ARTICLES
Aggressive Behavior in Clinically Depressed Adolescents

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ABSTRACT

Objective

To investigate the prevalence and characteristics of aggressive behavior in adolescent inpatients and outpatients with major depressive disorder (MDD). Differences between males and females in prevalence and type of aggression, and level of parent-child agreement in report of aggression, were analyzed.

Method

Participants were 74 adolescents with MDD, aged 13 to 17 years. The Structured Clinical Interview for DSM-IV Axis I Disorders was used to identify MDD. Adolescents' aggressive behavior was assessed using an adapted version of the Brown-Goodwin Assessment for Lifetime History of Aggression; the Measure of Aggression, Violence, and Rage in Children; and the Buss-Durkee Hostility Inventory-Adapted Version.

Results

Results indicate high levels of aggressive behavior in adolescents with MDD. Amount and type of aggression did not differ by gender. Results indicate poor correspondence between parent and adolescent reports of aggression, which was most marked for females.

Conclusions

Aggressive behaviors are highly prevalent in depressed youths, with similar types and levels evident in males and females. Parents tend to underreport and may not be cognizant of aggressive behavior that occurs outside the home, particularly for females.

Section snippets

Measurement of Aggressive Behavior in Youths

The prevalence and nature of aggressive behavior in youths only recently received significant research attention, in part because of the increased media attention to recent acts of youth violence. Past research on aggression in youths has been impeded by the limited number of structured, psychometrically sound instruments addressing aggressive behavior in youths (Gothelf et al., 1997). Another impediment to the study of aggression in youths has been the debate over whether to rely on parent or

Participants

Participants were 74 adolescents with major depressive disorder (MDD) who were referred for treatment at a university-based psychiatric facility. Eighty-five percent of the sample were inpatients, and 15% were outpatients. Reasons for inpatient hospitalization included significantly impaired reality-testing, potential dangerousness to self or others, and incapacitating mental illness. The primary reason for admission was aggressive behavior/potential dangerousness to others for 12.2% of the

Prevalence and Characteristics of Aggressive Behavior in Depressed Adolescents

Means and standard deviations of scores on adolescent- and parent-report scales of aggression are reported in Table 2. Adolescents' responses to the BG indicate that 70% of the total sample reported a history of “frequent” verbal aggression at home, 24% reported frequent physical aggression in the home, 30% reported receiving detentions at school for aggression, and 14% reported being arrested for aggressive behavior. Nineteen percent reported frequent detentions, and 4% reported frequent

Prevalence and Nature of Aggressive Behavior in Depressed Adolescents

Results of this study indicate that depressed adolescents who are referred for treatment engage in high levels of aggressive behavior. Almost one fourth of the adolescents demonstrated significant, persistent aggression across settings, and a substantial majority demonstrated such aggression in at least one setting. With the exception of higher levels of aggression in youths with comorbid ODD and CD, the level of aggression was not associated with higher comorbidity.

The reason for the high

REFERENCES (49)

  • H Schubiner et al.

    Exposure to violence among inner-city youth

    J Adolesc Health

    (1993)
  • M Schwab-Stone et al.

    The Diagnostic Interview and Schedule for Children-Revised Version (DISC-R), II: test-retest reliability

    J Am Acad Child Adolesc Psychiatry

    (1993)
  • ME Schwab-Stone et al.

    Criterion validity of the NIMH Diagnostic interview Schedule for Children Version 2.3 (DISC-2.3)

    J Am Acad Child Adolesc Psychiatry

    (1996)
  • G Stevens et al.

    Occupational Status Index

    Soc Sci Res

    (1981)
  • TM Achenbach et al.

    Child/adolescent behavioral and emotional problems: implications for cross-informant correlations for situational specificity

    Psychol Bull

    (1987)
  • American Psychiatric Association

    Diagnostic and Statistical Manual of Mental Disorders

    (1987)
  • Bass JW, Geenens DL, Popper C (1993), Measure of Aggression, Violence, and Rage in Children (MAVRIC) (abstract). In:...
  • L Berkowitz

    Frustration-aggression hypothesis: examination and reformation

    Psychol Bull

    (1989)
  • B Birmaher et al.

    Neuroendocrine response to 5-hydroxy-L-tryptophan in prepubertal children at high risk of major depressive disorder

    Arch Gen Psychiatry

    (1997)
  • K Bjorkvist et al.

    Do girls manipulate and boys fight?

    Aggressive Behav

    (1992)
  • SL Boone et al.

    A psychometric analysis of aggression and conflict-resolution behavior in adolescent males

    Soc Behav Pers

    (1988)
  • AH Buss et al.

    An inventory for assessing different kinds of hostility

    J Consult Psychol

    (1957)
  • EJ Costello et al.

    Validity of the NIMH Diagnostic Interview Schedule for Children: a comparison between psychiatric and pediatric referrals

    J Abnorm Child Psychol

    (1985)
  • C Epkins

    Parent ratings of children's depression, anxiety, and aggression: a cross-sample analysis of agreement and differences with child and teacher ratings

    J Clin Psychol

    (1996)
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    This research was supported by a grant to Dr. King from the American Foundation for Suicide Prevention. The authors express their appreciation to Elizabeth Weidmer-Mikhail, M.D., Azmaira Maker, Ph.D., Steve Katz, Ph.D., Diane Koram, M.S.W., Sarah Degue, Jodi Kleinman, Phil Walker, and George Stegeman.

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