JAACAP open最新文献

{"title":"Attention-Deficit/Hyperactivity Disorder Symptoms and Anger and Aggression in Russian Adolescents","authors":"Johan Isaksson PhD ,&nbsp;Denis G. Sukhodolsky PhD ,&nbsp;Roman Koposov MD, PhD ,&nbsp;Andrew Stickley PhD ,&nbsp;Mia Ramklint MD, PhD ,&nbsp;Vladislav Ruchkin MD, PhD","doi":"10.1016/j.jaacop.2024.01.006","DOIUrl":"10.1016/j.jaacop.2024.01.006","url":null,"abstract":"<div><h3>Objective</h3><div>Aggression is a multifaceted behavior that involves cognitive, behavioral, and affective components. Although aggressive behaviors are commonly observed among individuals with attention-deficit/hyperactivity disorder (ADHD), potential sex-specific aspects of the association between ADHD symptoms and different components of aggression need to be evaluated, while also controlling for comorbid problems.</div></div><div><h3>Method</h3><div>In the present cross-sectional study, self-reported data were collected from 2,838 adolescents (mean age = 14.89 years) from Russia on ADHD symptoms and cognitive (anger rumination, aggressive beliefs), behavioral (physical, verbal, social, proactive), and affective (trait anger) aspects of aggression as well as comorbid emotional and conduct problems. Generalized linear model analyses were used to examine the associations between ADHD symptoms and aggression and to explore sex differences, while also adjusting for comorbid problems.</div></div><div><h3>Results</h3><div>Clinically significant levels of ADHD symptoms were associated with all components of aggression, and the associations remained significant after adjusting for emotional and conduct problems. Overall, females had higher levels of trait anger and anger rumination, whereas males had higher levels of aggressive beliefs, proactive aggression, and physical and verbal aggression. There was also a sex-specific association, where males with ADHD symptoms reported higher levels of social aggression. Conduct problems moderated the association between ADHD and aggression, increasing the likelihood of trait anger and social aggression in adolescents without ADHD symptoms.</div></div><div><h3>Conclusion</h3><div>Clinically significant levels of ADHD symptoms seem to impact all components of aggression independent of comorbidity. It is therefore important to consider aggression when evaluating and treating ADHD.</div></div><div><h3>Plain language summary</h3><div>This study investigated the association between self-rated attention-deficit/hyperactivity disorder (ADHD) symptoms and different components of aggression among Russian adolescents. ADHD was related to cognitive, behavioral, and affective aspects of aggression, even when taking emotional and conduct problems into consideration. The findings stress the importance of considering aggression when evaluating and treating ADHD.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 1","pages":"Pages 126-136"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stimulant Medication Shortens the Duration of Impairing Emotional Outbursts","authors":"Lauren M. Spring MD,&nbsp;Joseph E. Schwartz PhD,&nbsp;Gabrielle A. Carlson MD","doi":"10.1016/j.jaacop.2024.01.002","DOIUrl":"10.1016/j.jaacop.2024.01.002","url":null,"abstract":"<div><h3>Objective</h3><div>Emotional dysregulation, often presenting as severe emotional outbursts, is being increasingly recognized as a source of considerable impairment for individuals with attention-deficit/hyperactivity disorder (ADHD). The aim of this study was to conduct a secondary analysis of data examining the impact of standing stimulant medication on the duration of emotional outbursts.</div></div><div><h3>Method</h3><div>The as needed (PRN)–medicated outbursts of psychiatrically hospitalized children, 5 to 12 years of age, were tracked by psychiatric nurses using the Behavioral Activity Rating Scale from the time of PRN administration until the child became calm. The impact of extended-release (ER), immediate-release (IR) stimulant and dose, type and reason for outburst/PRN (aggression, agitation, distress), standing concomitant psychotropic medications and time of day, and days since admission were examined.</div></div><div><h3>Results</h3><div>Forty-seven children had a total of 405 outbursts, 96 of which occurred when no stimulant was prescribed and 309 with stimulant medication. Controlling for time of day and standing neuroleptic dose, outbursts that occurred on an ER stimulant medication were statistically significantly shorter than those that occurred on no stimulant by about 20 minutes (52.7 vs 72.4 minutes), or 30 minutes for aggressive outbursts. Results were unchanged when further controlling for stimulant type and dose, α-agonist, days since admission, PRN medication type, or reason for PRN/outburst. Immediate-release stimulants and short-acting stimulants did not shorten outburst duration.</div></div><div><h3>Conclusion</h3><div>In children with ADHD with severe outbursts, ER stimulants were associated with shorter outburst duration than IR stimulants.</div></div><div><h3>Plain language summary</h3><div>This study examined psychiatrically hospitalized children with attention-deficit/hyperactivity disorder who had emotional outbursts requiring as-needed medication. Children who took extended-release stimulant medication (stimulants that are designed to last throughout the day) had shorter outbursts (by about 20 minutes) than children on no stimulant medication or short-acting stimulant medication.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 1","pages":"Pages 114-125"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139538456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family Conflict, Perceived Criticism, and Aggression in Symptomatic Offspring of Parents With Mood Disorders: Results From a Clinical Trial of Family-Focused Therapy","authors":"David J. Miklowitz PhD ,&nbsp;Megan C. Ichinose PhD ,&nbsp;Marc J. Weintraub PhD ,&nbsp;John A. Merranko MA ,&nbsp;Manpreet K. Singh MD, MS","doi":"10.1016/j.jaacop.2024.01.008","DOIUrl":"10.1016/j.jaacop.2024.01.008","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;In offspring of parents with bipolar or major depressive disorder, we examined the longitudinal association between parents’ and youths’ ratings of family conflict and criticism and youths’ levels of impulsive aggression during a 6-month randomized trial of family intervention.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;Following a diagnostic evaluation, we offered adolescents (aged 13-19 years) and parents with mood disorders a 12-session, 18-week protocol of family-focused therapy, with random assignment to mobile applications that enabled mood tracking or encouraged practice of mood management and family communication skills, also with mood tracking. At pretreatment, 9 weeks, 18 weeks (posttreatment), and 27 weeks, parents completed measures of adolescent aggression and irritability, and parents/adolescents completed measures of dyadic conflict and perceived criticism.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Parent- and youth-rated dyadic conflict scores and perceived criticism ratings were concurrently associated with youths’ composite aggression scores across the 4 timepoints. In lagged association analyses, parent-rated dyadic conflict scores in 1 9-week study interval predicted youths’ aggression scores in subsequent 9-week intervals (&lt;em&gt;F&lt;/em&gt;&lt;sub&gt;1,109&lt;/sub&gt; = 7.36, &lt;em&gt;p&lt;/em&gt; = .008). In contrast, youths' aggression scores in 1 interval predicted youths’ ratings of dyadic conflict in subsequent intervals (&lt;em&gt;F&lt;/em&gt;&lt;sub&gt;1,107&lt;/sub&gt; = 8.16, &lt;em&gt;p&lt;/em&gt; = .005). Levels of family conflict, perceived criticism, and youth aggression decreased over 6 months in both mobile app conditions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;In offspring of parents with mood disorders, levels of family conflict, criticism, and adolescent aggression are intercorrelated over time and suggest bidirectional, mutually influential processes within families. Aggression and its precipitants within family interactions should be a focus of interventions for youths with or at risk for mood disorders.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;The study’s purpose was to determine whether aggression in teenagers (aged 13-19 years) who had a biological parent with a mood disorder (major depression or bipolar disorder) was related to family conflict and parent/offspring criticism over 6 months. Adolescents and their parents received 12 telehealth family-focused therapy (FFT) sessions over 4 months and had access to either of 2 randomly assigned mobile phone applications. One enabled them to track their moods and the other to practice behavioral skills, such as mood management strategies or effective family communication between sessions. Family conflict and teen aggression were correlated in each of the study’s 9-week intervals, and parent-rated family conflict scores in one study interval predicted teens’ aggression scores in the next interval. Levels of family conflict, perceived criticism, and adolescents’ aggression decreased over 6 months i","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 1","pages":"Pages 73-84"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140467909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editors’ Best of 2024","authors":"Robert R. Althoff MD, PhD,&nbsp;Kara S. Bagot MD,&nbsp;Joseph Blader PhD,&nbsp;Daniel P. Dickstein MD, FAAP,&nbsp;Robert L. Findling MD, MBA,&nbsp;Manpreet K. Singh MD, MS","doi":"10.1016/j.jaacop.2024.12.003","DOIUrl":"10.1016/j.jaacop.2024.12.003","url":null,"abstract":"","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 1","pages":"Pages 1-5"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scoping Review and Clinical Guidance: Disparities in the Care of Youth With Agitation or Aggression in the Emergency Department","authors":"Megan M. Mroczkowski MD ,&nbsp;Mitch Otu MD, MBA ,&nbsp;Nasuh Malas MD, MPH ,&nbsp;Vera Feuer MD ,&nbsp;Ruth Gerson MD","doi":"10.1016/j.jaacop.2024.01.007","DOIUrl":"10.1016/j.jaacop.2024.01.007","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This scoping review aims to summarize the current state of research literature on disparities in the care of youth with agitation or aggression in the emergency department (ED), including referral, assessment, diagnosis, use of pharmacologic interventions, and use of restraint and seclusion.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;This study used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) extension for scoping reviews searching PubMed and PsycINFO databases (May 1, 2013 through May 5, 2023) for studies that reported disparities in the care of youth with agitation or aggression in the pediatric ED.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Disparities in the care of youth with agitation or aggression in the ED have been documented for race, sex, age, developmental status, and insurance status. There are no data available on disparities in ED-based care of youth with agitation or aggression based on gender identity and/or presentation, sexual orientation, socioeconomic status (SES), systems involvement (including child welfare, foster care, juvenile justice), or language proficiency.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Although there are some data on disparities in the care of youth with agitation or aggression the ED documented for race, sex, age, developmental status, and insurance status, further work in this area is needed. Actionable steps to address mental health disparities in the pediatric ED are discussed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;This scoping review aimed to summarize the current state of research on disparities in the care of youth with agitation and aggression in the emergency department (ED), including referral, assessment, diagnosis, use of pharmacologic interventions, and utilization of restraint and seclusion. While there are some data on disparities in the care of youth with agitation or aggression in the ED documented for race, sex, age, developmental status, and insurance status, further work in this area is needed, including for sexual and gender minority youth. Actionable steps to address mental health disparities in the pediatric ED are discussed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study preregistration information&lt;/h3&gt;&lt;div&gt;Disparities in the Care of Youth with Agitation or Aggression in the Emergency Department: A Scoping Review and Clinical Guidance; &lt;span&gt;&lt;span&gt;https://osf.io/eg7tk&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Diversity &amp; Inclusion Statement&lt;/h3&gt;&lt;div&gt;One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balan","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 1","pages":"Pages 6-13"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aggressive Behavior in Children and Adolescents With Bipolar Spectrum Disorder: A Systematic Review of the Prevalence, Associated Factors, and Treatment","authors":"Clàudia Aymerich MD ,&nbsp;Edward Bullock MSc, BSc ,&nbsp;Savannah M.B. Rowe MBChB (Candidate) ,&nbsp;Ana Catalan MD, PhD ,&nbsp;Gonzalo Salazar de Pablo MD, PhD","doi":"10.1016/j.jaacop.2024.02.009","DOIUrl":"10.1016/j.jaacop.2024.02.009","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Bipolar disorder (BD) in childhood and adolescence is associated with aggressive behaviors, which might be common and in turn associated with poor clinical outcomes. This is the first systematic review to provide a comprehensive view of the current status of the knowledge about aggressive behaviors in youth with BD.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;We conducted a PRISMA–compliant systematic review of studies investigating aggressive behaviors in children and adolescents with BD (PROSPERO: CRD42023431674). A systematic multi-step literature search was performed on PubMed and the Web of Science. Literature search and data extraction were carried out independently. We provided a systematic synthesis of the findings from the included studies We assessed risk of bias using a modified version of the Newcastle-Ottawa Scale for cross-sectional and cohort studies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of the 2,277 identified records 35 were included; mean age was 12.4 years, and 57.1% were male individuals. 7 studies reported on the prevalence of aggressive behavior among BD children and adolescent population, with 5 of them reporting a prevalence of over 69.0%. Aggressive behaviors were more common in children and adolescents with BD than in those with ADHD or depression. Aggressive behaviors were associated with borderline personality disorder features and poor family functioning. Valproic acid received empirical support for its efficacy in reducing aggressive behavior in BD.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Aggressive behaviors are prevalent among youth with BD and warrant clinical attention and specific evidence-based management. Further research on prognostic factors and psychosocial interventions evaluated prospectively is required.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;In a systematic review including 35 articles, aggressive behaviors were found to be prevalent among young people with bipolar disorder. Aggressive behaviors among children and adolescents are more common in youth with bipolar disorder than youth with major depressive and attentional disorders and are associated with borderline personality disorder features and poor family functioning. More research is needed on prognostic factors and treatments for these highly impacting behaviors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Diversity &amp; Inclusion Statement&lt;/h3&gt;&lt;div&gt;One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper self-identifies as living with a disability. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 1","pages":"Pages 42-55"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140762285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review: Intervention Strategies for Treating Relational Aggression in Female Juvenile Offenders and At-Risk Female Youth","authors":"Jenny Magram MS,&nbsp;Erica Ackerman MS,&nbsp;Claire Stafford MS,&nbsp;Tom D. Kennedy PhD","doi":"10.1016/j.jaacop.2024.04.003","DOIUrl":"10.1016/j.jaacop.2024.04.003","url":null,"abstract":"<div><h3>Objective</h3><div>Female juvenile offenders commonly display a distinct form of aggression, known as relational aggression, which demands its own dedicated focus and specialized intervention approaches, as exemplified by the limited yet steadily growing body of research on the issue. This review set out to explore current relational aggression interventions specifically designed for incarcerated female youth, which was subsequently broadened to include at-risk female adolescents.</div></div><div><h3>Method</h3><div>In stage 1, the effectiveness of intervention strategies targeting relationally aggressive behaviors in female juvenile offenders was systematically reviewed. As so few studies existed in the peer-reviewed literature, in stage 2, a review was conducted with a broader scope examining intervention strategies only with at-risk female adolescents.</div></div><div><h3>Results</h3><div>The electronic databases JBI EBP, PsycINFO, and PubMed/MEDLINE were searched for the systematic review. At stage 1, 16 full-text articles were reviewed for quality, and of these articles, 13 were excluded due to sample population, outcomes, and lack of measuring correlates of relevant behavior. At stage 2, 12 full-text articles were reviewed for quality, and of these articles, 6 were excluded for the above-mentioned reasons.</div></div><div><h3>Conclusion</h3><div>There are promising advancements in the development and implementation of interventions tailored to attenuate relationally aggressive behaviors in female youth deemed at risk or currently in the juvenile justice system.</div></div><div><h3>Plain language summary</h3><div>Female juvenile offenders commonly display a distinct form of aggression, known as relational aggression. The effectiveness of intervention strategies targeting relationally aggressive behaviors in female juvenile offenders and subsequently at-risk female adolescents were systematically reviewed in 2 separate stages. It was found that there were promising advancements in the development and implementation of interventions tailored to attenuate relationally aggressive behaviors observed in young females deemed at-risk or currently in the juvenile justice system.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 1","pages":"Pages 56-72"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric Features, Score Distributions, and Factor Structure of the Retrospective Modified Overt Aggression Scale From a Pediatric Cohort Referred for Behavioral Health Treatment","authors":"Joseph C. Blader PhD","doi":"10.1016/j.jaacop.2024.02.004","DOIUrl":"10.1016/j.jaacop.2024.02.004","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Aggression is a complication of many psychiatric conditions in youth, but a need remains to measure its specific behaviors. This study evaluated the psychometric and other features of the Retrospective-Modified Overt Aggression Scale (R-MOAS), a 16-item, adult-informant measure for the frequency of verbal, property-related, physical, and self-directed aggressive behaviors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;Parents of 4,155 youth, aged 5 to 17 years, completed the R-MOAS following referral for behavioral health concerns from general pediatric settings. Analyses examined the following: (1) score distributions, (2) internal consistency, test–retest reliability, and validity, (3) item response theory (IRT) performance, and (4) factor structure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Scores best fit a zero-modified exponential distribution. Self-directed aggressive behavior decreased less with age among female patients. Cronbach α and McDonald ω were high (0.88 and 0.87, respectively), indicating good internal consistency. Test–retest reliability was 0.70. The pattern of correlations with other measures demonstrated convergent and discriminant validity. IRT analyses showed good discrimination covering a range of scores. IRT supports the ordinality of ratings within items but not the scale’s traditional approach to weighting item severity. Factor analysis suggested a 2-factor structure. One factor has high loadings from verbal items and milder physical and property-directed aggression (“Eruptive”), and the other factor’s loadings drew from self-directed and more destructive behaviors (“Harmful/Distressed”). Measures of affective disturbances made unique contributions to the Harmful/Distressed factor only, whereas the Eruptive factor showed stronger influences of impulsiveness and externalizing behavior.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The R-MOAS fulfills psychometric criteria for reliability, validity, and IRT performance. It can be a useful component in clinical care and research for the identification, quantification, and outcome monitoring of aggressive behavior in youth. Scoring using item scores is superior to the weighting methods of prior versions, which should be disfavored in youth populations. Factor structure suggests one phenotype that features verbal and relatively minor forms of aggression and another in which self-directed and severe harmful behaviors accompany greater affective disturbance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;Aggressive behavior is a common and serious concern among youth receiving mental health care. Measuring this behavior is important for clinical care and research. This study shows that a parent-report rating scale, the Revised – Modified Overt Aggression Scale (R-MOAS), is useful based on analysis of scales completed for over 4,000 children and adolescents in pediatric/psychiatric collaborative care settings. Its psychometric properties fulfill standard criteria f","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 1","pages":"Pages 85-100"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Agenda in Childhood Impairing Emotional Outbursts: A Report of the AACAP Presidential Taskforce on Emotional Dysregulation","authors":"Robert R. Althoff MD, PhD ,&nbsp;Manpreet K. Singh MD, MS ,&nbsp;Argyris Stringaris MD, PhD ,&nbsp;John N. Constantino MD ,&nbsp;Lisa Amaya-Jackson MD, MPH ,&nbsp;Tami D. Benton MD ,&nbsp;Christopher Bellonci MD ,&nbsp;Jeff Q. Bostic MD, EdD ,&nbsp;Jaclyn Datar Chua DO ,&nbsp;Robert L. Findling MD, MBA ,&nbsp;Cathryn A. Galanter MD ,&nbsp;Ruth S. Gerson MD ,&nbsp;Jon M. McClellan MD ,&nbsp;Michael T. Sorter MD ,&nbsp;James G. Waxmonsky MD ,&nbsp;Gabrielle A. Carlson MD","doi":"10.1016/j.jaacop.2024.08.001","DOIUrl":"10.1016/j.jaacop.2024.08.001","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;As part of the 2019-2021 presidential term of the American Academy of Child and Adolescent Psychiatry (AACAP), the AACAP Presidential Initiative on Emotion Dysregulation in Youth Taskforce was established. The aim was to address emotion dysregulation in children and adolescents, focusing on developing methods for clinicians to identify, characterize, and treat impairing emotional outbursts along with development of a research agenda that would guide relevant researchers and research funders. One method to characterize emotion dysregulation was accomplished by recommendations for use of a diagnostic code that is available in the &lt;em&gt;DSM.&lt;/em&gt; The research agenda is presented here.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;The Taskforce specifically focused on aggressive behaviors and emotions associated with outbursts. The development of a research agenda took place over 2 years of examination of the current needs in the literature, with contributions from experts in the field. This work dovetailed with the efforts from the Congress on Pediatric Irritability and Dysregulation, which had been meeting since 2015 to advance research into the measurement, pathophysiology, and treatment of emotion regulation problems in youth. We concentrated on the central questions concerning the measurement of outbursts, key questions linking outbursts to other psychopathologies, and how behavior in outbursts is separable from typical behavior.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A description of the qualitative data gathering process is provided here, along with the following: recommendations in the research areas of measurement; pathophysiology; delineating outbursts from other psychopathologies; exploring the cultural, social, and interpersonal aspects of outbursts; understanding the prevention and treatment of outbursts; and exploring how outbursts manifest and are treated based on setting. Specific examples of research opportunities and future directions are provided.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;A call is made to funding agencies to examine the spaces within their strategic plans that will allow for engagement in critical efforts to improve the lives of children and adolescents with severe emotional outbursts—some of the most impaired individuals presenting for care in child and adolescent psychiatry.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;The 2019 to 2021 AACAP Presidential Initiative on Emotion Regulation in Youth Taskforce was created by Dr. Gabrielle A. Carlson and aimed to address the field of treatment and research of youth with impairing emotional outbursts. The taskforce was made up of clinicians and researchers, including experts from the Congress on Pediatric Irritability and Dysregulation, and focused on developing methods for clinicians to identify, characterize, and treat impairing emotional outbursts. The 2-year taskforce led to the development of a research agenda to guide next steps for researchers","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 1","pages":"Pages 147-155"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Machine Learning to Determine a Functional Classifier of Retaliation and Its Association With Aggression","authors":"Robert James Richard Blair PhD ,&nbsp;Johannah Bashford-Largo MEd, MA, PLMHP ,&nbsp;Ahria J. Dominguez BA ,&nbsp;Melissa Hatch BS ,&nbsp;Matthew Dobbertin DO ,&nbsp;Karina S. Blair PhD ,&nbsp;Sahil Bajaj PhD","doi":"10.1016/j.jaacop.2024.04.007","DOIUrl":"10.1016/j.jaacop.2024.04.007","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Methods to determine integrity of integrated neural systems engaged in functional processes have proven elusive. This study sought to determine the extent to which a machine learning retaliation classifier (retaliation vs unfair offer) developed from a sample of typically developing (TD) adolescents could be applied to an independent sample of clinically concerning youth and the classifier-determined functional integrity for retaliation was associated with antisocial behavior and proactive and reactive aggression.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;Blood oxygen level–dependent response data were collected from 82 TD and 120 clinically concerning adolescents while they performed a retaliation task. The support vector machine algorithm was applied to the TD sample and tested on the clinically concerning sample (adolescents with externalizing and internalizing diagnoses).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The support vector machine algorithm was able to distinguish the offer from the retaliation phase after training in the TD sample (accuracy = 92.48%, sensitivity = 89.47%, and specificity = 93.18%) that was comparably successful in distinguishing function in the test sample. Increasing retaliation distance from the hyperplane was associated with decreasing conduct problems and proactive aggression.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The current study provides preliminary data of the importance of a retaliation endophenotype whose functional integrity is associated with reported levels of conduct problems and proactive aggression.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;This study used a machine learning retaliation classifier developed from a sample of typically developing adolescents and applied it to data from an independent clinical sample. Goal directed aggression in the clinically concerning youth related to a failure to recruit the neural systems implicated in retaliation. The current study suggests a marker of retaliation response for use as a treatment target.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Diversity &amp; Inclusion Statement&lt;/h3&gt;&lt;div&gt;We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure sex balance in the selection of non-human subjects. We worked to ensure diversity in experimental samples through the selection of the cell lines. We worked to ensure diversity in experimental samples through the selection of the genomic datasets. Diverse cell lines and/or genomic datasets were not available. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of histo","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 1","pages":"Pages 137-146"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141412538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}