched areas of research globally: childhood aggression. How child-instigated aggression can harm parents is widely referred to, but different framings, definitions, and conceptualisations are used which creates problems when attempting to identify the broader literature which may be relevant to child-to-parent violence researchers.

METHODS

Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, 55 papers were reviewed from EBSCO, PubMed, SCOPUS, and Web of Science to explore how location, field of the researcher, and terminology can impact how researchers conceptualise and frame this form of harm.

RESULTS

Three themes were identified (1) child-to-parent violence is a behavioural indicator of childhood distress or developmental needs, (2) children are 'perpetrators' of deviant behaviour, and (3) the parents are 'victims' of child-to-parent violence.

CONCLUSIONS

Children and parents are both harmed by child-to-parent violence. It is important that future researchers and practitioners recognise the bi-directionality of the parent-child relationship, and not be complicit in hiding the harms caused by child-to-parent violence by subsuming it under the broader childhood aggression literature.

Infidelity in the Adolescence Stage: The Roles of Negative Affect, Hostility, and Psychological Well-Being

BACKGROUND

Infidelity is a relational process common in all types of romantic relationships and has been established as one of the main causes of relationship breakdown. However, little is known about this type of transgression in adolescent romantic relationships, although it manifests as a fairly frequent behavior involving different motivations. Even less is known about the emotional impact of infidelity on the offending person and its association with hostile behavior and psychological well-being.

METHODS

Through an experimental study (N = 301 Spanish adolescents (190 female and 111 male; M_age = 15.59, SD = 0.69; range from 15 to 17), we sought to analyze the effect of manipulating two types of motivations for infidelity (sexual vs. emotional dissatisfaction) on negative affect, hostility, and psychological well-being.

RESULTS

The main results revealed that committing infidelity motivated by hypothetical sexual (vs. emotional) dissatisfaction was indirectly related to lower psychological well-being through its effects on increased negative affect and hostility.

CONCLUSIONS

Last but not least, we discuss these findings, highlighting the possible implications of infidelity for the psychosocial and psychosexual development of adolescents.

Aggressive-like behaviour and neurocognitive impairment in alcohol herbal mixture-fed mice are associated with increased neuroinflammation and neuronal apoptosis in the prefrontal cortex

Alcohol-induced aggression and related violence is a serious and common social problem globally. Alcohol use is increasingly found in the form of alcoholic herbal mixtures (AHM) with indiscriminate and unregulated alcohol content. This study investigated the effects of AHM on aggressive-like, neurocognitive impairment and brain biochemical alteration in mice. Thirty-two male resident mice were paired housed with female mice for 21 days in four groups (n = 8). Resident mice were treated orally with normal saline, AHM, ethanol and AHM + ethanol daily for 14 days. Aggressive-like behaviour was scored based on the latency and frequency of attacks by the resident mouse on the intruder. Neurocognitive impairment was determined using the Y-maze test (YMT) and novel object recognition test (NORT). Acetylcholinesterase, glutamic acid decarboxylase (GAD), pro-inflammatory and oxidative stress parameters were determined in the prefrontal cortex (PFC). Neuronal morphology, cytochrome c (Cyt-c) and nuclear factor-kappa B (NF-ĸB) expressions were determined. AHM and in combination with ethanol showed an increased index of aggression typified by frequency of attack and reduced latency to attack when compared to normal saline-treated animals. Co-administration of AHM and ethanol significantly reduced cognitive correct alternation (%) and discrimination index in the YMT and NORT, respectively. AHM and ethanol increased acetylcholinesterase, Pro-inflammatory cytokines and oxidative stress parameters while they reduced GAD. There were significantly reduced neuronal counts and increased expression of Cyt-c and NF-ĸB, respectively Alcoholic herbal mixture increased aggressiveness and caused neurocognitive impairment via increased oxido-inflammatory stress in the prefrontal cortex.

Professional Preparedness Implications of Workplace Violence against Medical Students in Hospitals: A Cross-Sectional Study

Workplace violence is an increasing public health concern around the world. In Vietnam, attacks on healthcare workers have become a huge issue in recent years. Our study aims to shed more light on the issue and look at what variables affect acts of violence toward healthcare workers. We conducted this cross-sectional study by surveying 550 medical students from 3 universities in Vietnam. Following this survey on SurveyMonkey's platform (surveymonkey.com), the participants were suggested to invite their associates who met the selection criteria to join in this online survey. The structured questionnaire included demographics and details on the violence. There were 90.5% of respondents were medical students, the mean age was 23.3, and verbal abuse had a prevalence rate of 29.3%. Women respondents are less likely to suffer from violent experiences than men (OR = 0.48, 95% CI = 0.28-0.84), and those specializing in nurse and technician also faced a lower rate of acts of aggression (physical violence: OR = 0.35; 95% CI = 0.19-0.63, sexual harassment: OR = 0.36; 95% CI = 0.15-0.87, and any type of violence: OR = 0.55, 95% CI = 0.37-0.82). Medical students working in Ho Chi Minh City (OR = 0.55; 95% CI = 0.34-0.89), and other regions (OR = 0.40; 95% CI = 0.19-0.85) were significantly less likely to face verbal abuse than those working in Hanoi. The workplace culture needs to be changed to make sure that people feel comfortable reporting, especially those who are younger. Protecting medical students also ensures patient safety since victims of assault in the workplace can have severe aftereffects affecting their ability to provide good patient care. Hence, policies need to be implemented at both the government and hospital administration levels to keep health workers safe.

Aggressive behavior in adolescent: The importance of biopsychosocial predictors among secondary school students

Introduction

Overt aggression is a common type of aggression observed among adolescents, which is apparent and outward confrontational acts manifested physically and verbally, such as fighting and shouting. It has become a major public health concern, as it results in detrimental health impacts like injury, mental health, and social problems.

Methods

An observational study was conducted among 16-year-old school students to determine their biopsychosocial predictors, using stratified proportionate population sampling. Pre-tested surveys were distributed to measure students' aggression, biological, psychological, and social factors.

Results

A total of 463 students from four public secondary schools participated in the study, with a median aggression score was 23.00 (IQR=12.00). The significant predictors of aggression from multivariate analysis were Malay race, frequent dessert intakes, attitude towards aggression, low family income, and peer deviant affiliation (F [8, 244] = 15.980, p < 0.001, adjusted R ² = 0.290).

Discussion

Adolescent aggression determinants are collectively impacted as a result of biological, psychological, and social predictors and need to be focused on in interventional strategies.

Adjustment and maladjustment to later life: Evidence about early experiences in the family

Introduction

Previous parenting studies with European-American families have identified optimal parenting as being based on warmth combined with strictness (i.e., authoritative parenting). The present study analyzes, in adolescents and adults, their adjustment and maladjustment related to age and their early experiences in the family.

Methods

The sample consisted of 2,158 Spanish people (58.29% women): 624 adolescents, 630 young adults, 504 middle-aged adults, and 400 older adults. The families were classified into one of the four parental typologies (authoritative, indulgent, authoritarian, and neglectful) based on their scores in the two main dimensions (warmth and strictness). Child functioning was measured as components of adjustment (self-esteem, emotional self-concept, and empathy) and maladjustment (aggression and hostile sexism).

Results

Overall, only adolescents and adult children raised in indulgent families reported the highest self-esteem, emotional self-concept, and empathy, and the lowest aggression and hostile sexism. Authoritative parenting (warmth with strictness) was related to a lower emotional self-concept and greater aggression and hostile sexism than indulgent parenting (warmth without strictness). The worst scores corresponded to authoritarian and neglectful parenting.

Discussion

The present findings provide new evidence about early experiences in the family, even after parental socialization has ended. Interestingly, contrary to the main findings from classic studies with European-American families, only high parental warmth combined with low parental strictness (i.e., indulgent parenting) is always positive for greater adjustment and less maladjustment in all age groups.

The association between peer rejection and aggression types: A meta-analysis

BACKGROUND

Although previous studies have assessed the association between peer rejection and aggression, the results are mixed.

OBJECTIVE

This article presents a meta-analysis of the association between peer rejection and aggression types (overt vs. relational) among children and adolescents.

PARTICIPANTS AND SETTING

A total of 61 eligible studies with 70 independent effect sizes were included in the analysis (45,966 participants, M_age = 10.34, SD = 3.13).

METHODS

First, random-effects meta-analyses were conducted to explore the association between peer rejection and aggression types (overt vs. relational). Next, moderation analyses were conducted based on the Q statistics for categorical variables (culture, reporting method of peer rejection, reporting method of aggression) and the meta-regression analyses for continuous variable (age).

RESULTS

Peer rejection was positively correlated with overall aggression (r = 0.42, 95 % CI [0.38, 0.47], p < 0.001), overt aggression (r = 0.46, 95 % CI [0.38, 0.54], p < 0.001) and relational aggression (r = 0.43, 95 % CI [0.35, 0.51], p < 0.001). This correlation was positive for each type when controlling for other form of aggression. Moderation analyses suggested that reporting method of aggression (self-report vs. peer-nomination vs. adult-report vs. observation), reporting method of peer rejection (self-report vs. peer-nomination vs. adult-report) and culture (collectivist vs. individualist) were moderators of the association between peer rejection and overall aggression. Culture moderated the association between peer rejection and overt aggression, while age moderated the association between peer rejection and relational aggression.

CONCLUSIONS

The findings showed a strong positive association between peer rejection and aggression, although this association varied by aggression type and other moderating variables.

Effects of Alcohol Consumption on Oxidative Stress in a Sample of Patients Recruited in a Dietary Center in a Southern University Hospital: A Retrospective Study

Background and objectives: The aim of this retrospective study was to evaluate the effects of alcohol consumption on oxidative stress. Materials and Methods: The study was conducted by analyzing the increase in lipid peroxidation, the reduction of antioxidant defenses and the alteration of the oxidation/antioxidant balance after the administration of ethanol in 25% aqueous solution (v/v) at a concentration of 0.76 g/kg of body weight daily in two doses for 3 days. The changes in oxidative stress indices were investigated by standard methods previously described. Results: Ethanol administration has determined a significant increase in plasma levels of lipid hydroperoxide (LOOH), malonilaldehyde (MDA) and oxidized glutathione (GSSH), and a decrease in total antioxidant capacity (TAC), reduced glutathione (GSH) and GSH/GSSH ratio. Conclusions: In the proposed experimental condition, the excessive and repeated consumption of ethanol causes oxidative damage, as shown by the increase in lipid peroxidation, the reduction of antioxidant defenses and the alteration of the oxidation/antioxidant balance, which, at least in part, are responsible for the harmful effects of excess ethanol.

Effectiveness of aggression management training (AMT) on self‐esteem, impulsivity, and aggressive behavior among adolescents residing in delinquent homes—A feasibility study from east India

PURPOSE

This feasibility study examined the aggression management training (AMT) interventions on self-esteem, impulsivity, and aggressive behavior among adolescents residing in delinquent or observation homes.

METHODS

A quantitative research approach with the quasi-experimental nonequivalent control group (comparison) pretest and Posttest design was adopted. A total of 32 male adolescents (16 each in experimental and comparison groups) residing in two different observation homes in the state of Bihar, India were selected by convenience sampling technique. The study evaluated the following outcome measures: self-esteem, impulsivity, and aggressive behavior for both groups at baseline and 1 month. AMT was administered to the experimental group bi-weekly for 4 weeks covering four components in 8 sessions.

RESULTS

We analysed the data with independent and paired t-tests for between and within the group differences, and Pearson correlation for a relationship. AMT intervention improved self-esteem and reduced aggressive behavior and impulsivity among adolescents residing in delinquent homes. A correlation was found between aggression and impulsivity, and between self-esteem and impulsivity.

PSYCHIATRIC NURSING IMPLICATIONS

The study had provided initial evidence for practice that can help psychiatric nurses significantly implement these types of interventions among significant, vulnerable, and ignored groups of adolescents detained in observation homes to prevent the occurrence of repeat offenses.

Testing effects of social rejection on aggressive and prosocial behavior: A meta-analysis

Social rejection elicits profound feelings of distress. From an evolutionary perspective, the best way to alleviate this distress is to behave prosocially, minimizing the likelihood of further exclusion. Yet, examples ranging from the playground to the pub suggest rejection commonly elicits aggression. Opposing theoretical perspectives and discordant empirical results have left a basic question unanswered: does rejection more commonly elicit prosocial or aggressive behavior? We conducted three meta-analyses (one with studies measuring aggressive behavior; one with studies measuring prosocial behavior; and one with studies measuring both aggressive and prosocial behavior; N = 3864) to quantify: (1) the extent to which social rejection elicits prosocial or aggressive behavior and (2) potential moderating effects on these relations. Random-effects models revealed medium effects such that social rejection potentiated aggressive behavior (k = 19; d = 0.41, p < .0001) and attenuated prosocial behavior (k = 7; d = 0.59, p < .0001), an effect that remained consistent even when participants were given the option to behave prosocially or aggressively (k =  15; d = 0.71, p < .0001). These results cast doubt on the theory that rejection triggers prosocial behavior, and instead suggest it is a robust elicitor of aggression. Statement of Relevance: To our knowledge, these meta-analyses are the first to directly test whether social rejection elicits aggressive or prosocial behavior. By including a comprehensive collection of both published and unpublished research studies, and examining a wide variety of previously untested moderators, we show that social rejection robustly elicits aggressive behavior and inhibits prosocial behavior. Additionally, we demonstrate that aggressive behavior following social rejection is not simply a function of limited choices in response options. In fact, aggressive behavior was evoked even when the option to engage in prosocial behavior was provided. Furthermore, we conducted a comprehensive narrative review of the neural mechanisms underlying social rejection-elicited aggressive and prosocial behavior to supplement primary analyses. Overall, we believe that our work makes a critical theoretical contribution to the field.

Cascading indirect genetic effects in a clonal vertebrate

Understanding how individual differences arise and how their effects propagate through groups are fundamental issues in biology. Individual differences can arise from indirect genetic effects (IGE): genetically based variation in the conspecifics with which an individual interacts. Using a clonal species, the Amazon molly (Poecilia formosa), we test the hypothesis that IGE can propagate to influence phenotypes of the individuals that do not experience them firsthand. We tested this by exposing genetically identical Amazon mollies to conspecific social partners of different clonal lineages, and then moving these focal individuals to new social groups in which they were the only member to have experienced the IGE. We found that genetically different social environments resulted in the focal animals experiencing different levels of aggression, and that these IGE carried over into new social groups to influence the behaviour of naive individuals. These data reveal that IGE can cascade beyond the individuals that experience them. Opportunity for cascading IGE is ubiquitous, especially in species with long-distance dispersal or fission-fusion group dynamics. Cascades could amplify (or mitigate) the effects of IGE on trait variation and on evolutionary trajectories. Expansion of the IGE framework to include cascading and other types of carry-over effects will therefore improve understanding of individual variation and social evolution and allow more accurate prediction of population response to changing environments.

Case of Treatment-Resistant Aggression in the Context of a Medically Underserved Community

Aggression tends to decrease as a child matures and develops conflict resolution skills. However, aggression can persist if children are exposed to consistent negative stimuli, such as poor parenting and adverse childhood experiences (ACEs). Furthermore, aggression is commonplace in numerous psychiatric disorders, such as attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder. These negative stimuli and comorbid conditions could ultimately stunt a child’s development during pivotal moments, leading to worsening aggressive behaviors, such as criminal activity. Behavioral interventions are imperative for individuals with these comorbid conditions and experiences.

Our patient is an 11-year-old male with a pertinent past medical history of ADHD and disruptive mood dysregulation disorder (DMDD) on multiple psychotropic medications, who presented to the emergency department for the evaluation of homicidal ideation and suicidality. This also occurred with worsening aggressive behavior, demonstrated by his killing of family pets and subsequent threats to kill his family. The patient has had multiple emergency department visits for similar threats and has been admitted to numerous inpatient psychiatric facilities. Currently, the patient is being treated at an out-of-state inpatient psychiatric facility.

Our patient’s aggression most likely stems from his comorbid ADHD and DMDD, complicated by other factors, such as low socioeconomic status, limited access to mental health services, and living in a medically underserved community. Factors such as increasing primary care provider comfort in managing these conditions, especially in underserved communities where there are already shortages of mental health providers, could help address this issue. Furthermore, it is imperative to screen for other contributing factors, such as ACEs. This case also highlights the need for genetic testing as a part of the medical workup in psychiatric cases that display psychotropic medication resistance. However, genetic testing is something that is not readily available in our state and is not covered by Medicaid.

Early treatment of mental health conditions can prevent social difficulties later in life. With aggression, providing appropriate interventions is key to preventing an individual from engaging in harmful activities. It is important to screen for ACEs in order to address well-known aggravating factors. Underserved populations also face a myriad of challenges that prevent them from accessing healthcare services. There are numerous problems contributing to this disparity, ranging from lack of adequate mental health services to lack of access. Accordingly, it is imperative that primary care physicians and providers practicing in underserved areas receive the training necessary to recognize and treat mental health conditions. Furthermore, physicians should be able to focus on psychosocial stressors that contribute to these mental health conditions and provide the resources necessary to address these factors.

CHILDHOOD EXPERIENCES AND FACTORS ASSOCIATED WITH PERPETRATION OF VIOLENCE AMONG YOUNG ADULTS IN DELTA STATE PRISONS

Background

Violent acts perpetrated by young people can cause physical and psychological harm to others and is of serious public health concern. This study was conducted to determine the prevalence of childhood trauma, and to assess the relationship between adverse childhood experiences and other predicting factors, and the perpetration of violence among young adults in Delta state prisons.

Methods

A descriptive cross-sectional study design was conducted amongst 293 youths who were convicted prison inmates in Delta State Correctional facilities. Three out of the five facilities in Delta State were selected using simple random sampling, after which a total sampling of incarcerated inmates from the three selected facilities was carried out. Data were collected using the; Childhood Trauma Questionnaire (CTQ) to measure adverse childhood experiences, and a proforma to classify the offence of the inmate (whether violent or non-violent).

Results

The mean age of the respondents was 28.4 ± 5.4 years. The overall prevalence of childhood trauma was 5.1%. The most common abuse/neglect experienced while growing up was physical neglect with 26.3% followed by emotional neglect (20.5%), physical abuse (7.2%), emotional abuse (2.4%) and sexual abuse (1%).The prevalence of violent offences was 46.1%. Age, (OR=0.3; CI= 0.2-0.6, p=0.001), attaining primary education (OR=3.4; CI= 1.5-7.8, p=0.004) and having witnessed violence while growing up (OR=2.0; CI= 1.2-3.3, p=0.007) were all significant predictors of the perpetration of violence.

Conclusion

The overall prevalence of childhood trauma was low; however, the perpetuation of violence was found to be high in this study. Further research is required to develop study instruments for childhood trauma that are more context specific bearing in mind local sociocultural practices.

Measurement properties of the life history of aggression in adolescents: Data from Morocco, Serbia, Sweden, Vietnam, and the USA

The Life History of Aggression (LHA) is a frequently used scale for assessing trait aggression, but its psychometric properties have not been evaluated among adolescents. The aim of this study was to evaluate the psychometric properties of the LHA among high school students from Morocco, Serbia, Sweden, Vietnam, and the United States of America (USA). The total sample included 4867 adolescents, aged 15-19 years, from Morocco (n = 508), Serbia (n = 1067), Sweden (n = 1570), Vietnam (n = 1401), and the USA (n = 321). A two-factor, nine-item model containing an aggression factor (5 items) and a consequences/antisocial behavior factor (4 items) was created. The two-factor model had an acceptable-to-good model fit for the data for the total sample and all five countries, including gender. Cronbach's alpha (α) was satisfactory across countries. Still, the construct was noninvariant across countries and genders. The LHA with nine items in two subscales showed sound construct validity and internal consistency and can be used for group-level or within-group assessments of trait aggression in adolescents by either gender or country. However, it should not be used for cross-gender or cross-country comparisons due to a lack of measurement invariance.

Eliciting preferences for continuing medication among adult patients and parents of children with attention-deficit hyperactivity disorder

BACKGROUND

Adherence to medication for attention-deficit hyperactivity disorder (ADHD) is less than optimal. Previous studies have primarily focused on qualitative assessment of factors that influence medication adherence.

OBJECTIVE

This study aimed to quantify the factors that influence patient and parent preferences for continuing ADHD medication.

METHOD

A discrete-choice experiment was conducted to investigate preferences. Adults, and parents of children, with ADHD were presented with eight hypothetical choice tasks of three options (Medication A, Medication B, No Medication) described by six attributes related to medication outcomes. Preferences were estimated using a mixed multinomial logit model.

RESULTS

Overall, respondents' preferences (n = 216) for continuing medication were negative (mean [β] = -1.426, p < .001); however, a significant heterogeneity in preferences was observed amongst respondents (standard deviation = 0.805, p < .001). Improvements in education, aggressive behaviour, social behaviour and family functioning, and side effects and stigma, influenced respondents' decision to continue taking medication. The respondents were willing to continue medication if they experienced positive effects, but side effects (even moderate) were the strongest concern for not continuing medication. While side effects were the most important factor for both adult patients and parents of children with ADHD, improvement in education was relatively more important for adults and improvement in aggressive behaviour, social behaviour and family functioning was relatively more important for parents of children with ADHD. Parents were more likely to not continue a medication with severe side effects even at the highest level of improvement in education.

CONCLUSIONS

Side effects are the most important factor that influenced preferences for continuing medication for both adults with ADHD, as well as parents of children with ADHD. While overall the respondents preferred not to take/give medication, discrete-choice experiment showed that the relative importance of factors that influenced continuation of medications was different for the two groups.

PATIENT AND PUBLIC INVOLVEMENT

Adults, and parents of children, with ADHD participated in this study by completing the online questionnaire. The questionnaire was based on findings of research in the literature, as well as earlier focus groups conducted with adults, and parents of children, with ADHD. The face validity of the questionnaire was determined by asking parents of children, and adults, with ADHD (n = 3) to complete the survey and participate in a short discussion on their understanding of the questions and their recommendations on improving the clarity of the survey.

Dominance in humans

Dominance captures behavioural patterns found in social hierarchies that arise from agonistic interactions in which some individuals coercively exploit their control over costs and benefits to extract deference from others, often through aggression, threats and/or intimidation. Accumulating evidence points to its importance in humans and its separation from prestige-an alternate avenue to high status in which status arises from information (e.g. knowledge, skill, etc.) or other non-rival goods. In this review, we provide an overview of the theoretical underpinnings of dominance as a concept within evolutionary biology, discuss the challenges of applying it to humans and consider alternative theoretical accounts which assert that dominance is relevant to understanding status in humans. We then review empirical evidence for its continued importance in human groups, including the effects of dominance-independently of prestige-on measurable outcomes such as social influence and reproductive fitness, evidence for specialized dominance psychology, and evidence for gender-specific effects. Finally, because human-specific factors such as norms and coalitions may place bounds on purely coercive status-attainment strategies, we end by considering key situations and contexts that increase the likelihood for dominance status to coexist alongside prestige status within the same individual, including how: (i) institutional power and authority tend to elicit dominance; (ii) dominance-enhancing traits can at times generate benefits for others (prestige); and (iii) certain dominance cues and ethology may lead to mis-attributions of prestige. This article is part of the theme issue 'The centennial of the pecking order: current state and future prospects for the study of dominance hierarchies'.

Association between Bone Lead Concentration and Aggression in Youth from a Sub-Cohort of the Birth to Twenty Cohort

BACKGROUND

An association between blood-lead levels and aggression has been demonstrated in children and adolescent youth in South Africa. However, there are limited studies that have assessed aggression as an outcome for cumulative lead exposure using bone lead concentration. This study aims to assess the association between bone lead concentration and aggressive behaviour among a sample of youth in South Africa.

METHODS

Bone lead in 100 participants (53 males and 47 females) recruited and followed in the Birth to Twenty (BT20) Cohort were measured using 109 Cd-based, K-shell X-ray fluorescence (KXRF). The Buss-Perry Aggression questionnaire was used to measure aggressive behaviour. Linear regression models were fitted to determine the association between aggression score for physical, verbal, anger and hostility and bone lead, adjusting for known confounders.

RESULTS

A one-microgram-per-gram increase in bone lead was found to increase the score for all four scales of aggression, but significantly only for anger (β = 0.2 [95% CI 0.04-0.370]). Psychosocial factors such as a history of family violence and exposure to neighbourhood crime were significant predictors for aggression.

CONCLUSIONS

The study provides a preliminary overview of the relationship between cumulative lead exposure and behavioural problems such as aggression. A larger sample, across exposed communities, may prove more definitive in further investigating the association between these two important public health factors and to maximize generalizability.

Personal Risk and Protective Factors Involved in Aggressive Behavior

The study of aggression plays a prominent role in psychology and public health, because of the important adverse consequences of such behavior for victims, aggressors, and society in general. The General Aggression Model (GAM) provides a general conceptual framework for understanding the aggressive as a result of three stages: (a) inputs: personal and situational factors; (b) present internal states: affect, cognition, and arousal; and (c) outcomes: decision processes with a (non)aggressive result. The main objective of this research was to study the personal protective and risk factors most strongly associated with aggressive behavior acting at the first stage of the GAM model. A total of 282 young adult participants took part in this study. Participants were assessed for aggression levels and a set of the most relevant variables that have been associated with aggressive behavior in the previous literature. Stepwise multiple regression analysis revealed that levels of aggression were mainly associated (73.2% of the explained variance) with the following protective factors: the ability to manage emotions as a component of emotional intelligence (EI), and perspective-taking and personal distress as components of empathy, and with the following risk factors: negative and positive urgency as a component of impulsivity, fantasy as a component of empathy, negative affect, and expressive suppression of emotions. These findings provide a better understanding of the mechanisms underlying aggressive behavior and provide greater empirical value to the current theoretical models. In addition, this research can help to inform the design of more successful programs for the prevention, control, and treatment of aggressive behavior. Limitations and future lines of research are discussed.

Selective Serotonin Reuptake Inhibitors (SSRIs) and Their Effect on Patient Aggression in Adult Patients in a State Psychiatric Facility: A Retrospective Analysis

OBJECTIVE

The utility of selective serotonin reuptake inhibitors (SSRIs) has been overshadowed by the box warning they received when the United States (US) Food and Drug Administration (FDA) identified an increased risk of suicidality in patients 24 years of age or younger. Newer studies have identified suicidality as self-aggression and hypothesized whether this might also apply to aggression toward others. The controversy surrounding SSRIs has led to a decrease in prescriptions from healthcare clinicians and number of patients seeking the necessary treatment. The objective of this study was to determine if there is a relationship between SSRI use and aggressive behavior in an inpatient state psychiatric facility.

DESIGN

Using a retrospective analysis, patients (N=64) admitted to an inpatient state psychiatric facility between January 1, 2013, and December 31, 2020, who were taking SSRIs were assessed to determine if they had an increased risk of aggression, whether toward themselves or others. Patients served as their own comparators and were required to have a period without an SSRI and an equivalent period taking an SSRI. Patients were assessed through markers of aggression, including psychiatric emergencies; restraints; seclusions; as needed (PRN) medication use or STAT medication use for agitation, aggression, violence, poor impulse control, or psychosis; and PRN nicotine use.

RESULTS

There was no statistical significance in any of the analyses demonstrating that SSRI use led to an increased risk of aggression in this sample of inpatients.

CONCLUSION

The FDA warning of increased risk of suicidality and case reports of aggression potentially associated with the use of certain antidepressants should not prevent prescribers from treating adult patients with SSRI medications.

Predictors of deliberate self-harm among adolescents: Answers from a cross-sectional study on India

BACKGROUND

Although existing research supports the correlation of hereditary and psychological factors with an adolescent's deliberate self-harm, there is a dearth of research that focus on their socio-economic characteristics. This paper intends to identity the potential risk factors that influence an adolescent's deliberate self-harm.

METHODS

Data for this study was obtained from Understanding the Lives of Adolescents and Young Adults (UDAYA) study conducted in 2015-16 with sample of 5,969 adolescent boys and 9,419 girls aged 10-19 years. The outcome variable was deliberate self-harm among adolescents. The explanatory variables added in the study were age, current schooling status, working status, media exposure, access to internet, parental abuse, involvement in fights, substance use, depressive symptoms, caste, religion, wealth index, residence and states. Bivariate analysis along with binary logistic regression analysis was done to fulfill the study objectives.

RESULTS

About 4.5% and 3.2% of adolescent boys and girls, respectively had deliberate self-harm. The odds of deliberate self-harm were 50 per cent more likely among adolescent girls who had internet access [OR 1.50; CI 1.05-2.16]. The likelihood of deliberate self-harm was 49 per cent and 61 per cent significantly more likely among adolescent boys [OR 1.49; CI 1.11-2.0] and girls [OR 1.61; CI 1.27-2.04] who experienced parental physical abuse respectively. With reference to minimal/mild depressive symptoms, adolescents who had moderate [boys-OR 2.10; CI 1.29-3.4 and girls-OR 2.50; CI 1.774-3.59] or moderately high/severe [boys-OR 4.58; CI 2.88-7.29 and girls-OR 4.18; CI 3.1-5.63] depressive symptoms had significantly higher odds of deliberate self-harm.

CONCLUSIONS

Internet access, parental abuse, involvement in fights, and depressive symptoms emerged as significant predictors of deliberate self-harm among adolescent boys and girls. Results suggest that an early identification of the predictors and intervention might prevent deliberate self-harm among adolescents. Since parents play a major role in the lives and development of adolescents, it is highly recommended that they initiate open and supportive communication with their children.

Psychological, psychophysiological and behavioural effects of participant-selected vs. researcher-selected music in simulated urban driving

We investigated the effect of participant-selected (PSel) and researcher-selected (RSel) music on urban driving behaviour in young men (N = 27; M_age = 20.6 years, SD = 1.9 years). A counterbalanced, within-subjects design was used with four simulated driving conditions: PSel fast-tempo music, PSel slow-tempo music, RSel music and an urban traffic-noise control. The between-subjects variable of personality (introverts vs. extroverts) was explored. The presence of PSel slow-tempo music and RSel music optimised affective valence and arousal for urban driving. NASA Task Load Index scores indicated that the urban traffic-noise control increased mental demand compared to PSel slow-tempo music. In the PSel slow-tempo condition, less use was made of the brake pedal. When compared to extroverts, introverts recorded lower mean speed and attracted lower risk ratings under PSel slow-tempo music. The utility of PSel slow-tempo and RSel music was demonstrated in terms of optimising affective state for simulated urban driving.

Experimental Social Stress: Dopaminergic Receptors, Oxidative Stress, and c-Fos Protein Are Involved in Highly Aggressive Behavior

Aggression is defined as hostile behavior that results in psychological damage, injury and even death among individuals. When aggression presents itself in an exacerbated and constant way, it can be considered escalating or pathological. The association between social stress and the emergence of exacerbated aggressiveness is common and is suggested to be interconnected through very complex neurobiological factors. For example, alterations in the expression of the dopaminergic receptors D1 and D2, reactive oxygen species (ROS) and the c-Fos protein in the cortex have been observed. Our objective was to analyze which factors are involved at the neurobiological level in the highly aggressive response of Swiss Webster adult male mice in a vivarium. In this work, we investigated the relationship among dopaminergic receptors, the production of ROS and the expression of c-Fos. Mice with exacerbated aggression were identified by the model of spontaneous aggression (MSA) based on the grouping of young mice and the regrouping of the same animals in adulthood. During the regrouping, we observed different categories of behavior resulting from social stress, such as (i) highly aggressive animals, (ii) defeated animals, and (iii) harmonic groups. To evaluate the dopaminergic system and the c-Fos protein, we quantified the expression of D1 and D2 dopaminergic receptors by Western blotting and fluorescence immunohistochemistry and that of the c-Fos protein by fluorescence immunohistochemistry. The possible production of ROS was also evaluated through the dihydroethidium (DHE) assay. The results showed that aggressive and subordinate mice showed a reduction in the expression of the D1 receptor, and no significant difference in the expression of the D2 receptor was observed between the groups. In addition, aggressive mice exhibited increased production of ROS and c-Fos protein. Based on our results, we suggest that exacerbated aggression is associated with social stress, dysregulation of the dopaminergic system and exacerbated ROS production, which leads to a state of cellular oxidative stress. The overexpression of c-Fos due to social stress suggests an attempt by the cell to produce antioxidant agents to reduce the toxic cellular concentration of ROS.

Cluster analysis of risky behaviors among the youth in Western Iran: Determining correlates and comparing clusters based on severity of disability and attitude toward mental health help-seeking

BACKGROUND AND AIMS

The objectives of the study were (i) cluster analysis of risky behaviors; (ii) determining correlates; and (iii) comparing clusters with regard to the attitude toward mental health help seeking.

METHODS

The current cross-sectional study is a part of the first phase of the Persian Youth Cohort. From October 2014 to January 2017, 2990 individuals from Ravansar City in western Iran completed structured interviews and national and international standard questionnaires. The obtained data were analyzed using two-stage cluster analysis, multinomial logistic regression analysis, and Chi-square test.

RESULTS

This model provided three distinct clusters: (i) low-risk group with mild distress, (ii) high-risk group with high distress, and (iii) violent group with medium distress. Some sociodemographic and lifetime psychiatric disorders were the correlates of unhealthy clusters (P < 0.05). Compared to the reference cluster, a higher number of members in unhealthy clusters were suffering from medium to severe disability. Nevertheless, the participants in these clusters were less inclined to mental health help seeking.

CONCLUSIONS

More than half of the youth were suffering from suicidal and violent behaviors. Since high-risk participants are less inclined to mental health help seeking, the health policymakers can successfully utilize the results in planning general health programs.

The Role of Verbal Aggression in Cyberbullying Perpetration and Victimization by Middle School Students

This manuscript examined the role trait verbal aggression plays in cyberbullying victimization and perpetration in adolescence. More than 400 middle school students (46.8% males and 52.2% females) completed a questionnaire on trait verbal aggression and their history of cyberbullying perpetration and victimization. Linear regression analyses revealed that trait verbal aggression was a statistically significant predictor of both cyberbullying perpetration and victimization, that cyberbullying perpetration and cyberbullying victimization are related, and that cyberbullying perpetration appears to increase with age, while cyberbullying victimization does not. Ideas and implications for future applications of verbal aggression and cyberbullying are discussed.

Predicting the time trend of first episodes of aggressive behaviors in pediatric psychiatric inpatient units

The goal of the current study is to assess whether the scores of Brief Rating of Aggression by Children and Adolescents (BRACHA) at the emergency room (ER) can predict the aggressive incidents at pediatric psychiatric inpatient units. The study aims to identify predictors for two outcome measurements: 1) hazard rates for the first aggressive incident and 2) numbers of days between admission and the first aggressive incident, using the Cox regression model and Poisson regression model, respectively. The clinical records of a total of 5,610 adolescents admitted into the pediatric psychiatric inpatient units of Cincinnati Children's Hospital Medical Center were extracted for the analysis. The aggressive incident was defined as a score >0 from any category of the Overt Aggression Scale (OAS) and the high-aggressive incident was defined as a score ≥ 2 from any category of the OAS. The results indicate that the BRACHA score was not associated with high-aggressive incidents (hazard ratio: 0.98, p = 0.7543). Similarly, the BRACHA scores was only associated with the number of days from admission to the first aggressive incident (Poisson regression coefficient: 0.24, p < 0.0001) but not the number of days from admission to the first high-aggressive incident (Poisson regression coefficient: 0.03, p = 0.3994). Furthermore, the second peak of first aggressive incidents during the hospitalization highlights the importance of interventions at the end of the inpatient treatment course. To summarize, BRACHA scores based on initial assessments at the ER could correlate with first aggressive incidents, but not the first high-aggressive incidents.

Cortisol and Oxytocin Could Predict Covert Aggression in Some Psychotic Patients

Background: The covert or indirect type of aggression has a risk of converting in violent acts and, considering that, it is very important to identify it in order to apply effective preventive measures. In cases of psychotic patients, the risk of becoming violent is harder to predict, as even neuter stimuli may be perceived as threat and trigger aggression. Treating all the psychiatric patients as potential aggressive subjects is not the best preventive measure as only a few of them are aggressive and this measure may further enhance the stigma on mentally ill patients. There is a current need for better understanding of covert aggression and to find objective measures, such as biological markers, that could be indicative of potential violent behavior. In this work, we try to investigate the role of cortisol and oxytocin as potential biomarkers of aggression in patients with psychosis. Material and Methods: We analyzed the level of peripheral oxytocin (pg/mL) and cortisol level (ng/mL) in 28 psychotic patients (they were not on psychotropic treatment at the moment of admission and those with substance abuse or personality disorder were excluded from the study) and correlated it with the intensity of aggression reported by the patient (overt and covert type) using the Overt Covert Aggression Inventory and the level of observed aggression of the patient in the past 7 days (rated by the health care provider) using the Modified Overt Aggression Scale. Results: We found that psychotic patients with a higher level of covert aggression had a lower level of cortisol (61.05 ± 8.04 ng/mL vs. 216.33 ± 12.6.9 ng/mL, p ˂ 0.01) and a higher level of oxytocin (102.87 ± 39.26 vs. 70.01 ± 25.07, p = 0.01) when compared with patients with a lower level of covert aggression. Furthermore, we observed significant negative correlation between cortisol and covert aggression (r = −0.676, p < 0.001) and between oxytocin and covert type of aggression (r = 0.382, p = 0.04). Moreover, we found that a lower level of cortisol together with a higher level of oxytocin are significant predictors of a style of internalized manifestation of aggression, with the predictive model explaining 55% of the variant of the internalized manifestation of aggression (F (2.25) = 17.6, p < 0.001, β = 0.35, R² = 55.2). We did not find significant correlations between cortisol and overt aggression, and neither between oxytocin and overt aggression. Positive correlations were also found between the overt type of self-reported aggression and overt aggression reported by the rater (r = 0.459, p = 0.01). Conclusions: The importance of a predictive model in understanding covert aggression is imperative and the results of our study show that oxytocin and cortisol warrant to be further investigated in establishing a definitive predictive model for covert aggression.

Targeting GluN2B/NO Pathway Ameliorates Social Isolation-Induced Exacerbated Attack Behavior in Mice

Exacerbated attack behavior has a profound socioeconomic impact and devastating social consequences; however, there is no satisfactory clinical management available for an escalated attack behavior. Social isolation (SI) is widespread during this pandemic and may exert detrimental effects on mental health, such as causing heightened attack behavior. To explore the therapeutic approaches that alleviate the SI-induced heightened attack behavior, we utilized pharmacological methods targeting the GluN2B/NO signaling pathway during the attack behavior. Ifenprodil and TAT-9C peptide targeting GluN2B showed that the inhibition of GluN2B mitigated the SI-induced escalated attack behavior and the SI-induced aberrant nitric oxide (NO) level in the brain. Additionally, the potentiation of the NO level by L-arginine reversed the effects of the inhibition of GluN2B. Moreover, we showed that high doses of L-NAME and 7-NI and subeffective doses of L-NAME in combination with ifenprodil or TAT-9C or subeffective doses of 7-NI plus ifenprodil or TAT-9C all decreased the SI-induced escalated attack behavior and reduced the NO level, further supporting the idea that GluN2B/NO signaling is a crucial modulator of the escalated attack behavior.

Variation rs6971 in the Translocator Protein Gene (TSPO) is Associated with Aggressiveness and Impulsivity but Not with Anxiety in a Population-Representative Sample of Young Adults

Expression of the 18-kDa translocator protein (TSPO), originally identified as a peripheral benzodiazepine receptor, has been found to be altered in several psychiatric disorders. A common single nucleotide polymorphism (rs6971) in the TSPO gene leads to an amino acid substitution, Ala147Thr, which dramatically alters the affinity with which TSPO binds drug ligands. As cholesterol also binds TSPO in the same transmembrane domain, it is suggested that this substitution may impair the ability of TSPO to bind or import cholesterol, and hence may affect steroid synthesis and hypothalamic-pituitary-adrenal function. The analysis was carried out on older birth cohort (n = 655) of the longitudinal Estonian Children Personality, Behavior and Health Study sample. Anxiety, aggressive behavior, impulsiveness, and history of stressful life events were self-reported in various data collection waves. Psychiatric assessment of lifetime prevalence of anxiety disorders was carried out at 25 years of age by experienced clinical psychologists. TSPO rs6971 was genotyped in all participants. TSPO rs6971 was not associated with self-reported levels of anxiety or lifetime prevalence of anxiety disorders. However, participants homozygous for the minor A allele displayed the highest aggressiveness and dysfunctional impulsivity scores. The positive, adaptive aspect of impulsivity was sensitive to stressful life events, as the AA genotype was associated with functional impulsivity only when the participants had experienced a low number of stressful life events during childhood. TSPO rs6971 polymorphism may be related to development of aggressiveness and impulsivity by adulthood, regardless of the participants' gender.

Measurement of aggression in older adults

Aggressive behaviors are prevalent in late-life and are associated with important consequences for older adults, caregivers, and healthcare providers. Age-related changes in the manifestation of aggression are precipitated in part by the rise of cognitive impairment. Such changes necessitate the use of psychometrically sound measures. The present article identifies existing measures of aggression for older adults, highlights the strengths and limitations of these measures, and proposes avenues for future research in this area. Five full-scale measures of aggression, as well as five subscales of aggression embedded within larger non-aggression measures in older adults were identified. Overall, measures of aggression specific to late-life are predominately observational and limited to individuals with dementia or older adults living in long-term care settings. The psychometric properties of aggression scales in late-life generally indicate adequate internal consistency, interrater reliability, and concurrent validity. In contrast, the reliability and validity of subscales of aggression contained within larger neuropsychiatric measures are more difficult to ascertain due to limited research. Future investigations would benefit from examining the psychometric properties of widely-used self-report measures of aggression among older adults, further evaluating the psychometric properties of aggression subscales, and developing additional measures which are predictive of aggressive behaviors.

Catechol-O-Methyltransferase Gene Val158Met Polymorphism Moderates the Effect of Social Exclusion and Inclusion on Aggression in Men: Findings From a Mixed Experimental Design

Accumulating research has identified the interactive effects of catechol-O-methyltransferase (COMT) gene Val158Met polymorphism and environmental factors on aggression. However, available evidence was mainly based upon correlational design, which yields mixed findings concerning who (Val vs. Met carriers) are more affected by environmental conditions and has been challenged for the low power of analyses on gene–environment interaction. Drawing on a mixed design, we scrutinized how COMT Val158Met polymorphism (between-group variable) impacts on aggression, assessed by hostility, aggressive motivation, and aggressive behavior, under different social conditions (exclusion vs. inclusion, within-group variable) in a sample of 70 Chinese male undergraduate students. We found that both Val/Val homozygote and Met alleles carriers showed differences in the feelings of hostility and aggressive motivation under conditions of exclusion versus inclusion, but these differences were more pronounced for Met allele carriers. These findings implied that COMT Val158Met polymorphism did not respond to environmental stimuli in an all-or-none way and shed light on the importance of examining the gene–environment interaction using a mixed design.

Pathways From Early Family Violence to Adolescent Reactive Aggression and Violence Victimization

PURPOSE

The current study examined how early childhood (EC) family violence and risk (i.e., maternal aggression, sibling aggression, environmental risk) predicted early adolescent (EA) reactive physical and relational aggression and violence victimization through middle childhood (MC) parenting (i.e., guilt induction, power assertive discipline).

METHOD

Mother-infant dyads (N = 216; 72% African American) were recruited as part of a larger longitudinal study on prenatal cocaine and other substance exposure. Observations, interviews, and maternal and child self-report measures were collected from dyads in early childhood (1 to 36 months), middle childhood (84 months), and early adolescence (12 to 15 years).

RESULTS

A cascading path model was specified where current variables were regressed on variables from the preceding time point. Primary results showed that environmental risk and EC child physical aggression predicted higher levels of MC caregiver power assertive discipline, which subsequently predicted lower levels of EA reactive relational aggression. Maternal substance use in pregnancy and the child's continuous placement with biological caregivers predicted higher levels of reactive physical aggression in EA. Finally, MC physical aggression and EA reactive relational aggression predicted higher levels of EA violence victimization.

CONCLUSION

There were a series of direct paths from early childhood family violence and demographic factors to reactive aggression and violence victimization. The current study underscores the importance of evaluating multiple facets of family violence and risk when evaluating aggressive behavior and victimization.

A Behavioral Addiction Model of Revenge, Violence, and Gun Abuse

Data from multiple sources point to the desire for revenge in response to grievances or perceived injustices as a root cause of violence, including firearm violence. Neuroscience and behavioral studies are beginning to reveal that the desire for revenge in response to grievances activates the same neural reward-processing circuitry as that of substance addiction, suggesting that grievances trigger powerful cravings for revenge in anticipation of experiencing pleasure. Based on this evidence, the authors argue that a behavioral addiction framework may be appropriate for understanding and addressing violent behavior. Such an approach could yield significant benefits by leveraging scientific and public health-oriented drug abuse prevention and treatment strategies that target drug cravings to spur development of scientific and public-health-oriented "gun abuse" prevention and treatment strategies targeting the revenge cravings that lead to violence. An example of one such "motive control" strategy is discussed. Approaching revenge-seeking, violence, and gun abuse from the perspective of compulsion and addiction would have the added benefit of avoiding the stigmatization as violent of individuals with mental illness while also acknowledging the systemic, social, and cultural factors contributing to grievances that lead to violent acts.

Association Between Witnessing and Justifying Workplace Violence Towards Nurses in Israel

BACKGROUND

Workplace violence perpetrated by patients and their families towards nurses has become a global problem.

PURPOSE

The present study explores associations between individuals' having witnessed violent incidents in the past and holding attitudes justifying violence in the present, and their intention to behave violently in a nurse-patient interaction at a healthcare facility.

DESIGN

A cross-sectional study sampled 1,350 participants from among the general public in Israel.

METHODS

A self-administered questionnaire measured attitudes regarding violence towards nurses and confronted the participants with two vignettes eliciting verbal and physical violence towards nurses. Multiple logistic regression was conducted to explore the association between attitudes and intention to act violently. A mediation analysis (using the PROCESS macro) was conducted to explore the mediation factors.

RESULTS

Over half of the participants witnessed an incident of verbal violence in health care and substantially fewer witnessed a physically violent event (51.5% and 16.1%, respectively). An attitude of highly justifying violence was found to be directly associated with the intention to act verbally and physically violent. Past witnessing of verbal or physical violence in healthcare settings had an indirect association through an attitude that justifies violence, which served as a mediating factor for the intention to act verbally and physically violent in a situation presented via the vignettes.

CONCLUSIONS

Witnessing a violent event in healthcare systems has social consequences that may cause normalization of violence and lead to the intention to use verbal or even physical violence towards nurses.

CLINICAL RELEVANCE

Nurses should be encouraged to report incidents of violence, while healthcare and judicial systems must address this issue seriously. It is recommended that systems alerting for risk indicators be applied, to identify patients with a potential for violence in healthcare facilities. Healthcare policymakers and workers must act to promote an environment of zero tolerance for violence in order to minimize such events. In order to prevent violence towards healthcare staff, a holistic multisystem approach should be implemented, involving a focus by sociocultural elements on social values and structures, as violence in healthcare reflects violence in society at large.

Examining the Reliability of Various Interpersonal Acceptance-Rejection Theory (IPARTheory) Measures in Vietnamese Adolescents

Perceiving one's self as accepted by important others, such as parents, is fundamental and crucial for the well-being of each individual. One major aspect of interpersonal acceptance-rejection theory (IPARTheory) is examining how parental acceptance-rejection affects people's psychological adjustment. This theory has been validated in many countries and cultural groups around the world, but has not been utilized in the Vietnamese context. This research aims to assess the reliability of IPARTheory measures in Vietnam and applicability of the theory itself among a Vietnamese sample. Participants included 162 students from a high school in Hanoi (M_age = 15.58 years; 69.8% female). Materials consisted of Vietnamese versions of various IPARTheory measures: Parental Acceptance-Rejection Questionnaire, Personality Assessment Questionnaire, Interpersonal Relationship Anxiety Questionnaire, and a demographics form designed specifically for this research. Analyses show that psychological maladjustment significantly correlated with perceived paternal rejection, maternal rejection, and their subscales. Cronbach's alphas were strong, ranging from .73 to .97, except for the dependency subscale and hostility subscale of the Personality Assessment Questionnaire. Thus, the results provide evidence for the reliability of various IPARTheory measures in Vietnam. The relationships found in this study have implications for parents, teachers, and psychologists to employ in order to provide adolescents with appropriate guidance and intervention based on the importance of perceived parental acceptance-rejection.

Victimization by Friends and Victimization by Other Peers: Common Risk Factors or Mutual Influence?

Much research effort has been placed on understanding peer victimization. However, few studies have focused on victimization within friendships, which affects up to half of adolescents and bears similar consequences as victimization by the larger peer group. This study examined the temporal stability and the risk factors of victimization within friendships and victimization by other peers. In regard to the first objective, moderate to high levels of stability over a one-year period were expected for victimization by friends and by other peers. In regard to the second objective, two - not necessarily mutual exclusive - hypotheses were tested. The Common Risk Factors Hypothesis postulated that victimization by friends and by other peers share common personal and familial risk factors. Alternatively, the Mutual Influence Hypothesis proposed that victimization within one relationship context may increase the risk of being victimized in the other relationship context. These hypotheses were tested with a sample of 878 adolescents (Mage = 15.08 years, range 14.50-15.75; 52% female) assessed in Grades 8 and 9. Structural equation modeling revealed moderate and weak one-year stability for victimization by friends and by other peers, respectively. No common risk factors emerged, but victimization within one relationship context increased the risk of victimization in the other relationship context one year later. These results are in line with the mutual influence hypothesis and provide evidence of a cross-context transfer of victimization in adolescence.

Developmental joint trajectories of anxiety-depressive trait and trait-aggression: implications for co-occurrence of internalizing and externalizing problems

BACKGROUND

In youth, anxiety-depressive traits (ADT) and trait-aggression (TA) are important risk factors of exhibiting maladaptive behaviors in adulthood (i.e. violence and substance use). However, the developmental co-occurrence of these traits in youth remains unknown. We thus sought to investigate the developmental trajectories of ADT and TA within a data-driven approach. The aim was two-fold: (i) to examine the developmental trajectories of ADT and TA in youth from ages 10 to 16, and (ii) to investigate both childhood predictors and problematic outcomes of the identified joint trajectories.

METHOD

The sample comprised 1354 children provided from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) Consortium. Group-based trajectory modeling was first employed to identify individual trajectory models of ADT and TA independently (from ages 10 to 16). Then, joint trajectory models were built on the found trajectories. Last, logistic regressions were used to evaluate the childhood characteristics and negative outcomes of the joint trajectory groups.

RESULTS

Our results showed five trajectory groups with varying levels of ADT and TA. A significant co-occurrence between ADT and TA was found in three of the trajectory groups. Notably, higher levels of childhood psychopathology and more severe/frequent childhood abuse were found in the groups with moderate to high ADT and high TA. The groups with higher ADT and high TA were also more likely to exhibit violence and substance use.

CONCLUSIONS

This study exposes the importance of assessing ADT and TA simultaneously and early in childhood to prevent and manage the risk of problematic behaviors in adolescence.