An Approach to Treating Maladaptive Aggression in Youth

Trying to orchestrate a treatment plan for maladaptive aggression in youth often involves a combination of multiple treatment modalities from counseling to pharmacotherapy, but what is the evidence base to this approach? The Center for Education and Research on Mental Health Therapeutics developed an approach to treatment of maladaptive aggression that started with a systematic review, followed by a survey of experts on what they do, and then culminated in a consensus conference of experts. The result of their work appears in two special articles being released this week. One by Knapp et al. (doi: 10.1542/peds.2010-1360) discusses how to deal with family engagement, diagnosis, and assessment, so as to better recognize both the family and social situation in which aggression occurs and the co-morbid psychiatric conditions that can co-exist. The second special article by Scotto Rosato et al. (doi: 10.1542/peds.2010-1361) defines an approach using psychosocial interventions and medication to treat these children and teens. While these two articles do not reflect a defined (as of yet) AAP policy, we believe they are the best evidence-based guidelines available, with a strong systematic approach that warrants sharing them in our journal. We think you will find both extremely helpful whether you deal with these children from a primary care or mental health perspective.