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When leveraged together, variable-centered and person-centered statistical methods have the potential to illuminate the factors predicting mental health recovery. However, because extant studies have largely relied on only one of these methods, we do not yet understand why some youth demonstrate recovery while others experience chronic symptoms. This omission limits our understanding of trajectories of physical aggression (AGG) in particular, which are frequently characterized by desistance. The present study examined the development of AGG across childhood and adolescence via variable-centered and person-centered modeling, with neighborhood and family characteristics considered as predictors. Variable-centered results indicated a mean-level decline in AGG with age but were more useful for illuminating predictors of AGG at baseline than predictors of declining engagement. Person-centered analyses, by contrast, identified low parent-child conflict and high household income as predictors of desistance. Although variable-centered analyses were integral to modeling the average AGG trajectory and identifying predictors of engagement at baseline, person-centered techniques proved more useful for understanding predictors of desistance.
Impulsivity and aggression are known risk factors for suicide, with observed age and sex differences in their impact.
Aims
To explore variations in impulsivity and aggression based on sex and age and examine their roles in predicting suicide.
Method
We examined 582 participants (406 individuals who died by suicide, 176 non-suicidal sudden-death controls) using the psychological autopsy method. Measures of impulsivity and aggression included the Barratt Impulsiveness Scale (BIS) and the Brown–Goodwin History of Aggression (BGHA). Participants were categorised into four groups: suicide male, control male, suicide female and control female. For group comparisons, we used analyses of variance and Spearman’s rank correlation to assess the relationship between age and BIS and/or BGHA ratings. Stepwise logistic regression was used to identify predictors of suicide for each sex.
Results
Higher levels of BIS and BGHA ratings were found in the suicide group compared with controls (BIS: 51.3 v. 42.2, P = 0.002, η2 = 0.017; BGHA: 7.1 v. 4.1, P < 0.001, η2 = 0.028), with no significant sex differences. BIS and BGHA ratings decreased with age in the suicide groups (suicide male: impulsivity ρ = −0.327, P < 0.001; suicide female: aggression ρ = −0.175, P = 0.038) but not among controls. Logistic regression analysis revealed that for men, aggression (odds ratio 1.072, 95% CI: 1.032–1.112) was a key predictor. For women, younger age (odds ratio 0.970, 95% CI: 0.948–0.993), low BIS impulsivity ratings (odds ratio 1.018, 95% CI: 1.001–1.036) and living with children (odds ratio 0.448, 95% CI: 0.208–0.966) were protective factors.
Conclusions
Impulsive and aggressive behaviours are critical factors in suicide risk among younger individuals, indicating an age effect but no sex dimorphism, with aggressive behaviours being a better predictor for men and impulsive and aggressive behaviours for women.
This editorial explores dual harm – the co-occurrence of self-harm and aggression – particularly among forensic populations. Historically approached as two separate and even opposing behaviours, emerging evidence shows that those who engage in self-harm and aggression experience greater adversity and poorer outcomes. This underscores the importance of enhancing our understanding of dual harm. We review key developments within the field, including how dual harm may be best conceptualised and managed, and identify critical gaps in the literature. In order to improve the care and outcomes of those who engage in self-harm and aggression, emphasis is placed on adopting more integrated approaches that consider the duality of these behaviours, as well as the complex needs of this high-risk group, within research and practice.
Conduct disorder is a psychological condition marked by persistent patterns of rule-breaking, aggression and disregard for societal norms. As pornography consumption becomes increasingly prevalent among young adults, concerns have emerged regarding its potential psychological and social implications. This study explores how pornography consumption may contribute to conduct disorder symptoms among young adults through an in-depth qualitative analysis. Using a case-study approach, four individuals with a history of frequent pornography consumption and behavioural issues linked to conduct disorder were selected. Data were collected through detailed interviews, focusing on their experiences, behavioural patterns and psychological effects. The analysis revealed that prolonged exposure to certain types of pornography was associated with increased impulsivity, aggression and rule-breaking tendencies. Participants also reported social and emotional challenges, further reinforcing conduct disorder symptoms. This study suggests that specific patterns of pornography consumption may play a role in the development or worsening of conduct disorder symptoms. Recognizing these behavioural links is crucial for creating effective prevention and intervention strategies, especially for young adults at risk of engaging in deviant or criminal behaviour.
We assess the proposition that intergroup conflict (IGC) in non-human primates offers a useful comparison for studies of human IGC and its links to parochial altruism and prosociality. That is, for non-linguistic animals, social network integration and maternal influence promote juvenile engagement in IGC and can serve as the initial grounding for sociocultural processes that drive human cooperation. Using longitudinal data from three cohorts of non-adult vervet monkeys (Chlorocebus pygerythrus), we show that non-adults are sensitive to personal (age) and situational risk (participant numbers). The frequency and intensity of participation, although modulated by rank and temperament, both mirrors maternal participation and reflects non-adult centrality in the grooming network. The possibility of social induction is corroborated by the distribution of grooming during IGC, with non-adults being more likely to be groomed if they were female, higher-ranking and participants themselves. Mothers were more likely to groom younger offspring participants of either sex, whereas other adults targeted higher-ranking female participants. Although we caution against a facile alignment of these outcomes to human culturally mediated induction, there is merit in considering how the embodied act of participation and the resultant social give-and-take might serve as the basis for a unified comparative investigation of prosociality.
A lifetime history of non-suicidal self-injury (NSSI) is a risk factor for subsequent behavioural and emotional problems, including depression, aggression and heightened emotional reactivity. Traumatic experiences, which are frequently reported by individuals with NSSI, also show predictive links to these mental health problems. However, the exact connections between these areas and their subdomains remain unclear.
Aims
To explore in detail the relationships of specific characteristics of NSSI (e.g. termination in adolescence, duration, frequency, reinforcement mechanisms) and various types of traumatic experience (emotional, physical, sexual) with distinct aspects of emotional reactivity (sensitivity, intensity, persistence), aggression (behavioural, cognitive, affective) and severity of depression in university students.
Method
Via online survey, 150 university students aged 18 to 25 years, who had self-injured at least once, provided information on NSSI, and completed questionnaires including the Childhood Trauma Questionnaire, Patient Health Questionnaire, Emotion Reactivity Scale, and Aggression Questionnaire. Regression analyses were conducted to determine risk factors linked to increased depression scores, aggression and emotional reactivity. The study was pre-registered in the German Clinical Trials Register (DRKS00023731).
Results
Childhood emotional abuse contributed to emotional reactivity, aggression and depressive symptom severity (β = 0.33–0.51). Risk factors for sustained NSSI beyond adolescence included increased automatic positive reinforcement (odds ratio: 2.24).
Conclusions
Childhood emotional abuse significantly contributes to emotional and behavioural problems and needs to be considered in NSSI therapy. NSSI was found to persist into adulthood when used as an emotion regulation strategy.
This chapter of the handbook inspects the relationship between antisociality and morality from the dual perspectives of moral psychology and moral neuroscience. The authors provide a comprehensive overview of research on the moral cognition of different types of antisocial individuals. Based on their review of the research, they suggest that the capacity for moral reasoning in psychopathy is less defective than generally assumed. While the propensity of psychopathic individuals to engage in immoral behavior is due largely to affective deficits, it also stems from dysfunction in the neural circuitry underlying moral decision making. This simple narrative, however, is complicated by the fact that there is no single explanation of the immoral behavior exhibited by the full range of antisocial individuals. For example, while dysfunction in the neural circuitry of moral decision making may account for the immoral behavior of individuals with primary psychopathy and individuals prone to proactive aggression, it is less apt for explaining similar behavior by individuals with secondary psychopathy and a propensity for reactive aggression.
Julianne House, Universität Hamburg/Hun-Ren Hungarian Research Centre for Linguistics /Hellenic American University,Dániel Z. Kádár, Dalian University of Foreign Languages/Hun-Ren Hungarian Research Centre for Linguistics/University of Maribor
In Chapter 4 we discuss the pitfall of associating positive and negative values with political actors, including both individuals such as Trump or Biden, and political entities such as the US and the EU. In our view, such an association is problematic and dangerous because it precludes approaching language and politics in a more neutral way. As a case study, we analyse the transcript of an unofficial tape recording in which representatives of the EU – which is often regarded as a democratic organisation – attempted to prevent the newly established Slovenian and Croatian states from declaring independence following plebiscites. We use strictly linguistic evidence to illustrate the rather undemocratic procedure through which representatives of the EU – who were supposed to be the upholders of democracy – aggressively persuaded Slovenians and Croatians to temporally suspend declaring independence, hence opposing the results of valid plebiscites.
Julianne House, Universität Hamburg/Hun-Ren Hungarian Research Centre for Linguistics /Hellenic American University,Dániel Z. Kádár, Dalian University of Foreign Languages/Hun-Ren Hungarian Research Centre for Linguistics/University of Maribor
In Chapter 9, we look at how the pragmatician can capture the interactional dynamics of seemingly confusing cases of aggression in mediated political settings. In mediated scenes of politics, conflict may evolve in a seemingly ad hoc way, and in order to be able to analyse such settings it is necessary to linguistically analyse exactly what is happening in them. As a case study, we present a corpus of heckling incidents, including cases such as when the previous US first lady Michelle Obama was heckled in public. We argue that while heckling appears as a ‘disorderly’ incident, manifestations of heckling can be systematically categorised into major types, which impose different ritual frames on the public speaker being heckled. Following this view, our analysis shows that heckling is a standard situation in which the participants actually follow conventional forms of behaviour.
Richard Tremblay started his professional career as a clinician with juvenile delinquents and mentally ill offenders. He spent the rest of his career doing longitudinal and experimental studies to identify effective preventive interventions during the preschool and elementary school years. Results from these studies showed that early interventions with at risk children and their parents had very long-term impacts. Within these longitudinal studies, he also studied genetic and epigenetic effects on the development of violent behavior.
There has been concern about violent acts and other criminal behaviour by people with a possible history of mental health problems. We therefore assessed the effects of community treatment orders (CTOs) on self-, third-party-, and agency-reported criminal behaviour when compared to voluntary treatment.
Methods
A systematic search of PubMed/Medline, Embase, PsycINFO and criminal justice bibliographic databases for observational or randomised controlled trials (RCTs) comparing CTO cases with controls receiving voluntary psychiatric treatment. Relevant outcomes were reports of violence and aggression or contacts with the criminal justice system such as arrests and court appearances.
Results
Thirteen papers from 11 studies met inclusion criteria. Nine papers came from the United States and four from Australia. Two papers were of RCTs. Results for all outcomes were non-significant, the effect size declining as study design improved from non-randomised data on self-reported criminal behaviour, through third party criminal justice records and finally to RCTs. Similarly, there was no significant finding in the subgroup analysis of serious criminal behaviour.
Conclusions
On the limited available evidence, CTOs may not address aggression or criminal behaviour in people with mental illness. This is possibly because the risk of violence is increased by comorbid or nonclinical variables, which are beyond the scope of CTOs. These include substance use, a history of victimisation or maltreatment, and the wider environment. The management of risk should therefore focus on the whole person and their community through social and public health interventions, not solely legislative control.
Co-occurring self-harm and aggression (dual harm) is particularly prevalent among forensic mental health service (FMHS) patients. There is limited understanding of why this population engages in dual harm.
Aims
This work aims to explore FMHS patients’ experiences of dual harm and how they make sense of this behaviour, with a focus on the role of emotions.
Method
Participants were identified from their participation in a previous study. Sixteen FMHS patients with a lifetime history of dual harm were recruited from two hospitals. Individuals participated in one-to-one, semi-structured interviews where they reflected on past and/or current self-harm and aggression. Interview transcripts were analysed using reflexive thematic analysis.
Results
Six themes were generated: self-harm and aggression as emotional regulation strategies, the consequences of witnessing harmful behaviours, relationships with others and the self, trapped within the criminal justice system, the convergence and divergence of self-harm and aggression, and moving forward as an FMHS patient. Themes highlighted shared risk factors of dual harm across participants, including emotional dysregulation, perceived lack of social support and witnessing harmful behaviours. Participants underlined the duality of their self-harm and aggression, primarily utilising both to regulate negative emotions. These behaviours also fulfilled distinct purposes at times (e.g. self-harm as punishment, aggression as defence). The impact of contextual factors within FMHSs, including restrictive practices and institutionalisation, were emphasised.
Conclusions
Findings provide recommendations that can help address dual harm within forensic settings, including (a) transdiagnostic, individualised approaches that consider the duality of self-harm and aggression; and (b) cultural and organisational focus on recovery-centred practice.
Antisocial personality disorder (ASPD) is a mental condition in which a person exhibits a pattern of repeated disregard for and violation of others’ rights. The Diagnostic and Statistical Manual of Mental Disorders (DSM) provides the framework for diagnosing ASPD. The prevalence rate of ASPD is high in prisons. Genetics, epigenetics, neuroscience, sociology, epidemiology, psychology, and other behavioral science fields have attempted to find a primary etiology. Despite decades of research, the precise etiology of ASPD has not been found, and its pathophysiology remains a complex question. The interaction between genes and the environment appears to be a significant factor in the development of ASPD. Brain imaging in subjects with ASPD has revealed structural brain changes in those with ASPD. Individuals with ASPD are challenging to manage for health care providers because of their complicated clinical presentation, high comorbidity of medical and mental disorders, lack of licensed pharmacotherapies for ASPD, and increased utilization of healthcare resources. ASPD requires tremendous effort from treating clinicians. Clinicians can successfully manage individuals with ASPD if they remain aware of the unique challenges of these patients while thoughtfully applying available research.
This systematic review and meta-analysis evaluates the prevalence of disruptive mood dysregulation disorders (DMDD) in community-based and clinical populations.
Methods
PubMed and PsychINFO databases were searched, using terms specific to DMDD, for studies of prevalence and comorbidity rates conducted in youths below 18.
Results
Fourteen studies reporting data from 2013 to 2023 were included. The prevalence of DMDD in the community-based samples was 3.3% (95% confidence interval [CI], 1.4–6.0) and 21.9% (95% CI, 15.5–29.0) in the clinical population. The differences in the identification strategy of DMDD were associated with significant heterogeneity between studies in the community-based samples, with a prevalence of 0.82% (95% CI, 0.11–2.13) when all diagnosis criteria were considered. Anxiety, depressive disorders, and ADHD were the most frequent comorbidity present with DMDD. The association with other neurodevelopmental disorders remained poorly investigated.
Conclusions
Caution is required when interpreting these findings, considering the quality of the reviewed data and the level of unexplained heterogeneity among studies. This review stresses the importance of considering a strict adhesion to DMDD criteria when exploring its clinical correlates.
Aggression is often defined with reference to the intended consequences of an act exhibited by a person, or as any behaviour exhibited by a person where they intentionally acted to cause harm to another. Behaviours which cause harm but without associated intent tend not to be defined as aggression. Some people with intellectual disability may engage in behaviours with intent to cause harm to another, while for others, especially those with severe to profound intellectual disability, an absence of intent may exist. Aggressive behaviour exhibited by people with intellectual disability can take the form of verbal threats, physical aggression directed towards others including punching, kicking, slapping and biting, amongst other behaviours, as well as property damage and destruction. Aggressive behaviour can cause serious harm to others which may be life-threatening and result in social exclusion and a reduced quality of life. This chapter provides an overview of severe aggression and self-injurious behaviour relevant to people with disorders of intellectual development, and focuses on the evidence base for the various challenging behaviours and whether there is benefit from medication or alternative approaches.
Agitation is a neuropsychiatric syndrome that is commonly seen in those with major neurocognitive disorders. Those demonstrating agitation can show increase in motor activity, restlessness, emotional distress, and physical or verbal aggression. Agitation is the third most common neuropsychiatric symptom in dementia after apathy and depression. Up to 80% of people with dementia experience some degree of agitation at some point during the course of the illness. The pharmacologic management of agitation in those with major neurocognitive disorders is complex and many studies have shed light on the topic.
Biopsychosocial-spiritual distress, also known as agitation, can be experienced by anyone with unmet biological needs, safety needs, need for love and belonging, and need for self-actualization. Signs of potential biopsychosocial-spiritual distress can include: restlessness, aggression, agitation, sundowning, wandering, exit seeking, social withdrawal, repetitive behaviors, and increased anxiety. Common unmet biopsychosocial needs in long-term care can include loneliness, boredom, pain, hunger, toileting issues, difficulty communicating needs, medical interventions, changes in routine, interpersonal conflicts, staff issues, and issues with other residents. Potential signs of psychosis in those with major neurocognitive disorders can include screaming out, picking at the skin, extreme agitation with personal care, talking to oneself, signs of compulsive behaviors, and the presence of paranoia. The presence of psychosis in major neurocognitive disorder may warrant the use of antispsychotic angents.
Abstract: Chapter 4 tells stories of mischievous, naughty and fierce boys and girls, prompting us to rethink gendered moralities and how they are learned in childhood. Systematic behavioral analyses reveal gendered patterns in children’s moral experience, for example, boys initiate physical aggression, dominance and swearing more than girls, but girls assert themselves in more subtle ways, such as through tattling and scolding. I further explore how children’s learning of authority, aggression, boyhood, and violence is shaped by their family life as well as the larger historical trends. The chapter also examines how young girls understand their own situations and defend themselves. Despite the entrenched son-preference in this community, little girls are far from passive or submissive. To honor Arthur Wolf’s legacy on marriage and adoption and offer new insights on young girls’ emotional experience, which was not addressed in Wolf’s previous works, I present the case of an adopted daughter: an “unruly” girl who defies parental commands, asserts her own will, and negotiates love-hate relationships with different family members.
Building on the success of previous editions (Cryer et al.), this popular textbook is now expanded and updated in a 5th edition featuring two new co-authors, Elies van Sliedregt and Valerie Oosterveld. A market leader and one of the most globally trusted textbooks on international criminal law, it is known for its accessible and engaging tone and for an even-handed approach that is both critical and constructive. Comprehensively updated and rewritten, this new edition introduces readers to the main concepts of international criminal law, as well as the domestic and international institutions that enforce it, and addresses the latest challenges and controversies surrounding the International Criminal Court. Written by a team of international criminal lawyers who have extensive academic and practical experience in the field, the book engages with critical questions, political and moral challenges, and alternatives to international justice. It contains helpful references to other literature, making it a valuable research resource.