Reconsidering the failure model: Using a genetically controlled design to assess the spread of problems from reactive aggression to internalizing symptoms through peer rejection across the primary school years

According to the failure model (Patterson & Capaldi, 1990), peer rejection is the intermediary link between problem behaviors and internalizing symptoms. The present study tested the model with 464 monozygotic and same-sex dizygotic twin pairs (234 female, 230 male dyads). Teacher-reported reactive aggression and internalizing symptoms, and peer-reported peer rejection were collected at ages 6, 7, and 10 (from 2001 to 2008). Support for the failure model emerged in conventional non-genetically controlled analyses, but not twin-difference score analyses (which remove shared environmental and genetic contributions). Univariate biometric models attributed minimal variance in failure model variables to shared environmental factors, suggesting that genetic factors play an important unacknowledged role in developmental pathways historically ascribed to nonshared experiences in the failure model.

Parallel Trajectories of Proactive and Reactive Aggression in Middle Childhood and Their Outcomes in Early Adolescence

This study used an accelerated longitudinal design to investigate trajectories of proactive and reactive aggression in middle childhood and their outcomes in early adolescence. Children (N = 1420; ages 5-12; 48% female) were assessed biannually over 6 school years. Classroom teachers rated students' proactive and reactive aggression throughout grades K-5; and multi-method (teacher-report, self-report, school records) measures of peer problems, depressive symptoms, academic performance, disciplinary actions, and school absenteeism were collected throughout grades 3-5. Latent class growth models were estimated to differentiate parallel-process trajectories of proactive-reactive aggression. Class membership was then examined as a predictor of outcomes at the end of 5th grade. The best-fitting solution had four trajectory classes: (1) low aggression, 76.7%; (2) high proactive-reactive aggression, 4.7%; (3) declining aggression, 4.9%; and (4) predominantly reactive aggression, 13.7%. Most classes showed seasonal upticks in aggressive behavior in the spring semester relative to fall; these were especially pronounced for proactive aggression, both as a variable and for the proactive-reactive class. Relative to their low-aggression peers, children in any elevated-aggression class had higher levels of peer problems, depressive symptoms, and disciplinary actions and lower GPAs at the end of 5th grade. The reactive class-which on no occasion had the highest total aggression-exhibited the most consistently unfavorable pattern of outcomes across methods and measures. Findings offer new insights concerning the multifinality and heterogeneity of aggressive behavior in childhood. Research, theory, and practice could benefit from adopting person-centered conceptualizations that consider the long-term trajectories, short-term variations, and proactive vs. reactive functions of youth aggression.

Aggressive-Depressive Trajectories in Childhood and Their Associations with Drinking Behaviors and Problems in Adolescence and Emerging Adulthood

Research indicates that externalizing and internalizing pathways emanated in childhood are connected to later drinking behaviors; however, no study has investigated the contemporaneous effects of the two pathways using a person-centered approach that categorizes individuals based on their various developmental patterns. This study examined the distinct patterns of concurrent development of aggression and depressive symptoms in childhood and their associations with later drinking behaviors using data from a 15-year Taiwanese cohort since age 8 (N = 2854, 49% females). Group-based multi-trajectory modeling identified four aggressive-depressive trajectory groups: Moderate, Aggressive, Depressive, and Comorbid, which manifested a sequential risk gradient in alcohol use. Comorbid group, characterized by persistently high levels of aggression and depressive symptoms, has the highest levels of alcohol use and drinking problems and the earliest onset of drinking. Aggressive and Depressive groups have higher levels of alcohol use and earlier onset of drinking than Moderate group. These findings imply the importance of monitoring aggression and depressive symptoms simultaneously and continually in childhood to prevent later drinking.

Dual Pathways from Reactive Aggression to Depressive Symptoms in Children: Further Examination of the Failure Model

The failure model posits that peer rejection and poor academic performance are dual pathways in the association between early aggressive behavior and subsequent depressive symptoms. We examined this model using an accelerated longitudinal design while also incorporating proactive and reactive aggression and gender moderation. Children in 1st, 3rd, and 5th grades (n = 912; ages 6-12; 48% female) were rated three times annually by their primary teachers on measures of proactive and reactive aggression, peer rejection, academic performance, and depressive symptoms. Using Bayesian cross-classified estimation to account for nested and planned-missing data, path models were estimated to examine whether early reactive aggression predicted subsequent peer rejection and academic performance, and whether these, in turn, predicted subsequent depressive symptoms. From 1st to 3rd grade, reactive aggression predicted peer rejection (not academic performance), proactive aggression predicted academic performance (not peer rejection), and academic performance and peer rejection both predicted depressive symptoms. From 3rd to 5th grade, however, neither peer rejection nor academic performance predicted subsequent depressive symptoms. Results were not moderated by gender. Overall, these findings provide mixed and limited support for the failure model among school-age children. Early reactive aggression may be a key risk factor for social problems, whereas proactive aggression may be linked to improved academic functioning. The "dual pathways" of peer rejection and academic performance may operate during early but not later elementary school. Limitations and implications are discussed.

Children of parents with a history of depression: The impact of a preventive intervention on youth social problems through reductions in internalizing problems

The current investigation examined if changes in youth internalizing problems as a result of a family group cognitive behavioral (FGCB) preventive intervention for families with a parent with a history of depression had a cascade effect on youth social problems over 24 months and the bidirectional nature of these effects. One hundred eighty families with a parent with a history of major depressive disorder (M age = 41.96; 88.9% mothers) and a youth age 9 to 15 years (49.4% females; M age = 11.46) participated. Findings from a panel model indicated that, compared to a minimum intervention condition, the FGCB intervention significantly reduced youth internalizing problems at 12 months that in turn were associated with lower levels of social problems at 18 months. Similarly, the FGCB intervention reduced internalizing problems at 18 months, which were associated with fewer social problems at 24 months. Changes in social problems were not related to reductions in subsequent internalizing problems. The findings suggest that reductions in youth internalizing problems can lead to lower levels of social problems. Youth social problems are difficult to change; therefore, targeting internalizing problems may be an effective way to reduce the social problems of children of parents with a history of depression.

Early Callous-Unemotional Behavior, Theory-of-Mind, and a Fearful/Inhibited Temperament Predict Externalizing Problems in Middle and Late Childhood

Childhood externalizing problems are more likely to be severe and persistent when combined with high levels of callous-unemotional (CU) behavior. A handful of recent studies have shown that CU behavior can also be reliably measured in the early preschool years, which may help to identify young children who are less likely to desist from early externalizing behaviors. The current study extends previous literature by examining the role of CU behavior in very early childhood in the prediction of externalizing problems in both middle and late childhood, and tests whether other relevant child characteristics, including Theory-of-Mind (ToM) and fearful/inhibited temperament moderate these pathways. Multi-method data, including parent reports of child CU behavior and fearful/inhibited temperament, observations of ToM, and teacher-reported externalizing problems were drawn from a prospective, longitudinal study of children assessed at ages 3, 6, and 10 (N = 241; 48 % female). Results demonstrated that high levels of CU behavior predicted externalizing problems at ages 6 and 10 over and above the effect of earlier externalizing problems at age 3, but that these main effects were qualified by two interactions. High CU behavior was related to higher levels of externalizing problems specifically for children with low ToM and a low fearful/inhibited temperament. The results show that a multitude of child characteristics likely interact across development to increase or buffer risk for child externalizing problems. These findings can inform the development of targeted early prevention and intervention for children with high CU behavior.

Impulsive Aggression as a Comorbidity of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

OBJECTIVE

This article examines the characteristics of impulsive aggression (IA) as a comorbidity in children and adolescents with attention-deficit/hyperactivity disorder (ADHD), focusing on its incidence, impact on ADHD outcomes, need for timely intervention, and limitations of current treatment practices.

METHODS

Relevant literature was retrieved with electronic searches in PubMed and PsycINFO using the search strategy of "ADHD OR attention deficit hyperactivity disorder" AND "impulsive aggression OR reactive aggression OR hostile aggression OR overt aggression" AND "pediatric OR childhood OR children OR pre-adolescent OR adolescent" with separate searches using review OR clinical trial as search limits. Key articles published before the 2007 Expert Consensus Report on IA were identified using citation analysis.

RESULTS

More than 50% of preadolescents with ADHD combined subtype reportedly display clinically significant aggression, with impulsive aggression being the predominant subtype. Impulsive aggression is strongly predictive of a highly unfavorable developmental trajectory characterized by the potential for persistent ADHD, increasing psychosocial burden, accumulating comorbidities, serious lifelong functional deficits across a broad range of domains, delinquency/criminality, and adult antisocial behavior. Impulsive aggression, which triggers peer rejection and a vicious cycle of escalating dysfunction, may be a key factor in unfavorable psychosocial outcomes attributed to ADHD. Because severe aggressive behavior does not remit in many children when treated with primary ADHD therapy (i.e., stimulants and behavioral therapy), a common practice is to add medication of a different class to specifically target aggressive behavior.

CONCLUSIONS

Impulsive aggression in children and adolescents with ADHD is a serious clinical and public health problem. Although adjunctive therapy with an aggression-targeted agent is widely recommended when aggressive behaviors do not remit with primary ADHD therapy, empirical evidence does not currently support the use of any specific agent. Randomized controlled trials are needed to identify aggression-targeted agents with favorable benefit-risk profiles.

The Role of Reactive Aggression in the Link Between Hyperactive-Impulsive Behaviors and Peer Rejection in Adolescents

Attention-deficit/hyperactivity disorder (ADHD) symptoms and aggressive behaviors are both associated with peer rejection, but little is known the nature of this association with respect to the two symptom dimensions of hyperactivity-impulsivity and inattention and different types of aggression. The present study examines the relations between dimensions of ADHD symptomatology, proactive and reactive aggression, and peer rejection in adolescence. Teacher-reported data were obtained for 200 high school students (grades 9-12; 48% female; predominately Latino). In structural equation modeling path analyses, the indirect effects of reactive aggression accounted for the link between hyperactivity-impulsivity and peer rejection. Within the same model, neither inattention nor proactive aggression were associated with peer rejection. These findings suggest that reactive aggression may be a key mechanism through which hyperactive-impulsive behavior is associated with peer rejection. Future research and intervention efforts should address the role of reactive aggression among youth with ADHD symptomatology.

Emotion regulation and childhood aggression: longitudinal associations

Accumulating evidence suggests that emotion dysregulation is associated with psychopathology. This paper provides a review of recent longitudinal studies that investigate the relationship between emotion regulation and aggressive behavior in childhood age. While there is substantial evidence for assuming a close relation of emotion regulation and aggressive behavior, moderating and mediating factors like gender and peer rejection have been established. Furthermore, results suggest emotion dysregulation as an important risk factor of aggressive behavior. Several directions for future research are pointed out to further validate and refine the reviewed relationships.

Transactional associations among teacher support, peer social preference, and child externalizing behavior: a four-wave longitudinal study

The links between children's externalizing behaviors and two characteristics of children's social interactions within the classroom, namely, peer social preference and received support from the teacher, were studied in 570 children followed from their 2nd- to 3rd-grade years of elementary school. Data consisted of peer and teacher reports of externalizing behavior, sociometric "liked most" and "liked least" nominations, and teacher rated support. Results showed consistent paths from externalizing behavior to (low) peer social preference. Peer social preference, in turn, predicted decreases in externalizing behavior, even after taking teacher support into account. Teacher support was not consistently linked to the development of externalizing behavior across time. However, an indirect path from externalizing behavior, via (low) peer social preference, to lower levels of teacher support was found. These results were similar for girls and boys.

Individual differences in the development of early peer aggression: integrating contributions of self-regulation, theory of mind, and parenting

This prospective longitudinal study focused on self-regulatory, social-cognitive, and parenting precursors of individual differences in children's peer-directed aggression at early school age. Participants were 199 3-year-old boys and girls who were reassessed following the transition to kindergarten (5.5-6 years). Peer aggression was assessed in preschool and school settings using naturalistic observations and teacher reports. Children's self-regulation abilities and theory of mind understanding were assessed during a laboratory visit, and parenting risk (corporal punishment and low warmth/responsiveness) was assessed using interview-based and questionnaire measures. Individual differences in children's peer aggression were moderately stable across the preschool to school transition. Preschool-age children who manifested high levels of aggressive peer interactions also showed lower levels of self-regulation and theory of mind understanding, and experienced higher levels of adverse parenting than others. Our main finding was that early corporal punishment was associated with increased levels of peer aggression across the transition from preschool to school, as was the interaction between low maternal emotional support and children's early delays in theory of mind understanding. These data highlight the need for family-directed preventive efforts during the early preschool years.

Child and context characteristics in trajectories of physical and relational victimization among early elementary school children

Transactional models suggest that peer victimization results from both individual and context differences, and understanding these differences may point to important targets for prevention and interventions that reduce victimization. Multilevel modeling was used to examine within-person (aggression and emotional dysregulation), between-person (sex and age), and between-school (participation in a victimization prevention program) factors that influence changes in physical and relational victimization over the first three years of elementary school. Children (n = 423) reported their experiences of peer victimization at entry into Grade 1 and at the end of Grade 1, Grade 2, and Grade 3. On average, trajectories of both physical and relational victimization declined. However, for individual children, teacher-rated aggression was associated with increases in physical and relational victimization, while emotional dysregulation was associated with attenuation of longitudinal declines in physical victimization and increases in relational victimization. Individual differences in sex and age at entry into Grade 1 did not significantly influence victimization trajectories over Grades 1 to 3. Children who participated in the WITS® victimization prevention program showed significant declines in physical and relational victimization. Levels of victimization among nonparticipants remained stable. Implications of child and context characteristics for preventing peer victimization in elementary school are discussed.

Aggression

Bei aggressiven Verhalten im Kindes- und Jugendalter handelt es sich um eine besonders häufig auftretende und stabile Problematik. Entwicklungsmodelle aggressiven Verhaltens tragen dazu bei, dass Erscheinungsformen, komorbide Störungen und Verläufe präziser eingeordnet und fundierte Behandlungsprognosen erstellt werden können. Evidenzbasierte Präventions- und Behandlungsprogramme liegen altersspezifisch ausgestaltet vor. Aggressives Verhalten und die in der Regel auftretenden komorbiden Störungen stellen die höchsten Anforderungen an die Behandlung, wobei Therapieansätze langfristig und komplex (unter Einbezug des sozialen Umfeldes des Kindes) angelegt sein müssen.

Elterliche Psychopathologie, Aggression und Depression bei Kindern und Jugendlichen

Aggressiv-dissoziales Verhalten und depressive Symptome treten bei Kindern und Jugendlichen auch gemeinsam auf. Eine solche Komorbidität zweier unterschiedlicher Störungsbilder kann oft durch einen gemeinsamen Risikofaktor erklärt werden. Aus der bevölkerungsbezogenen BELLA-Studie wurde aus insgesamt 1356 Teilnehmern im Altern von elf bis 17 Jahren (51.6 % Jungen) eine Risikogruppe aggressiver Kinder und Jugendlicher (n = 422; 68.7 % Jungen) identifiziert und untersucht, ob und inwieweit die Beziehungen zwischen elterlicher Psychopathologie und einer der beiden Störungen von der jeweils anderen Störung vermittelt werden. Hierzu wurden alters- und geschlechtsadjustierte Mediatoranalysen durchgeführt. Die Analysen wurden stratifiziert, je nachdem ob sich die Kinder und Jugendlichen als vorwiegend proaktiv (n = 145; 52.4 % Jungen), reaktiv (n = 173; 76.3 % Jungen) oder reaktiv-proaktiv (n = 104; 78.8 % Jungen) aggressiv einstuften. Für alle Risikogruppen mediierte sowohl aggressiv-dissoziales Verhalten den Pfad auf Depression als auch Depression den Pfad auf aggressiv-dissziales Verhalten. Die Varianzaufklärung der Modelle war für proaktiv- und reaktiv-aggressive Jugendliche deutlich höher, wenn Depression den Pfad von elterlicher Psychopathologie auf aggressiv-dissoziales Verhalten mediierte. Für reaktiv-proaktiv aggressive Kinder und Jugendliche war dieses Verhältnis umgekehrt. Die Ergebnisse werden vor dem Hintergrund aktueller Ergebnisse und Komorbiditätskonzepte diskutiert.

Reactive and proactive aggression in childhood and adolescence: precursors, outcomes, processes, experiences, and measurement

This paper reviews and critiques the growing literature on the distinction between reactive and proactive aggression in children and adolescents. Empirical findings suggest that the subtypes of aggression are (a) preceded by different familial precursors, (b) associated with different behavioral outcomes, (c) driven by different social-cognitive and emotional processes, and (d) related to different social experiences. Because measurement difficulties have been a prominent concern in the study of reactive and proactive aggression, a discussion of various assessment approaches is included. Suggestions are made for future research directions, including a greater use of observational and laboratory-based methods, more longitudinal designs, and a greater focus on the careful assessment of the subtypes of aggression.

Evaluation of a program for reduction of childhood aggression

The Peaceful Alternatives to Tough Situations (PATTS) was evaluated for reduction of childhood aggression. A quasi-experimental pre- and posttest comparison group design was used to evaluate 71 PATTS participants who were selected by school personnel or juvenile caseworkers due to prior aggression. The participants responded to the Conflict Tactics Scale-Revised and a modified version of the Mauger Forgiveness Scale on the first and last group meetings. Analyses (n=71 PATTS; n=35 comparison group) indicated significant positive decreases in physical assault, psychological aggression, and vengefulness, and increased forgiveness of others in the PATTS group participants. There was also a reduction of school suspensions, principal referrals, or new criminal offenses for PATTS group participants.