Closing the gap: unmet needs of individuals with impulsive aggressive behavior observed in children and adolescents

Abstract Impulsive aggressive (IA, or impulsive aggression) behavior describes an aggregate set of maladaptive, aggressive behaviors occurring across multiple neuropsychiatric disorders. IA is reactive, eruptive, sudden, and unplanned; it provides information about the severity, but not the nature, of its associated primary disorder. IA in children and adolescents is of serious clinical concern for patients, families, and physicians, given the detrimental impact pediatric IA can have on development. Currently, the ability to properly identify, monitor, and treat IA behavior across clinical populations is hindered by two major roadblocks: (1) the lack of an assessment tool designed for and sensitive to the set of behaviors comprising IA, and (2) the absence of a treatment indicated for IA symptomatology. In this review, we discuss the clinical gaps in the approach to monitoring and treating IA behavior, and highlight emerging solutions that may improve clinical outcomes in patients with IA.

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Nutritional Intervention with Dried Bonito Broth for the Amelioration of Aggressive Behaviors in Children with Prenatal Exposure to Dioxins in Vietnam: A Pilot Study

Nutrients ◽

10.3390/nu13051455 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1455

Author(s):

Muneko Nishijo ◽

Tai The Pham ◽

Ngoc Thao Pham ◽

Hai Thai Thu Duong ◽

Ngoc Nghi Tran ◽

...

Keyword(s):

Aggressive Behavior ◽

Prenatal Exposure ◽

Intervention Group ◽

Experimental Period ◽

Nutritional Intervention ◽

Autism Spectrum ◽

Aggressive Behaviors ◽

Post Intervention ◽

Dioxin Exposure ◽

Covert Aggression

Dioxins have been suggested to induce inflammation in the intestine and brain and to induce neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), partly due to deficits in parvalbumin-positive neurons in the brain that are sensitive to inflammatory stress. Previously, we reported ADHD traits with increased aggressiveness in children with prenatal exposure to dioxins in Vietnam, whereas dried bonito broth (DBB) has been reported to suppress inflammation and inhibit aggressive behavior in animal and human studies. In the present study, we investigated the association between dioxin exposure and the prevalence of children with highly aggressive behaviors (Study 1), as well as the effects of DBB on the prevalence of children with highly aggressive behaviors (Study 2). Methods: In Study 1, we investigated the effects of dioxin exposure on the prevalence of children with high aggression scores, which were assessed using the Children’s Scale of Hostility and Aggression: Reactive/Proactive (C-SHARP) in dioxin-contaminated areas. The data were analyzed using a logistic regression model after adjusting for confounding factors. In Study 2, we performed nutritional intervention by administering DBB for 60 days to ameliorate the aggressiveness of children with high scores on the C-SHARP aggression scale. The effects of DBB were assessed by comparing the prevalence of children with high C-SHARP scores between the pre- and post-intervention examinations. Results: In Study 1, only the prevalence of children with high covert aggression was significantly increased with an increase in dioxin exposure. In Study 2, in the full ingestion (>80% of goal ingestion volume) group, the prevalence of children with high covert aggression associated with dioxin exposure was significantly lower in the post-ingestion examination compared with in the pre-ingestion examination. However, in other ingestion (<20% and 20–79%) groups and a reference (no intervention) group, no difference in the prevalence of children with high covert aggression was found between the examinations before and after the same experimental period. Conclusions: The findings suggest that DBB ingestion may ameliorate children’s aggressive behavior, which is associated with perinatal dioxin exposure.

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Insight and aggressive Behavior in acute Schizophrenic Patients

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1602 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S441-S441

Author(s):

S. Campi ◽

C. Esposito ◽

P. andreassi ◽

P. Bandinelli ◽

P. Girardi ◽

...

Keyword(s):

Aggressive Behavior ◽

Treatment Compliance ◽

Aggressive Behaviors ◽

Self Monitoring ◽

Poor Treatment ◽

Schizophrenic Patients ◽

Competing Interest ◽

The Relationship ◽

Acute Patients

Introductionaggressive behavior in wards is associated to poor treatment compliance and low clinical insight. Most studies focused on the clinical and cognitive dimensions of insight, while the relationship between metacognitive dimension and aggressive behaviors was not investigated. Our aim was to understand what relationship occurs between dimensions of insight (metacognitive, cognitive, clinical), and specific aggressive behaviors in acute patients.Methodswe recruited 75 acute schizophrenic patients using: aQ; MO aS; IS; P aNSS; BCIS.Resultsa positive correlation between the IS score and the hostility, angry and physical aggression sub-scores of the aQ was highlighted, while no correlation between the score of IS and MO aS total score was found. No correlation between the score of the P aNSS G12 item and the aQ scores and MO aS was found, and no correlation between BCIS scores, MO aS and aQ scores was found.Conclusionsin our patients, a higher level of metacognitive insight, but not clinical nor cognitive insight, was associated to higher levels of hostility. we suggest that a higher ability to monitor and appraise one's own altered processes of thought and related discomfort, feeling of destabilization and loss of control, could contribute to enhance resentment and suspiciousness. Findings help develop specific therapeutic strategies to enhance metacognitive and self-monitoring abilities, helping patient's understanding of the illness, improving compliance with treatment, and patient's quality of life. Our results support the multidimensional nature of insight in schizophrenia, confirming that clinical, cognitive and metacognitive dimensions are independent though related facets of the phenomenon of insight in schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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