Potentiation of Divergent Medial Amygdala Pathways Drives Experience-Dependent Aggression Escalation.

Heightened aggression can be serious concerns for the individual and society at large and are symptoms of many psychiatric illnesses, such as post-traumatic stress disorder. The circuit and synaptic mechanisms underlying experience-induced aggression increase, however, are poorly understood. Here we find that prior attack experience leading to an increase in aggressive behavior, known as aggression priming, activates neurons within the posterior ventral segment of the medial amygdala (MeApv). Optogenetic stimulation of MeApv using a synaptic depression protocol suppresses aggression priming, whereas high-frequency stimulation enhances aggression, mimicking attack experience. Interrogation of the underlying neural circuitry revealed that the MeApv mediates aggression priming via synaptic connections with the ventromedial hypothalamus (VmH) and bed nucleus of the stria terminalis (BNST). These pathways undergo NMDAR-dependent synaptic potentiation after attack. Furthermore, we find that the MeApv-VmH synapses selectively control attack duration, whereas the MeApv-BNST synapses modulate attack frequency, both with no effect on social behavior. Synaptic potentiation of the MeApv-VmH and MeApv-BNST pathways contributes to increased aggression induced by traumatic stress, and weakening synaptic transmission at these synapses blocks the effect of traumatic stress on aggression. These results reveal a circuit and synaptic basis for aggression modulation by experience that can be potentially leveraged toward clinical interventions.SIGNIFICANCE STATEMENT Heightened aggression can have devastating social consequences and may be associated with psychiatric disorders, such as post-traumatic stress disorder. The circuit and synaptic mechanisms underlying experience-induced aggression escalation, however, are poorly understood. Here we identify two aggression pathways between the posterior ventral segment of the medial amygdala and its downstream synaptic partners, the ventromedial hypothalamus and bed nucleus of the stria terminalis that undergo synaptic potentiation after attack and traumatic stress to enhance aggression. Notably, weakening synaptic transmission in these circuits blocks aggression priming, naturally occurring aggression, and traumatic stress-induced aggression increase. These results illustrate a circuit and synaptic basis of aggression modulation by experience, which can be potentially targeted for clinical interventions.

Quantifying behaviors of children with Sanfilippo syndrome: the Sanfilippo Behavior Rating Scale.

The Sanfilippo Behavior Rating Scale (SBRS), a 68 item questionnaire, has been developed to assess the behavioral phenotype of children with Sanfilippo syndrome and its progression over time. Fifteen scales rate orality, movement/activity, attention/self-control, emotional function including anger and fear, and social interaction. Items within scales intercorrelate; measures of internal consistency are adequate. Twelve scales are grouped into 4 abnormality clusters: Movement, Lack of fear, Social/emotional and Executive Dysfunction. A Loess age-trajectory analysis showed that Lack of Fear, Social/Emotional and Executive Dysfunction increased steadily with age; Orality and Mood/Anger/Aggression leveled off. Movement peaked around 6years, then declined as children's excessive/purposeless actions stopped. Compared with standard scales, SBRS Movement was appropriately associated with the Vineland Motor scale; SBRS Lack of Fear had significant associations with the Autism Diagnostic Observation Schedule (ADOS), indicating a symptom overlap between Sanfilippo syndrome and autism. This suggests that reduced fearfulness may be the most salient/sensitive SBRS marker of disease progression. Volumetric MRI showed that increased Lack of Fear was significantly associated with reduced amygdala volume, consistent with our hypothesis that the behavior seen in Sanfilippo syndrome is a variant of Klüver-Bucy syndrome. Hippocampal volume loss had twice the effect on Social-Emotional Dysfunction as amygdala loss, consistent with a hippocampal role in attachment and social emotions. In conclusion, the SBRS assesses the Sanfilippo behavioral phenotype; it can measure behavior change that accompanies disease progression and/or results from treatment.

Acquired autistic behaviors in children with mucopolysaccharidosis type IIIA.

OBJECTIVES: To assess autism spectrum disorder (ASD) behaviors in children with mucopolysaccharidosis type IIIA (MPS IIIA) using a standard measure, understand the behavioral evolution of the disease, and provide specific guidelines for diagnosis. STUDY DESIGN: Children (n = 21) with documented enzyme deficiency and SGSH gene mutations, cognitive age-equivalent >12 months, and early onset were administered the Autism Diagnostic Observation Schedule (ADOS) (module 1) and Bayley Scales of Infant Development-Third Edition. ADOS Social Affect and Restricted Repetitive Behavior total scores, as well as Bayley Scales of Infant Development-Third Edition cognitive age-equivalent scores, are reported using descriptive statistics and graphic presentations. RESULTS: Thirteen of the 21 children evaluated met the ADOS criteria for ASD/autism. ADOS score was strongly associated with age; all 11 children aged >46 months met the criteria, compared with only 2 of 10 aged <46 months. Social and affective abnormalities were most frequent; restricted interests and repetitive behaviors were largely absent. Lack of cognitive growth paralleled ADOS score. CONCLUSION: An increased incidence of ASD-like social behaviors was seen at age 3-4 years in children with early-onset MPS IIIA. Although more frequent in the severely impaired children, ASD-like behaviors were observed across the entire range of cognitive impairment. Clinicians must be aware that when a child acquires ASD-like behaviors, MPS IIIA should be included in the differential diagnosis.

Revenge: an adaptive system for maximizing fitness, or a proximate calculation arising from personality and social-psychological processes?

Revenge appears among a "suite" of social interactions that includes competition, alliance building (a prerequisite for tribal revenge raids), and so forth. Rather than a modular "system" directly reflecting evolutionary fitness constraints, revenge may be (another) social cost-benefit calculation involving potential or actual aggression and proximately controlled by individual personality characteristics and beliefs that can work against fitness.

Levels of Aggression Escalation in Adult/Geriatric Occupational Therapy Workplaces.

Workplace aggression can escalate from verbal to physical, adding risk of physical injury to negative psychological impact. Understanding escalation is necessary to develop effective violence intervention/prevention programs, but its occurrence is not well documented. An online survey determined if and how aggression escalates in occupational therapy (OT) workplaces. Because local culture can influence workplace events we compared surveys from northeastern states with the lowest rates of homicide to southeastern states with the highest. Ninety four OTs working in southeastern or northeastern states reported details of the most recent verbal and/or physical aggressive event initiated by clients (NIOSH Type 2) or staff (NIOSH Type 3) they witnessed or experienced in the workplace within the last year. Aggressor status, motivation, actions; therapist reactions, injuries and psychological sequelae were queried in logical order. Behavior inter-correlation followed by cluster analysis determined if levels of escalation could be detected. Analyses grouped events into five escalation levels in which progressively more hostile or damaging behaviors were added at each successive level. Higher levels involved known risk factors: Younger, reactively angry clients with prior aggression histories escalated attacks to involve restraint, calls for help and physical injury. Southeastern aggressor/target interactions appeared more combative, seemingly regardless of personal risk. Remarkably, northeastern OTs reported significantly more positive and fewer negative feelings across levels of escalation. OT workplace aggression occurs frequently, can escalate to injurious levels and requires prevention/intervention. How therapists maintain positive attitudes in the face of violence deserves further study.

Non-angry aggressive arousal and angriffsberietschaft: A narrative review of the phenomenology and physiology of proactive/offensive aggression motivation and escalation in people and other animals.

Human aggression typologies largely correspond with those for other animals. While there may be no non-human equivalent of angry reactive aggression, we propose that human proactive aggression is similar to offense in other animals' dominance contests for territory or social status. Like predation/hunting, but unlike defense, offense and proactive aggression are positively reinforcing, involving dopamine release in accumbens. The drive these motivational states provide must suffice to overcome fear associated with initiating risky fights. We term the neural activity motivating proactive aggression "non-angry aggressive arousal", but use "angriffsberietschaft" for offense motivation in other animals to acknowledge possible differences. Temporal variation in angriffsberietschaft partitions fights into bouts; engendering reduced anti-predator vigilance, redirected aggression and motivational over-ride. Increased aggressive arousal drives threat-to-attack transitions, as in verbal-to-physical escalation and beyond that, into hyper-aggression. Proactive aggression and offense involve related neural activity states. Cingulate, insular and prefrontal cortices energize/modulate aggression through a subcortical core containing subnuclei for each aggression type. These proposals will deepen understanding of aggression across taxa, guiding prevention/intervention for human violence.

Reduced Gain and Shortened Time Constant of Vestibular Velocity Storage as a Source of Balance and Movement Sensitivities in Gravitational Insecurity.

Gravitational insecurity (GrI) involves lifetime movement and balance concerns whose pathophysiological origins are unclear. We tested whether balance symptoms in mild GrI might involve anomalies in vestibular velocity storage (VVS), a brainstem/cerebellar circuit that amplifies gain and prolongs the persistence of weak vestibular signals from small/slow head movements. A Provisional Gravitational Insecurity Index (PGrI) was developed, evaluated for psychometrics/demographics, and used to identify otherwise healthy adults with life-long balance challenges as well as sex, age, and ethnicity-matched comparison adults without such challenges. Balance confidence, sensory hypersensitivities, spatial orientation, anxiety, and hearing loss were self-reported. Standing balance under visual/proprioceptive restrictions and perrotary vestibulo-ocular nystagmus were evaluated. The PGrI showed approximated test-retest reliability and convergent and discriminant validity. When only vestibular input was available, mild GrI participants on a tilting platform used effortful hip strategies for balance significantly more than did comparison participants. Rotation testing revealed that mild GrI participants had significantly less low frequency gain and shortened VVS persistence. Combined, these two parameters correlated significantly with PGrI. The PGrI also correlated with problematic spatial orientation, but surprisingly, not to anxiety. Balance/movement issues in GrI are likely due to VVS deficiencies. Additional mechanisms may account for other GrI symptoms. Better understanding of GrI's pathophysiological basis will be useful in informing the larger health-provider community about this condition.

Liquid risperidone in the treatment of rages in psychiatrically hospitalized children with possible bipolar disorder.

OBJECTIVE: To examine the safety and efficacy of liquid risperidone to reduce duration of rages in children with severe mood dysregulation (SMD) or possible bipolar disorder (BP). METHOD: The sample included 151 consecutive admissions of 5-12 year old children to a psychiatric inpatient unit. Diagnostic information and history of prior rage outbursts were obtained at admission. In hospital, a first rage was treated with seclusion. If a second rage occurred, the child was offered liquid risperidone to help him/her regain control. Durations of unmedicated and last medicated rage were compared. Rage frequency in children with SMD and several definitions of BP were compared. RESULTS: Although 82 of 151 admissions were prompted by rages, rages occurred during only 49 hospitalizations and occurred more than once in only 24. In 16 multiply medicated children, duration of rages dropped from a baseline of 44.4 +/- 20.2 min to 25.6 +/- 12.5 min at the child's last dose. Neither SMD nor any definition of BP influenced rage response in this small sample. The average liquid risperidone dose was 0.02 mg/kg. All but two children also took atypical antipsychotics daily. In the evaluation of medicated rage episodes with standard rating scales, no extrapyramidal side effects, akathisia, or abnormal involuntary movements were observed, and the rate of sedation/sleepiness (7/67 = 10.4%) was similar and not significantly different from that observed during nonmedicated episodes (8/46 = 17.4%). CONCLUSIONS: Liquid risperidone may be a safe and effective way to shorten the duration of rage episodes regardless of diagnosis. However, definitive conclusions cannot be drawn in the absence of a placebo control as children were also receiving other behavioral and psychopharmacologic treatments.

The behavioral organization, temporal characteristics, and diagnostic concomitants of rage outbursts in child psychiatric inpatients.

Angry outbursts, sometimes called rages, are a major impetus for the psychiatric hospitalization of children. In hospitals, such outbursts are a management problem and a diagnostic puzzle. Among 130 4- to 12-year-olds successively admitted to a child psychiatry unit, those having in-hospital outbursts were likely to be younger, have been in special education, have had a preadmission history of outbursts, and to have a longer hospital stay. Three subsets of behaviors, coded as they occurred in 109 outbursts, expressed increasing levels of anger; two other subsets expressed increasing levels of distress. Factor structure, temporal organization, and age trends indicated that outbursts are exacerbations of ordinary childhood tantrums. Diagnostically, children with outbursts were more likely to have language difficulty and a trend toward attention-deficit/hyperactivity disorder. Outbursts of children with anxiety diagnoses showed significantly more distress relative to anger. Outbursts were not especially associated with our small sample of bipolar diagnoses.

Rages or temper tantrums? The behavioral organization, temporal characteristics, and clinical significance of angry-agitated outbursts in child psychiatry inpatients.

Angry, agitated outbursts (AAOs) are a common precipitant of children's psychiatric hospitalization. In the hospital, AAOs present both management and diagnostic challenges, e.g., while they have recently been described as manic "rages", older studies suggest that they may be exacerbated temper tantrums. Factor analyses of 109 AAOs had by 46 hospitalized 4-12 year olds yielded 3 subsets of behaviors expressing different intensities of anger and 2 subsets expressing different intensities of distress (sadness). Cluster analysis of behavior time course supported the anger-distress distinction; the former behaviors are most probable at AAO onset and then decline while the latter are more evenly distributed across the outburst. Age trends, factor structure, and temporal organization of AAOs all indicate that they are exacerbated tantrums. The AAOs of children with anxiety or PDD diagnoses showed significantly more distress relative to anger. AAOs have clinical implications; their particular characteristics may have diagnostic significance.

Responses to dominance challenge are a function of psychopathy level: A multimethod study.

This study assesses the relationship between psychopathy and dominance, both as a trait level and in 2 interpersonal contexts. Following the interpersonal circumplex model, we expected that interacting with a dominant interviewer would reduce dominance displays by low psychopathy participants (interpersonal complementarity) but might increase such displays in those with higher psychopathy (anticomplementarity). Psychopathic traits and dominance were assessed in a community sample (N = 91) using multiple dominance indicators: self-reported overall dominance level, job preference, dominance displays observed during identical interviews with a subordinate and dominant interviewer, and baseline and postinterview measures of personal space and testosterone level. Psychopathic traits were positively related to dominance on both trait measures and in the interviews. As a trait, higher self-reported psychopathy scores were associated with higher levels of self-reported dominance and preference for supervisory job positions. Higher Factor 1 psychopathy scores were associated with increased dominance display in interaction with the dominant interviewer. Higher Factor 2 scores were associated with allowing the dominant interviewer to approach more closely (reduced physical distancing). Psychopathy was partly related to a delayed increase in testosterone levels after interaction. Psychopathic traits may include a general tendency to dominate, a tendency which increases when interacting with a dominant other. The emotional/interpersonal psychopathy factor is specifically related to increased dominance displays when interacting with a dominant individual, while the behavioral factor of psychopathy is related to reduced physical distancing of a dominant partner. At higher psychopathy levels the general rule of dominant-subordinate reciprocity during social interaction is reversed. (PsycINFO Database Record

Tantrums, Emotion Reactions and Their EEG Correlates in Childhood Benign Rolandic Epilepsy vs. Complex Partial Seizures: Exploratory Observations.

We explored associations between EEG pathophysiology and emotional/behavioral (E/B) problems of children with two types of epilepsy using standard parent questionnaires and two new indicators: tantrums recorded by parents at home and brief, emotion-eliciting situations in the laboratory. Children with Benign Rolandic epilepsy (BRE, N = 6) reportedly had shorter, more angry tantrums from which they recovered quickly. Children with Complex Partial Seizures (CPS, N = 13) had longer, sadder tantrums often followed by bad moods. More generally, BRE correlated with anger and aggression; CPS with sadness and withdrawal. Scores of a composite group of siblings (N = 11) were generally intermediate between the BRE and CPS groups. Across all children, high voltage theta and/or interictal epileptiform discharges (IEDs) correlated with negative emotional reactions. Such EEG abnormalities in left hemisphere correlated with greater social fear, right hemisphere EEG abnormalities with greater anger. Right hemisphere localization in CPS was also associated with parent-reported problems at home. If epilepsy alters neural circuitry thereby increasing negative emotions, additional assessment of anti-epileptic drug treatment of epilepsy-related E/B problems would be warranted.

Sequence and priming in 15 month-olds' reactions to brief arm restraint: evidence for a hierarchy of anger responses.

Brief, gentle arm restraint is widely used in experimental studies of children's anger, but the pattern of responses generated by such restraint has been incompletely described. We now describe a hierarchy of responses within trials as well as an escalation across trials that have both methodological and theoretical significance. Mothers of 87 15-month olds prevented them from playing with a toy by restraining their arms on two consecutive 30 sec trials. Physical struggling was the first and most frequent response; children who struggled were significantly more likely to vocalize, and those who vocalized were significantly more likely to show facial expressions of anger. The children's responses became more probable, rapid, and intense during Trial 2 restraint. Overall, the hierarchy was orderly enough to meet criteria for Guttman scalability. The particular sequence observed suggests situational, as opposed to bio-energetic, ordering of responses. Methodologically, the two trial paradigm is a simple, ecologically valid model for studying anger escalation that parallels the "attack priming" of aggression in other species. The magnitude and persistence of anger priming may provide novel measures of anger regulation. Theoretically, the existence of an orderly response hierarchy is consistent with previous observations suggesting that, within a situational context, the sequential appearance of specific behaviors may indicate progressive increases in anger intensity.

Previously unrecognized behavioral phenotype in Gaucher disease type 3.

OBJECTIVE: To provide a comprehensive description of abnormal behaviors in patients with Gaucher disease type 3 (GD3) and relate these behaviors to demographic, neurodevelopmental, and neurologic characteristics. METHODS: Thirty-four Egyptian patients with GD3 (mean age of 7.9 years) were enrolled in the study. They were selected based on parent report and/or physician observation of one or more abnormal behaviors documented in 2 settings and by 2 different individuals and/or by video recording. Behaviors were grouped into 4 categories: Crying/Withdrawal, Impatience/Overactivity, Anger/Aggression, and Repetitive Acts. Baseline and follow-up 6-12 monthly neurologic evaluations included IQ assessment and an EEG. All patients were receiving enzyme replacement therapy (30-60 IU/kg every 2 weeks) and were followed for periods of 3-10 years. RESULTS: Supranuclear palsy of horizontal gaze, and of both horizontal and vertical gaze, bulbar symptoms, seizures, convergent strabismus, abnormal gait, and neck retroflexion were present in 97.1%, 50%, 55.9%, 29.4%, 29.4%, 20.6%, and 4.4% of patients, respectively. The most abnormal behavioral features were excessive anger (88.2%) and aggression (64.7%), and both were significantly higher in males. Anger/Aggression scores were highly correlated with IQ but not with either EEG/Seizure status or neurologic signs. CONCLUSIONS: We describe behavioral problems with a unique pattern of excessive anger and aggression in patients with GD3. Defining these components using quantitative behavioral scoring methods holds promise to provide a marker of neurologic disease progression and severity.

Temper tantrums in young children: 1. Behavioral composition.

Although tantrums are among the most common behavioral problems of young children and may predict future antisocial behavior, little is known about them. To develop a model of this important phenomenon of early childhood, behaviors reported in parental narratives of the tantrums of 335 children aged 18 to 60 months were encoded as present or absent in consecutive 30-second periods. Principal Component (PC) analysis identified Anger and Distress as major, independent emotional and behavioral tantrum constituents. Anger-related behaviors formed PCs at three levels of intensity. High-intensity anger decreased with age, and low-intensity anger increased. Distress, the fourth PC, consisted of whining, crying, and comfort-seeking. Coping Style, the fifth PC, had high but opposite loadings on dropping down and running away, possibly reflecting the tendency to either "submit" or "escape." Model validity was indicated by significant correlations of the PCs with tantrum variables that were, by design, not included in the PC analysis.

Temper tantrums in young children: 2. Tantrum duration and temporal organization.

This article completes the analysis of parental narratives of tantrums had by 335 children aged 18 to 60 months. Modal tantrum durations were 0.5 to 1 minute; 75% of the tantrums lasted 5 minutes or less. If the child stamped or dropped to the floor in the first 30 seconds, the tantrum was likely to be shorter and the likelihood of parental intervention less. A novel analysis of behavior probabilities that permitted grouping of tantrums of different durations converged with our previous statistically independent results to yield a model of tantrums as the expression of two independent but partially overlapping emotional and behavioral processes: Anger and Distress. Anger rises quickly, has its peak at or near the beginning of the tantrum, and declines thereafter. Crying and comfort-seeking, components of Distress, slowly increase in probability across the tantrum. This model indicates that tantrums can provide a window on the intense emotional processes of childhood.

Sex differences in childhood anger and aggression.

There are few differences in the frequency or intensity of men's and women's self-reported or observed anger. Women are more likely to be angered by relationship conflicts than men. Men are more frequently the targets of anger than women. Typically, men see the expression of anger as exerting dominance, where as women view it as a loss of control. There are also sex differences in the mode of anger expression. At ages 8 and older, girls are more likely to engage in "relational" aggression (eg, deliberate social ostracism). The most consistent and salient difference in anger expression is women's tendency to cry when angry, whereas men are more likely to throw things or hit. The difference in physical aggression appears in children who are as young as 1 to 2 years of age. Despite an overall reduction in physical aggression after 2 to 3 years of age, the sex difference remains consistent into adulthood. In contrast to differences in physical aggression, differences in anger are few and inconsistent up to 4 or 5 years of age. By this age, girls tend to suppress the expression of anger consciously. By about 7 to 8 years of age, adult like differences become more consistent, with boys expressing more anger.

Mucopolysaccharidosis Type IIIA presents as a variant of Klüver-Bucy syndrome.

Mucopolysaccharidosis Type IIIA (MPS IIIA) is a neurodegenerative disease with behavioral symptoms unique among the mucopolysaccharidoses. Children with MPS IIIA reportedly mouth things, explore novel environments almost continuously, disregard danger, and empathize/socialize and comply less with parents. These characteristics resemble Klüver-Bucy syndrome (K-Bs). To test the K-Bs hypothesis, 30 children with MPS IIIA were compared to 8 "posttransplant" mucopolysaccharidosis Type IH patients in an experimental "risk room." The room contained attractive and mildly frightening objects, exposure to a 92-dB startle noise triggered by contact with an attractive toy, mother's return after a brief absence, and compliance with her cleanup directive. Children with MPS IIIA: (a) left mother sooner, (b) wandered more, (c) were more likely to approach frightening objects, (d) were less likely to respond to loud noise with whole body startle, (e) were less likely to avoid the toy associated with the startle noise, (f) interacted less with mother upon her return, and (g) complied less with her cleanup command. K-Bs is associated with loss of amygdala function. Brain magnetic resonance imaging (MRI) of a subset of the children with MPS IIIA showed volume loss that was greater in the amygdala than in the hippocampus; only amygdala loss correlated with reduced fearfulness. MPS IIIA may be the first identified pediatric disease presenting systematically as a K-Bs variant. If validated by further studies, the K-Bs hypothesis of MPS IIIA would provide important clinical and theoretical information for the guidance of families as well as markers for natural disease progression and treatment effects.

Temporal and frontal lobe initiation and regulation of the top-down escalation of anger and aggression.

The widespread, across-species strategy of stagewise escalation of aggression in agonistic encounters can be understood in terms of resource capture and control with least risk and cost. Human anger likely follows similar principles. As an adaptive phenomenon, escalation may involve particular neural circuitry. To advance beyond a standard view that the frontal lobe tonically inhibits subcortical circuits of aggression, a model is proposed which starts with the general rostrally directed flow of information in the brain. Earlier stage processing of visual and auditory input is transmitted from posterior and middle temporal cortices to anterior temporal lobe where rudimentary appraisals of threat and provocation are developed. These directly but diffusely activate cortical/subcortical anger/aggression response systems. At the same time, the anterior temporal loci transmit the modality-specific perceptual information to orbito-frontal cortex where it is integrated with information about, e.g., the opponent's relative dominance/social status and evaluated for likelihood of potential rewards and punishments associated with different modes of responding and so forth. These frontal areas then impose an inhibitory gating or modulation and focusing of activity initiated by the anterior temporal loci through their projections to GABAergic interneurons in the same cortical/subcortical circuits. Escalation occurs as the inhibition imposed by the frontal areas is progressively lifted. Exploration of the implications, applications and hypotheses flowing from this model will improve our understanding of the biologically important and socially significant phenomena of escalation.

Screaming, yelling, whining, and crying: categorical and intensity differences in vocal expressions of anger and sadness in children's tantrums.

Young children's temper tantrums offer a unique window into the expression and regulation of strong emotions. Previous work, largely based on parental report, suggests that two emotions, anger and sadness, have different behavioral manifestations and different time courses within tantrums. Individual motor and vocal behaviors, reported by parents, have been interpreted as representing different levels of intensity within each emotion category. The present study used high-fidelity audio recordings to capture the acoustic features of children's vocalizations during tantrums. Results indicated that perceptually categorized screaming, yelling, crying, whining, and fussing each have distinct acoustic features. Screaming and yelling form a group with similar acoustic features while crying, whining, and fussing form a second acoustically related group. Within these groups, screaming may reflect a higher intensity of anger than yelling while fussing, whining, and crying may reflect an increasing intensity of sadness.