Benson Betsey A, Brooks Whitney T
Nisonger Center, Ohio State University, Columbus, Ohio 43210, USA.
Curr Opin Psychiatry. 2008 Sep;21(5):454-8. doi: 10.1097/YCO.0b013e328306a090.
The aim of this article is to review reports of aggressive challenging behaviour in individuals with intellectual disability from September 2006 to March 2008.
Studies continued to demonstrate the prevalence and significance of aggressive challenging behaviour in persons with intellectual disability. Over half of the population engages in some form of aggression, but only a small number is responsible for frequent or severe acts. A publication that identified aggression profiles offered a promising new approach. Aggressive behaviour in adults often has multiple functions. The most frequently studied interventions were either behavioural or somatic. Parents learned skills to effectively intervene with their aggressive preschool child. Reviews of medication efficacy studies concluded that there was insufficient evidence to recommend a single medication. Psychiatrists agreed that medication should not be the first treatment option. In one study, a class of medication was found to reduce aggression, but not aggression with self-injury, or self-injury alone.
Research on aggressive challenging behaviour requires assessment instruments that address the topography and severity of aggression. Identifying aggression types may clarify mixed results of previous research and improve treatment effectiveness. Greater access to effective, nonmedication treatments is needed.
本文旨在回顾2006年9月至2008年3月期间有关智力残疾个体攻击性行为的报告。
研究继续表明智力残疾者攻击性行为的普遍性和重要性。超过半数的人群存在某种形式的攻击行为，但只有少数人频繁实施或实施严重攻击行为。一份确定攻击行为特征的出版物提供了一种有前景的新方法。成年人的攻击行为通常具有多种功能。最常研究的干预措施是行为干预或躯体干预。家长学会了有效干预其具有攻击行为的学龄前儿童的技能。药物疗效研究综述得出结论，没有足够证据推荐单一药物。精神科医生一致认为药物不应作为首选治疗方案。在一项研究中，发现一类药物可减少攻击行为，但不能减少伴有自伤的攻击行为或单独的自伤行为。
对攻击性行为的研究需要能够评估攻击行为的形式和严重程度的评估工具。确定攻击行为类型可能会澄清以往研究的混杂结果并提高治疗效果。需要更多获得有效非药物治疗的途径。
