Aggression Treatment & Rehab in Fort Smith

Aggression is any form of behavior that one person uses with the proximate (immediate) to cause pain, suffering, and/or damage to another person. These behaviors are forceful, hostile, and/or attacking and may occur with or without provocation. Additionally, the perpetrator must believe that the behavior will harm the target and that the target is motivated to avoid the behavior. Often, anger and aggression go together, however, they are not synonymous. Anger is a normal, needed human emotion that allows us to naturally respond to threats, and inspires powerful – often aggressive – feelings that allow people to fight when attacked. When expressed properly, in an assertive, non-aggressive manner, anger allows people to make their needs clear without hurting others. Uncontrolled anger can become destructive and lead to aggressive behavior.

While most people associate aggression with physical violence, there are a number of types of aggressive behaviors. Physical aggression includes behaviors such as hitting or kicking another person while verbal aggression includes screaming at others or making threats. There are two broad categories of aggressive behaviors: affective aggression and instrumental aggression.

Affective aggression, also called “hostile aggression” or “retaliatory aggression” is often employed when a person feels intense anger and is associated with impulse, unplanned, overt, semi-uncontrolled behaviors, and spur-of-the-moment behaviors. These aggressive behaviors are used to physically or emotionally harm another person or group of people. Examples of affective aggression include:

  • Hitting
  • Kicking
  • Biting
  • Pinching
  • Spitting
  • Hair-pulling
  • Pushing

Instrumental aggression, also called “predatory aggression” is often a purpose-directed form of aggression that can be physical or relational. People who engage in instrumental aggression do so without provocation in order to obtain a particular outcome or coerce others as a means to an end. This type of aggressive behavior is seen as proactive, premeditated, and cold-blooded; those who engage in instrumental aggression are often associated with callous traits such as a lack of remorse, empathy, or guilt. A common form of instrumental aggression is relational aggression, which is used – often by children and teens – to spread rumors and gossip, socially exclude, or otherwise cause harm to a certain person or group of people. Instrumental aggressive behaviors include:

  • Bullying
  • Teasing
  • Spreading rumors
  • Gossiping
  • Excluding others
  • Name-calling
  • Destruction of objects
  • Ignoring

While often used interchangeably, aggression is not the same as conflict – the situation that occurs when two or more individuals have opposing goals or interests. Conflict is resolved in different manners including, negotiation, persuasion, or taking turns. Aggressive behaviors are a way that some people manage their conflicts, however not all conflicts involve aggression.

There are a number of reasons a person or group of people may become aggressive toward others. These include, but are not limited to, the following:

  • Expressing anger or hostility
  • Assert dominance
  • To intimidate or threaten
  • To achieve a goal
  • To express possession
  • As a response to fear
  • As a reaction to pain
  • To compete with others
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What is Childhood and Teen Aggression?

Aggression in children and teens garners much focus from mental healthcare professionals and parents. Childhood aggression remains stable over time and is clearly linked to a variety of negative outcomes in adult life that, without proper intervention, may become chronic. Physical and verbal aggression is often the first symptom while later, it becomes the defining characteristic of serious childhood and teenage mental health disorders such as oppositional defiant disorder and conduct disorder.

While occasional outbursts of aggression and anger are quite common and normal, aggressive behaviors in teens and children become problems as these outbursts occur often or in a pattern. Aggressive behaviors in teens and children stem from an inability to control behaviors or a misunderstanding of appropriate responses to challenges in life. Many times, this aggressive behavior is self-directed and can lead to serious disability in these children.

There are a number of risk and protective factors that influence a child or teen’s development of aggressive behaviors.

Risk factors for childhood and teen aggression:

  • History of violence
  • Victim of sexual or physical abuse
  • Exposure to violence at home or in the surrounding environment
  • Hereditary factors
  • Drug or alcohol abuse
  • Access to firearms
  • Stressful family life
  • Brain damage from a brain injury

Reduction of the following factors may decrease or prevent the occurrence of aggressive behaviors. Exhibiting these behaviors in childhood increases the risks for aggression in adults.

As it is challenging to determine who will become aggressive and who will not, scientists have learned many ways of preventing aggression in children. Parents and caregivers can reduce aggression and violence by raising their children in a loving, safe home.

Protective factors for aggression:

  • Parents who do not hit their child(ren)
  • Parents modeling appropriate behaviors through their own actions
  • Providing children and teens consistent love and support
  • Consistency about rules and consequences for breaking the rules
  • Ensuring there is not easy access to firearms in the home
  • Preventing a child or teen from seeing violence in the community and media

What Causes Aggression in Children and Teens?

Aggression itself is not a diagnosis, rather it can be a symptom of many different problems, including mental health disorders and medical conditions. Keep in mind that no child or teen is “always bad” and that an effective, individualized treatment plan that focuses upon more than symptom abatement is necessary to sustain more positive outcomes.

Mental illnesses that often have aggression as a symptom include:

Attention-deficit hyperactivity disorder (ADHD): Individuals with ADHD may have problems with proper decision-making, which, when combined with the impulsivity of ADHD, may lead to aggressive behaviors. However, these aggressive behaviors are not done out of malice, these children and teens are simply unable to understand the implications of their behaviors and actions.

Autism/autism spectrum disorders (ASDs): ASDs are typified by an ability to understand and process his or her emotions, so children and teens with ASDs are often unable to handle feelings of frustration or anxiety in a way that is considered normal. This can lead to aggressive behaviors and outbursts. Also, aggressive behavior may be the result of impulsive actions without considering the implications or consequences.

Childhood/adolescent bipolar disorder: Children and teens who have bipolar disorder may lash out at others during a manic phase during which they lose control over their emotions. During the depressive cycle of bipolar disorder, these same individuals may become irritable, which may be evidenced by aggressive behaviors.

Conduct disorder (CD): Largely, conduct disorder is characterized by aggression toward others. But unlike children who cannot comprehend the consequences of their actions, children with conduct disorder are calculatedly malevolent toward others. Their actions are intended to cause harm to others.

Oppositional defiant disorder (ODD): A mental health disorder typified by an ongoing pattern of cantankerous moods; argumentative, defiant behavior towards those in authority, accompanied by a sense of maliciousness. Those with ODD frequently lash out at others or their property.

Schizophrenia: Schizophrenia is characterized by delusions and hallucinations that are very real to the child or teen experiencing them. This means that a child or teen experiences a break in reality in which he or she cannot determine what is real and what is not. As a result, some of the auditory hallucinations may tell a child or teen to provoke a violent or aggressive outburst toward others.

As each of these mental health disorders present differently each individual, it’s vital for parents and caregivers to receive a proper diagnosis from a highly-skilled child or adolescent psychiatrist. This can ensure the best possible treatment outcomes for the child or teen.

If you feel that you are in crisis, or are having thoughts about hurting yourself or others, please call 9-1-1 or go to the nearest emergency room immediately.

What Causes Aggression in Adults?

Aggression in adults may be the result of a number of life circumstances working in tandem or as a symptom of a mental health disorder. In fact, there are a large number of mental illnesses that include aggression as a symptom. The most common mental illnesses that feature aggression as a symptom include:

Antisocial personality disorder (ASPD): ASPD is a personality disorder  characterized by a long-standing pattern of disregard for, and abject violation of, the rights of other people. This personality disorder may be the result of a lack of morals, decreased conscience, or an inability to see others as anything beyond objects. People who have ASPD  often have a pervasive history of criminal behavior (often beginning in the teen years), incarceration, legal problems, as well as impulsive, overtly aggressive acts.

Bipolar disorder: People who have bipolar disorder may act aggressively during acutely manic cycles and the irritability experienced by those in depressive cycles may trigger depression.

Borderline personality disorder (BPD): People with borderline personality disorder happen to be prone to major emotional instability. During periods of anger and impulsiveness, they may lash out at others both verbally and physically.

Histrionic personality disorder (HPD): HPD is characterized by long-standing patterns of extreme, intense emotions and attention-seeking behaviors. If someone who has HPD feels that the wanted attention is not provide, they may act aggressively in order to get the desired attention.

Intermittent explosive disorder (IED): Involves a pattern of impulsive, violent, aggressive, and angry outbursts that are completely out of proportion to the situation at hand. During these outbursts, people with IED may attack others, destroy possessions, and face the legal ramifications of causing property damage and/or bodily injury.

Schizoaffective disorder: Involves symptoms of schizophrenia – hallucinations and delusions – in addition to the symptoms of a mood disorder, bipolar disorder or depression. During a psychotic break, people with this disorder may become aggressive as they respond to internal stimuli.

Schizophrenia: It’s important to note that most people with schizophrenia never become violent. However, the breaks in reality associated with this disorder lead to full-blown psychosis. During psychotic episodes, in which a person experiences delusions and/or hallucinations, a person may respond to internal stimuli and act violently or aggressively toward others out of genuine fear.

Substance abuse: People addicted to drugs or alcohol may experience bouts of aggression while they are intoxicated. Methamphetamines, PCP, and alcohol have particularly high rates of aggression during intoxication and can be quite dangerous to themselves or others around them.

Treatment of mental illnesses that can cause aggression must be tailored for the individual and their unique situation so that the best possible outcome is obtained.

What Causes Aggression in Senior Adults?

Senior adults face innumerable amount of challenges not often experienced by younger individuals, including late-onset depression, dementia, medical problems, financial problems, loss of a partner, complicated grieving, and other equally challenging problems. Some of these challenges may lead to the development of aggressive behaviors, often as a result of an underlying condition. These may include:

Alzheimer’s disease: Alzheimer’s disease, the most common form of dementia, directly affects the brain by systematically destroying areas of the brain involved in emotional regulation. As a result, many senior adults behave violently or aggressively during the later stages of the disease.

Dementia: Is not a single disorder, but rather a group of disorders that lead to changes in personality, behavior, memory, and cognition. Senior adults may not know who – or where – they are and lash out at caregivers and others in response to internal stimuli. Others may resort to aggression out of fear or anxiety stemming from their confusion.

Psychosis: Psychosis is an altered mental states and a break from reality. Senior adults may be prone to this syndrome in which violent behavior is not out of the ordinary.

Treating senior adults must be handled by a comprehensive team of medical and psychiatric personnel to rule out any other conditions such as adverse medication reactions and other medical conditions.

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