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aggression

Etiology: - conduct disorder - television violence - increased television viewing 1-3 hours/day vs < 1 hr/day increased likelihood of aggressive & violent behavior in adolescents by 50% [1] Eppidemiology: - verbal aggression (77%) > physical aggression (54%) > sexual aggression (7%) [5,6] Management: - target initial treatment to the underlying disorder; i.e., a disorder that antedates onset of aggression - behavioral support [4] - consider an antipsychotic if aggression persists after a trial of treating the underlying disorder (including psychosocial treatments) - electrical stimulation devices not recommended [4] - reassess effects of treatment frequently [2]

Related

conduct disorder

Specific

aggressive behavior in the elderly assault (violence) homicidal ideation (HI)

General

behavior sign/symptom

References

  1. Journal Watch 22(9):72, 2002 - Johnson JG et al Television viewing and aggressive behavior during adolescence and adulthood. Science 295:2468, 2002 PMID: 11923542 - Anderson CA & Bushman BJ Psychology. The effects of media violence on society. Science 295:2377, 2002 PMID: 11923513
  2. Knapp P et al Treatment of Maladaptive Aggression in Youth: CERT Guidelines I. Engagement, Assessment, and Management Pediatrics, May 28, 2012 PMID: 22641762 http://pediatrics.aappublications.org/content/early/2012/05/23/peds.2010-1360.abstract - Scotto Rosato NS, Correll CU et al Treatment of Maladaptive Aggression in Youth: CERT Guidelines II. Treatments and Ongoing Management Pediatrics, May 28, 2012 PMID: 22641763 http://pediatrics.aappublications.org/content/early/2012/05/23/peds.2010-1361.abstract
  3. Jones RM, Arlidge J, Gillham R et al Efficacy of mood stabilisers in the treatment of impulsive or repetitive aggression: systematic review and meta-analysis. Br J Psychiatry. 2011 Feb;198(2):93-8. PMID: 21282779
  4. FDA News Release. April 22, 2016 FDA proposes ban on electrical stimulation devices intended to treat self-injurious or aggressive behavior. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm497194.htm - DEPARTMENT OF HEALTH AND HUMAN SERVICES. Food and Drug Administration 21 CFR Parts 882 and 895 Banned Devices; Proposal to Ban Electrical Stimulation Devices Used to Treat Self-Injurious or Aggressive Behavior. https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-09433.pdf
  5. Cen X, Li Y, Hasselberg M et al. Aggressive behaviors among nursing home residents: association with dementia and behavioral health disorders. J Am Med Dir Assoc. 2018;19(12):1104 PMID: 30409493 https://www.jamda.com/article/S1525-8610(18)30501-2/fulltext
  6. Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022