lecture 3 - Agression interventions Flashcards
angry outbursts and agression are some of the most frequent reasons for….
Angry outbursts and aggression are some of the most frequent reasons
for child mental health outpatient referrals
what is conduct disorder
Repeated, persistent patterns of antisocial, aggressive, or defiant behaviour, worse than normal for that age.
* More extreme and problematic as child gets older & more independent.
* Serious rule (and law) violations at home, school, community.
risk factors for conduct disorder
- Aggression commonly associated with Conduct Disorder (CD) in adolescence.
- Also at risk are children with e.g. ADHD, anxiety disorders, and mood disorders
-being a male
-living in an urban environment
-poverty
-a family history of mental illness
-have other associated psychiatric disorders
-parents with an alochol or drug addiction
a dysfunctional home
-history of experiencing traumatic events
-being abused or neglected
what can parents and teachers do to reduce agression / conduct disorder
- Create non-aggressive environments to reduce chances for
conflict. - Reduce or eliminate anything that might reinforce aggression, eg don’t make the aggressive act rewarding in any way > proactive aggression in particular.
incompatible response technique
time out
modelling and coaching
incompatible response technique
- Ignore all but the most serious
aggressive behaviours - Reinforce positive acts eg sharing
time out :
Time-out: for more serious behaviours
(take them out the situation , but not isolating them -like excluding them- not done in a punishing way)
* Avoids escalating conflict and
reinforcement
* Best when combined with positive
reinforcement
modelling and coaching
- Help look for nonhostile cues to reappraise the situation.
- Help the child find alternative solutions to conflict.
- Help the child be more aware of others’ feelings; promote empathy.
agression interventions
- Social-cognitive competencies
- Interpersonal problem solving
- Parenting skills
- Coping with stress
- Home / school climate
effectivness of agression intervention
-Farrington et al (2017) review
-what worked best
Systematic reviews of developmental prevention programs
* 5 General (multi-factor)
* 9 family-based
* 11 individually-focused (eg child skills training)
* 25 school-based
General (multi-factor) programs: best effects with those that included
parenting skills training and behavioural modelling.
- Family programs more successful with children under 15 years old. (children less conected to parent after these years)
- In schools, universal school-wide programs worked better than small-
group ones; multi-faceted worked better than targeted. - Anti-bullying programs worked better with younger children (age5-12 years) than older children.
- Start early when children are young.
review of overt agression interventions
focused on?
a) Parent Management Training (PMT)
The Family environment
(b) Cognitive Behavioural Therapy (CBT)
The Child
Review of Overt Aggression interventions
Parent management technique Training (PMT)
-what is it based on
-what can it help in particular
- Operant conditioning principle
- Positive reinforcement.
- Appreciates multiple interacting risk factors and pathways to
childhood anger/irritability. - PMT aims to improve family interaction patterns that maintain and support tantrums, aggression, and noncompliance.
- Mainly with parents but sometimes children are involved.
Review of Overt Aggression interventions
PMT - key principles
Identify why the child is behaving aggressively / angrily
Give praise for positive and
appropriate behaviour
Communicate instructions and directions effectively (verbal skills)
Ignore maladaptive attention-
seeking behaviour
Use consistent approaches to
dealing with disruptive behaviours
what is the positive parenting program (PPP)
-parenting programme,
-doesnt tell you how to be a parent , more like a toolbox of ideas , you choose the strategies you need
-all about making triple P work for you
PMT and autism and OCD
- PMT has made Modifications for Autism and obsessive compulsive disorder (OCD)
-eg autism can cause sensory issues and may come out agressivley in child - Careful consideration of angry/aggressive behaviour and how to deal with them in the context of specific conditions
PTM modification for neurdivergent/ other conditions example
RUBI autism network
note on applied behavioural analysis :
-* Aims to reinforce desired behaviours.
* Early versions included both punishment and reward.
* Debate on what is ‘desired’ behaviour, eg fitting societal
‘norms
review of Overt agression interventions
Cognitive-Behavioural Therapy (CBT): child
-what does it involve
Identify reasons for and consequences of aggressive behaviour
Strategies to learn better recognition and regulation
of anger
Cognitive restructuring, problem
solving
Model and rehearse socially appropriate behaviours to
replace anger and aggression
- Emphasis on learning principles.
- Targets difficulties in emotion regulation and social problem-solving.
- Parental involvement: communication, environment, support.
- Recognise child’s efforts (positive reinforcement)
CBT: child - anger control and management training
- Emphasis on learning principles.
- Targets difficulties in emotion regulation and social problem-solving.
- Parental involvement: communication, environment, support.
- Recognise child’s efforts (positive reinforcement)
Review of Overt Aggression interventions
-Cognitive-Behavioural Therapy (CBT): specific :
Social Skills Training (SST)
- Based on Social learning theory (Bandura, 1973).
- Enhance social behaviours that can be used instead of aggression.
- Help develop more positive friendships with non-aggressive peers.
- Targets weak verbal skills, poor conflict resolution skills
Review of Overt Aggression interventions
Cognitive-Behavioural Therapy (CBT): specific :
Problem Solving Skills Training (PSST)
- Modelling.
- Role-playing.
- Positive reinforcement of
appropriate behaviour. - Teaching alternative
behaviours. - Child sessions but parents
can observe and learn
how to support. - Homework to do.
Review of Overt Aggression interventions
-Randomized control trials : effectiveness on social skills training (SST) and problem solving skills training (PPST)
- Measured effectiveness of Social Skills Training (SST) and Problem
Solving Skills Training (PPST); N=26. - Both showed reduced aggression.
- Problem-solving training showed greater reduction of Hostile Attribution Bias.
- Social skills training showed greater improvement in anger control skills
relational agression
“…non-physical aggression in which one manipulates or harms
another’s social standing or reputation.”
(Leff et al., 2010, pg 509
- Direct (“I don’t want to be your friend”) or indirect (spreading
rumours behind backs to influence others’ opinions) - Associated with problematic friendships, rejection, depressive
symptoms, and school avoidance. - Only recently have interventions been considered
main difficulties with relational agression
- Social problem-solving.
- Emotion regulation.
- Academic.
- Predicts future psychosocial maladjustment.
Can be highly associated with
physical aggression which makes
this complex to address.
Similarities between overt/physical and relational aggression:
- Hostile attribution bias.
- Favourable evaluations of aggressive solutions.
- Considerable social influence within their peer group.
- Adept at social manipulation, influential, popular within certain
circles – high status.
relation regression
-early childhood friendship project
explain what it is
Early Childhood Friendship Project (Ostrov et al., 2009)
* Classroom-based, children aged 3-5 years. 6 weeks.
* Designed to reduce both relational and physical aggression and increase prosocial
behaviours.
-Puppet shows: social skills, friendships.
-Weekly participatory activities to
reinforce social skills. Role-playing.
-Concept activities: eg small group art or picture books.
-Reinforcement: Praise during free-
play (from a puppet and adult).
elation regression
-early childhood friendship project
intervention reviews
- 9 intervention and 9 control classrooms in urban and suburban areas.
- Researcher observations within classrooms of aggression.
- Teacher measures of prosocial behaviour.
- Large positive effects on relational aggression and moderate effects on
physical aggression. - But requires larger samples
relational agression intervention
- ICPS (i can problem solve
-evidence based , universal primary prevention program
Not specific to relational aggression but general problem-solving skills could be effective.
However, it is a really long and intensive programme, school-based.
relational regression
-social agression prevention programe (SAPP)
- Designed to reduce girls’ use of social aggression and increase skills in empathy, social problem solving, and prosocial behaviours.
- Small groups, 5th grade (USA; age 10-11), randomly assigned to SAPP vs control.
- Self-report, teacher-report, and peer evaluations
- Little effect overall, but further analyses suggest it may be more effective for high-risk girls in
social problem solving, prosocial behaviours, and empathy
what are design considerations for agression interventions
Age-appropriate
* Verbal skills, parental / teacher involvement, report tasks, medium.
Aggression-appropriate
* Physical and relational aggression, proactive vs reactive aggression.
Community-appropriate
* Include key community individuals when designing the intervention
(teachers, counsellors, education psychologists, police officers, parents).
