Self-esteem and cortical thickness correlate with aggression in healthy children: A surface-based analysis.

Aggressive behavior can have serious physical, psychological, and social consequences. However, little is known about the personality and neurological antecedents underlying aggressive behavior in children. The objective of this study was to investigate the relationship between self-esteem, aggression, and brain structure (i.e., cortical thickness and surface area) in a population of healthy children (N = 78; 9-12 years; mean age: 9.95 ± 0.90 years). The results revealed that self-esteem showed a negative association with aggression and significantly predicted aggressive behavior. No gender differences were found in aggression and its neural correlates. We performed the cortical parcellation method to further explore the neural foundations underlying the association of self-esteem with aggression. Children with higher aggression had increased cortical thickness in four clusters after multiple comparison correction: right medial orbitofrontal cortex, right lateral orbitofrontal cortex, right superior frontal gyrus, and left insula. In a mediation analysis, cortical thickness in the right medial orbitofrontal cortex contributed to the effect of self-esteem on aggression. These findings extend our understanding of morphological correlates of aggression in children, suggesting that an increased cortical thickness in childhood is a potential mechanism linking low self-esteem to aggression.

"My [Search Strategies] Keep Missing You": A Scoping Review to Map Child-to-Parent Violence in Childhood Aggression Literature.

Child-to-parent violence is often referred to as one of the most 'under-researched' forms of family violence. However, it is closely associated with one of the most widely researched areas of research globally: childhood aggression. How child-instigated aggression can harm parents is widely referred to, but different framings, definitions, and conceptualisations are used which creates problems when attempting to identify the broader literature which may be relevant to child-to-parent violence researchers. METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, 55 papers were reviewed from EBSCO, PubMed, SCOPUS, and Web of Science to explore how location, field of the researcher, and terminology can impact how researchers conceptualise and frame this form of harm. RESULTS: Three themes were identified (1) child-to-parent violence is a behavioural indicator of childhood distress or developmental needs, (2) children are 'perpetrators' of deviant behaviour, and (3) the parents are 'victims' of child-to-parent violence. CONCLUSIONS: Children and parents are both harmed by child-to-parent violence. It is important that future researchers and practitioners recognise the bi-directionality of the parent-child relationship, and not be complicit in hiding the harms caused by child-to-parent violence by subsuming it under the broader childhood aggression literature.

Integrative Multi-omics Analysis of Childhood Aggressive Behavior.

This study introduces and illustrates the potential of an integrated multi-omics approach in investigating the underlying biology of complex traits such as childhood aggressive behavior. In 645 twins (cases = 42%), we trained single- and integrative multi-omics models to identify biomarkers for subclinical aggression and investigated the connections among these biomarkers. Our data comprised transmitted and two non-transmitted polygenic scores (PGSs) for 15 traits, 78,772 CpGs, and 90 metabolites. The single-omics models selected 31 PGSs, 1614 CpGs, and 90 metabolites, and the multi-omics model comprised 44 PGSs, 746 CpGs, and 90 metabolites. The predictive accuracy for these models in the test (N = 277, cases = 42%) and independent clinical data (N = 142, cases = 45%) ranged from 43 to 57%. We observed strong connections between DNA methylation, amino acids, and parental non-transmitted PGSs for ADHD, Autism Spectrum Disorder, intelligence, smoking initiation, and self-reported health. Aggression-related omics traits link to known and novel risk factors, including inflammation, carcinogens, and smoking.

Capturing mechanisms of change: Weekly covariation in anger regulation, hostile intent attribution, and children's aggression.

Interventions for children's aggression typically target assumed underlying mechanisms, such as anger regulation and hostile intent attribution. The expectation here is that targeting these mechanisms will result in within-person changes in aggression. However, evidence for these mechanisms is mostly based on between-person analyses. We, therefore, examined whether within-person changes in adaptive anger regulation and hostile intent attribution covaried with within-person changes in children's aggression. Children (N = 223; age 7-12; 46% boys) filled out four weekly report measures to assess adaptive anger regulation, hostile intent attribution, and aggression. The psychometric properties of these novel measures were adequate. Results of multi-level analyses revealed within-person effects: weekly changes in adaptive anger regulation and hostile intent attribution covaried with changes in children's aggression. This corresponded with between-person findings on the same data: children with lower levels of adaptive anger regulation and higher levels of hostile intent attribution reported more aggression than other children. These findings support the idea that targeting anger regulation and hostile intent attribution in interventions may lead to changes in individual children's aggression.

Structural Brain Development and Aggression: A Longitudinal Study in Late Childhood.

This longitudinal study examined the neurodevelopmental correlates of aggression in children, focusing on structural brain properties. A community sample of 110 (60 females) children participated at age 8 years and again at age 10 years. Brain structure was assessed by using magnetic resonance imaging (MRI), and parents reported on child aggression using the Child Behavior Checklist. Analyses examined the relationship between aggression and development of volume of subcortical regions, cortical thickness, and subcortical-cortical structural coupling. Females with relatively high aggression exhibited reduced right hippocampal growth over time. Across males and females, aggression was associated with amygdala- and hippocampal-cortical developmental coupling, with findings for amygdala-cortical coupling potentially indicating reduced top-down prefrontal control of the amygdala in those with increasing aggression over time. Findings suggest that aggressive behaviors may be associated with alterations in normative brain development; however, results were not corrected for multiple comparisons and should be interpreted with caution.

Urinary Amine and Organic Acid Metabolites Evaluated as Markers for Childhood Aggression: The ACTION Biomarker Study.

Biomarkers are of interest as potential diagnostic and predictive instruments in personalized medicine. We present the first urinary metabolomics biomarker study of childhood aggression. We aim to examine the association of urinary metabolites and neurotransmitter ratios involved in key metabolic and neurotransmitter pathways in a large cohort of twins (N = 1,347) and clinic-referred children (N = 183) with an average age of 9.7 years. This study is part of ACTION (Aggression in Children: Unraveling gene-environment interplay to inform Treatment and InterventiON strategies), in which we developed a standardized protocol for large-scale collection of urine samples in children. Our analytical design consisted of three phases: a discovery phase in twins scoring low or high on aggression (N = 783); a replication phase in twin pairs discordant for aggression (N = 378); and a validation phase in clinical cases and matched twin controls (N = 367). In the discovery phase, 6 biomarkers were significantly associated with childhood aggression, of which the association of O-phosphoserine (ß = 0.36; SE = 0.09; p = 0.004), and gamma-L-glutamyl-L-alanine (ß = 0.32; SE = 0.09; p = 0.01) remained significant after multiple testing. Although non-significant, the directions of effect were congruent between the discovery and replication analyses for six biomarkers and two neurotransmitter ratios and the concentrations of 6 amines differed between low and high aggressive twins. In the validation analyses, the top biomarkers and neurotransmitter ratios, with congruent directions of effect, showed no significant associations with childhood aggression. We find suggestive evidence for associations of childhood aggression with metabolic dysregulation of neurotransmission, oxidative stress, and energy metabolism. Although replication is required, our findings provide starting points to investigate causal and pleiotropic effects of these dysregulations on childhood aggression.

Perspectives on clinical guidelines for severe behavioural problems in children across Europe: a qualitative study with mental health clinicians.

Clinical guidelines for severe behavioural problems (SBPs) in children have recently been developed in several European countries. However, questions emerged regarding their applicability to practice. Our study aimed to provide a first European insight into guidelines' fitness-for-purpose by exploring mental health clinicians' familiarity with, use and perceived value of guidelines for SBPs in children. Participants included 161 clinicians, primarily psychiatrists, from 24 countries. Clinicians completed a semi-structured qualitative questionnaire on existing SBPs guidelines and development of new guidelines where not available. Clinicians' responses were mapped against academic experts' perceptions on SBPs guidelines highlighted in a previous study (Gatej et al. in Eur Psychiatry 57:1-9, 2019). Under half of the clinicians reported being unaware of guidelines. Of these, 37.6% represented countries where guidelines were available according to experts. The remaining half of clinicians who were aware of guidelines on average reported being moderately familiar with their content, perceiving them as moderately useful and using them some of the time. Additionally, 60.8% clinicians agreed that SBPs guidelines need to be developed, as these would create a shared scientific knowledge base and common practice. Guideline improvements included taking a multifactorial approach, creating specific case recommendations, and dissemination efforts. The modest familiarity with and use of guidelines amongst practitioners may highlight guidelines poor fitness-for-purpose, or, alternatively, an underlying confusion around the meaning and purpose of guidelines. Moving forward, efforts should be directed at disseminating clearer definitions of guidelines, addressing existing challenges, and unifying efforts to further develop and audit application of international guidelines for SBPs.

The relation between the age at diagnosis of problem behaviors related to aggression and distal outcomes in Swedish children.

Severe childhood aggressive behaviors are known to predict negative outcomes later in life; however, little is known about the effect of when in childhood aggression problems are diagnosed. While an earlier first diagnosis of problematic aggressive behavior might be associated with increased severity and, thus, worse outcomes, it is also possible that an earlier diagnosis affords an earlier start of treatment programs or indicates that greater attention is being paid to behavioral problems, thus resulting in attenuation of the severity of childhood aggression's impact on distal outcomes. The current study analyzed data from the population-based Swedish Data Registries, which include data on all children formally diagnosed by the Swedish medical system with a wide range of aggression problems between ages 8 and 18 (N = 5816) during the years 1987-2013, along with a matched control. Time-to-event analyses investigated whether the age at time of diagnosis affects later life outcomes while controlling for relevant confounders. Results show that for both boys and girls, those with a later diagnosis had lower average incomes (regression coefficient b = - 0.055, p < 0.005) and a higher probability of having a criminal record (odds ratio 1.126, p < 0.005) than children with earlier diagnoses. The effect on suicide attempts was not significant after correcting for multiple testing (odds ratio 1.264, p = 0.016). Grade score was not significantly affected. The results warrant further research concerning the potential advantage of earlier diagnoses, especially concerning generalizability beyond the Swedish population.

Childhood aggression: A synthesis of reviews and meta-analyses to reveal patterns and opportunities for prevention and intervention strategies.

This study provides a synthesis of meta-analyses and systematic reviews on non-pharmacological treatments for childhood aggression. Treatments referred to universal prevention, selective prevention, indicated prevention, or intervention (Mrazek and Haggerty, 1994). Seventy-two meta-analyses and systematic reviews met the inclusion criteria. We describe their characteristics, effect sizes across types of treatments, and the effects of various moderators. For universal and selective prevention, effects were mostly absent or small; for indicated prevention and interventions, effects were mostly small or medium. Only two moderators had a positive effect on treatment effectiveness, namely pre-test levels of aggression and parental involvement. These results identified similarities between indicated prevention and intervention treatments, on the one hand, and universal prevention and selective prevention, on the other. Our findings suggest that research distinguishing between targets of treatments (i.e., factors associated with childhood aggression vs. present aggressive behaviors) would be promising. Moreover, to further increase effectiveness of treatments for childhood aggression, individual differences warrant scientific attention.

Influences of Gender, Religion, Dietary Patterns, and Mixed-sex Education on Aggressiveness in Children: A Sociodemographic Study in Municipal Primary Schools of South Delhi.

BACKGROUND: Increasing antisocial and violent behaviors in adolescents and young adults present serious challenges for public health. Children with persistent high levels of aggressiveness are often associated with developing conduct disorders later in life. Early detection of highly aggressive children and sociodemographic risk-modifying factors are important for developing effective preventive strategies. OBJECTIVES: The present study was undertaken to assess levels of aggressiveness for detecting highly aggressive children in sample populations of primary school children in an urban setting and determine significant biosociocultural risk-modifying factors in this scenario. METHODS: The study was conducted during August-September, 2015 in 5 primary schools of South Delhi Municipal Corporation. Sociodemographic data on 2080 students were collected. Overall aggressiveness scores (OA-Scores) were estimated using a self-report questionnaire in Hindi. RESULTS: Categorizing students according to their OA-Scores, the data revealed that highly aggressive children constituted 4.3% of the study population. Analysis showed significant influence of (a) gender: boys displayed higher levels of aggressiveness compared to girls; (b) dietary pattern: omnivores showed higher aggressiveness than vegetarians; and (c) school environment: boys in mixed-sex (coeducational) schools displayed lower aggressiveness than from single-sex schools. Statistically significant influences of religion (Hindu/Muslim) and family type (joint/nuclear) on aggressiveness profiles were not noticeable. CONCLUSIONS: Vegetarian diets and mixed-sex education act as protective factors in the development of aggressiveness in children, especially among boys. Extending investigations to populations differing in geography and cultural backgrounds are warranted to verify present results.

Parental Self-Control and the Development of Male Aggression in Early Childhood: A Longitudinal Test of Self-Control Theory.

A number of studies have evaluated associations between parenting practices, adolescent self-control, and adolescent antisocial behavior. Yet, few studies have examined associations between these constructs in early childhood or examined the extent to which both maternal and paternal self-control shapes them. To address these gaps, the current study utilizes longitudinal data collected on a sample of 117 Dutch boys and their parents to investigate the across time interrelationships between parental self-control, ineffective parenting, child self-control, and child aggression. The results provide evidence of an indirect association between maternal self-control and early childhood self-control through maternal ineffective parenting, an indirect association between maternal ineffective parenting and early childhood aggression through early childhood self-control, and an indirect association between maternal self-control and early childhood aggression through both maternal ineffective parenting and early childhood self-control. In contrast, paternal self-control and paternal ineffective parenting were unrelated to child self-control and child aggression. The implications and limitations of the study are discussed.

Changing Health Care Professionals' Attitudes Toward Spanking.

Twenty-two pediatric residents and 31 medical students viewed the Play Nicely program. The Play Nicely program is a multimedia program that teaches health care professionals how to counsel parents to use positive parenting and disciplining strategies in response to early childhood aggression. Health care professionals completed pre- and posttraining questionnaires to assess changes in comfort with counseling, parenting knowledge, and attitudes toward spanking. Results indicated at posttraining that health care professionals were significantly more comfortable with counseling parents, had increased parenting knowledge, and decreased positive attitudes toward spanking. Findings suggest that this program holds promise for educating health care professionals on how to counsel parents on positive parenting strategies and positively change attitudes toward spanking.

Abordaje del abuso sexual infantil: combatiendo la revictimizacion / Addressing child sexual abuse: fighting revictimization

Cuando el médico tiene poca experiencia o no suele enfrentarse a este tipo situaciones, el diagnóstico de abuso sexual es difícil y cuando es un niño o una niña es aún más complicado. En la dinámica de estos eventos intervienen diversos factores. Al evaluar al niño o niña afectada es indispensable evitar la revictimización, que al tomar lugar se convierte en una nueva agresión, para lograr lo anterior se requiere que sea un equipo interdisciplinario y con experiencia, el que lleve a cabo la evolución. Se debe evitar la duplicación de interrogatorios, entrevistas y exploración física. En los casos de abuso crónico, se puede prescindir del examen físico. La relación predominante en los casos de abuso es la de padre e hija y el tipo de agresión más frecuente es el tocamiento en casi el 90% de los casos. Premisa que nos lleva a considerar que es frecuente encontrar el área genito-anal totalmente indemne durante la exploración física. Las consecuencias de sucesos como estos dependerán del apoyo familiar, el grado de culpabilidad que se genere en el niño y del abordaje y las estrategias que se pongan en marcha para enfrentar la agresión.

When the doctor has little experience, the diagnosis of sexual abuse is difficult and when the victim is a child, is even more complicated. The dynamic of these events involved several factors. When assessing the affected youth it is essential to avoid re-victimization, which becomes a new aggression. In order to achieve this is required an interdisciplinary and experienced team to develop the analysis. Avoid duplication of interrogations, interviews and physical examination. In cases of chronic abuse, the physicians can dispense physical examination. The predominant relationship in cases of abuse is father and daughter and the most frequent type of aggression is touching, almost in 90% of cases. Reason why is not uncommon to get no abnormal findings in physical examination. The consequences of these kinds of events will depend on family support, the degree of culpability that is generated on the child and the approach and the implemented strategies to deal with aggression.

Cumulative effects of maternal age and unintended pregnancy on offspring aggression.

Research on physical aggression often points to teen motherhood as being a primary contributor in the development of aggressive tendencies among young children. As a result of poor parenting practices, limited education, and a lack of emotional, physical, and financial resources, children born to young mothers often exhibit high levels of aggression across the life course. Meanwhile, unintentional pregnancy and young motherhood are likely to share many of the same risk factors and negative consequences for offspring, yet there is a dearth of research examining pregnancy intentionality and offspring aggression. Using the Fragile Families and Wellbeing Study, our study examines how mother's age and pregnancy intention status influence aggression among their 5-year-old children. We find that young motherhood and unintended births, despite being likely to co-occur, each provide distinct mechanisms for the formation of aggressive behavior in childhood.