Introduction to a Special Series on Aggressive Behavior as a Focus of Psychiatric Attention

Aggressive behavior in children and adolescents is a frequent complication of numerous psychiatric, developmental, environmental, and medical factors.¹ When present, aggression often is of paramount importance regardless of the underlying disturbances or environmental factors from which it stems.² From a clinical standpoint, aggression influences important decisions about emergency service use, hospitalization, pharmacotherapy, and safety for the patient and others.^3-5 Socially, children with frequent lack of control of their aggressive behaviors experience rejection by peers and exclusion from settings that are part of ordinary development and socialization.⁶ The burden on families can be significant and may curtail their opportunities for enjoyable and beneficial activities to the detriment of other children in the household.⁷ When the underlying disorders are severe enough to warrant special settings to remediate them (eg, partial hospitalization, specialized educational or recreational settings), aggressive behavior often leads to a child's ineligibility to benefit from them. None of these consequences are conducive to a satisfying childhood or to a gratifying self-image. The risk for long-term maladjustment is high,⁸ in many contexts exceeding what the same underlying psychiatric condition would incur without aggression.