Behandling av maladaptiv aggresjon hos ungdom: CERT-retningslinjer II.

Treatment of Maladaptive Aggression in Youth: CERT Guidelines II. Treatments and Ongoing Management

Authors
Rosato, N. S. Correll, C. U. Pappadopulos, E. Chait, A. Crystal, S. Jensen, P. S. Treatment of Maladaptive Aggressive in Youth Steering Committee
Year
2012
Journal
Pediatrics
Volume
129
Pages
E1577-E1586
OBJECTIVE: To develop guidelines for management and treatment of maladaptive aggression in youth in the areas of psychosocial interventions, medication treatments, and side-effect management. METHODS: Evidence was assembled and evaluated in a multistep process, including systematic reviews of published literature; an expert survey of recommended practices; a consensus conference of researchers, policymakers, clinicians, and family advocates; and review by the steering committee of successive drafts of the recommendations. The Center for Education and Research on Mental Health Therapeutics Treatment of Maladaptive Aggression in Youth guidelines reflect a synthesis of the available evidence, based on this multistep process. RESULTS: This article describes the content, rationale, and evidence for 11 recommendations. Key treatment principles include considering psychosocial interventions, such as evidence-based parent and child skills training as the first line of treatment; targeting the underlying disorder first following evidence-based guidelines; considering individual psychosocial and medical factors, including cardiovascular risk in the selection of agents if medication treatment (ideally with the best evidence base) is initiated; avoiding the use of multiple psychotropic medications simultaneously; and careful monitoring of treatment response, by using structured rating scales, as well as close medical monitoring for side effects, including metabolic changes. CONCLUSIONS: Treatment of children with maladaptive aggression is a "moving target" requiring ongoing assimilation of new evidence as it emerges. Based on the existing evidence, the Treatment of Maladaptive Aggression in Youth guidelines provide a framework for management of maladaptive aggression in youth, appropriate for use by primary care clinicians and mental health providers. Pediatrics 2012;129:e1577-e1586

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Type of intervention

Treatment and Child Welfare Interventions

Topic

Mental Health Problems and Disorders

Behavior Problems

Antisocial Behaviors

Intervention

Psychological Treatments

Family Therapy

Parent Guidance / Therapy

Pharmacological Treatment

Antidepressants

Stimulants

Antipsychotics

Age group

Preschool Aged Children (3-5 years)

School Aged Children (6-12 years)

Adolescents (13-18 years)

Age not specified

More information
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