What is Aggression?

by Dave Piltz

According to the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013), aggression is not a disorder but is associated with several disorders. Those disorders are oppositional defiant disorder, intermittent explosive disorder, conduct disorder, antisocial personality disorder, pyromania, and kleptomania. In addition there are several other disorders and medical conditions in which aggression is associated such as, but not limited to delirium, schizophrenia, temporal lobe epilepsy, paranoid disorder, and iatrogenic or steroid use (Preston, & Johnson, 2014). Aggression is 1) acts towards others that violate their personal rights, 2) disruptive, and 3) acts that involve the inability to control one’s impulses. Aggression behaviors are frequent, persistent and pervasive in which the individual’s normal functioning in daily life is disrupted (American Psychiatric Association, 2013).

According to the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013), oppositional defiant disorder’s symptoms include angry and irritable mood, argumentative and defiant behavior, and vindictiveness. Intermittent explosive disorder’s and conduct disorder’s symptoms include verbal and physical aggression towards others, animals or property while conduct disorder also includes deceitfulness, theft and serious violations of rules. Across the disorders the symptom of aggression is harm (of some sort, some less harmful than others) towards others, animals or property.

            Underlying causes

            Aggression is a behavior that disregards the worth of others and also is a behavior that has lack of control. It is an impulse behavior in which he person is unable to control and/or limit their emotions and/or behaviors and is associated with developmental stages of an individual According to the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013),

            Psychopharmacological

            Aggression is not typically considered the essential issue but rather the disorder in which aggression is a symptom. There tends to be little success in treating aggression alone but higher success when treated along with disorders associated with aggression. As in all treatment strategies, side effects need to be considered in prescribing pharmacological interventions such as but not limited to antipsychotics, atypical antipsychotics, anticonvulsants, and selective serotonin reuptake inhibitors (Preston, & Johnson, 2014).

Psychotherapeutic

            Since emotions, impulse control and behaviors are the issues with aggression, treatment should focus on understanding and regulating emotions so that appropriate behaviors are chosen. From a systems perspective using therapies such as Bowen Intergenerational to recognize patterns of living that have been transferred from past generations, or Satir’s Communications approach to deal with recognizing and communicating emotions in a healthy way, or Solution-Focused approach to create new behaviors that are not impulsive would be beneficial. In addition, psychoeducation along with family sessions using all of these approaches is advisable. Non-system based therapies that are effective is mindfulness, cognitive behavior therapy and dialectical behavior therapy (Gehart, & Tuttle, 2003)

            Alternative treatments

            Since aggression can be associated with other medical issues, having a full medical work-up and possibly a neurological work-up to rule out medical issues is advisable. In addition, one should consider meditation, yoga, and or massage to help to relax and calm the person. Exercise and proper nutrition is also key in allowing the body to be well balanced so that the impulses can be controlled more effectively.

 

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Gehart, D., & Tuttle, A., (2003) Theory-based treatment planning for marriage and family therapists. Belmont, CA: Cengage Learning.

Gehart, D., (2014). Mastering competencies in family therapy a practical approach to theories and clinical case documentation. Belmont, CA:  Cengage Learning.

Patterson, J. E., & Albala, A.A., & McCahill, M.E., & Edwards, T.M. (2010). The therapist’s guide to psychopharmacology: Working with patients, families, and physicians to optimize care. New York: Guilford Press.

Preston, J., & Johnson, J. (2014). Clinical psychopharmacology made ridiculously simple. 8th Miami, FL: MedMaster.

Smith, P., (2008). A concise guide to better health and longevity what you must know about vitamins, minerals, herbs & more choosing the nutrients that are right for you. Garden City Park, NY: Square One Publishers.

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