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Aggression in Children – Causes, Behavioral Manifestations and Management

Article  in  Journal of Pakistan Medical Students · November 2014

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Shamsa Ali
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Aggression in children is the first step on the slippery slope to the misbehavior. Occasional
outbursts of aggression in children are normal but if it occurs frequently in a pattern it is
considered as a problem. Aggression is a forceful, inappropriate, non adaptive verbal or physical
action designed to pursue personal interest (Stuart, 2009).

Aggressive behavior can be self-directed, reactive, or in revenge. It can also be proactive, overt
or secretive (Pouw, Rieffe, Oosterveld, Huskens & Stockmann, 2013). Aggressive behavior can
be well explained in the example given below.

A 10-years-old boy appears irritable, impulsive and restless. He is argumentative and verbally
aggressive. He screams, bites, hits and breaks things to release his frustration. He is often
disobedient and resentful to his parents and teachers. He has been a high achiever at school but
now shows lack of interest and poor performance in studies.

His aggressive behavior disrupts lessons in school and threatens other children in the class. He
also responds to his friends angrily and shows distress which is hard to calm by his parents. His
aggressive behavior is now a matter of concern for his parents. Worried parents wonder if they
lacked something in the upbringing of the child or society is the reason of their child being so
aggressive.
The aggression prevalence rate in children was reported as 35% in South Asian countries in
2010. The prevalence of aggression in children is 49.6% in Pakistan. Among them 56% is the
aggression prevalence rate of the children in Sind in 2010 (Kanne & Mazurek, 2011). The
current statistics demands a lot of hard work for the behavior modification of the children.

The key to handle aggressive behavior is to understand the factors which trigger aggression. The
neurobiological theories suggest that the low serotonin levels and increased activity of dopamine
and nor epinephrine are associated with aggressive behaviors. Whereas, neuro imaging studies
indicate that the aggressive behaviors are associated with abnormalities in limbic, frontal and
temporal lobes of cerebral cortex (Siever, 2008).

The aggressive conduct can result from media violence, prior experiences and actual traumas that
trigger the fight response in the nervous system. Thus the children responds aggressively to the
perceived threat (Kliem & Rehbein, 2014). Secondly, an unhealthy relationship or
communication gap between parents and children also affects their behavior. Ineffective,
authoritarian, harsh and rejecting parenting styles contribute to such behaviors (Fikkers,
Piotrowski, Weeda, Vossen & Valkenburg, 2013). Psychological problems in parents such as
depression, drug abusing and misusing, and alcoholism can also contribute to aggression in
children.

Thirdly, aggressive actions in children are the effects of the attention-deficit hyperactivity
disorder (ADHD), manic stage of bipolar disorder, schizophrenia, paranoia or other psychotic
conditions (Stuart, 2009). Sometimes, children behave cobative due to fear of inability to deal
with emotions, especially frustration and are incapable to verbalize the situation efficiently.
Other factors including environmental influences, unrelieved stress, lack of appropriate problem
solving skills and coping strategies can also result in aggressive behaviors (Kanne & Mazurek,
2011).

Aggression imposes adverse impacts on the child’s health. Physically, there is hormonal
imbalance resulting in an increased risk for self harm or suicide. In addition, aggressive children
are at risk of developing serious anti-social behavioral disorders. Socially, they are unable to
communicate effectively, resulting in disruptive relationships leading to social isolation.

Psychologically, aggressive children remain unhappy, upset and distressed. They always indulge
in fights with others and end their conversations in conflicts. These children are at risk of
developing psychiatric problems (Pouw, Rieffe, Oosterveld, Huskens & Stockmann, 2013).

Aggression in children is a significant concern of our society. Some measures can be taken to
improve the behavior. Initially, by using General Aggression Model, I as a nurse can first
identify the primary cause or underlying factors of aggressive behaviors in children. It
emphasizes on three critical stages of aggression i.e. personal factors, situational inputs and
present internal states (i.e., cognition, arousal, affect, including brain activity) and outcomes of
appraisal and decision-making processes(Denson, 2011).
In addition, screening can be done to rule out hormonal imbalance leading to aggression. I as an
educator can teach parents about the nonaggressive techniques to deal with the situations. Parents
can find age appropriate ways of explaining, teaching and reinforcing these techniques to their
children.

At institutional level, I as a counselor can enhance the use of psychotherapies for behavior
modification. Cognitive behavioral therapy (CBT) can be used to teach the ways to control the
aggressive behavior of the children. (Stuart,2009). In addition, talking therapy can help in
understanding the causes of aggression and work with the feelings leading to such attitude.
(Kliem & Rehbein, 2014). These therapies help to regulate emotions, identify etiological factors,
and develop coping skills in children.

Moreover, discipline strategies teach children new methods to handle their negative feelings and
behaviors. Time out strategy and withdrawal of privileges (i.e. taking away something the
children enjoys, or missing out on a favorite activity, like watching television) can also be
helpful (Gini, Pozzoli & Hymel, 2014).

Positive discipline such as reward system and praising can motivate children to withdraw the
aggressive behavior. Moreover, calm, consistent response from parents can teach the children to
react evenly to life’s frustrations. I as a collaborator can work with policy makers and the
government to ensure the implementation of the non-aggressive techniques to deal with
aggressive children.

In conclusion, aggression in children is the issue that needs to be addressed. The current statistics
demands a lot of hard work and dedication in promoting and educating parents about dealing
with aggressive children. Health care provider with the collaboration of parents can assist in
behavior modification of children. It is important to resolve the issue to help children in
maintaining their health.
 References

Denson, T. (2011). A social neuroscience perspective on the neurobiological bases of aggression.

The American Journal of Psychiatry, 161.Retrieved from:

Fikkers, K., Piotrowski, J., Weeda, W., Vossen, H., & Valkenburg, P. (2013). DoubleDose: High
Family Conflict Enhances the Effect of Media Violence Exposure on

Adolescents’ Aggression. Societies, 3(3), 280-292.Retrieved from:

Gini, G., Pozzoli, T., & Hymel, S. (2014). Moral disengagement among children and youth:
Ameta-analytic review of links to aggressive behavior. Aggressive Behavior, 40(1), 56-68.
Retrieved from: http://onlinelibrary.wiley.com/doi/10.1002/ab.21502/pdf

Kanne, S., & Mazurek, M. (2011). Aggression in children and adolescents with ASD:
prevalenceand risk factors. Journal of Autism and Developmental Disorders, 41(7), 926-937.
Retrieved from: http://link.springer.com/article/10.1007/s10803-010-1118-4

Kliem, S., & Rehbein, F. (2014). Longitudinal Effects of Violent Media Usage on Aggressive
Behavior—The Significance of Empathy. Societies, 4(1), 105-124. Retrieved from:
http:///C:/Windows/system32/config/systemprofile/Downloads/societies-04-00105.pdf

Pouw, L., Rieffe, C., Oosterveld, P., Huskens, B., & Stockmann, L. (2013). Reactive/proactive
aggression and affective/cognitive empathy in children with ASD. Research in Developmental
Disabilities, 34(4), 1256-1266.Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/23417131

Siever, L. J. (2008). Neurobiology of aggression and violence. The American Journal of

Stuart, G.W. (2009). Principles and practice of psychiatric nursing (9th ed.). St. Louis: Mosby.

About the Author: Shamsa Hadi is a third year student of Bachelors of Science in Nursing at
Aga Khan University, Pakistan. Her area of interest is public health management. She can be
reached at [email protected]

About this article: This article is competing for the JPMS International Medical Writing Contest
2014.

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