Aggression is highly common among patients requested psychiatric treatment.
Among adults the number of physical assault in patients referred for psychiatric hospitalization has risen 150% for females and 50% for males over the past 10 years (Tardiff et al., 1997). Among psychiatrically referred children and adolescents, aggressive behavior patterns have shown a detectable increase over the past two decades (Achenbach and Howell, 1993) and are now the most common reason for referral regardless of ambulatory or institutional setting (Carlson, 1995). The prevalence of aggression significantly augments the overall cost of child and adolescent mental health services. It is highly associated with psychosocial, behavioral, and academic impairment in youth (Vivona et al., 1995); can have an early age of onset (Moffit, 1993); and demonstrates marked stability over time into adulthood, especially for males (Farrington, 1991).
The component behaviors subsumed under the domain of aggression are quite varied. Previous reviews of the development of aggression have repeatedly emphasized the importance of subtyping aggressive behavior into theoretically and empirically distinguishable subcategories (Hinshaw and Anderson, 1996; Parke and Slaby, 1983; Vitiello and Stoff, 1997).
Distinct subtypes may possess differing diagnostic, biological and psychosocial correlates; novel responses to psychosocial and somatic therapies; and varying prognoses.
Much previous research on aggression in children and adolescents has focused on psychiatric diagnoses such as conduct disorder and the disruptive behavior disorders, nonspecific behavior problems, violence, and crime (American Psychiatric Association, 1994; Hinshaw and Anderson, 1996; Loeber et al., 1995; Raine et al., 1994, 1996; Widom, 1989). The use of conduct disorder for studying aggression in youth has been criticized as inadequate.
This diagnosis offers no guidelines to help clinicians distinguish pathological from non-pathological aggression, ignores developmental issues, and ignores the environmental context in which aggressive behavior occurs (Richters, 1996). Furthermore, disruptive behavior disorder diagnoses, behavior problems, crime, and...