JAACAP open最新文献

{"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 , Edward Bullock MSc, BSc , Savannah M.B. Rowe MBChB (Candidate) , Ana Catalan MD, PhD , 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":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Method</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div><div><h3>Plain language summary</h3><div>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.</div></div><div><h3>Diversity & Inclusion Statement</h3><div>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":"Altered Neural Activation in First Episode Psychosis Patients With Comorbid Conduct Disorder: A Pilot Investigation","authors":"Nathan J. Kolla MD, PhD, FRCPC ,&nbsp;Ryan Aloysius BSc ,&nbsp;George Gainham BSc ,&nbsp;Colin Hawco PhD","doi":"10.1016/j.jaacop.2024.04.001","DOIUrl":"10.1016/j.jaacop.2024.04.001","url":null,"abstract":"<div><h3>Objective</h3><div>Most individuals with psychosis do not perpetrate violence. However, conduct disorder (CD) increases the risk of violence in psychotic conditions. Because it is currently unknown whether the neural correlates of first-episode psychosis (FEP) differ when CD is present, we used functional magnetic resonance imaging (fMRI) during a Go/No-Go impulsivity paradigm to investigate. Based on previous research, we hypothesized that activation differences between FEP and FEP+CD would be found in the prefrontal cortex, cingulate cortex, and inferior parietal lobule.</div></div><div><h3>Method</h3><div>We scanned 51 male participants: 17 FEP, 16 FEP+CD, and 18 healthy controls with an average age of 24.2 years (range, 17-34 years). Whole-brain images were analyzed via a general linear model, and first-level contrast images were created comparing successful No-Go &gt; Go trials. Paired <em>t</em> tests were conducted at the group level and included confound regressors for age, IQ, antipsychotic dose, psychotic symptoms, and framewise displacement. A voxel-based <em>Z</em>-score threshold of Z &gt; 3.1 (<em>p</em> &lt; 0.001, uncorrected) and a cluster-level extent threshold of <em>p</em> &lt;0.01, corrected, was considered significant.</div></div><div><h3>Results</h3><div>Successful response inhibition elicited hyperactivation in FEP+CD vs FEP in the cingulate gyrus; regions of the PFC, including right middle frontal gyrus (RMFG); bilateral inferior parietal lobule; temporal gyrus; and cerebellum (<em>p</em> values ranged from 1.11E-08 to 0.0031). There was no region in which activation was greater in FEP &gt; FEP+CD.</div></div><div><h3>Conclusion</h3><div>These preliminary results tentatively suggest that brain regions subserving response inhibition may be altered when CD is comorbid with FEP.</div></div><div><h3>Plain language summary</h3><div>Conduct disorder increases the risk of aggression among individuals with psychosis. This study used fMRI during a task measuring impulsivity to determine whether individuals with first episode psychosis and comorbid conduct disorder have different brain responses than individuals with first episode psychosis alone and healthy controls. Increased activation of the prefrontal cortex, cingulate gyrus, bilateral inferior parietal lobule, temporal gyrus and cerebellum was found in first episode psychosis with conduct disorder versus first episode psychosis alone. These preliminary results suggest that brain regions subserving response inhibition may be altered when conduct disorder is comorbid with first episode psychosis.</div></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"3 1","pages":"Pages 101-113"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510264","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}