Vitiello B, Stoff D M
Child and Adolescent Disorders Research Branch, National Institute of Mental Health, Rockville, MD 20857, USA.
J Am Acad Child Adolesc Psychiatry. 1997 Mar;36(3):307-15. doi: 10.1097/00004583-199703000-00008.
To review the evidence for qualitatively distinct subtypes of human aggression as they relate to childhood psychopathology.
Critical review of the pertinent literature.
In humans, as well as in animals, the term aggression encompasses a variety of behaviors that are heterogeneous for clinical phenomenology and neurobiological features. No simple extrapolation of animal subtypes to humans is possible, mainly because of the impact of complex cultural variables on behavior. On the whole, research into subtypes of human aggression has been rather limited. A significant part of it has been conducted in children. Clinical observation, experimental paradigms in the laboratory, and cluster/factor-analytic statistics have all been used in an attempt to subdivide aggression. A consistent dichotomy can be identified between an impulsive-reactive-hostile-affective subtype and a controlled-proactive-instrumental-predatory subtype. Although good internal consistency and partial descriptive validity have been shown, these constructs still need full external validation, especially regarding their predicting power of comorbidity, treatment response, and long-term prognosis.
Our understanding and treatment of children and adolescents with aggressive behavior can benefit from research on subtypes of aggression. The differentiation between the impulsive-affective and controlled-predatory subtype as qualitatively different forms of aggressive behavior has emerged as the most promising construct. Specific therapeutic hypotheses could be tested in this context and contribute to a full validation of these concepts.
回顾人类攻击行为在质性上不同的亚型与儿童精神病理学相关的证据。
对相关文献进行批判性综述。
在人类以及动物中，攻击行为这一术语涵盖了多种行为，这些行为在临床现象学和神经生物学特征方面具有异质性。动物亚型无法简单地外推至人类，主要是因为复杂的文化变量对行为有影响。总体而言，对人类攻击行为亚型的研究相当有限。其中很大一部分是在儿童中进行的。临床观察、实验室实验范式以及聚类/因子分析统计都被用于尝试细分攻击行为。在冲动 - 反应 - 敌意 - 情感亚型和可控 - 主动 - 工具性 - 掠夺性亚型之间可以确定一种一致的二分法。尽管已显示出良好的内部一致性和部分描述效度，但这些结构仍需要全面的外部验证，尤其是在它们对共病、治疗反应和长期预后的预测能力方面。
我们对有攻击行为的儿童和青少年的理解与治疗可受益于对攻击行为亚型的研究。冲动 - 情感型和可控 - 掠夺型亚型作为攻击行为在质性上不同的形式，已成为最有前景的结构。在此背景下可以检验特定的治疗假设，并有助于对这些概念进行全面验证。
