Document Detail


Experts' recommendations for treating maladaptive aggression in youth.
MedLine Citation:
PMID:  22196314     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Psychiatric treatment for children and adolescents with clinically significant aggression is common and often involves the use of antipsychotic medications. Increasingly, pediatricians are initiating or managing such treatments despite limited evidence on optimal diagnostic, psychosocial, and medication approaches for pediatric aggression.
AIMS: The objective of this study was to gather clinicians' and researchers' expertise concerning the treatment of maladaptive aggression, using expert consensus survey methods to aid the development of guidelines for pediatricians and psychiatrists on the outpatient treatment of maladaptive aggression in youth (T-MAY).
METHODS: Forty-six experts (psychiatrists, pediatricians, and researchers) with >10 years of clinical and/or research experience in the treatment of pediatric aggression completed a 27-item survey (>400 treatment alternatives) about optimal diagnostic, psychosocial, and medication treatments. Data were analyzed using descriptive statistics and confidence intervals.
RESULTS: Expert consensus methodology clearly differentiated optimal versus nonoptimal treatment strategies for maladaptive aggression. In contrast to current practice trends, results indicated that experts support the use of psychosocial interventions and parent education and training before the use of medication for maladaptive aggression at every stage of medication treatment, from diagnosis to maintenance to medication discontinuation.
CONCLUSION: Overall findings indicate that evidence-informed strategies for outpatient treatment of pediatric maladaptive aggression, guided by systematically derived expert opinions, are attainable. In light of the gap between the research literature and clinical practice, expert consensus opinion supports specific practices for optimal outpatient management in children and adolescents with severe and persistent behavioral difficulties.
Authors:
Elizabeth Pappadopulos; Nancy Scotto Rosato; Christoph U Correll; Robert L Findling; Judith Lucas; Stephen Crystal; Peter S Jensen
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Publication Detail:
Type:  Journal Article; Practice Guideline; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of child and adolescent psychopharmacology     Volume:  21     ISSN:  1557-8992     ISO Abbreviation:  J Child Adolesc Psychopharmacol     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-26     Completed Date:  2012-04-24     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  9105358     Medline TA:  J Child Adolesc Psychopharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  505-15     Citation Subset:  IM    
Affiliation:
Center for the Advancement of Children's Mental Health, Columbia University, New York, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent*
Aggression / drug effects*,  psychology*
Child*
Consensus*
Data Collection
Humans
Psychotherapy / methods*
Psychotropic Drugs / therapeutic use*
Grant Support
ID/Acronym/Agency:
U18-HS016097/HS/AHRQ HHS
Chemical
Reg. No./Substance:
0/Psychotropic Drugs
Comments/Corrections

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