Internalizing Symptoms and Affective Reactivity in Relation to the Severity of Aggression in Clinically Referred, Behavior-Disordered Children

Abstract

We examined the affective correlates of aggression in children referred to a partial hospitalization program for the treatment of behavior disorders who did not have a mood or anxiety disorder. Parent and teacher ratings of the children's impulsivity, internalizing symptoms, affective reactivity, and aggression were examined for their interrelationships and then entered into regression analyses to predict the child's level of aggression in the home, at school, and in the treatment program. Intercorrelations among three affective reactivity factors were modest. Both internalizing symptoms and affective reactivity contributed to aggression severity beyond impulsivity and demographics. Only child irritability predicted treatment program aggression. Because of their potential role in understanding children's behavioral disturbances, internalizing symptoms and negative emotionality merit careful assessment and treatment in treatment programs serving hard-to-manage children with behavior disorders.

Severe Mood Dysregulation, Irritability, and the Diagnostic Boundaries of Bipolar Disorder in Youths

“…Second, diagnostic questions about pediatric bipolar disorder also highlight the relative paucity of research on irritability: operationalized definitions, reliable rating scales (although see references 23–25), and normative data are all sparse. In fact, DSM-IV provides no definition of irritability, despite the inclusion of this symptom as a criterion for at least six diagnoses in children (manic episode, oppositional defiant disorder, generalized anxiety disorder, dysthymic disorder, posttraumatic stress disorder, and major depressive episode).…”

Severe Mood Dysregulation, Irritability, and the Diagnostic Boundaries of Bipolar Disorder in Youths

“…Second, diagnostic questions about pediatric bipolar disorder also highlight the relative paucity of research on irritability: operationalized definitions, reliable rating scales (although see references [23][24][25], and normative data are all sparse. In fact, DSM-IV provides no definition of irritability, despite the inclusion of this symptom as a criterion for at least six diagnoses in children (manic episode, oppositional defiant disorder, generalized anxiety disorder, dysthymic disorder, posttraumatic stress disorder, and major depressive episode).…”

Examining the Presence of Anxiety in Aggressive Individuals: The Illuminating Role of Fight-or-Flight Mechanisms

“…Increased reactivity has been linked to both anxiety (Carthy et al 2010a, b) and aggression (Valiente et al 2003). Although aggression and anxiety together can be related to strong emotional reactivity (e.g., Kolko et al 2007), several research studies have demonstrated that anxiety and aggression are also associated with specific emotional responses to provocation. For example, Stadler et al (2006) found that larger affective arousal (i.e., self-reported anger following a provocation), but not physiological arousal (i.e., changes in skin conductance or heart rate), significantly predicted aggression in a sample of children ages 9-14.…”