Aggressiveness, inhibitory control, and emotional states: A provocation paradigm.

The current study examines the effects of trait aggressiveness, inhibitory control and emotional states on aggressive behavior in a laboratory paradigm. One hundred and fifty-one adult participants took part (73 men, 71 women, and 7 nondisclosed). Event Related Potentials (ERPs) during a Go/No-Go task were utilized to capture the extent of inhibitory processing, with a laboratory provocation paradigm used to assess aggression. Contrary to the expectations, negative affective responses to provocation were negatively associated only with short-lived aggression and only among those with high past aggressiveness. Furthermore, past aggressiveness was related to a continuous increase in laboratory aggressive behavior regardless of the level of inhibitory control (P3 difference amplitude). However, feeling hostile was associated with short-lived aggressive behavior, only in those with lower levels of inhibitory control. These findings demonstrate the effect of distinct mechanisms on different patterns of aggressive behavior.

Being on top versus not dangling at the bottom: Popularity motivation and aggression in youth.

Whereas research on aggression and status motivation in youth has predominantly looked at a promotion focus (striving for popularity), a prevention focus (wanting to avoid low popularity) could also be an important determinant of aggression, as youth who fear low popularity may use strategic aggression to secure their position. The aim of the current study was to develop reliable measures for both popularity motivations, and examine how both motivations are uniquely and jointly related to aggression. Participants were 1123 Dutch secondary school students (M age = 14.4 years, 48% girls), who completed a 3-item measure of striving for high popularity based on existing questionnaires (Li & Wright, 2014; Ojanen et al., 2005), and a 3-item measure of avoiding low popularity consisting of an adapted version of the high popularity items. Aggressive behavior was measured through peer nominations. Motivations were moderately correlated (r = .51), but did not always co-occur within the same person, as 17% of the sample belonged to a cluster that scored low on striving for popularity, but moderately high on avoiding low popularity. When considered simultaneously, striving for high popularity was not related to any type of aggression, whereas avoiding affiliation with unpopular peers was related to strategic aggression. For physical and verbal aggression, gossiping, excluding and bullying, the association of avoiding low popularity with aggression was strongest when youth also strived for high popularity. Future work should take both popularity motivations into account to better understand, predict and intervene on youth's aggression toward peers.

Aggression, psychological violence and sexual harassment in seafarers in France.

BACKGROUND: In a working environment that is predominantly male, very tough physically, with a difficult working environment, occupational exposures and working, verbal and physical aggression can be more frequent than in other sectors. Fishing, merchant shipping and yachting are all sectors where fitness to sail is reassessed every year by doctors in the Seafarers' Health Service. Seafarers are increasingly reporting insulting, violent or sexist behaviour. The main types of abuse seen on board can be verbal and/or physical aggression, humiliation, whether in private or in front of others. Sexual harassment of women is a very worrying subject. MATERIALS AND METHODS: It was a retrospective observational study which is part of the professional monitoring of seafarers. The target population was adult seafarers coming for a fitness to sail visit. The group was recruited from seafarers aged over 18 who were being monitored by one of the seafarers' health services (or local centres). The inclusion period was 4 months between January and April 2023. All the information was collected using a self-questionnaire developed from the questionnaires of the Surveillance Médicale des Expositions des Salariés au Risques Professionnels (SUMER) for health status, job satisfaction and the European mini-module, verbal and physical aggression and psychological violence at work (based on the Leymann questionnaire), sexual violence and aggression based on the sexual harassment questionnaire and the PCLS-5 scale validated and translated into French to assess post-traumatic stress. The population studied was therefore 788 sailors. RESULTS: The study population was predominantly male (82.3%). The average age was 41.4 years (standard deviation = 11.7). 46.7% of seafarers estimate being in very good health. During the past 12 months, overall, 24.5% of seafarers disclaimed having been victim in work-related context of a verbal aggression, with a significant difference according to the gender (21.1% for men and 41.0% for women). During the last 12 months, overall, 3.2% of seafarers have been victim in work-related context of a physical aggression (2.6% for men and 5.8% for women, NS), whereas 10.9% of seafarers reported hostile behaviour at present. Twenty per cent of seafarers reported sexual harassment in the last 12 months. During the entire working life of seafarers, 65.5% of women and 38.2% of men reported sexual harassment, and 38.8% of seafarers stated that they had experienced at least one traumatic event in the last 12 months. DISCUSSION: A quarter of seafarers say they have been the victim of verbal or physical aggression at work in the last twelve months. These figures are high, and higher than those of the global survey on violence and harassment at work carried out by the International Labour Organization. One of the most alarming results of our study is the overexposure of women working in the maritime industry to the risk of physical, verbal or sexual assault of any kind. Indeed, in all the questions concerning the experience of verbal and physical aggression, the number of women victims is twice as high as that of their male colleagues, and this difference is statistically significant. As far as prevention is concerned, it seems that an effort is needed in terms of information, since only one seafarer in two knows the procedure to follow in the event of aggression within their shipyard. Communication between shipowners and seafarers needs to be stepped up to ensure that everyone is familiar with the procedures.

Impact of racial microaggressions in psychotherapy vignettes with african american clients: An experimental analogue design.

Mental health researchers have focused on promoting culturally sensitive clinical care (Herman et al., 2007; Whaley & Davis, 2007), emphasizing the need to understand how biases may impact client well-being. Clients report that their therapists commit racial microaggressions-subtle, sometimes unintentional, racial slights-during treatment (Owen et al., 2014). Yet, existing studies often rely on retrospective evaluations of clients and cannot establish the causal impact of varying ambiguity of microaggressions on clients. This study uses an experimental analogue design to examine offensiveness, emotional reactions, and evaluations of the interaction across three distinct levels of microaggression statements: subtle, moderate, and overt. We recruited 158 adult African American participants and randomly assigned them to watch a brief counseling vignette. We found significant differences between the control and three microaggression statements on all outcome variables. We did not find significant differences between the microaggression conditions. This study, in conjunction with previous correlational research, highlights the detrimental impact of microaggressions within psychotherapy, regardless of racially explicit content. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Factors associated with the recurrence of violence against children and adolescents. Mato Grosso-Brazil, 2013 to 2019. / Fatores associados à recorrência de violência em crianças e adolescentes. Mato Grosso-Brasil, 2013 a 2019.

This study examined factors associated with the recurrence of interpersonal violence against children and adolescents in Mato Grosso state, considering cases recorded in the Notifiable Diseases Information System, from 2013 to 2019. Associations between variables were estimated by logistic regression and stratified by age group (children and adolescents). The frequency of recurrent violence against children was 49.0% and, against adolescents, 42.9%. For both, recurrent violence was positively associated with occurrence at home, psychological or emotional violence, aggressors' being more than two, their being relatives and threats being the means of aggression. Neglect or abandonment and male or both-sex aggressors were positively associated with recurrent violence against children. Against adolescents, poor education, sexual violence and intimate-partner aggressors were positively associated with recurrent violence, while other aggressors and firearms or physical force were negatively associated. The findings offer significant contributions to knowledge of factors associated with recurrent violence, which is still little studied in the national and international literature. This is essential in order to inform strategies to reduce the recurrence of violence and protect children and adolescents.

O objetivo do estudo foi analisar os fatores associados à recorrência da violência interpessoal contra crianças e adolescentes em Mato Grosso. Estudo com casos registrados no Sistema Informação de Agravos de Notificação no período de 2013 a 2019. A associação entre as variáveis foi estimada pela regressão logística, estratificada por faixa etária (crianças e adolescentes). A frequência da violência recorrente em crianças foi de 49,0%, e de 42,9% em adolescentes. Para ambos, a violência recorrente associou-se positivamente com ocorrência em residência, violência psicológica/moral, com mais de dois agressores envolvidos, agressores familiares e meio de agressão, ameaça. Para as crianças, negligência/abandono, sexo do agressor masculino ou ambos associaram-se positivamente com a recorrência da violência. Para adolescentes, baixa escolaridade, violência sexual e agressor parceiro íntimo estiveram associados positivamente à recorrência da violência, enquanto outros agressores e arma de fogo ou força corporal associaram-se negativamente. Os resultados trazem contribuições relevantes para o conhecimento dos fatores associados à violência recorrente, ainda pouco estudada na literatura nacional e internacional, sendo fundamental para apoiar estratégias de redução da recorrência da violência e de proteção às crianças e adolescentes.

Understanding the moral cognition of aggression: Longitudinal serial effects of personal relative deprivation and hostility on within-person changes in civic moral disengagement.

Moral disengagement is an important aggressive and moral cognition. The mechanisms of changes in moral disengagement remain unclear, especially at the within-person level. We attempted to clarify this by exploring the serial effects of personal relative deprivation and hostility on civic moral disengagement. We conducted a three-wave longitudinal survey with 1058 undergraduates (63.61% women; mean age = 20.97). The results of the random intercept cross-lagged panel model showed that personal relative deprivation at Wave 1 and hostility at Wave 2 formed a serial effect on the within-person changes in civic moral disengagement at Wave 3, and the longitudinal indirect effect test showed that the within-person dynamics in hostility at Wave 2 acted as a mediator. The results of multiple group analysis across genders further showed that the longitudinal indirect role of hostility at Wave 2 was only observed for men, but not for women, which indicates the moderating effect of gender. These findings facilitate an understanding of the mechanisms of aggressive cognitions at the within-person level and offer implications for the prevention and intervention of aggression from the perspective of moral cognition.

Network analysis of trait aggression among community youths and juvenile offenders.

OBJECTIVE: The mainstream view in trait aggression research has regarded the structure as representing the latent cause of the cognitions, emotions, and behaviors that supposedly reflect its nature. Under network perspective, trait aggression is not a latent cause of its features but a dynamic system of interacting elements. The current study uses network theory to explain the structure of relationships between trait aggression features in juvenile offenders and their peers. METHODS: Network analysis was applied to investigate the dynamic system of trait aggression operationalized by the Buss-Perry Aggression Questionnaire in a sample of community youths (Mage = 17.46, N = 715) and juvenile offenders (Mage = 18.36, N = 834). RESULTS: The facet level networks showed that anger is a particularly effective mechanism for activating all other traits. In addition, anger was more strongly associated with physical aggression and the overall network strength was greater in juvenile delinquency networks than in their peers. The item level networks revealed that A4 and A6 exhibited the highest predictability and strength centrality in both samples. Also, the Bayesian network indicated that these two items were positioned at the highest level in the model. There are similarities and differences between juvenile delinquents and community adolescents in trait aggression. CONCLUSION: Trait aggression was primarily activated by difficulty controlling one's temper and feeling like a powder keg.

The Movement in Resistance against Eye Aggressions by MOCAO as a social movement for justice, reparation and the right to peace and freedom in Colombia.

The collective action of MOCAO, Movimiento en resistencia contra las agresiones oculares del ESMAD (Escuadrón Móvil An-tidisturbios) is a social strateg y to demand access to justice and the fulfilment of guarantees of reparation and non-repetition in Colombia. A brief account of significant events in our trajecto-ry as a social movement is presented, together with our letter of petitions to the national government as victims and survivors of ocular aggressions in the framework of police violence. Al-though ESMAD today has been reformed under the name of the Unit for Dialogue and Maintenance of Order (UNDMO), we consider that there have not yet been structural changes to ensure that its function is related to protecting the constitution-al right to social protest.

Racism in obstetric care: a psychometric study of the Gendered Racial Microaggressions Scale among Global Majority birthing people in obstetric contexts.

In the United States, maternal health inequities disproportionately affect Global Majority (e.g., Asian, Black, and Hispanic) populations. Despite a substantial body of research underscoring the influence of racism on these inequities, little research has examined how experiences of gendered racial microaggressions during pregnancy and birth impact racially and ethnically diverse Global Majority pregnant and birthing people in obstetric hospital settings. We evaluated the psychometric properties of an adapted version of Lewis & Neville's Gendered Racial Microaggressions Scale, using data collected from 417 Global Majority birthing people. Findings from our study indicate that our adapted GRMS is a valid tool for assessing the experiences of gendered racial microaggressions in hospital-based obstetric care settings among Global Majority pregnant and birthing people whose preferred languages are English or Spanish. Item Response Theory (IRT) analysis demonstrated high construct validity of the adapted GRMS scale (Root Mean Square Error of Approximation = 0.1089 (95% CI 0.0921, 0.1263), Comparative Fit Index = 0.977, Standardized Root Mean Square Residual = 0.075, log-likelihood c2 = -85.6, df = 8). IRT analyses demonstrated that the unidimensional model was preferred to the bi-dimensional model as it was more interpretable, had lower AIC and BIC, and all items had large discrimination parameters onto a single factor (all discrimination parameters > 3.0). Given that we found similar response profiles among Black and Hispanic respondents, our Differential Item Functioning analyses support validity among Black, Hispanic, and Spanish-speaking birthing people. Inter-item correlations demonstrated adequate scale reliability, α = 0.97, and empirical reliability = 0.67. Pearsons correlations was used to assess the criterion validity of our adapted scale. Our scale's total score was significantly and positively related to postpartum depression and anxiety. Researchers and practitioners should seek to address instances of gendered racial microaggressions in obstetric settings, as they are manifestations of systemic and interpersonal racism, and impact postpartum health.

Exposure to aggression in three contexts of emergency response: A longitudinal examination of the relationship with psychological characteristics of the emergency responder.

Some emergency responders are more often exposed to workplace aggression than others. Victimological theories and previous studies suggest that characteristics of the target may predict exposure to workplace aggression. This paper examines the relationship between negative affect, hostile attribution, dominance, empathy, self-evaluations, and exposure to workplace aggression among emergency responders. Emergency medical workers, firefighters and police officers in the Netherlands filled in a survey during three measurement occasions (6 months apart). Results from the three occupational groups were presented separately. Results suggest that some psychological characteristics are related to exposure to workplace aggression, but that the contribution of these characteristics in the explanation of exposure to workplace aggression is limited. In addition, although differences between occupational groups could not be statistically tested due to differences in the factor structure of exposure to workplace aggression between the three groups of emergency response, differences seem to occur in models between emergency response contexts. Implications and suggestions for future research are discussed.

Approach-avoidance tendencies in proactive and reactive aggression.

Aggressive behaviors have been related to approach/avoidance tendencies. In our current study, we investigated whether approach/avoidance tendencies for angry versus fearful emotional expressions were differentially predictive of children's reactive and proactive aggression. A total of 116 children (58 girls, Mage = 10.90, standard deviation SDage = 0.98) completed an approach/avoidance task (AAT) and a stimulus-response compatibility task (SRCT), both measuring the extent to which they tended to approach or avoid angry and fearful facial expressions relative to neutral facial expressions. Children also completed a self-report scale of reactive and proactive aggression. Although none of the approach/avoidance tendency scores correlated significantly with either of the aggression scores, stronger approach tendencies for angry faces and stronger avoidance tendencies for fearful faces in the AAT predicted more reactive aggression. Similar yet nonsignificant results were found for proactive aggression, but no effects were replicated in the SRCT. Our results thus invite the conclusion that reactive aggression is characterized by a tendency to approach angry faces and a tendency to avoid fearful faces. However, the poor discrimination between both types of aggression as well as the lack of convergence between the results of our two measures of approach/avoidance tendencies indicates that further research is needed to establish the role of approach/avoidance tendencies for emotional faces as markers for childhood aggression.

Mitigating Identity-Related Anxiety through Humor and Immersive Storytelling with 360-Degree Video in Virtual Reality: A Study on Microaggressions' Mental Health Effects.

Background: Microaggressions are subtle slights that can cause significant psychological distress among marginalized groups. Few studies have explored interventions that might mitigate these effects. Objective: This study aimed to investigate if and how humor-infused immersive storytelling via virtual reality (VR) could reduce identity-related psychological distress caused by microaggressions. Methods: Using a community-based participatory research approach, we developed a 7-min 360-degree VR film depicting scenarios of microaggressions across various identities. Forty-six college students participated in a controlled study where they were exposed to this immersive VR experience. We measured identity-related psychological anxiety, character identification, perceived humor, and perceived psychological presence. Results: The findings demonstrated a significant anxiety reduction following the VR intervention, supporting the efficacy of humor-infused storytelling in alleviating the impact of microaggressions. Character identification significantly predicted anxiety reduction, while perceived humor and psychological presence did not directly influence anxiety reduction but indirectly contributed through enhanced character identification. Conclusions: Humor-infused immersive storytelling, facilitated by VR, effectively reduces identity-related psychological distress primarily through character identification. The structural equation modeling results emphasize the importance of integrating humor and psychological presence to enhance character connection, advocating for a balanced approach that combines traditional narrative elements with technological innovations in health interventions aimed at combating the adverse psychological effects of microaggressions.

The relationship between sleep disturbance and aggressive behaviour among community-dwelling schizophrenia patients: a moderated mesomeric effect model.

OBJECTIVE: Sleep disturbance is the most common concern of patients with schizophrenia and can lead to a poor prognosis, a low survival rate and aggressive behaviour, posing a significant threat to social security and stability. The aim of this study was to explore the mediating role of depression in the relationship between sleep disturbance and aggressive behaviour in people with schizophrenia living in the community, as well as the regulatory role of family intimacy and adaptability. These findings, in turn, may provide a theoretical basis and constructive suggestions for addressing the physical and mental health problems of these patients. METHOD: From September 2020 to August 2021, a convenience sampling method was used to select schizophrenia patients from the community attending follow-up appointments at the Fourth People's Hospital of Pengzhou City, China. The researchers conducted a survey in the form of a star questionnaire. The survey included questions about general demographic data and disease-related questionnaires: the Pittsburgh Sleep Quality Index (PSQI), the revised Chinese version of the Modified Over Aggression Scale (MOAS), the Self-Rating Depression Scale (SDS), and the Family Adaptability and Cohesion Scale, Second Edition. FACES-II and SPSS 21.0 were used to organize and analyse the data. RESULTS: A total of 818 schizophrenia patients living in the community participated in the survey, and 785 valid questionnaires were ultimately collected, for a response rate of 95.97%. The results of multivariate analysis indicated that sex, number of psychiatric medications used, outpatient follow-up, history of hospitalization for mental disorders and sleep disturbances were factors influencing aggressive behaviour. Depression played a partial mediating role between sleep disturbance and aggressive behaviour, and the indirect effect size was 0.043 (57.33% of the total). In addition to sleep disturbance, family intimacy (ß=-0.009, P < 0.01) and adaptability (ß=-0.145, P < 0.001) can significantly predict depression. CONCLUSION: The findings indicate that sleep disturbance in schizophrenia patients in the community is a risk factor for aggressive behaviour, and depression plays a partial mediating role in the relationship among sleep disturbance, aggressive behaviour and family intimacy. In addition, adaptability plays a regulatory role in the relationship between depression and sleep disturbance.

Potential association between suicide risk, aggression, impulsivity, and the somatosensory system.

Aggression and impulsivity are linked to suicidal behaviors, but their relationship to the suicidal crisis remains unclear. This magnetoencephalography (MEG) study investigated the link between aggression, impulsivity, and resting-state MEG power and connectivity. Four risk groups were enrolled: high-risk (HR; n = 14), who had a recent suicidal crisis; lower-risk (LR; n = 41), who had a history of suicide attempts but no suicide attempt or ideation in the past year; clinical control (CC; n = 38), who had anxiety/mood disorders but no suicidal history; and minimal risk (MR; n = 28), who had no psychiatric/suicidal history. No difference in resting-state MEG power was observed between the groups. Individuals in the HR group with high self-reported aggression and impulsivity scores had reduced MEG power in regions responsible for sensory/emotion regulation vs. those in the HR group with low scores. The HR group also showed downregulated bidirectional glutamatergic feedback between the precuneus (PRE) and insula (INS) compared to the LR, CC, and MR groups. High self-reported impulsivity was linked to reduced PRE to INS feedback, whereas high risk-taking impulsivity was linked to upregulated INS to postcentral gyrus (PCG) and PCG to INS feedback. These preliminary findings suggest that glutamatergic-mediated sensory and emotion-regulation processes may function as potential suicide risk markers.

Assessing the determinants of crash propensity using structural equation modeling: Role of distractions caused by fellow drivers.

INTRODUCTION: Aggressive behavior of drivers is a source of crashes and high injury severity. Aggressive drivers are part of the driving environment, however, excessive aggressive driving by fellow drivers may take the attention of the recipient drivers away from the road resulting in distracted driving. Such external distractions caused by the aggressive and discourteous behavior of other road users have received limited attention. These distractions caused by fellow drivers (DFDs) may agitate recipient drivers and ultimately increase crash propensity. Aggressive driving behaviors are quite common in South Asia and, thus, it is necessary to determine their contribution to distractions and crash propensity. METHOD: Our study aimed to evaluate the effects of DFDs using primary data collected through a survey conducted in Lahore, Pakistan. A total of 801 complete responses were obtained. Various hypotheses were defined to explore the associations between the latent factors such as DFDs, anxiety/stress (AS), anxiety-based performance deficits (APD), hostile behavior (HB), acceptability of vehicle-related distractions (AVRD), and crash propensity (CP). Structural Equation Modeling (SEM) was employed as a multivariate statistical technique to test these hypotheses. RESULTS: The results supported the hypothesis that DFDs lead to AS among recipient drivers. DFDs and AS were further found to have positive associations with APDs. Whereas, there was a significant negative association between DFD, AS, and AVRD. As hypothesized, DFD and AS had positive associations with CP, indicating that distractions caused by aggressive behaviors leads to stress and consequently enhances crash propensity. PRACTICAL APPLICATIONS: The results of this study provide a statistically sound foundation for further exploration of the distractions caused by the aggressive behaviors of fellow drivers. Further, the results of this study can be utilized by the relevant authorities to alter aggressive driving behaviors and reduce DFDs.

Impact of Workplace Bullying on Nursing Care Quality: A Comprehensive Review.

Workplace bullying, commonly known as mobbing, persists as a significant problem across various industries, including the healthcare sector. To establish effective interventions and protocols for enhancing the well-being of healthcare workers and patients, it is vital to fully grasp the link between workplace bullying and the quality of nursing care. The analysis highlights the complex link between workplace bullying and nursing care quality, stressing the urgency of addressing this issue due to its wide-reaching impact on individuals and healthcare organizations, ultimately affecting patient safety. Emphasizing the significance of addressing workplace bullying across different professional settings is crucial for protecting the mental health and well-being of employees. The research identifies various forms of aggression and emphasizes the need to understand how these behaviors affect patient outcomes. Further investigation is needed to clarify nurses' responses to workplace violence, particularly in specialized settings like mental health facilities. The studies underscore the numerous challenges nurses encounter when trying to report incidents of workplace bullying. This insight is vital for developing effective reporting mechanisms and targeted interventions to combat bullying behaviors in medical environments. Ultimately, establishing a safer working environment for nurses is paramount. This article aims to review the associations between workplace bullying and the quality of nursing care.

Modeling trajectories of physical aggression from infancy to pre-school age, their early predictors, and school-age outcomes.

This study identified latent trajectories of physical aggression (TPA) from infancy to preschool age and evaluated (a) effects of early parent, parenting and child predictors on TPA as well as on social, behavioral, and academic functioning in Grade 2, and (b) TPA effects net of early predictor effects on Grade 2 functioning. We used data from the Behavior Outlook Norwegian Developmental Study (BONDS), which included 1,159 children (559 girls). Parents reported on risk and protective factors, and on physical aggression from 1 to 5 years of age; teachers reported on Grade 2 outcomes. We employed latent class growth curve analyses and identified nine TPA. In fully adjusted models simultaneously testing all associations among predictors, trajectories, and outcomes, maternal and paternal harsh parenting, child gender, and sibling presence predicted TPA, which significantly predicted externalizing and academic competence in Grade 2. Child gender had a pervasive influence on all outcomes as well as on TPA. To our knowledge, this is the first trajectory study to determine which predictors are most proximal, more distal, or just confounded, with their relative direct effect sizes, and to link early paternal as well as maternal harsh parenting practices with children's TPA. Our findings underscore the need to include fathers in developmental research and early prevention and intervention efforts.

Paranoia and Social Anxiety: Predicting Aggressive Behavior.

Aggression is a transdiagnostic behavior that is associated with poor clinical outcomes. As such, it is important to understand factors that contribute to various manifestations of aggressive behavior. Recent research has revealed a subtype of individuals with social anxiety disorder (SAD) who tend to display relatively high amounts of aggression and experience more severe social anxiety and dysfunction compared to individuals in the prototypical SAD group. The current study used a status threat manipulation along with behavioral indices of aggression to examine the impact of paranoia and social anxiety symptom severity on aggression in a sample of undergraduates with social anxiety (N = 220). Analyses indicated that paranoia uniquely predicted indirect aggression whereas an interaction between social status threat, paranoia, and social anxiety severity uniquely predicted direct aggression. These findings suggest that paranoia may be a particularly important contributor to aggression among individuals with social anxiety.

Detecting agitation and aggression in persons living with dementia: a systematic review of diagnostic accuracy.

OBJECTIVE: 40-60% of persons living with dementia (PLWD) experience agitation and/or aggression symptoms. There is a need to understand the best method to detect agitation and/or aggression in PLWD. We aimed to identify agitation and/or aggression tools that are validated against a reference standard within the context of PLWD. METHODS: Our study was registered on PROSPERO (CRD42020156708). We searched MEDLINE, Embase, and PsycINFO up to April 22, 2024. There were no language or date restrictions. Studies were included if they used any tools or questionnaires for detecting either agitation or aggression compared to a reference standard among PLWD, or any studies that compared two or more agitation and/or aggression tools in the population. All screening and data extraction were done in duplicates. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Data extraction was completed in duplicates by two independent authors. We extracted demographic information, prevalence of agitation and/or aggression, and diagnostic accuracy measures. We also reported studies comparing the correlation between two or more agitation and/or aggression tools. RESULTS: 6961 articles were screened across databases. Six articles reporting diagnostic accuracy measures compared to a reference standard and 30 articles reporting correlation measurements between tools were included. The agitation domain of the Spanish NPI demonstrated the highest sensitivity (100%) against the agitation subsection of the Spanish CAMDEX. Single-study evidence was found for the diagnostic accuracy of commonly used agitation scales (BEHAVE-AD, NPI and CMAI). CONCLUSIONS: The agitation domain of the Spanish NPI, the NBRS, and the PAS demonstrated high sensitivities, and may be reasonable for clinical implementation. However, a limitation to this finding is that despite an extensive search, few studies with diagnostic accuracy measurements were identified. Ultimately, more research is needed to understand the diagnostic accuracy of agitation and/or aggression detection tools among PLWD.

The impact of acute violent videogame exposure on neurocognitive markers of empathic concern.

Research examining the purported association between violent gaming and aggression remains controversial due to concerns related to methodology, unclear neurocognitive mechanisms, and the failure to adequately consider the role of individual differences in susceptibility. To help address these concerns, we used fMRI and an emotional empathy task to examine whether acute and cumulative violent gaming exposure were associated with abnormalities in emotional empathy as a function of trait-empathy. Emotional empathy was targeted given its involvement in regulating not only aggression, but also other important social functions such as compassion and prosocial behaviour. We hypothesized that violent gaming exposure increases the risk of aberrant social behaviour by altering the aversive value of distress cues. Contrary to expectations, neither behavioural ratings nor empathy-related brain activity varied as a function of violent gaming exposure. Notably, however, activation patterns in somatosensory and motor cortices reflected an interaction between violent gaming exposure and trait empathy. Thus, our results are inconsistent with a straightforward relationship between violent gaming exposure and reduced empathy. Furthermore, they highlight the importance of considering both individual differences in susceptibility and other aspects of cognition related to social functioning to best inform public concern regarding safe gaming practices.