Propiedades psicométricas de las versiones larga y corta del cuestionario de agresión AQ en una muestra de presos españoles / Psychometric properties of the long and short forms of the AQ aggression questionnaire in a sample of Spanish inmates

Objetivos: El cuestionario de agresión (AQ) de Buss-Perry (Buss-Perry Aggression Questionnaire; Buss y Perry, 1992) es una medida utilizada en la población en general. Existe un debate sobre la interpretación de las puntuaciones y la utilidad de una versión más breve (AQ-SV [short version]). El objetivo de este estudio es analizar y comparar las propiedades psicométricas de la versión larga (AQ-LV [long version]) y la breve y comprobar la fiabilidad de la versión breve en una muestra de varones encarcelados. Material y método: La muestra estaba formada por 236 varones encarcelados (edad media de 40,4 años) del Centro Penitenciario Ocaña I (Toledo), que se ofrecieron a participar en el estudio. La muestra se seleccionó mediante la técnica de muestreo aleatorio por niveles, basada en el número de reclusos internos. También se incluyó una lista aleatoria de posibles sustitutos en caso de negativa a ser entrevistados, interrumpiéndose la sustitución en caso de dos negaciones consecutivas. Este estudio es un diseño descriptivo transversal. Resultados: La versión breve de la escala demostró un mejor ajuste que la versión larga, como indican los valores mayores del índice de ajuste comparativo (CFI, comparative fit index) y los menores del cuadrado medio residual ponderado (WRMR, weighted root mean square residual). El número de penas de prisión se asoció positivamente con la agresión física, la agresión verbal, la ira y la hostilidad. Los coeficientes fueron ligeramente superiores para la versión breve que para la versión larga. Discusión: La versión breve del cuestionario AQ es un instrumento válido y de utilidad para medir la agresividad en contextos penitenciarios en relación con la versión larga, y se correlaciona con subescalas de agresión con más fuerza que la versión larga.(AU)

Objectives: The Buss-Perry Aggression Questionnaire (AQ; Buss & Perry, 1992) is a broad measurement tool used with the general public in Spain. There is some debate regarding the interpretation of AQ scores and the usefulness of a shorter version. The aim is to study and compare the psychometric properties of the long and short version of the AQ and check the reliability of the short version in a sample of male prisoners. Material and method: The sample was composed of 236 incarcerated males (mean age of 40.4 years of age) from Ocaña 1 prison center who volunteered to participate in the study. The sample was selected by using the tiered random sampling technique based on the internal inmate number. A random list of possible substitutes was also included in the event of refusal to be interviewed, with replacement being discontinued in the event of two consecutive refusals. This study is a descriptive cross-sectional design. Results: The short version of the scale demonstrated better adjustment than the long version, as indicated by the larger CFI and smaller WRMR values. The number of prison sentences was positively associated with physical aggression, verbal aggression, anger, and hostility. The coefficients were slightly higher for the short version of the scale than the long one. Discussion: The short version of the AQ is a valid instrument for measuring aggressiveness in prison contexts in relation to the long version, and correlates with subscales of aggression more strongly than the long one.(AU)

Differences among perpetrators of intimate partner violence utilizing proactive versus reactive aggression

This research aimed to categorize perpetrator’s aggression as reactive or proactive regarding intimate partner violence and explore the relationship with relevant variables. Victim statements in police reports of 60 predominantly Hispanic male adult perpetrators on probation in South Texas were rated, categorizing statements as reactive or proactive. It was hypothesized that more men would display reactive aggression and it would be associated with severe violence, emotion regulation difficulties, state anger, and impulsivity. The study further suggested that emotion regulation, state anger, and impulsivity would moderate the relationship between severity of violence and reactive/proactive classification, and impulsivity would mediate the relationship between state anger and reactive/proactive classification. Results showed 79% of perpetrators using reactive aggression and 21% using proactive aggression. Men with reactive aggression exhibited more severe violence, emotion regulation difficulties, impulsivity, and state anger. There were no moderation effects of study variables on severity of violence and reactive/proactive classification. Impulsivity fully mediated the relationship between state anger and reactive/proactive classification. Our results support approaches that emphasize reactive aggression in intimate partner violenceperpetration due to its frequency and potential recidivism effects. (AU)

Esta investigación tuvo como objetivo categorizar la agresión del maltratador como reactiva o proactiva en la violencia de pareja y explorar la relación con variables relevantes. Se clasificaron las declaraciones de las víctimas en los informes policiales de 60 hombres adultos agresores predominantemente hispanos en libertad condicional en el sur de Texas, categorizando las declaraciones como reactivas o proactivas. Se hipotetizó que más hombres mostrarían agresión reactiva y que estaría asociada con violencia grave, dificultades en la regulación emocional, ira-estado e impulsividad. El estudio sugirió además que la regulación emocional, la ira-estado y la impulsividad moderarían la relación entre la gravedad de la violencia y la clasificación reactiva/proactiva, y que la impulsividad mediaría la relación entre la ira-estado y la clasificación reactiva/proactiva. Los resultados mostraron que el 79% de los agresores utilizaban la agresión reactiva y el 21% la proactiva. Los hombres con agresión reactiva mostraban una violencia más grave, dificultades en la regulación emocional, impulsividad e ira-estado. No hubo efectos moderadores de las variables estudiadas sobre la gravedad de la violencia y la clasificación reactiva/proactiva. La impulsividad medió totalmente en la relación entre la ira-estado y la clasificación reactiva/proactiva. Nuestros resultados apoyan las perspectivas que enfatizan la agresión reactiva en la violencia en las relaciones de pareja debido a su frecuencia y potenciales efectos de reincidencia. (AU)

Violência física, sexual e psicológica segundo a análise conceitual evolucionista de rodgers / Physical, sexual and psychological violence according to rodgers' evolutionary conceptual analysis / Violencia física, sexual y psicológica según el análisis conceptual evolutivo de rodgers

RESUMO Objetivo: esclarecer os conceitos de violência física, psicológica e sexual e, a partir dos resultados obtidos, comparar similaridades e diferenças entre conceitos, suas características, condições para acontecimentos e possíveis desfechos. Métodos: utilizou-se a análise de conceito evolutivo de Rodgers. Os antecedentes, atributos e consequentes foram extraídos de 91 documentos publicados em 2018, em português, inglês, francês ou espanhol, por busca utilizando os descritores "violência física", "violência psicológica" e "violência sexual". Resultados: para "violência física" foram extraídos 17 atributos, um antecedente e sete consequentes; para "violência sexual" 31 atributos, 10 antecedentes e dois consequentes; e para "violência psicológica" 33 atributos, quatro antecedentes e seis consequentes. Considerações finais: distintas tipologias de violência apresentam diferentes atos que as caracterizam, e que quando (re)conhecidos pelo enfermeiro, oportunizam um planejamento da assistência otimizado e de qualidade.

ABSTRACT Objective: to clarify the concepts of physical, psychological, and sexual violence and, from the results obtained, to compare similarities and differences among concepts, their characteristics, conditions for events, and possible outcomes. Methods: Rodgers' evolving concept analysis was used. The antecedents, attributes and consequents were extracted from 91 documents published in 2018, in Portuguese, English, French or Spanish, by search using the descriptors "physical violence", "psychological violence" and "sexual violence". Results: for "physical violence" 17 attributes, one antecedent and seven consequents were extracted; for "sexual violence" 31 attributes, 10 antecedents and two consequents; and for "psychological violence" 33 attributes, four antecedents and six consequents. Final considerations: different types of violence have different acts that characterize them, and that when (re)known by the nurse, allow for an optimized and quality care planning.

RESUMEN Objetivo: aclarar los conceptos de violencia física, psicológica y sexual y, a partir de los resultados obtenidos, comparar las similitudes y diferencias entre los conceptos, sus características, las condiciones de los acontecimientos y los posibles resultados. Métodos: Se utilizó el análisis conceptual evolutivo de Rodgers. Los antecedentes, atributos y consecuentes se extrajeron de 91 documentos publicados en 2018, en portugués, inglés, francés o español, mediante la búsqueda con los descriptores "violencia física", "violencia psicológica" y "violencia sexual". Resultados: para la "violencia física" se extrajeron 17 atributos, un antecedente y siete consecuentes; para la "violencia sexual" 31 atributos, 10 antecedentes y dos consecuentes; y para la "violencia psicológica" 33 atributos, cuatro antecedentes y seis consecuentes. Consideraciones finales: los diferentes tipos de violencia presentan diferentes actos que los caracterizan, y que al ser (re)conocidos por la enfermera, permiten una planificación de cuidados optimizada y de calidad.

Evidence for the taxonic latent structure for DSM-5 intermittent explosive disorder in adults.

BACKGROUND: Identification of individuals with clinically significant aggressive behavior is critical for the prevention and management of human aggressive behavior. A previous population-based taxometric study reported that the Diagnostic and Statistical Manual of Mental Disorders-4th Edition (DSM-IV) intermittent explosive disorder (IED) belongs to its own discrete class (taxon) rather than existing along a continuum. METHODS: This study sought to extend previous population-based findings in a clinical research sample of adults with DSM-5 IED (n = 346), adults with non-aggressive DSM-5 disorders (n = 293), and adults without any DSM-5 disorder (n = 174), using standardized assessments of DSM-5 diagnoses, aggression, and other related measures not available in past studies. RESULTS: Analyses revealed a taxonic latent structure that overlapped with the DSM-5 diagnosis of IED. Within the sample, taxon group members had higher scores on a variety of measures of psychopathology than did the complement members of the sample. Comorbidity of other diagnoses with IED did not affect these results. CONCLUSION: These findings support the proposition that DSM-5 IED represents a distinct behavioral disorder rather than the severe end of an aggressive behavior continuum.

Violencia de odio en los servicios de urgencias de hospitales de tercer nivel. Primeros datos en España / Hate violence in the emergency rooms of third level hospitals. First data in Spain

OBJETIVO: Describir los casos de violencia de odio atendidos en servicios de urgencias. MÉTODO: Estudio transversal de una serie de casos de agresión atendidos en los servicios de urgencias de dos hospitales de Madrid, entre abril de 2015 y marzo de 2018. Se describen los casos de violencia de odio en cuanto a características sociodemográficas, clínico-epidemiológicas y del incidente, y se comparan con las de otros tipos de violencia dentro del estudio. RESULTADOS: Se incluyeron 147 pacientes. El 49% refirieron haber sido víctimas de la violencia de odio. El 61% eran hombres, la media de edad fue de 36 años y un 48% tenían un nivel de estudios medio-alto. Las motivaciones más frecuentes son el aspecto físico, la nacionalidad y el origen étnico. El lugar de la agresión es la calle en un 50% de los casos, y en el 61% la agresión fue perpetrada por más de una persona (el 83% por hombres). La lesión más común fue la contusión (71%) y las localizaciones más frecuentes fueron la cabeza y el cuello (71%). El 8% de las víctimas requirieron ingreso. CONCLUSIONES: La vigilancia de la violencia de odio permitiría conocer con mayor exactitud la magnitud real y las características de este problema de salud, así como mejorar la calidad de la atención a las víctimas

OBJECTIVE: To describe the cases of hate violence attended in emergency services. METHOD: A cross-sectional study of a series of cases of aggression treated in the emergency rooms of two hospitals in Madrid, between April 2015 and March 2018. The cases of hate violence are described in terms of their sociodemographic, clinical-epidemiological and incident data and compared with other types of violence within the study. RESULTS: A total of 147 patients were included and 49% reported having been victims of hate violence. Among the victims, 61% were men, the average age was 36 years and 48% had a medium-high level of education. The most frequent motivations were physical appearance, nationality and ethnic origin. The place of aggression was the street in 50%, and in 61% of the cases it was perpetrated by more than one person (83% by men). The most common injury was contusion (71%) and the most frequent location the head and neck (71%). Only 8% required admission. CONCLUSIONS: The surveillance of hate violence would foster more accurate knowledge of the real magnitude and characteristics of this health problem and improve the quality of care for victims

Profile of violence against older individuals registered at the dial 100 in the period 2011-2015 in Brazil / Perfil da violência contra a pessoa idosa registrada no Disque 100 de 2011 a 2015, Brasi

OBJETIVO: Analisar o perfil das denúncias de violência contra os idosos registradas no Disque 100, entre os anos de 2011 e 2015. METODOLOGIA: Estudo descritivo-retrospectivo, baseado em amostra composta de 130.164 denúncias. Para coleta de dados, elaborou-se um roteiro contendo as seguintes variáveis: cidade, sexo, faixa etária, raça/cor, local onde ocorre a agressão, tipo da violência e relação da vítima com o suspeito. RESULTADOS: Ao analisarmos os dados por região brasileira, nota-se que o maior número de registros ocorreu na Região Sudeste (42,27%) e o menor na Região Norte (6,79%). Quando analisamos as denúncias por 100.000 habitantes, encontramos como estados líderes no ranking de denúncia de violência contra o idoso Amazonas, Distrito Federal e Rio Grande do Norte. O perfil das possíveis vítimas denunciadas foi: idade entre 76 e 80 anos, com predominância feminina e de cor branca. Observa-se que os filhos são os principais suspeitos de cometer agressão e os netos elencam a segunda posição no ranking de suspeitos. Em relação ao local da ocorrência do ato violento, os dados indicam que o maior percentual de violência ocorre na casa da vítima, seguido pela casa do suspeito. No que se refere aos tipos de violência, a negligência (36,72%) foi a mais recorrente, seguida da violência psicológica (28,46%) e do abuso financeiro (20,45%). CONCLUSÃO: O Disque 100 é uma das ferramentas mais eficazes para romper o silêncio e a invisibilidade da violência contra os idosos, fornecendo um panorama de denúncias em nosso país.

OBJECTIVE: To analyze the profile of the reports of violence and abuse against older people registered in the Dial 100 helpline from 2011 to 2015. METHODS: This was a descriptive, retrospective study, based on a sample of 130 164 denunciation reports of the Dial 100. The data collection considered the following variables: city, sex, age, race, place of abuse, type of abuse, and the victim's relationship with the suspect. RESULTS: The greatest number of reports was registered in the Southeast (42.27%), and the lowest in the North (6.79%). When we analyze the complaints per 100 000 inhabitants, we found as leading states in the ranking of complaints of violence against older people: Amazonas, Federal District, and Rio Grande do Norte. The main profile of possible victims was age from 76 to 80 years, predominantly women, and white. The main abusers were the victim's children and grandchildren. The most frequent type of abuse was negligence (36.72%), followed by psychological abuse (28.46%), and financial abuse (20.45%). CONCLUSION: The Dial 100 helpline is one of the most effective tools for breaking the silence and invisibility of abuse and violence against older adults, offering a panorama of abuse denunciation in our country.

Perpetration of Alcohol-Related Aggression by Male and Female College Students: An Examination of Overt and Relational Aggression.

Existing literature exemplifies the relationship between alcohol and overt aggression, especially for adult males. Less clear is the relationship between alcohol and aggression among male and female college students, in particular, the nature of this aggression and the co-occurrence of drinking and aggression on the same day (temporal proximity). This study examines the chronic and temporal nature of males' and females' alcohol-related aggression among college students. Two hundred fourteen students completed a web-based 7-day event-level survey measuring alcohol consumption and perpetration of physical aggression, verbal aggression, anger, and relational aggression over 4 weeks, resulting in 4,256 observations (days). The global analysis revealed students who are heavy drinkers are more likely to perpetrate all four forms of aggression, whereas the event-level analysis revealed that specific forms of aggression are associated with drinking at the time, while other forms were not linked to drinking occasions. Cross-tabulation revealed males and females were more likely to use verbal and physical aggression when drinking. For females, drinking was also associated with relational aggression and anger. Despite often being overlooked in research on aggression during emerging adulthood, relational aggression was prevalent. Discrepancies between the global and temporal analysis revealed factors other than alcohol might explain the relationship between chronic alcohol consumption and specific forms of aggression. This is one of the first event-level studies to show the temporal relationship between alcohol and relational aggression. The distinctions in the current study, exemplifying the diversity of alcohol-related aggression, are critical for understanding aggressive behavior, potential gender differences, and for developing interventions. The temporal relationship between alcohol and aggression suggests health interventions should target drinking and aggression simultaneously.

Violencia en mujeres embarazas por parte de su pareja íntima: factores predisponentes / Intimate partner violence in pregnant women: predisposing factors

OBJETIVO: La violencia de la pareja íntima es un grave problema de salud en todo el mundo y debería ser un tema prioritario para los responsables políticos. Tener información adecuada ayuda a elaborar estrategias para erradicar esta lacra. El objetivo de este trabajo fue determinar los factores asociados con situaciones de violencia ejercida por la pareja sobre las mujeres durante el embarazo. MÉTODOS: Durante 2015 se realizó un estudio transversal en mujeres embarazadas en el sur de España. Se recopiló información sobre variables sociodemográficas e información sobre el embarazo, el parto y el puerperio, mediante entrevistas y documentos clínicos oficiales. Para determinar la situación de violencia se utilizó el Woman Abuse Screening Tool (WAST) en su versión corta. Se realizaron comparaciones de medias mediante el t test, se usó la prueba de chi cuadrado y regresión binaria, así como la prueba de U de Mann-Whitney o la prueba de Kruskal-Wallis para las variables que no seguían una distribución normal. RESULTADOS: Participaron en el estudio 141 mujeres. El porcentaje de mujeres en situación de víctima de violencia de pareja durante el embarazo fue del 31,2% (44). Tener un bajo nivel educativo las parejas de las mujeres, la convivencia con personas que requieren atención y cuidado, ser soltera como estado civil, ser multípara, estar en situación de desempleo las parejas de las mujeres, no tener un trabajo estable la mujer y tener un embarazo no buscado parecieron ser factores predisponentes para una situación de violencia íntima por parte de la pareja durante el embarazo (p < 0,05). CONCLUSIONES: Ciertos factores sociales, como el nivel educativo y la estabilidad laboral, pueden influir en la existencia de violencia ejercida por la pareja sobre las mujeres durante el embarazo

OBJECTIVE: Intimate partner violence is a serious health problem worldwide and should be a priority issue for policy makers. Having adequate information helps to develop strategies to eradicate this scourge. The objective of this study was to determine the factors associated with situations of intimate partner violence during pregnancy. METHODS: During 2015 a cross-sectional study was carried out in pregnant women in southern Spain. Information on sociodemographic variables, information on pregnancy, childbirth, and the puerperium was collected through interviews and official clinical documents. To determine the situation of violence, the Woman Abuse Screening Tool (WAST) was used in its short version. Comparisons of means were made using the t test; chi square and binary regression, as well as the Mann-Whitney U test or the Kruskal-Wallis test for variables that did not follow a normal distribution were used. RESULTS: 141 women participated in the study; the percentage of women in situations of intimate partner violence during pregnancy was 31.2% (44). A low level of education for women's partners, multiparous women, coexistence with people who require care and care, single marital status, women's partners were unemployed, women not having a permanent employment and having an unwanted pregnancy seem be predisposing factors for a situation of intimate partner violence during pregnancy (p < 0.05). CONCLUSIONS: Certain social factors, such as educational level and job stability, can influence the existence of intimate partner violence during pregnancy

Cross-sectional study on patient-physician aggression in Belgium: physician characteristics and aggression types.

OBJECTIVES: The aim of this Belgian research study was to describe the characteristics of physicians who are at increased risk for patient-physician aggression. Second, aggression subtypes were described and data were provided on the prevalence of patient-physician aggression in Belgium. DESIGN: Cross-sectional survey. SETTING: Primary and secondary care inside and outside hospitals. PARTICIPANTS: Any physician who had worked in Belgium for the preceding 12 months was eligible to participate (n=34 648). MAIN OUTCOME MEASURES: An online, original questionnaire was used to obtain physician characteristics (eg, age, sex, native language), department, working conditions and contact with aggressive patients during their career and during the preceding 12 months. RESULTS: The questionnaire was completed by 4930 participants and 3726 (76%) were valid to take into account for statistics. During the preceding 12 months, 37% had been victims of aggression: 33% experienced verbal aggression, 30% psychological, 14% physical and 10% sexual. Multiple answers were allowed. Women and younger physicians were more likely to experience aggression. Psychiatric departments and emergency departments were the settings most commonly associated with aggression. Physicians who provided primarily outpatient care were more subject to aggression. CONCLUSION: Belgian physicians experience several forms of aggression. Those most at-risk of aggression are young and female physicians who work in outpatient, emergency or psychiatric settings.

Exploring typology categorizations of male perpetrators: a methodology study / La exploración de las categorizaciones de la tipología de los varones violentos en la pareja: un estudio metodológico

Intimate partner violence (IPV) perpetrators were categorized based on whether they were generally violent (GV) or family only violent (FO) using self-report or arrest records. Classification criteria to assess recidivism in perpetrators of IPV were evaluated herein to determine the incremental validity of using a perpetrator's criminal history in addition to their self-report information for categorization purposes. The concordance rates for categorizing subtypes of male perpetrators were compared for two methods, namely, self-report versus criminal history data. Categorizations were made based on self-reported history of violence and federal criminal records separately. Between measures consistency was defined as whether or not the self-report categorizations matched federal criminal record categorizations. It was hypothesized that self-report would not be sufficient as the sole method of categorizing male perpetrators, and the use of criminal history data would add to the validity of the categorization system. Self-reports of aggression were higher than criminal records of aggression. Using data sources together may yield the best outcomes for offenders and society. Implications are discussed

Se clasificaron los varones que ejercen violencia en las relaciones de pareja (VP) en función de si eran violentos en general (VG) o solo en el entorno familiar (VF), empleando registros de autoinformes o de arrestos. Se analizaron los criterios de clasificación para evaluar la reincidencia de los infractores de VP con el fin de determinar la validez incremental del uso de los antecedentes penales del infractor, además de la información procedente de su autoinforme para la clasificación. Se compararon los índices de concordancia para categorizar los subtipos de infractores masculinos para dos métodos: los datos procedentes de autoinforme y los de antecedentes penales. La categorización se basó en la historia de violencia autoinformada y en los antecedentes penales por separado. La congruencia entre medidas se definió como la coincidencia o discrepancia de la categorización de autoinforme con la categorización de antecedentes penales. Se planteó la hipótesis de que el autoinforme no bastaba como único método para clasificar a los infractores masculinos y que el uso de datos procedentes de antecedentes penales aumentaba la validez del sistema de categorización. Hubo más autoinformes sobre agresión que antecedentes penales de agresión. El uso conjunto de ambos podría tener mejores resultados, tanto para los delincuentes como para la sociedad. Se discuten las implicaciones de estos resultados

Maladaptive Aggression: With a Focus on Impulsive Aggression in Children and Adolescents.

Objective: Aggressive behavior is among the most common reasons for referral to psychiatric clinics and confers significant burden on individuals. Aggression remains poorly defined; there is currently no consensus on the best ways to recognize, diagnose, and treat aggression in clinical settings. In this review, we synthesize the available literature on aggression in children and adolescents and propose the concept of impulsive aggression (IA) as an important construct associated with diverse and enduring psychopathology. Methods: Articles were identified and screened from online repositories, including PubMed, PsychInfo, the Cochrane Database, EMBase, and relevant book chapters, using combinations of search terms such as "aggression," "aggressive behavio(u)r," "maladaptive aggression," "juvenile," and "developmental trajectory." These were evaluated for quality of research before being incorporated into the article. The final report references 142 sources, published from 1987 to 2019. Results: Aggression can be either adaptive or maladaptive in nature, and the latter may require psychosocial and biomedical interventions when it occurs in the context of central nervous system psychopathology. Aggression can be categorized into various subtypes, including reactive/proactive, overt/covert, relational, and IA. IA in psychiatric or neurological disorders is reviewed along with current treatments, and an algorithm for systematic evaluation of aggression in the clinical setting is proposed. Conclusions: IA is a treatable form of maladaptive aggression that is distinct from other aggression subtypes. It occurs across diverse psychiatric and neurological diagnoses and affects a substantial subpopulation. IA can serve as an important construct in clinical practice and has considerable potential to advance research.

An exploratory study on microaggressions in medical school: What are they and why should we care?

INTRODUCTION: Microaggressions and their impact have been documented in minority college students; however, little is known about the experience of medical students. This study reports the prevalence and understanding of microaggressions among medical students at the University of Florida College of Medicine (UFCOM), while gaining insights into experiences of medical students dealing with microaggressions. METHOD: A nine-question survey was sent out to all medical students at the UFCOM in the spring of 2017 to understand their experiences with microaggressions. The authors used simple statistics and chi-test to analyze the demographic data and an inductive thematic qualitative analysis was performed on the open-ended responses to study medical students' understanding of the term, experiences, and impact of microaggressions. RESULTS: The response rate was 64% (n = 351/545). Fifty-four percent reported experiencing microaggressions, of those the majority were female students (73% compared with 51% among male students, p = 0.0003); for female students from minority backgrounds this was 68% and for white female students 76% (p = 0.2606). Microaggressions are more common in the second year of medical school (30%), followed by the third year (23%). Most students were able to recognize and identify microaggressions, but some denied the concept existed, attributing concerns about microaggressions to a culture promoting oversensitivity and political correctness. Students described microaggressions related to sexism; religion; skin colour; and ethnicity. Students described indifference, emotional reactions and denial of the event as coping mechanisms. CONCLUSION: Microaggressions are prevalent on a day-to-day basis among medical students with female students from a minority background as well as white female students experiencing more microaggressions. Further research is needed to explore interventions to counter microaggressions in order to ensure a healthy learning environment.

La respuesta del Derecho Penal y Administrativo frente a las agresiones a profesionales sanitarios en España / The response of Criminal and Administrative Law on violence in the workplace against health professionals in Spain

La entrada en vigor de la Ley Orgánica 1/2015 ha supuesto la materialización de importantes modificaciones en el tratamiento punitivo de los supuestos de agresiones a profesionales sanitarios. En particular, y junto con la tipificación expresa como delito de atentado (art. 550 CP) de los supuestos de agresiones a profesionales sanitarios, se incluye como novedad más relevante la previsión de una agravación en el delito de homicidio cuando los hechos resulten constitutivos de un atentado (art. 138.2.b CP). Al hilo de lo anterior, el presente trabajo pretende establecer con nitidez el nuevo panorama concurrente en la esfera sancionatoria (penal y administrativa) en dichos supuestos de agresiones a los mencionados profesionales

The coming into effect of Organic Law 1/2015 has involved relevant changes in the criminal treatment of cases of violence against health professionals. In particular, the reform expressly establishes the offence as assault on the authority, its agents and civil servants (Article 550 Spanish Criminal Code) of the cases of aggression against health professionals. It also includes, as a relevant novelty, the prevision of an aggravated modality of homicide when the facts prove to be constitutive of an assault on the authority, its agents and civil servants (Article 138.2.b Spanish Criminal Code). Consequently, the present paper is devoted to clarifying the current legal framework in the punitive sphere (penal and administrative) in cases of aggression against health professionals

Subtypes of aggression in intermittent explosive disorder.

Research in aggression has distinguished two major subtypes of aggressive behavior: hostile and instrumental. Previous research has examined these subtypes in healthy individuals and forensic samples but not in intermittent explosive disorder (IED), a disorder characterized by recurrent and severe aggressive behavior. We examined aggression subtypes in individuals with IED, healthy subjects, and psychiatric control subjects. We also considered the relationship between aggression subtypes and measures of trait anger and impulsivity to evaluate whether the hostile/instrumental dichotomy adequately captures the heterogeneity of aggressive behavior in this sample. Finally, we consider the implications of these results for research on aggression, including neuroscience research on aggression.

Development of Aggression Subtypes from Childhood to Adolescence: a Group-Based Multi-Trajectory Modelling Perspective.

The persistence of elevated subtypes of aggression beginning in childhood have been associated with long-term maladaptive outcomes. Yet it remains unclear to what extent there are clusters of individuals following similar developmental trajectories across forms (i.e., physical and indirect) and functions (i.e., proactive and reactive) of aggression. We aimed to identify groups of children with distinct profiles of the joint development of forms and functions of aggression and to identify risk factors for group membership. A sample of 787 children was followed from birth to adolescence. Parent and teacher reports, and standardised assessments were used to measure two forms and two functions of aggressive behaviour, between six and 13 years of age along with preceding child, maternal, and family-level risk-factors. Analyses were conducted using a group-based multi-trajectory modelling approach. Five trajectory groups emerged: non-aggressors, low-stable, moderate-engagers, high-desisting, and high-chronic. Coercive parenting increased membership risk in the moderate-engagers and high-chronic groups. Lower maternal IQ increased membership risk in both high-desisting and high-chronic groups, whereas maternal depression increased membership risk in the high-desisting group only. Never being breastfed increased membership risk in the moderate-engagers group. Boys were at greater risk for belonging to groups displaying elevated aggression. Individuals with chronic aggression problems use all subtypes of aggression. Risk factors suggest that prevention programs should start early in life and target mothers with lower IQ. Strategies to deal with maternal depression and enhance positive parenting while replacing coercive parenting tactics should be highlighted in programming efforts.

Predictors of childhood trajectories of overt and indirect aggression: An interdisciplinary approach.

The aim of this study was to advance our understanding of the development of aggression in boys and girls by testing a model combining insights from both evolutionary theory and developmental psychology. A sample of 744 children (348 girls) between six and 13 years old was recruited in schools with high deprivation indices. Half of the sample (N = 372; 40.1% girls) had received special educational services for behavioral and/or socio-emotional problems. Two trajectories for overt aggression and two trajectories for indirect aggression were identified and binomial logistic regressions were used to identify environmental predictors and sex-specific patterns of these trajectories. Results indicated that peer rejection predicted overt aggression and indirect aggression and that extraversion and male sex predicted overt aggression. The results also showed that interaction between parental practices and some child temperament traits predicted overt aggression (coercion and lack of supervision associated with extraversion or low effortful control) or indirect aggression (coercion and neglect associated with negative affect or low effortful control), and the absence of a father figure predicted high indirect aggression in girls.

Specific Contributions of Age of Onset, Callous-Unemotional Traits and Impulsivity to Reactive and Proactive Aggression in Youths with Conduct Disorders.

Youths with conduct disorders (CD) are particularly studied for their violent and aggressive behaviors. Many researchers considered aggressive behaviors as being either reactive or proactive. Moreover, factors such as age of CD onset, impulsivity, and callous-unemotional traits, separately, have been related to these different types of aggressive behaviors. However, very few studies addressed the combined contribution of these three factors on proactive and reactive aggression. This question was tested in a sample composed of 43 male adolescents with CD. A single regression analysis including all predictors and outcomes, using Bayesian statistics, was computed. Results indicated that impulsivity was related to reactive aggression, while CU traits were related to proactive aggression. These results suggest first, an important heterogeneity among youth with CD, probably leading to different trajectories and, second, that youths with callous-unemotional traits should receive special attention and care as they are more at risk for proactive aggression.

Focus on aggressive behaviour in mental illness.

Background: Aggression is a behaviour with evolutionary origins, but in today's society it is often both destructive and maladaptive. Increase of aggressive behaviour has been observed in a number of serious mental illnesses, and it represents a clinical challenge for mental healthcare provider. These phenomena can lead to harmful behaviours, including violence, thus representing a serious public health concern. Aggression is often a reason for psychiatric hospitalization, and it often leads to prolonged hospital stays, suffering by patients and their victims, and increased stigmatization. Moreover, it has an effect on healthcare use and costs in terms of longer length of stay, more readmissions and higher drug use. Materials and methods: In this review, based on a selective search of 2010-2016 pertinent literature on PubMed, we analyze and summarize information from original articles, reviews, and book chapters about aggression and psychiatric disorders, discussing neurobiological basis and therapy of aggressive behaviour. Results: A great challenge has been revealed regarding the neurobiology of aggression, and an integration of this body of knowledge will ultimately improve clinical diagnostics and therapeutic interventions. The great heterogeneity of aggressive behaviour still hampers our understanding of its causal mechanisms. Still, over the past years, the identification of specific subtypes of aggression has released possibilities for new and individualized treatment approaches. Conclusions: Neuroimaging studies may help to further elucidate the interrelationship between neurocognitive functioning, personality traits, and antisocial and violent behaviour. Recent studies point toward manipulable neurobehavioral targets and suggest that cognitive, pharmacological, neuromodulatory, and neurofeedback treatment approaches can be developed to ameliorate urgency and aggression in schizophrenia. These combined approaches could improve treatment efficacy. As current pharmacological and therapeutic interventions are effective but imperfect, new insights into the neurobiology of aggression will reveal novel avenues for treatment of this destructive and costly behaviour.

Subtypes of suicide attempters based on longitudinal childhood profiles of co-occurring depressive, anxious and aggressive behavior symptoms.

Because suicide attempts are multi-determined events, multiple pathways to suicidal behaviors exist. However, as a low-frequency behavior, within group differences in trajectories to attempts may not emerge when examined in samples including non-attempters. We used longitudinal latent profile analysis to identify subtypes specific for suicide attempters based on longitudinal trajectories of childhood clinical symptoms (i.e., depression, anxiety, and aggression measured in 2nd, 4th-7th grades) for 161 young adults (35.6% male; 58.6% African American) who attempted suicide between ages 13-30 from a large, urban community-based, longitudinal prevention trial (n = 2311). Differences in psychiatric diagnoses, suicide attempt characteristics, criminal history and traumatic stress history were studied. Three subtypes emerged: those with all low (n = 32%), all high (n = 16%), and high depressive/anxious, but low aggressive (n = 52%) symptoms. Those with the highest levels of all symptoms were significantly more likely to report a younger age of suicide attempt, and demonstrate more substance abuse disorders and violent criminal histories. Prior studies have found that childhood symptoms of depression, anxiety and aggression are malleable targets; interventions directed at each reduce future risk for suicidal behaviors. Our findings highlight the link of childhood aggression with future suicidal behaviors extending this research by examining childhood symptoms of aggression in the context of depression and anxiety.

Effect of personality traits, age and sex on aggressive driving: Psychometric adaptation of the Driver Aggression Indicators Scale in China.

This study aimed to assess the reliability and validity of the Chinese version of the Driver Aggression Indicators Scale (DAIS), which measures aggressive driving behaviors. Besides, demographic variables (sex and age) and the big five personality traits were examined as potential impact factors of aggressive driving. A total of 422 participants completed the DAIS, Big Five Personality Inventory (BFPI), and the socio-demographic scale. First, psychometric results confirmed that the DAIS had a stable two-factor structure and acceptable internal consistency. Then, agreeableness and conscientiousness were negatively correlated with hostile aggression and revenge committed by the drivers themselves, while neuroticism was positively correlated with aggressive driving committed by the drivers themselves. Meanwhile, more agreeable drivers may perceive less hostile aggression and revenge. More neurotic drivers may perceive more aggressive warning. Finally, the effects of age and sex on aggressive driving were not same as most studies. We found that older age group perceived and committed more hostile acts of aggression and revenge than younger age groups. Female drivers of 49-60 years perceived more aggressive warnings committed by other drivers.