Smeijers Danique, Bulten Erik, Buitelaar Jan, Verkes Robbert-Jan
1 Department of Psychiatry, Radboud University Medical Centre Nijmegen, The Netherlands.
2 Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.
Int J Offender Ther Comp Criminol. 2018 Sep;62(12):3834-3852. doi: 10.1177/0306624X17747052. Epub 2017 Dec 18.
Aggression replacement training (ART) is widely used to reduce aggression. Results regarding its effectiveness, however, are inconclusive regarding adults and specific populations displaying severe aggression. The current open uncontrolled treatment study aimed at assessing the social skills and anger control modules of the ART to reduce aggression in forensic psychiatric outpatients (FPOs). Furthermore, characteristics associated with treatment outcome and dropout were examined. The results suggested that aggression changed during the ART. In addition, higher baseline levels of trait aggression were associated with greater reductions of aggression, whereas more cognitive distortions were associated with less reduction. Treatment dropouts were characterized by higher levels of psychopathic traits, proactive aggression, and more weekly substance use. As there was a considerable amount of dropout; it is important to assess risk of dropping out of treatment and, subsequently, improve treatment motivation. This might enhance treatment adherence which may lead to a more successful reduction of aggression.
攻击性替代训练（ART）被广泛用于减少攻击行为。然而，关于其对成年人及表现出严重攻击行为的特定人群的有效性的研究结果尚无定论。当前这项开放的非对照治疗研究旨在评估ART的社交技能和愤怒控制模块，以减少法医精神病门诊患者（FPOs）的攻击行为。此外，还研究了与治疗结果和退出治疗相关的特征。结果表明，在ART治疗期间攻击行为有所改变。此外，特质攻击性的基线水平越高，攻击行为减少得就越多，而认知扭曲越多，攻击行为减少得就越少。退出治疗的患者具有较高水平的精神病态特质、主动攻击性和更多的每周物质使用情况。由于有相当数量的患者退出治疗，评估治疗退出风险并随后提高治疗动机很重要。这可能会增强治疗依从性，从而可能更成功地减少攻击行为。
