Subtyping aggression and predicting cognitive behavioral treatment response in adolescents. What works for whom?

Abstract

This dissertation describes the clinical relevance of the distinction between proactive and reactive aggression in adolescents with aggression problems. These subtypes of aggression can be clinical distinguished on the level of severity rather than typology; proactive aggression is always accompanied with reactive aggression. Furthermore, predictors of cognitive behavioral treatment response (Aggression Replacement Training) were examined in order to optimize treatment in adolescents. ART can be used to significantly decrease both forms of reactive and proactive aggression, but if CU-traits are present additional treatment is needed. Also, care should be taken when placing adolescents with different levels of aggression in one group and the occurrence of cognitive distortions and IQ of the adolescents should be investigated before treatment. In addition, deficits in emotion-recognition and ‘hot’ executive functions (i.e. immediate reward sensitivity and risk taking behavior) seem to predict less reduction of aggression after following ART.