Predictors of Aggression In Institutionalized Youth

描述（由申请人提供）：本R03建议调查的目标是前瞻性地确定预测并最终预防青少年在机构治疗期间表现出的极端攻击行为的个人和环境因素。该研究利用现有的数据档案来解决这一广泛的目标：1)访问和编码来自住院青少年精神病院存档来源（入院/治疗记录和关键事件数据库）的个人、环境和行为数据；2)通过检查个体和环境变量对自我和他人导向的攻击行为和相关关键事件（即隔离和约束）的预测，测试制度化护理期间发生的攻击行为模型。这项调查是由几个具体目标指导的。首先，确定在机构治疗期间与自我导向和他人导向攻击发生相关的个体生物心理特征和情境社交影响。这涉及到在一个高风险的青年样本中识别一些因素，这些因素区分了那些在机构治疗期间有严重攻击行为的人和没有严重攻击行为的人。其次，研究个体和环境因素在多大程度上预测了整个机构治疗过程中攻击的模式和持久性。这包括研究个体环境因素如何导致治疗期间攻击行为的增加、减少或非线性趋势。通过两组分析得出的关于自我和他人导向攻击行为的个体情境预测因素的信息将用于制定适合于高危青少年攻击发展和治疗的研究和实践的评估措施。这一工具将被设计为对这一群体的攻击行为进行更大规模纵向研究的基础，也将直接适用于个别青年的治疗计划。这项调查的一个关键焦点是在高危青少年中确定一种攻击模式，这种模式可以用来促进研究结果的传播和刺激进一步的研究。拟议研究的结果将对主办机构以及更多致力于减少和预防高风险儿童和青少年的攻击和自残行为的科学家和从业人员产生影响。

DESCRIPTION (provided by applicant): The goal of this R03 proposed investigation is to identify prospectively the individual and contextual factors that predict and can ultimately prevent extreme aggression exhibited by youth during institutional treatment. The proposed study uses existing data archives to address this broad goal by 1) Accessing and coding individual, contextual, and behavioral data from archived sources (intake/treatment records and a critical incident database) in an inpatient youth psychiatric facility; and 2) Testing a model of aggressive behavior occurring during institutionalized care by examining the prediction of self- and other-directed aggressive behaviors and related critical incidents (i.e., seclusions and restraints) from individual and contextual variables. This investigation is guided by several specific aims. First, to identify the individual biopsychological characteristics and contextual socializing influences that are associated with the occurrence of self-directed and other-directed aggression during institutional treatment. This involves identifying factors in a very high-risk sample of youth that discriminate those who engage in serious aggression during institutional treatment from those who do not. Second, to examine the extent to which individual and contextual factors predict the patterns and persistence of aggression throughout institutional treatment. This involves the study of how individual-contextual factors lead to increases, decreases, or non-linear trends in aggression during treatment. Information about individual-contextual predictors of self- and other-directed aggressive behaviors derived through the two sets of analyses will be used to develop assessment measures suitable for research and practice on the development and treatment of aggression in very high-risk youth. This instrument will be designed to serve as the basis for a larger scale longitudinal study of aggression in that population, and also will be directly applicable to treatment planning for individual youth. A critical focus of this investigation also is to specify a model of aggression in very high-risk youth that can be used to facilitate the dissemination of findings and spur additional research. Results from the proposed study will have implications for the host facility as well as to the larger audience of scientists and practitioners invested in the reduction and prevention of assaultive and self-injurious behaviors among high-risk children and adolescents.