Reactive, Proactive, Relational, and Slow Dissipation of Aggression in Children

JAACAP Open. 2023 Dec 29;2(2):90-99. doi: 10.1016/j.jaacop.2023.12.007. eCollection 2024 Jun.

Abstract

Objective: This study investigated the associations between aggression subtypes (reactive, proactive, relational, and slow dissipation of aggression), callous-unemotional traits (CU), irritability (IRR), and sex among children.

Method: The sample included 508 children 5 to 12 years of age, rated by their mothers.

Results: A 4-factor model of aggression subtypes (reactive, proactive, relational, slow dissipation) provided a good fit to the data. Correlations between aggression subtypes and demographic variables were generally nonsignificant, except for a unique association between relational aggression and sex, with girls exhibiting higher scores, and proactive aggression was associated with younger age. Both CU and IRR correlated positively with all types of aggression. Slow dissipation of aggression showed a unique association with IRR, whereas reactive aggression was uniquely associated with both CU and IRR. Regressions showed an interaction between CU, IRR, and sex for slow dissipation and relational aggression. Interactions showed that boys with high levels of both CU and IRR demonstrated slower dissipation of aggression, indicating a tendency to hold grudges, and that sex differences in relational aggression depended on the co-occurrence of CU and IRR.

Conclusion: This study sheds light on the interplay among aggression subtypes, CU, IRR, and sex in children. Findings emphasize the need for psychiatrists and other mental health professionals to consider the multifaceted nature of aggressive behavior and the role of CU and IRR when assessing aggressive children or developing treatment plans for them. Further research is warranted to examine these relationships longitudinally and across diverse populations.

Clinical guidance: •Recognize the different types of aggression: Look beyond angry outbursts and consider reactive, proactive, relational, and slow dissipation of aggression to target intervention.•Emotional traits matter: Assess for callous-unemotional traits and irritability alongside aggression. High levels of both, especially in boys, may indicate greater difficulty managing anger and holding grudges.•Gender differences exist: Girls may be more prone to relational aggression compared to boys.•Proactive aggression might be more common in younger than in older children. Tailor interventions accordingly.

Keywords: aggression subtypes; callous-unemotional traits; children; irritability; sex differences.

Plain language summary

In this study of 508 children between age 5 to 12, maternal ratings were used to distinguish 4 different types of aggression in their children: reactive (like hitting back when teased), proactive (starting fights), relational (spreading rumors), and slow to cool down (holding grudges). Girls were found to be more relational aggressors, and proactive aggression was more common in younger children. Results also showed that children with certain emotional traits (callous and irritable) were more likely to show all types of aggression, and boys who were both callous and irritable held onto their anger. All 4 types of aggression were associated with externalizing disorders: attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder.