Treatment Recommendations for the Use of Antipsychotics for Aggressive Youth (TRAAY). Part I: A Review

Schur, Sarah B.; Sikich, Lin; Findling, Robert L.; Malone, Richard P.; Crismon, M. Lynn; Derivan, Albert T.; MacIntyre, James C.; Pappadopulos, Elizabeth; Greenhill, Laurence L.; Schooler, Nina R.; Orden, Kimberly A. Van; Jensen, Peter S.

doi:10.1097/00004583-200302000-00007

Cited by 151 publications

(34 citation statements)

References 96 publications

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“…12–14 There is also evidence (but no FDA-approved indication) to support risperidone treatment for children with below average to low average IQ. 15,16 Otherwise, much of the data are derived from open-label studies or studies with small sample sizes.…”

Section: Introductionmentioning

confidence: 99%

“…15,17 The recommendations are a 14-step approach to prescribing antipsychotics in youth, which include standardized ratings scales to track aggressive behavior, psychosocial and educational components to treatment, and treatment of primary psychiatric disorders prior to initiating treatment with an antipsychotic for aggression. 17 If significant aggression persists despite the initial steps, treatment with an SGA would be warranted.…”

Section: Introductionmentioning

confidence: 99%

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Antipsychotic Treatment Patterns and Aggressive Behavior Among Adolescents in Residential Facilities

Miller

Riddle

Pruitt

et al. 2013

J Behav Health Serv Res

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This study examined the association between acute aggressive behavior patterns of 145 adolescents in residential treatment facilities with use of and changes in antipsychotic medication for the chronic management of aggression. Seclusion/restraint (S/R) frequency over 12 months was used to categorize youth into none, low, moderate, and high S/R groups. Data were analyzed using longitudinal mixed effects logistic regression models that allowed for intra-subject variability over time. The high and moderate S/R groups were significantly more likely to receive antipsychotics, get higher doses, and have changes in medication compared with the none S/R group. Increases in antipsychotic dose were associated with a lower likelihood of changes in antipsychotic medication over time. Despite persistent antipsychotic use at higher doses, youth in the high and moderate S/R groups continued to be secluded/restrained frequently. The findings question the adequacy of these medications in managing aggressive behavior.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Antipsychotic Treatment Patterns and Aggressive Behavior Among Adolescents in Residential Facilities

Miller

Riddle

Pruitt

et al. 2013

J Behav Health Serv Res

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“…The effectiveness of psychological interventions targeting aggression might be attenuated by comorbid psychopathology, such as major depression (King et al, 2006; Knox, King, Hanna, Logan, & Ghaziuddin, 2000). Pharmacologic interventions for aggression have produced mixed results (Coccaro, Kavoussi, & McNamee, 2000; Schur et al, 2003). Thus the restrictive techniques of seclusion and restraint often are the sole remaining options for handling such behavior.…”

mentioning

confidence: 99%

Prediction of restraints among youth in a psychiatric hospital: application of translational action research

2011

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This study extends a translational action research program by applying a theoretically based measure of risk in predicting incidents of restraint among children and adolescents in a secure psychiatric hospital. Youth inpatients (N=149, ages 5-17) were assessed at intake for the presence of selected individual and contextual risk factors, and their involvement in critical incidents was tracked (i.e., number of episodes in which restraint was applied) for the remainder of their hospitalization. Models including history of aggression or history of previous placements as well as a combined model including several individual and contextual factors significantly predicted the likelihood of a youth becoming involved in at least one restraint. Unique predictors of restraint involvement included history of aggression against adults and history of previous psychiatric hospitalizations. None of the variables assessed predicted the extent of a youth’s restraint involvement. The implications of these findings are discussed with respect to future research and empirically informed practice with high-risk youth.

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“…Two classes of medication, however, deserve mention because of their recent and emerging data. Research indicates that anti‐convulsants (Khanzode et al., 2006; Rana et al., 2005; Saxena et al., 2005; Steiner et al., 2003) and atypical antipsychotics (Findling et al., 2005; Pappadopulos et al., 2003; Schur et al., 2003) appear to show early efficacy and potential for helping RADI youth to gain better control of their behaviours. Consensus guidelines exist for the use of these agents in the treatment of aggression and conduct disorder (Pappadopulos et al., 2003; Steiner, 1997; Steiner & Dunne, 1997).…”

Section: Levels Of Interventionmentioning

confidence: 99%

Evidence for Interventions for Young Offenders

Karnik¹,

Steiner

2007

Child Adoles Ment Health

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Young offenders are an issue of global concern. Despite a greater understanding of the aetiology of conduct disorder and juvenile delinquency, the research on treatments and the use of evidence-based methods of interventions has not kept pace. This review critically and selectively examined interventions for young offenders, and organises them based on levels of care. The challenge is to intervene using empirical strategies that are implemented based on our emerging understanding of aggression.

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Treatment Recommendations for the Use of Antipsychotics for Aggressive Youth (TRAAY). Part I: A Review

Cited by 151 publications

References 96 publications

Antipsychotic Treatment Patterns and Aggressive Behavior Among Adolescents in Residential Facilities

Antipsychotic Treatment Patterns and Aggressive Behavior Among Adolescents in Residential Facilities

Prediction of restraints among youth in a psychiatric hospital: application of translational action research

Evidence for Interventions for Young Offenders

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