Portal de Periódicos da CAPES

Aggressive Behavior

2016; Springer International Publishing; Linguagem: Inglês

10.1007/978-3-319-26583-4_27

2366-6013

Robert Didden, William R. Lindsay, Russell Lang, Jeff Sigafoos, Shoumitro Deb, Jan Wiersma, Nienke Peters-Scheffer, Peter B. Marschik, Mark F. O’Reilly, Giulio E. Lancioni,

Family and Disability Support Research

Aggressive behavior is common in individuals with intellectual and developmental disabilities (IDDs), and it is most often targeted for intervention. Psychological, contextual, and biological risk factors may contribute to the risk of aggressive behavior. Risk factors are gender (males), level of IDD (lower levels of IDD), autism spectrum disorder (ASD), communication deficits, emotion regulation problems, impulsivity, and mental health problems. Next to this, several genetic syndrome groups (e.g., Prader–Willi, fragile X) are associated with aggressive behavior. This chapter provides a selective review of the evidence based on four major treatment approaches: anger management treatment (AMT), behavioral interventions, psychotropic medications, and mindfulness-based procedures. Studies have shown that relaxation coupled with stress inoculation and a focus on adaptive responses are effective components of AMT. There is evidence that behavioral interventions—especially extinction, differential reinforcement, and functional communication training—are effective in reducing aggression. Prior to behavioral intervention, the function(s) of the aggressive behavior should be determined using functional assessment. On the basis of the scientific evidence, it is difficult either to recommend or to refute the use of psychotropic medications for the management of aggression in people with IDD. Good-quality evidence is available only for risperidone among children with IDD and/or ASD. Before initiating medication, a case formulation should be documented including assessment and rationale for the use of medication. Finally, mindfulness-based procedures have been shown to be effective in reducing aggressive behavior of individuals with IDD in studies by one research group. These results, however, need to be replicated before conclusions may be drawn on whether mindfulness is evidence-based practice for aggressive behavior in individuals with IDD.