Aggression and Antisocial Behavior in Children and Adolescents: Research and Treatment [NOOK Book]


This comprehensive volume reviews and synthesizes a vast body of knowledge on maladaptive aggression and antisocial behavior in youth. Written from a clinical-developmental perspective, and integrating theory and research from diverse fields, the book examines the origins, development, outcomes, and treatment of this serious problem in contemporary society. Major topics addressed include the types and prevalence of aggressive and antisocial behavior; the interplay among neuropsychiatric, psychosocial, and ...
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Aggression and Antisocial Behavior in Children and Adolescents: Research and Treatment

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This comprehensive volume reviews and synthesizes a vast body of knowledge on maladaptive aggression and antisocial behavior in youth. Written from a clinical-developmental perspective, and integrating theory and research from diverse fields, the book examines the origins, development, outcomes, and treatment of this serious problem in contemporary society. Major topics addressed include the types and prevalence of aggressive and antisocial behavior; the interplay among neuropsychiatric, psychosocial, and neurobiological processes in etiology; known risk and protective factors; gender variables; and why and how some children "grow out of" conduct disturbances. Chapters also discuss current approaches to clinical assessment and diagnosis and review the evidence for widely used psychosocial and pharmacological interventions.
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Editorial Reviews

From The Critics
Writing in a clear style that advanced undergraduates and graduate students will be able to follow, Connor (psychiatry, U. of Massachusetts Medical School, Worcester and director, pediatric psychopharmacology, U. of Massachusetts Memorial Health Care) addresses the complex issues of youth violence from a clinical-developmental perspective. Theory, types of behavior, and analysis of the prevalence of the behaviors are described in initial chapters. Connor then provides a complete review of current literature on the approaches, issues, and treatments for all aspects of the subject, including neurobiology, psychobiology, and female aggression. Annotation c. Book News, Inc., Portland, OR (
Doody's Review Service
Reviewer: Shiraz Butt, MD (Rush University Medical Center)
Description: This is a multidisciplinary review of the very broad subject of aggression in children and adolescents. It reviews empirical research in the field of aggression from the standpoint of biology, sociology, and treatment.
Purpose: The purpose is to present in a concise manner, empirical data from multiple disciplines on what is currently known about aggression and related behaviors in children and adolescents. It is also the author's goal to facilitate further research into these behaviors. The rates of delinquency and aggression for American youth are on the rise and this book is very timely and greatly needed.
Audience: The book is intended for clinicians and researchers in the field of child and adolescent mental health. It would be useful for professionals working with delinquent youth including psychiatrists, psychologists, and social workers. The author is an active clinical investigator who has extensive experience with this population.
Features: The author covers the subject of aggression in children from the angles of neurobiology, epidemiology, and psychopharmacology. He looks at the empirical data in detail; the chapters on risk factors and biology are especially useful. The author uses a developmental approach in assessment and treatment planning and does an excellent job of integrating the various treatment approaches. His use of algorithms and flow charts in the chapter on pharmacology, for example, is very useful.
Assessment: This is one of the most comprehensive and updated reviews of the research and current knowledge in the field of childhood aggression. It covers a wide range of issues with exhaustive references so that readers should be able to gain an excellent understanding of the current state of research in this area. The author also raises questions that should facilitate and encourage experts to embark upon more focused research.
From the Publisher

"Connor has drawn on his clinical experience and a large body of research to write a comprehensive account of a problem of increasing concern to clinicians, service providers, and the courts. The strength of this book is the biopsychosocial approach allied to the latest findings from research in brain function. It will become a major sourcebook for the many disciplines dealing with this growing problem in our society, and will be read by both experienced practitioners and psychiatrists-in-training."--Lionel Hersov, MD, FRCP, FRCPsych, The Tavistock Clinic, London, UK

"Filling an important gap in the literature on childhood aggression, this book is a highly informative guide for readers involved in clinical assessment, diagnosis, and the development of treatment strategies. It provides definitive coverage of the nature and prevalence of this dysfunctional behavior, and the interplay among environmental, psychosocial, and biological risk factors and influences. In the classroom, this text will inform a new generation of students and clinicians of the importance of developmental psychopathology in the etiology of maladaptive aggression. I recommend it for students at many levels, including undergraduate and graduate students in psychology, behavioral neuroscience, and criminal justice; medical students and psychiatric residents; and law students concerned with crime, violence, and antisocial behavior."--Richard Melloni, Jr., PhD, Department of Psychology and Program in Behavioral Neuroscience, Northeastern University

"A remarkably informative book, highly readable and insightful for students in the behavioral sciences and professionals working with juveniles. The volume draws extensively from empirical knowledge in usually disparate fields, such as psychiatry, developmental psychology, and criminology. It provides comprehensive coverage of the important interface between research findings on biological and social factors, on the one hand, and effective assessment and intervention, on the other. I highly recommend it."--Rolf Loeber, PhD, Department of Psychiatry, Department of Psychology, and School of Public Health, University of Pittsburgh

"There are few topics of greater importance than this one, in view of the extraordinary social costs associated with aggression, and few books that have dealt with it with such sensitivity, breadth, and scope....This is scientific scholarship at its best."--from the Foreword by Russell A. Barkley, PhD, University of Massachusetts Medical School

Annals of Clinical Psychiatry

"A valuable addition to the literature....Clinicians will appreciate the emphasis on the assessment and psychosocial as well as psychopharmacological treatment issues."--Annals of Clinical Psychiatry
Psychiatric Services

"A solid review of the current literature, a thoughtful analysis of current models of aggression, and an overview of the therapeutic interventions currently available."--Psychiatric Services

5 Stars! from Doody
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Product Details

  • ISBN-13: 9781462506194
  • Publisher: Guilford Publications, Inc.
  • Publication date: 4/19/2012
  • Sold by: Barnes & Noble
  • Format: eBook
  • Pages: 480
  • File size: 7 MB

Meet the Author

Daniel F. Connor, MD, is currently Professor of Psychiatry and Pediatrics at the University of Massachusetts Medical School in Worcester, Massachusetts. He is also Director of Pediatric Psychopharmacology at the University of Massachusetts Memorial Health Care. A clinician and clinical researcher in child and adolescent psychiatry, Dr. Connor is certified by the American Board of Psychiatry and Neurology in the specialty of Psychiatry and the subspecialty of Child and Adolescent Psychiatry. As a practicing clinician, Dr. Connor evaluates and treats a wide variety of youth with serious emotional and behavioral disturbances, most of whom have troubles with excessive, inappropriate, and maladaptive aggression and related problems. An active clinical investigator, Dr. Connor has authored numerous scientific articles and book chapters on aggression, pediatric psychopharmacology, attention-deficit/hyperactivity disorder (ADHD), and disruptive behavior disorders. As Director of the Pediatric Psychopharmacology Clinical Trials Program at the University of Massachusetts Medical School, he participates in many multisite clinical drug trials developing new therapies for children and adolescents with ADHD and disruptive behavior disorders.
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Read an Excerpt

Aggression and Antisocial Behavior in Children and Adolescents

Research and Treatment
By Daniel F. Connor

The Guilford Press

Copyright © 2002 The Guilford Press
All right reserved.

ISBN: 1-59385-091-3

Chapter One

Prevalence of Aggression, Antisocial Behaviors, and Suicide

Over the past 50 years, rates of maladaptive aggression and antisocial behaviors have increased in frequency and severity among children and adolescents in the United States. Although most youth are not seriously aggressive or antisocial, the rates of these behaviors are nevertheless alarming. The consequences of youth violence and related activities presently pose a major public health problem for society. The identification, containment, referral, assessment, and treatment of aggressive young people are challenges for many community institutions, including schools, juvenile justice authorities, and clinical mental health resources. After a peak in the late 1980s and early 1990s, rates of aggression and antisocial behaviors among young people are falling as the new century begins, but they remain at historically high levels.

This chapter discusses the prevalence of excessive, inappropriate aggressive behaviors in children and adolescents. Because some degree of aggression is generally very common and part of normal development, especially in young children, normal developmental aspects ofaggression are first discussed. A discussion of the prevalence of maladaptive aggression, antisocial behaviors, and suicide follows. This discussion first draws on community epidemiological data describing the prevalence of conduct disorder (CD), and then presents information from youth public opinion surveys ascertaining selfreported fears and concerns about aggression and violence. Juvenile justice statistics on rates of both victimization and offenses are next considered. Teenage suicide rates are then examined, since suicide can be viewed as the ultimate act of aggression against the self and since violent behavior increases the risk of suicide (Conner et al., 2001). Finally, how rates of juvenile aggression and suicide have affected referrals to clinical child and adolescent mental health treatment is discussed.

In Chapter 1, an attempt has been made to highlight the importance of careful definitions of aggression and to distinguish between adaptive and maladaptive aggression. This chapter defines the topic more broadly. Since little research using homogeneous definitions of aggression has been completed, by necessity this chapter mixes "aggression" with "violence," "delinquency," "crime," and "disruptive problem behavior."


Aggression is a normal and highly frequent behavior in young developing children. Healthy aspects of aggression facilitate competence in social assertiveness, competition in games, and success in meeting daily challenges. Infants can recognize facial configurations associated with the expression of anger in adults at 3 months of age (Izard et al., 1995). Almost all children display aggressive behavior to some degree during development. Across most cultures, boys are consistently found to be more aggressive than girls. The frequency of aggressive behavior in infants and young children has been examined by researchers studying social conflict. Observational studies (Holmberg, 1977) indicate that approximately 50% of the social interchanges between children 12-18 months of age in a nursery school setting can be viewed as disruptive or conflictual. By age 2 1/2 years, the proportion of conflicted social interchanges decreases to 20%. Almost all of the disruptive behavior in these children is directed toward peers, with very little directed toward adult caregivers. Early interpersonal conflicts serve as a training ground for infants to develop and learn effective social strategies for assertiveness, ownership of objects, and resolution of social conflict. These are important lessons for children to learn if they are to participate effectively in the greater social milieu as they grow older (Hay & Ross, 1982). As such, this type of aggression fits the definition of adaptive aggression.

The forms that aggressive behavior takes also change across development. There is a tendency for physical forms of aggression such as hitting to decrease, and verbally mediated forms of aggression to increase, between 2 and 4 years of age (Goodenough, 1931). In addition, the social purpose or goal of aggression seems to change with age. Children younger than 6 years engage in much aggressive behavior for the purpose of obtaining objects, territory, or privileges from others. This is called "instrumental" aggression (Rule, 1974). Slightly older children, aged 6-7 years, increasingly engage in person-oriented aggression ("hostile" aggression) designed as retaliation toward another child for presumed intentional frustration in a goal-directed activity, an insult, or other threats to one's self-esteem (Hartup, 1974). Over the preschool and early elementary school years, there appears to be a decrease in instrumental aggression and an increase in person-directed, hostile, retaliatory aggression (Parke & Slaby, 1983). At the same time, there is an overall decrease in the frequency and intensity of both kinds of aggression; verbally mediated interpersonal skills increase as children channel aggressive impulses and drives into more socially acceptable activities, such as sports, social, and academic achievement.

The precipitants or triggers of aggression also appear to change with development. Anger outbursts in infancy are usually elicited by physical discomfort or the need for attention, whereas "habit training" in toileting, hygiene, and feeding commonly causes outbursts in toddlers (Goodenough, 1931). Conflicts among peers over the possession of objects are also common from 18 to 65 months of age (Dawe, 1934; Hartup, 1974). As children grow older, insults and negative social comparisons (e.g., ridicule, tattling, criticism) become increasingly likely to elicit verbally mediated retaliatory aggression, but relatively unlikely to elicit physical attack (Parke & Slaby, 1983). As development proceeds into adolescence and young adulthood, overt aggression, defined as open confrontation with the environment (e.g., temper tantrums, physical fighting) tends to decline; covert or hidden aggression (e.g., breaking the rules, not telling the truth, cheating, stealing) becomes more common (Loeber, 1990). In adolescence, with the onset of sexual maturity, conflicts to establish or maintain social dominance may be important, especially for males.

Table 2.1 shows these general trends in the developmental aspects of normative aggression. Although hardly scientific, specific, or precise, these broad trends in development can help us begin to recognize which children may be at risk for developing more maladaptive forms of aggression. For example, the preschool child who largely directs aggression toward adults in an out-of-home environment such as a nursery school does not fit what is presently known about the normative aspects of aggression. The school-age child who frequently and repetitively initiates physical attacks on others, rather than beginning to modulate overt aggressive behavior with words, may also be deviating from a normative developmental trajectory. The elementary school child who continues to use physical aggression to obtain possessions from others is another example. These children may be at risk for the development of maladaptive aggression as they grow older. Knowledge about the normative developmental aspects of childhood aggression can help parents, teachers, and health care providers identify children who might benefit from further evaluation of their aggression at a young age, when treatment for maladaptive behavior may be more effective than later in development (Loeber & Hay, 1997).


Conduct Disorder

Since the psychiatric diagnosis of CD contains criteria for many varied acts of maladaptive aggression, prevalence surveys of CD can give a rough estimate of the prevalence of maladaptive aggression among youth living in the community in different countries. As noted in Chapter 1, CD is a disturbance of behavior lasting at least 6 months in which basic rights of others and/or major age-appropriate norms and rules of society are repeatedly violated (American Psychiatric Association [APA], 1994). Overt physical aggression, such as fighting and fighting with weapons, occurs commonly in this condition. Covert, hidden forms of aggression, such as stealing, fire setting, lying, and vandalism, are also frequent among youth meeting diagnostic criteria for this diagnosis. Seven of the 15 criteria used to make the diagnosis of CD in its current form (APA, 1994) code for various aspects of physical aggression. Standardization of the diagnostic criteria for CD has enabled epidemiological studies to determine the prevalence of this diagnosis in different societies.

A summary of these community-based studies is presented in Table 2.2. As can be seen, prevalence rates vary by sampling time frame and range from 0.9% to 20%, with the higher prevalence rates generally reflecting longer sampling times. These rates suggest that maladaptive aggression as ascertained by a diagnosis of CD is not rare among the youth of many different countries. In general, this disorder is less prevalent in prepubertal children than in adolescents. Boys have higher prevalence rates than girls in the prepubertal age range; however, the rate of CD rises for female adolescents and can approach the prevalence for males in the adolescent age range (Kashani et al., 1987). The peak ages for CD-like behavior in boys are 10-13 years. For girls, such behavior peaks at age 16 (Bauermeister, Canino, & Bird, 1994). These findings suggest sex-related differences in the prevalence rates of aggressive behavior that vary as a function of age. Thus, both age and gender are important factors to consider in documenting community prevalence rates for children and adolescents with CD.

Youth Attitudes, Fears, and Concerns about Violence

Public opinion surveys suggest that for many adolescents, issues of aggression, violence, and safety in their schools and neighborhoods are matters of daily concern. A survey of teenagers' attitudes completed in 1996 included a question about the most important problem facing the United States today and in the future; responses revealed that the issue most frequently endorsed by adolescents was "violence and crime." Adolescents also endorsed "violence and crime" as the third most important issue today facing America's youth (after "drugs" and "peer pressure") (Maguire & Pastore, 1997, p. 115). The percentage of high school seniors who reported worrying "sometimes or often" about violence and crime rose from 79.4% in 1986 to 90.1% in 1996, before falling slightly to 84.4% in 1998 (Maguire & Pastore, 1999, p. 148). Many adolescents also report safety concerns in their activities of everyday life. In 1995, 42% of teenagers reported feeling "only sometimes" or "never" safe in the area around school, and 28% reported safety concerns while inside their school building. Although 61% of teenagers reported never feeling unsafe in any situation, 28% reported avoiding at least one public place because of safety concerns (Young Women's Christian Association [YWCA], 1996). Public opinion surveys assessing youth attitudes therefore indicate that many teenagers have fears and concerns about violence and aggression.


Among other sources of information on prevalence rates of maladaptive aggression for children and adolescents living in the community are criminal justice statistics, particularly annual crime indices. The federal government keeps statistics on certain offenses called "index offenses." These offenses consist of the following eight felonies: willful homicide, forcible rape, robbery, burglary, aggravated assault, larceny over $50, motor vehicle theft, and arson. The Federal Bureau of Investigation combines statistics on these eight felonies into its annual "crime index." (Note that this index does not include drug-related offenses.) These offenses are much more serious crimes than the general idea of delinquency denotes.

Since the annual crime index includes statistics on the ages of crime victims and offenders, statistics on juvenile crime may be ascertained. Rates of youth victimization; youth offending for delinquency; youth offending for violent crime, such as murder, non-negligent manslaughter, and aggravated assault; and arrest rates in individuals under age 18 can be identified. These statistics have been kept for many years, and rates of change over time can be studied. Since only those offenses or events that come to the attention of authorities or result in the arrest of a perpetrator are counted in these statistics, they probably represent underestimations of the true offense and victimization prevalence rates for youth. This may be more true for less serious delinquent offenses and less true for more serious criminal offenses.

Self-Report Delinquency Methodology

The problem of underdetection of youth crime and delinquency as a result of relying on official arrest statistics has led to alternative methods of detecting child and adolescent offenses. One such method is "self-report delinquency methodology" (Loeber, Green, Lahey, & Stouthamer-Loeber, 1991). Instead of relying on official statistics, investigators ask youngsters, their parents, and their teachers directly about the youth's problem behaviors. Self-report studies usually aim to record nonpersonal crimes, victimless acts of delinquency, and covert acts of aggression, which official crime statistics often underestimate. The procedure followed in such research is to give respondents a standard list of specified delinquent activities. These can be presented as interview questions or as a self-report questionnaire. Often the information gathered from multiple informants (youngsters, parents, and teachers) is combined into a best-estimate evaluation (Hart, Lahey, Loeber, & Hanson, 1994). Evidence of validity for such an approach to estimating rates of antisocial behaviors among teenagers has emerged (Hart et al., 1994; Junger-Tas, 1992).

Self-report delinquency methodology is largely used with psychiatrically referred children and adolescents. Thus it cannot directly provide population-wide estimates of antisocial behavior prevalence rates. However, these methods represent a systematic approach to ascertaining the frequency of such events that are not covered by official crime indices. Findings on the nature of adolescent crime from self-report studies indicate that self-report data generally portray less serious offending overall, with the majority of undetected offending by young people being theft-related. Self-report studies suggest higher levels of delinquency among the juvenile population than would be anticipated on the basis of official statistics.


Excerpted from Aggression and Antisocial Behavior in Children and Adolescents by Daniel F. Connor Copyright © 2002 by The Guilford Press. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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Table of Contents

1. Definitions and Subtyping of Aggressive Behavior
2. Prevalence of Aggression, Antisocial Behaviors, and Suicide
3. Aggression: Stability, Impairment, and Desistance
4. The Relationship between Categorical Psychiatric Diagnosis and Aggression
5. Risk and Protective Factors in Aggression and Related Behaviors
6. Psychobiology: Neuropsychology, Psychophysiology, Brain Imaging, and Minor Physical Anomalies
7. Neurobiology: Biobehavioral Models and Neurological Disorders
8. Integrated Models of Aggression and Related Behaviors
9. Issues in Female Aggression and Related Behaviors
10. Clinical Assessment, Case Formulation, and Treatment Planning
11. Psychosocial Interventions
12. Psychopharmacological Treatments
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