Understanding Chronic Aggression and Its Treatment in Children and Adolescents

Curr Psychiatry Rep. 2019 Nov 18;21(12):123. doi: 10.1007/s11920-019-1105-1.

Abstract

Purpose of review: Youth aggression is common and has a significant burden on individuals, families, and society. However, its treatment is often a challenge for clinicians. Thus, this review will examine the current understanding of youth aggression, conceptualize aggression as a symptom rather than its own disorder, and provide an overview of treatment strategies.

Recent findings: Youth aggression is associated with complex genetic, neurobiological, and environmental risks. Prevention strategies are of the utmost importance for at-risk families and youth. Psychosocial interventions are the first line treatment. But if not fully effective, then pharmacologic interventions-including psychostimulants, alpha-2 agonists, atomoxetine, and risperidone-have shown benefits. Other medications, such as SSRIs, can be useful in certain scenarios. It is important to conceptualize youth aggression as being a trans-diagnostic symptom in psychopathology. Determining the underlying cause of aggression will help to guide treatment.

Keywords: ADHD; Aggression; Antipsychotic; Conduct; ODD; Pediatric; Stimulant; Treatment.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Aggression / drug effects*
  • Aggression / psychology
  • Antipsychotic Agents / therapeutic use
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / genetics
  • Attention Deficit Disorder with Hyperactivity / psychology
  • Attention Deficit and Disruptive Behavior Disorders / drug therapy*
  • Attention Deficit and Disruptive Behavior Disorders / genetics
  • Attention Deficit and Disruptive Behavior Disorders / psychology
  • Central Nervous System Stimulants / therapeutic use*
  • Child
  • Humans
  • Risperidone / therapeutic use

Substances

  • Antipsychotic Agents
  • Central Nervous System Stimulants
  • Risperidone