John James Rufus, Thavalingam Vignesh, Tye Michelle, Dean Kimberlie, Barzman Drew, Sorter Michael, Lin Ping-I
School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia; Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia.
School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.
Psychiatry Res. 2023 Sep;327:115368. doi: 10.1016/j.psychres.2023.115368. Epub 2023 Jul 24.
This study examined predictors of aggression and assessed whether different subgroups of children and young people (CYP) display varying risks of aggressive incidents during hospitalization. Data from 10,090 children admitted to the psychiatric inpatient units of Cincinnati Children's Hospital between April 2010 and June 2021 were analysed. Multivariable logistic regression models were used to determine significant predictors associated with aggression, followed by average marginal effects and cluster analyses to rank and establish clusters by the order of predictor importance. About 32.5% reported positive history of an aggressive incident. The mean BRACHA score was doubled compared to those without a prior history. The primary analysis showed that both younger and male CYPs had higher odds of aggressive incidents. We also found that CYP with an African descent, not being able to live with both biological parents, those who reported positive history of psychiatric hospitalisation, and prior externalising behaviours had higher odds of aggressive incidents. These findings have important clinical and public health implications, as they provide valuable knowledge for healthcare professionals to improve prevention strategies for aggression amongst this vulnerable population.
本研究调查了攻击行为的预测因素，并评估了儿童和青少年（CYP）的不同亚组在住院期间发生攻击事件的风险是否存在差异。对2010年4月至2021年6月期间入住辛辛那提儿童医院精神科住院部的10090名儿童的数据进行了分析。使用多变量逻辑回归模型来确定与攻击行为相关的显著预测因素，随后进行平均边际效应分析和聚类分析，以按预测因素的重要性顺序对聚类进行排名和确定。约32.5%的人报告有攻击事件的阳性史。与没有既往史的人相比，BRACHA评分平均值翻倍。初步分析表明，年龄较小的CYP和男性发生攻击事件的几率更高。我们还发现，有非洲血统、不能与亲生父母双方生活在一起、报告有精神病住院阳性史以及有既往外化行为的CYP发生攻击事件的几率更高。这些发现具有重要的临床和公共卫生意义，因为它们为医疗保健专业人员提供了宝贵的知识，以改进针对这一弱势群体攻击行为的预防策略。
