Client characteristics associated with behavior change for treated and untreated aggressive boys

This study examined the relationship between subject characteristics of aggressive boys and their behavioral changes during a school year. Seventy-six boys in the fourth, fifth, and sixth grades were identified by their teachers as the most disruptive and aggressive in their classes. These boys were assigned to untreated control, anger-coping, anger-coping plus goal-setting treatment, and minimal treatment goal-setting cells. The anger-coping treatment was based on cognitive behavioral procedures. In both anger-coping cells, greater reductions in rates of disruptive/aggressive off-task classroom behavior was predicted by having higher rates of these behaviors initially, and greater reductions in parents' ratings of aggression was predicted by having poor social problem-solving skills initially. Additional predictors of reductions in parents' ratings of aggression in one, but not both, anger-coping cells included having higher rates of somatic symptoms and poorer social acceptance by peers. In contrast to the other cells, those boys in the no-treatment group who demonstrated the greatest spontaneous improvement on these change measures were the ones who initially were the best problem-solvers and who had higher levels of self-esteem. This cognitive-behavioral treatment appeared to have most impact with those boys who were the most in need of intervention.Portions of this paper were presented at the American Psychological Association annual convention, Anaheim, California, August 1983. Acknowledgment is made of the administrative and/or financial support provided by the Durham County School System, the Duke University Medical Center Department of Psychiatry, and the Durham Community Guidance Clinic. Appreciation is expressed to the other coleaders of the groups: Rosalyn Alexander, Steve Harris, Pat Kirkley, Val McLean, Kathy McSwain, Connie Scott, Barbara Thornton, Mary Ann Black, Harvey Botman, Dr. Bonnie Gregory, and Dr. Renee Schoenfeld.     

Group therapy with sexually abused boys: leadership, projective identification, and countertransference issues

Group therapy is an essential component of the treatment of sexually abused children. Since the painful effects associated with the abuse are often dissociated or acted out, the group leaders learn of the affective experience of the abuse through the process of projective identification. The leaders must be aware of this process, set limits on the abusive acting out in the group, and help moderate, label, and empathize with the affect. It is through this difficult process that the children have a chance to reintegrate and work through their abuse experiences so they no longer feel compelled to act them out through repetitive abusive relationships. Specific leadership, countertransference, and projective identification issues in group therapy with sexually abused boys are discussed.     

Self-reported likelihood of sexually aggressive behavior: Attitudinal versus sexual explanations

The present study compared the relative effectiveness of sexuality variables versus attitudes hypothesized to be rape-supportive in the prediction of “likelihood to rape” (LR) and “likelihood to use sexual force” (LF) measures. This research was guided by the suggestion that understanding the variables which underlie LR and LF may shed light on the factors which cause some men to actually commit acts of violence against women. The results were inconsistent with viewing rape as primarily caused by sexual frustration or sexual maladjustment, since sexuality variables were generally not predictive of LF or LR. In contrast, a variety of rape-supportive attitudes and beliefs such as blaming the victim for her rape or viewing sexual violence as sexually arousing to women were successful predictors of both LF and LR. These data were interpreted as supporting theories of rape which consider cultural, socially transmitted attitudes about women and rape to be psychological releasers for sexual aggression. The findings also supported the notion of an “aggression toward women” continuum, rather than a conceptualization of rape as a discrete, isolated phenomenon with its own determinants.     

Situational consistency in behavioral patterns of aggressive boys: Methodological considerations on observational measures

The issue of situational consistency is of great interest for early intervention with aggressive boys, but efforts to show behavior stability across settings have been unsuccessful to date, due principally to methodological problems. It is argued here that a more appropriate matching of response form, interaction partner, and situations should increase the situation consistency of observed behavior. The results support this proposition in that, more crosssetting behavior consistency was found in the pairing of situations where aggressive boys (age 6–7 years) were interacting with an adult female (mother/child versus baby-sitter/child) than in the pairing of situations where the boys were interacting with an adult male (mother/child versus father/child) or with the teacher in a nondyadic situation (classroom). The implications of using an extreme group are also discussed.This research program was funded by Le Conseil Québécois de la Recherche Sociale, the Quebec Government's FCAR research program, the Social Sciences and Humanities Research Council of Canada, the Canadian Ministry of Employment and Immigration, and the University of Montreal FDR program.     

Dialectical behavior therapy for the treatment of anger and aggressive behavior: A review

ObjectiveThe management of anger and aggression is a public safety issue. Dialectical behavior therapy (DBT) is a promising treatment for reducing anger and violent behavior. This mode of therapy addresses maladaptive behavior by teaching emotion regulation, distress tolerance, interpersonal effectiveness, core mindfulness, and self-management skills.MethodsThis paper reviewed DBT treatment for anger and aggressive or violent behavior. The literature search included articles from 1998 to September 2013. A total of 21 peer-reviewed articles studying the effects of DBT on anger and aggressive behavior were reviewed.ResultsAdaptations or modifications were made to standard DBT to accommodate the specific needs of the variety of populations across studies. Nine studies attempted to understand the efficacy of DBT for anger and aggressive behavior while twelve studies measured the efficacy of DBT within the context of a BPD diagnosis. There are nine randomized controlled trials (RCT) assessing DBT to reduce anger and aggressive behavior.ConclusionResearch has shown that there are potentially clinically significant results when using DBT to treat anger and aggression in various samples. Findings from this review suggest that treatments, even when modified show a positive impact on the reduction of anger and aggressive behaviors.     

The effectiveness and generalization of a cognitive-behavioral group treatment to reduce impulsive/aggressive behavior for boys in a residential setting

Twenty of 150 boys living in a residential setting who were emitting high levels of impulsive/aggressive behavior participated in a study of the effectiveness of a cognitive-behavioral group treatment procedure designed to equip them with skills conducive to alternate and more socially appropriate behavior. Treatment involved 13 meetings of 55 minutes duration over a six-week period. The results indicated significant behavioral changes in school regarding: (1) the intensity of physical fighting, (2) the frequency and intensity of verbal fighting, (3) noncompliance, and (4) being in an inappropriate location. These behavioral changes did not generalize beyond the school setting. Significant increases in the number of identified logical consequences of aggressive behavior and in the number of alternative responses to aggressive behavior were observed compared to control boys. The behavioral changes observed in school largely extinguished during the five weeks between the last treatment session and the follow-up observations.     

Intervention for families of aggressive boys: A replication study

This study was an attempt to replicate an earlier investigation in which parents were trained to alter the behaviors of their aggressive children. Eleven consecutive referrals from community agencies received an average of 31.7 hr of professional time. Multiple criteria were used to evaluate treatment outcome. Observers collected systematic data in the homes during baseline and intervention. At termination, these data showed significant reductions in deviant child behaviors. Parents provided daily reports on the occurrence of selected problem behaviors; these data showed moderate reductions at termination. Some time after termination, parents were called and asked for global evaluations. All parents reported marked improvements in the behavior of the children. The findings are viewed as a replication of earlier findings.     

The best friendships of aggressive boys: relationship quality, conflict management, and rule-breaking behavior

The current study examined the best friendships of aggressive and nonaggressive boys (N = 96 boys, 48 dyads, mean age = 10.6 years). Friends completed self-report measures of friendship quality, and their interactions were observed in situations that required conflict management and provided opportunities for rule-breaking behavior. Although there were no differences in boys' self-reports of friendship quality, observers rated nonaggressive boys and their friends as showing greater positive engagement, on-task behavior, and reciprocity in their interactions compared with aggressive boys and their friends. Aggressive boys and their friends provided more enticement for rule violations and engaged in more rule-breaking behavior than did nonaggressive boys and their friends. Also, the intensity of negative affect in observed conflicts between aggressive boys and their friends was greater than that between nonaggressive boys and their friends. The findings suggest that friendships may provide different developmental contexts for aggressive and nonaggressive boys.     

Impact of social problem-solving training on aggressive boys: Skill acquisition,behavior change,and generalization

This study examined the impact of social problem-solving training on the behavior of five aggressive boys. Acquisition of problem-solving skills and changes in classroom behavior were evaluated using multiple-baseline designs within and across subjects. A generalization-programming procedure to promote the use of problem-solving skills in the natural environment was introduced across children in multiple-baseline fashion. Direct observation and behavior ratings were used to evaluate the treatment. Results indicated that each subject acquired the problem-solving skills at levels comparable to well-adjusted peers. Only one child showed behavioral improvement coincident with problem-solving skill acquisition. Three others showed moderate behavior change after the generalization-programming procedure was introduced. Only one child's gains on teacher ratings were maintained at the 6-month followup. The results suggest that cognitive-behavioral treatment of childrens' aggressive behavior may produce changes of limited magnitude and durability.This paper was based on a doctoral dissertation by the first author in partial fulfillment of the requirements of West Virginia University. The authors wish to thank Lianne Willis for her participation as a therapist. Appreciation is also extended to Barry Edelstein, David Hansen, Daniel Hursh, and Mark Cummings for their constructive comments.     

Theoretical and methodological considerations in cross-generational research on parenting and child aggressive behavior

The four studies in this special issue represent important advances in research on the intergenerational transmission of aggressive behavior. In this commentary, we review the key features and findings of these studies, as well as our own cross-generational study of aggression, the Columbia County Longitudinal Study. Next, we consider important theoretical issues (e.g., defining and operationalizing raggression and parenting assessing reciprocal effects of parenting and child aggression; identifying the ages at which aggression should be assessed across generations; broadening the investigation of contextual and individual factors). We then discuss several methodological issues (e.g., determining the most informative measurement intervals for assessing prospective effects; sampling considerations; measuring potential moderating and mediating variables that might explain cross-generational continuities and discontinuities in parenting and aggression). Finally, we raise implications of cross-generational research for designing interventions targeting the reduction and prevention of child aggression.     

A behavioral observation method for differentiating hyperactive and aggressive boys

This study employed a playroom observation technique to examine the behavioral differences between hyperactive and aggressive boys. Subjects were clinic-referred boys assigned to Hyperactive, Aggressive, or Hyperactive plus Aggressive goups on the basis of behavior checklists and ratings of psychiatric chart information. While significant discrimination was obtained in all three settings (free play, restricted play, and restricted academic), behavioral differences among the subject groups were most pronounced during the restricted academic period. Discriminant function analysis for the restricted academic period resulted in accurate classification of 86% of the subjects as hyperactive, aggressive, or hyperactive plus aggressive. The present findings suggest that children with externalizing disorders can be distinguished in light of their observed clinic behavior in the restricted academic setting.This was conducted as part of the author's dissertation. The author wishes to express thanks to Jan Loney, Richard Milich, and Richard Roberts for their assistance in completion of this study and preparation of this article.     

Students' perceptions of male sexually aggressive behavior as a function of educational level and gender

Two hundred and four students (108 college freshmen, sophomores, juniors, and seniors; 96 high school juniors and seniors) participated in this study. The socioeconomic status of the participants (high school = 93% Caucasian, 7% African-American; college = 96% Caucasian, 4% African-American) was primarily in the lower middle-class range. The purposes of this investigation were (1) to test whether or not differences exist between high school and college students' perceptions of one form of male sexually aggressive behavior against women, (2) to determine if differences exist between male and female students' perceptions of such behavior against women, and (3) to explore the sex role socialization theory by providing empirical observation of its basic tenets. Findings suggested that boys may experience slower maturation and development of sensitivity toward sexual aggression than girls, but that this gap may lessen with advancing age for college males.     

Group treatment for trichotillomania: behavior therapy versus supportive therapy

In this randomized controlled trial, group behavior therapy (BT; n = 12) was compared to group supportive therapy (ST; n = 12) in the treatment of trichotillomania (TTM). Both treatments were also compared to a naturally occurring waiting period, the time period that participants waited for groups to form. Participants completing group BT experienced significantly greater decreases in self-reported hair-pulling symptoms and clinician-rated hair loss severity than did those in group ST. Decreases were significantly greater after treatment than after the naturalistic waiting period. In addition, a significantly higher percentage of those in the BT than ST condition were rated as much improved or very much improved on the Clinical Global Impression scale at posttreatment. However, despite substantial symptom improvement, TTM severity remained problematic at posttreatment. Specifically, few participants in either treatment met criteria for clinically significant change at posttreatment. In addition, relapse of symptoms occurred over the 6-month follow-up period. Results provided partial support for the short-term efficacy of group BT. However, the group format may not maximize the efficacy of BT for TTM. Thus, it is recommended that future BT research test either individual therapy or a combination of group and individual formats for TTM.     

Prosocial behavior in hyperactive boys: Effects of stimulant medication and comparison with normal boys

To clarify the effects of stimulant medication on hyperactive (ADHD) children's prosocial as well as aversive behaviors toward peers, 19 hyperactive boys, aged 7–12, were observed as they acted as leaders for groups of 2–4 unfamiliar younger children. In a doubleblind crossover design, subjects were observed twice, once on placebo and again on a moderate (0.6 mg/kg) dose of methylphenidate (Ritalin). Thirteen comparison boys, without problems in attention and behavior, were also observed in the same leader roles. Relative to comparison boys, hyperactive boys on placebo were more socially engaged, used more aversive leadership techniques, and were rated as less likable by the younger children in their groups. Aversive social behaviors were the strongest predictors of being disliked by the younger children. No differences were found between comparison and unmedicated hyperactive boys for any aspect of prosocial behavior. Stimulant medication had a general dampening effect on social behavior, significantly reducing social engagement and increasing (mild) dysphoria relative to the placebo condition. The implications of these findings for understanding and treating the peer relationship difficulties of hyperactive children are discussed.This study was conducted at the Fernald Child Study Center, UCLA, and we very much appreciate the contributions of the many staff members of the program, especially those of Alice Huber-Dressler and Tracy Heller. We also are very grateful to staff and children of Corinne A. Seeds University Elementary School for their participation in this study.     

Predicting aggressive patterns in girls and boys: A developmental study

The aim of this multimethod, longitudinal study was to examine similarities and differences in aggressive expression and prediction among school-aged boys and girls. The primary research sample involved 174 children (93 females, 81 males). They were in the fourth grade at the beginning of the study, and the fifth grade at its conclusion. Embedded in the primary sample was a subgroup of 20 children identified as being highly aggressive (ten males, ten females), and a subgroup of 20 matched control children. The research measures included teachers' ratings of aggressive behavior, peer-nominations/reports of prior conflicts, individual interviews/self-ratings, and extensive behavioral observations. Analyses of the concurrent relations among measures pointed to a “public” cluster of measures (including peer-nominations, behaviors, and teacher ratings) and relatively “private” measures (ie, subjects' self-evaluations). In the primary sample, significant developmental trends were detected in the teacher ratings with increasing gender differentiation as children grew older. Few gender differences were observed in the high-aggressive subgroup, but the aggressive and the matched control groups differed on virtually all comparisons. Gender differences in predictability were a function of risk status, with high-aggressive girls showing as much stability as high-aggressive boys.     

Clinical application of conditioning and other behavioral techniques: Conceptual and professional considerations

It is only recently that conditioning and allied techniques have been applied on any large scale outside the laboratory. With the emergence of these procedures into the clinical world, in particular, a new class of problems present themselves. It is no longer sufficient to focus upon narrowly technical or theoretical problems; philosophies, social and practical issues must be taken into consideration and the new techniques evaluated conceptually and practically in direct comparison with their psychodynamic alternatives. Selected issues are presented and discussed.