Examining Behavioral Approach and Inhibition to Further Characterize Youth With Impulsive Aggression

Impulsive aggression in youth is a significant clinical and public health concern, spanning multiple diagnostic categories and causing significant psychosocial impairment. To advance its assessment and treatment, recent research has focused on developing an empirically derived nosology that can distinguish impulsive aggression from other common childhood problems. The current study is a secondary analysis examining the associations between this empirically defined form of impulsive aggression, other psychiatric symptom dimensions, and behavioral approach and inhibition motivation of youth.

Participants were 636 youth (61% male; 69% Black/African American; mean age = 11.10) who presented for treatment to a community mental health center or an academic medical center. Dimensions of psychopathology were based on a prior principal component analysis that yielded 5 components: aggression-impulsive/reactive (AIR), mania, depression, self-harm, and rule-breaking. All parents and a subset of youth (n = 363) rated behavioral approach and inhibition motivation of youth.

After controlling for demographic factors (age, sex, race) and other dimensions of psychopathology (mania, depression, self-harm, rule-breaking behavior), AIR was uniquely and positively associated with parent- and adolescent-reported behavioral approach motivation and negatively associated with parent-reported behavioral inhibition.

The results help to further characterize AIR, a clinically relevant and empirically defined construct of impulsive aggression, by showing that AIR is associated with high approach and low inhibition motivational dispositions above and beyond the effects of rule-breaking behavior and mood symptoms. These findings add to a growing literature that shows promise in improving assessment and treatment outcomes for this highly impairing clinical concern.