Citation:
Borgs GP, Runions K, Biskup CS, Königschulte W, Rao P, Wong J, et al. Reactive aggression in young patients with ADHD—a critical role for small provocations. Acta Psychiatrica Scandinavica. 2016;134(6):566-8
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Abstract:
ADHD is one of the most commonly diagnosed disorders in child and adolescent psychiatry and is characterized by attentional deficits, hyperactivity, and impulsivity. It is common for young people with ADHD to have problems with behavioural dysregulation in general and aggression specifically, as evidenced in the high rates of comorbidity of other disruptive behaviour disorders (DBD) (e.g., 16.5%) often marked by aggression. In particular, impulsive aggression is commonly observed in children with ADHD, with recent estimates up to 50% comorbid for combined subtype pre-adolescents. Impulsive or reactive aggression, and proactive (planned) aggression, have been widely studied. Reactive aggression (often also understood as ‘hot’ aggression) is conceptualized as a response to some perceived provocation, is emotionally charged and can also be fear-based, and is enacted in an impulsive way. Proactive aggression, by contrast, is seen as a comparatively ‘cold’ aggression that is not in response to any particular direct or immediate provocation, but is performed in a rather planned and goal-directed manner.