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Abstract Aim Brexpiprazole is the first FDA‐approved treatment for agitation associated with dementia due to Alzheimer's disease. Agitation in Alzheimer's dementia (AAD) occurs in high prevalence and is a great burden for patients and caregivers. Efficacy, safety, and tolerability of brexpiprazole were demonstrated in the AAD clinical trials. To demonstrate the agitation‐ameliorating effect of brexpiprazole in animals, we evaluated brexpiprazole in two AAD mouse models. Methods The resident–intruder test was conducted in 5‐ to 6‐month‐old Tg2576 mice, given vehicle or brexpiprazole (0.01 or 0.03 mg/kg) orally 1 h before the test. Locomotor activity was measured in 6‐month‐old APPSL‐Tg mice given vehicle or brexpiprazole (0.01 or 0.03 mg/kg) orally the evening before the start of locomotor measurement for 3 days. Results In the resident–intruder test, Tg2576 mice showed significantly higher attack number and shorter latency to first attack compared to non‐Tg mice. In the Tg mice, brexpiprazole treatment (0.03 mg/kg) significantly delayed the latency to first attack and showed a trend toward a decrease in attack number. APPSL‐Tg mice (≧6 months old) showed significantly higher locomotion during dark period Phase II (Zeitgeber time [ZT] 16–20) and Phase III (ZT20‐24) compared to non‐Tg mice, correlating with the clinical observations of late afternoon agitation in Alzheimer's disease. Brexpiprazole treatment (0.01 and 0.03 mg/kg) significantly decreased hyperlocomotion during the Phase III in APPSL‐Tg mice. Conclusion The suppression of attack behavior and the reduction of nocturnal hyperlocomotion in these Tg mice may be indicative of the therapeutic effect of brexpiprazole on AAD, as demonstrated in the clinical trials.

Abstract Background Dog bites to people are a serious public health problem. Limited information exists at the country level in Latin America. The COVID‐19 pandemic changed people's lifestyles and their relationship with pets, and this could potentially affect the incidence of dog bites injuries. Objective The main objectives of our study were to determine the prevalence of dog‐bite injuries in Uruguay from 2010 to 2020 and to compare the prevalence in 2020 to that of pre‐pandemic years. Methods Cross‐sectional study. Dog‐bite notifications for the 2010 and 2020 period were analysed using data from the Uruguayan Ministry of Public Health. Results The annual dog‐bite injury rate for the 2010–2020 period was 87.51 per 100,000 people. The frequency of bites varied with the victims’ sex, with males accounting for 51.8% of the bites (p < 0.0001), and with age, with a higher frequency of bites in the ≤14 years old age group (p < 0.01). The frequency of dog bites was also higher in spring and summer than in autumn (p < 0.0001). There was no statistical difference in the frequency of dog‐bite injuries when comparing 2020 with the pre‐COVID‐19 pandemic years. Conclusions In Uruguay, the frequency of dog‐bite injuries varied with season and with the age and sex of the victim. In the first year of the COVID‐19 pandemic, the number of people bitten by dogs was no different than that of previous years. This is the first study in Latin America to report national rather than regional data and to include all age groups.

Abstract Aggressive behaviour is thought to have significant consequences for fitness, sexual selection and the evolution of social interactions, but studies measuring its expression across successive encounters—both intra‐ and intersexual—are limited. We used the field cricket Teleogryllus oceanicus to evaluate factors affecting repeatability of male aggression and its association with mating success. We quantified focal male aggression expressed towards partners and received from partners in three successive, paired trials, each involving a different male partner. We then measured a proxy of focal male fitness in mating trials with females. The likelihood and extent of aggressive behaviour varied across trials, but repeatability was negligible, and we found no evidence that patterns of focal aggression resulted from interacting partner identity or prior experience. Males who consistently experienced aggression in previous trials showed decreased male mating ‘efficiency’—determined by the number of females a male encountered before successfully mating, but the effect was weak and we found no other evidence that intrasexual aggression was associated with later mating success. During mating trials, however, we observed unexpected male aggression towards females, and this was associated with markedly decreased male mating efficiency and success. Our findings suggest that nonadaptive aggressive spillover in intersexual mating contexts could be an important but underappreciated factor influencing the evolution of intrasexual aggression.

Abstract Aim The aim of this study was to conduct a 5‐h training programme on anger‐focused emotional management for nurses and verify its effectiveness. Design The study used a one‐group pretest–posttest design. Methods Participants (N = 283) attended a programme comprising lectures and exercises. The Japanese version of the Buss–Perry Aggression Questionnaire was administered pre‐, post‐ and 3‐month posttraining. Regression analyses were used to assess the effects of the programme by gender. Results For the total aggression score, the difference between the pre‐ and posttraining scores was −2.827 points and remained at −1.602 points 3‐month posttraining. Physical aggression scores decreased posttraining, but the scores increased after 3 months. There were statistically significant gender differences in hostility scores; pre‐training scores were slightly higher for men than for women and lower for men after 3 months. Total and physical aggression scores were higher for men than for women. The training programme decreased aggression, and the effect persisted after 3 months.

Abstract Objective In spite of anecdotal reports describing an association between chronic epilepsy and interictal aggressiveness, and of a few studies suggesting that such an association is common in temporal lobe epilepsy, this concept has not been generally accepted by epileptologists. In the course of studies of the long‐term consequences of limbic status epilepticus (SE) in juvenile rats, we noticed that experimental animals, unlike littermate controls, could not be housed together because of severe fighting. We now report a study of interictal aggression in those rats. Methods Long‐term behavioral consequences of lithium/pilocarpine SE were studied 3 months after SE had been induced with lithium and pilocarpine in male Wistar rats at age 28 days. Chronic spontaneous seizures developed in 100% of animals. We tested rats for territorial aggression under the resident‐intruder paradigm. We measured the number of episodes of dominance (mounting and pinning), and agonistic behavior (attacks, boxing, and biting). Results Untreated lithium/pilocarpine SE induced a large increase in aggressive behavior, which involved all aspects of aggression in the resident‐intruder paradigm when tested 3 months after SE. The experimental rats were dominant toward the controls, as residents or as intruders, and showed episodes of biting and boxing rarely displayed by controls. They also displayed increased aggressiveness compared with controls when tested against each other. Significance This robust model offers an opportunity to better understand the complex relationship between seizures, epilepsy, and aggression, and the role of age, SE vs. recurrent spontaneous seizures, and focal neuronal injury in the long‐term behavioral effects of SE.

The hippocampus is important for social behavior and exhibits unusual structural plasticity in the form of continued production of new granule neurons throughout adulthood, but it is unclear how adult neurogenesis contributes to social interactions. In the present study, we suppressed neurogenesis using a pharmacogenetic mouse model and examined social investigation and aggression in adult male mice to investigate the role of hippocampal adult-born neurons in the expression of aggressive behavior. In simultaneous choice tests with stimulus mice placed in corrals, mice with complete suppression of adult neurogenesis in adulthood (TK mice) exhibited normal social investigation behaviors, indicating that new neurons are not required for social interest, social memory, or detection of and response to social olfactory signals. However, mice with suppressed neurogenesis displayed decreased offensive and defensive aggression in a resident-intruder paradigm, and less resistance in a social dominance test, relative to neurogenesis-intact controls, when paired with weight and strain-matched (CD-1) mice. During aggression tests, TK mice were frequently attacked by the CD-1 intruder mice, which never occurred with WTs, and normal CD-1 male mice investigated TK mice less than controls when corralled in the social investigation test. Importantly, TK mice showed normal aggression toward prey (crickets) and smaller, nonaggressive (olfactory bulbectomized) C57BL/6J intruders, suggesting that mice lacking adult neurogenesis do not avoid aggressive social interactions if they are much larger than their opponent and will clearly win. Taken together, our findings show that adult hippocampal neurogenesis plays an important role in the instigation of intermale aggression, possibly by weighting a cost-benefit analysis against confrontation in cases where the outcome of the fight is not clear., (Published 2024. This article is a U.S. Government work and is in the public domain in the USA. Hippocampus published by Wiley Periodicals LLC.)

Social comparison is a universal social phenomenon that profoundly influences aggressive behaviours among young adults. Based on the general aggression model, this study investigated the relationship between social comparison and aggression, and the mediating role of relative deprivation. To further explore the mechanism underlying this influence, covert narcissism was examined as a moderator in this relationship, based on relative deprivation theory. The results from the current study using a total of 726 Chinese college students showed that social comparison was positively correlated with aggression, which was mediated by relative deprivation. Specifically, more frequent social comparison was associated with higher relative deprivation, which was, in turn, associated with higher aggression. Covert narcissism acted as a moderator in this model. Covert narcissism exacerbated the relationships between social comparison and relative deprivation and relative deprivation and aggression. Specifically, compared to individuals with low levels of covert narcissism, those with high levels of covert narcissism exhibited greater relative deprivation when subjected to the same social comparisons, subsequently displaying increased levels of aggression. This study deepens the understanding of the relationship between social comparison and aggression and provides an intervention direction and a theoretical basis for effectively preventing aggression in young adults., (© 2024 International Union of Psychological Science.)

ABSTRACT Importance Several studies conducted worldwide (mostly in Western countries) highlighted the negative effects of problematic internet use, particularly among adolescents aged 12 to 17, including depression, impulsivity, aggression, and social fear and avoidance. In Lebanon, literature on the prevalence and impact of problematic internet use among adolescents is limited. Objective This study aim was to study the association between problematic internet use and depression, impulsivity, anger, aggression and social phobia among Lebanese adolescents. Methods A cross‐sectional study was performed on 1103 young adolescents (14–17 years), recruited from October 2017 till April 2018. The Internet Addiction Test (IAT) was used to evaluate the level of problematic internet use. Data were analyzed using the MANCOVA analysis. The main independent variable of interest was the IAT, while the dependent variables included the psychological scales. Results The multivariate analysis taking the psychological scales as the dependent variables and the problematic internet use (IAT score) as an independent variable, showed that problematic internet use was associated with higher depression, impulsivity, aggression, anger, hostility and social anxiety. Interpretation Problematic internet use has become an important health issue that should not be overlooked, particularly because of the increased use of the internet by adolescents. Educational programs on early exposure to the internet should be developed.

Abstract Intergroup conflict is widespread in nature and is proposed to have strong impacts on the evolution of social behavior. The conflict–cohesion hypothesis predicts that exposure to intergroup conflict should lead to increased social cohesion to improve group success or resilience in future conflicts. There is evidence to support this prediction from studies of affiliative responses to outgroup threats in some animal societies. However, most of these studies have focused on behavioral changes over short time periods (minutes and hours after exposure to an outgroup), and hence very little is known about the dynamics and durability of responses to intergroup conflict over the longer term. We investigated this question by simulating intergroup encounters in wild banded mongooses (Mungos mungo) and measuring social behavior before, during, and after these encounters over a 5‐day period. We also ran control trials with non‐threatening stimuli. Banded mongooses reacted immediately to intrusion stimuli by vocalizing, grouping together, and advancing on the stimulus. In the first 5 min after simulated intrusions, we saw an elevation in grooming levels, but in the hour after exposure grooming rates declined sharply, contrary to our expectation. In the two subsequent days, grooming rates remained at this depressed rate. In control trials, the initial increase in grooming was not seen, but grooming declined compared to the longer‐term time periods. Grooming changed across time, but not in the same pattern as during intrusions, suggesting that intrusions had an impact above and beyond that of the experimental setup. The dynamics of grooming responses were short lived and more complex than we initially expected. We suggest this unexpected result may be linked to the frequency of aggressive intergroup encounters in this system. As control and experimental trials were run at different times of year, future work would be needed to confirm that these relative patterns are replicable. Our results indicate short‐lived impacts of outgroup threat on measures of social cohesion in this species, but cannot confirm longer‐term changes.

Abstract Smooth‐coated otters (Lutrogale perspicillata) and Malayan water monitor lizards (Varanus salvator) occupy similar habitats and interact regularly in Singapore's waterways. These interactions have a range of potential outcomes and are sometimes lethal. Few formal behavioral studies exist for either species. We analyzed interactions between otters and monitor lizards by gleaning data from publicly available videos from citizen scientists to examine what factors influence aggressive and defensive behaviors and what influences vigilance in otters. Behavioral sequence analysis revealed no obvious monitor lizard behavior that predicted otter aggression toward monitors. We found that the presence and number of otter pups are positively associated with otter aggression. Otters also tended to be more vigilant in groups with more pups and more vigilant on land than water. Monitor lizards almost always displayed aggressive and defensive behaviors, regardless of whether otters were aggressive toward the lizards. These observations suggest that otters vary their aggression and vigilance levels depending on their group composition and the physical environment of their interactions with monitor lizards.

Abstract Background There is growing evidence that inflammation influences mental health. Blood interleukin levels, which regulate inflammation, have been linked to aggression and internalizing behaviors. We performed a hypothesis‐driven genetic study to (1) evaluate the association of IL1B, IL2, and IL6 gene variants with aggression and internalizing behaviors and (2) explore gene–environment interactions with childhood adversity in a deeply phenotyped childhood‐onset aggression sample including 255 cases and 226 controls of European ancestry. Methods We evaluated the association of putative functional and tag SNPs within IL1B, IL2, and IL6 with aggression case status, parent‐reported internalizing problems, self‐reported anxiety symptoms, and self‐reported depressive symptoms in our sample. We also performed exploratory GxE analyses within cases, testing for statistical interaction between interleukin SNP genotype and childhood adversity for depressive symptoms. Results No significant association was observed between any of the interleukin SNPs and childhood‐onset aggression. We observed association of IL6 variant rs2069827 with depressive symptoms (p = 7.15×10–4), and trends for an interaction between severe childhood adversity and SNPs in IL1B and IL2 for depressive symptoms. Conclusions Our findings provide preliminary evidence that common variation in IL6 may be associated with depressive symptoms in children and adolescents, and that common variation in interleukin genes may sensitize individuals to the depressogenic effects of traumatic life experiences. Replication in independent samples is needed.

Abstract Pollinators and the pollination services they provide are critical for seed set and self‐sustainability of most flowering plants. Despite this, pollinators are rarely assessed in restored plant communities, where their services are largely assumed to re‐establish. Bird–pollinator richness, foraging, and interaction behavior were compared between natural and restored Banksia woodland sites in Western Australia to assess their re‐establishment in restored sites. These parameters were measured for natural communities of varying size and degree of fragmentation, and restored plant communities of high and low complexity for three years, in the summer and winter flowering of Banksia attenuata and B. menziesii, respectively. Bird visitor communities varied in composition, richness, foraging movement distances, and aggression among sites. Bird richness and abundance were lowest in fragmented remnants. Differences in the composition were associated with the size and degree of fragmentation in natural sites, but this did not differ between seasons. Restored sites and their adjacent natural sites had similar species composition, suggesting proximity supports pollinator re‐establishment. Pollinator foraging movements were influenced by the territorial behavior of different species. Using a network analysis approach, we found foraging behavior varied, with more frequent aggressive chases observed in restored sites, resulting in more movements out of the survey areas, than observed in natural sites. Aggressors were larger‐bodied Western Wattlebirds (Anthochaera chrysoptera) and New Holland Honeyeaters (Phylidonyris novaehollandiae) that dominated nectar resources, particularly in winter. Restored sites had re‐established pollination services, albeit with clear differences, as the degree of variability in the composition and behavior of bird pollinators for Banksias in the natural sites created a broad completion target against which restored sites were assessed. The abundance, diversity, and behavior of pollinator services to remnant and restored Banksia woodland sites were impacted by the size and degree of fragmentation, which in turn influenced bird–pollinator composition, and were further influenced by seasonal changes between summer and winter. Consideration of the spatial and temporal landscape context of restored sites, along with plant community diversity, is needed to ensure the maintenance of the effective movement of pollinators between natural remnant woodlands and restored sites.

Abstract The natural distributions of freshwater fish species are limited by their thermal tolerances via physiological constraints and increased interspecific competition as temperatures shift toward the thermal optima of other syntopic species. Species may mediate stress from temperature change physiologically, behaviorally, or both; but these changes may compromise competitive advantages through effects on feeding and social behavior. In the Appalachian Mountains of North America, creek chub (Semotilus atromaculatus) are found in warm‐water and cold‐water streams and overlap in range with brook trout (Salvelinus fontinalis) across lower thermal maxima, where they compete for food and space. As stream temperatures continue to increase due to climate change, brook trout are under increasing thermal stress which may negatively affect their ability to compete with creek chub. To examine the influences of temperature on competitive interactions between these species, we observed feeding behavior, aggression, and habitat use differences at three temperatures approaching brook trout thermal maxima (18°C, 20°C, and 22°C) among dyad pairs for all combinations of species in experimental flow‐through tanks. We also examined feeding and habitat use of both species under solitary conditions. We found as temperature increased, feeding and aggression of brook trout were significantly reduced in the presence of creek chub. Creek chub pairs were more likely to occupy benthic areas and refugia while brook trout pairs used surface water more. Space use patterns significantly changed by pairing treatment. Aggression and space use shifts allowed increased exploitative and interference competition from creek chub when paired with brook trout that was not present in conspecific pairs. The decreased dominance of a top predator may lead to diverse impacts on stream community dynamics with implications for the future range restriction of brook trout and demonstrate possible mechanisms to facilitate competitive advantages of warm water generalist species under thermal stress.

Abstract During secondary contact between two species when hybrids are less fit than parents, mating signals are expected to diverge, while aggressive signals are expected to converge. If a single signal trait is used in both mating and aggression, then the dynamics between these two forces could influence the evolutionary trajectory of that trait. We studied such a situation in an avian hybrid zone between two Setophaga species, where birdsong is used in both mate attraction and territory defense. We hypothesized that song modules of the two species will show separate and distinct geographic patterns due to the influence of selective pressures for effective territorial aggression and for effective mate attraction. We conducted geographic cline analyses and playback experiments across this hybrid zone. We found an unexpected geographic pattern of asymmetric introgression of song rhythm, which may be explained by results of the playback experiments that suggest that differences in song rhythm serve a greater role in mate attraction than in territory defense. In contrast, differences in syllable morphology show little evidence of importance in mate attraction or territorial defense. Song features converge in the hybrid zone, yet patterns of trait change suggest that the song production modules may vary in their modes of development and inheritance. Syringeal motor gesturing, which gives rise to syllable morphology, shows a nonclinal mosaic pattern, suggesting that this trait may be predominantly learned. In contrast, respiratory patterning, which forms song rhythm, shows a clinal geographic transition, suggesting that this trait could be more innate. The results indicate that opposing forces act independently on song via distinct modules of the song production mechanism, driving complex patterns of song trait evolution.

Abstract Aim This study aimed to investigate the frequency of documented aggression, on the part of cognitively impaired individuals, against health professionals in home care services and to highlight related factors. Design A retrospective cross‐sectional study was conducted using data obtained from the nursing documentation of six home care service organizations in Switzerland. Methods We analysed the nursing documentation of 1,186 clients in six home care services, between July 2019–September 2019, using the Cohen‐Mansfield Agitation Inventory. We conducted a factor analysis as well as a descriptive data analysis and logistic regression using IBM SPSS Statistics. Results A factor analysis revealed in five factors, of which three represented aggressive behaviour in the sample. These factors were physically aggressive behaviour, verbally aggressive behaviour and importunate behaviour. Aggressive incidents, documented in the nursing records of 14.7% of clients in our sample, tended to be associated with cognitive, communication and mobility difficulties. Impact statement This retrospective cross‐sectional survey gives an overview of the frequency and forms of documented aggressive behaviour on the part of persons with cognitive impairments towards health professionals in home care services. One of the motivating factors for this study was the awareness that aggressive behaviour on the part of clients may stress health professionals in various ways which in turn may have an impact on the quality of care provided. The study revealed that healthcare specialists, rather than more qualified general or psychiatric nurses, were routinely assigned to assisting such clients and therefore specific educational and training interventions for these specific group of staff are indicated.

Abstract The ecological success of ants has made them abundant in most environments, yet inter‐ and intraspecific competition usually limit nest density for a given population. Most invasive ant populations circumvent this limitation through a supercolonial structure, eliminating intraspecific competition through a loss of nestmate recognition and lack of aggression toward non‐nestmates. Native to South America, Brachymyrmex patagonicus has recently invaded many locations worldwide, with invasive populations described as extremely large and dense. Yet, in contrast with most invasive ants, this species exhibits a multicolonial structure, whereby each colony occupies a single nest. Here, we investigated the interplay between genetic diversity, chemical recognition, and aggressive behaviors in an invasive population of B. patagonicus. We found that, in its invasive range, this species reaches a high nest density with individual colonies located every 2.5 m and that colony boundaries are maintained through aggression toward non‐nestmates. This recognition and antagonism toward non‐nestmates is mediated by chemical differentiation between colonies, as different colonies exhibit distinct chemical profiles. We highlighted that the level of aggression between colonies is correlated with their degree of genetic difference, but not their overall chemical differentiation. This may suggest that only a few chemical compounds influence nestmate recognition in this species or that weak chemical differences are sufficient to elicit aggression. Overall, this study demonstrates that invasive ant populations can reach high densities despite a multicolonial structure with strong aggression between colonies, raising questions about the factors underlying their ecological success and mitigating negative consequences of competitive interactions.

Abstract Lesch‐Nyhan disease (LND) is a rare genetic disorder with an unusual behavioral phenotype that includes severe and involuntary self‐injury requiring the near constant use of protective devices and, for some individuals, dental extraction. Often, the person with LND also engages in emotional self‐injury in the form of both self‐sabotage and behaviors directed toward others that will have a negative social consequence. When these self‐destructive behaviors present themselves, it is sometimes challenging for caregivers, professionals, or other observers to fully recognize their lack of volition. It is an even greater challenge to accurately and convincingly convey their involuntary nature to medical students, colleagues, school staff, or even family members who might be unfamiliar with the disorder. It is difficult to find words to clearly and adequately convey the essence of behaviors like those that we find in LND without, in some way, implying intent.

Abstract Aim The primary aim of this qualitative inquiry is to explore the experiences of Registered Nurses working in Saudi Arabia, which was a guide to answer the question, “what are the lived experiences of Registered Nurses working in a selected government hospital in Eastern Region of Saudi Arabia towards workplace violence?” Background Workplace violence is a social phenomenon that needs a widespread campaign to eradicate. Incidence from all over the world continues to grow in number, especially among Registered Nurses in Saudi Arabia. Methods Descriptive phenomenology. Purposive‐convenience sampling was used in selecting 21 Registered Nurses as participants for individual in‐depth interviews. Data were gathered over an 11 month's period from September 2017 to August 2018. We used Colaizzi's method for analysing the data. COREQ criteria were adapted in reporting the results of the study. Results Three themes had emerged from the experiences of the participants: “co‐workers become unjust and violent”; “socio‐cultural divergence towards healthcare workers”; and “violence from outside influences affecting the workplace.”

Abstract Objectives Focused research on pediatric agitation is lacking despite being a common mental and behavioral health (MBH) emergency. Prevalence of pediatric agitation remains unknown, and prior reports may have underestimated the rate of restraint use for pediatric agitation. This is the largest study to provide a focused evaluation of the prevalence and predictors of pediatric agitation and restraint use as well as the emergency department (ED) length of stay (LOS) and admission rates for agitated patients. Methods We reviewed records of patients aged ≤18 years with MBH needs who visited the pediatric ED of a tertiary care hospital during a 3‐year‐period. We identified and ascertained agitated/aggressive patients using documented signs/symptoms, International Classification of Diseases, Tenth Revision codes, and Behavioral Activity Rating Scale scores. We performed descriptive and multivariable analyses using SAS 9.4 (SAS Institute). Results Of 10,172 patients with MBH needs, 1408 (13.8%) were agitated/aggressive. Of these (n = 1408), 63.7% were boys, and the mean age was 11.9 years. Among agitated patients, the prevalence of restraint use was 28.7%, with a predominance of pharmacologic restraint with atypical antipsychotics. Non‐Hispanic Blacks were more likely to be agitated (adjusted odd ratio [aOR], 1.8; 95% CI, 1.2–2.7), but not restrained (aOR, 0.8; 95% CI, 0.3–1.8). Predictors of restraint use include history of attention deficit hyperactivity disorder (aOR, 2.2; 95% CI, 1.5–3.3), autism (aOR, 2.9; 95% CI, 1.9–4.5), conduct disorder (aOR, 1.7; 95% CI, 1.2–2.5), psychosis (aOR, 14.3; 95% CI, 2.5–271.8), and substance use/overdose states (aOR, 1.9; CI, 1.2–3.2). Restrained agitated patients had longer ED LOS (8.4 vs 5.0 hours; P

Abstract Agitation and aggression are common in older emergency department (ED) patients, can impede the expedient diagnosis of potentially life‐threatening conditions, and can adversely impact ED functioning and efficiency. Agitation and aggression in older adults may be due to multiple causes, but chief among them are primary psychiatric disorders, substance use, hyperactive delirium, and symptoms of dementia. Understanding the etiology of agitation in an older adult is critical to proper management. Effective non‐pharmacologic modalities are available for the management of mild to moderate agitation and aggression in patients with dementia. Pharmacologic management is indicated for agitation related to a psychiatric condition, severe agitation where a patient is at risk to harm self or others, and to facilitate time‐sensitive diagnostic imaging, procedures, and treatment. Emergency physicians have several pharmacologic agents at their disposal, including opioid and non‐opioid analgesics, antipsychotics, benzodiazepines, ketamine, and combination agents. Emergency physicians should be familiar with geriatric‐specific dosing, contraindications, and common adverse effects of these agents. This review article discusses the common causes and non‐pharmacologic and pharmacologic management of agitation in older adults, with a specific focus on dementia, delirium, and pain.

Abstract Microplastics (MPs) are widespread in aquatic environments and have become a critical environmental issue in recent years due to their adverse impacts on the physiology, reproduction, and survival of aquatic animals. Exposure to MPs also has the potential to induce sub‐lethal behavioral changes that can affect individual fitness, but these effects are understudied. Many plastic additives introduced during the manufacture of MPs are known endocrine‐disrupting chemicals (EDCs) that mimic the action of natural hormones, alter sexual and competitive behavior, and impair reproductive success in fish. In addition, EDCs and other aquatic contaminants may adhere to MPs in the environment, the latter of which may serve as transport vectors for these compounds (i.e., the vector hypothesis). In this study, we staged territorial contests between control males, and males exposed to virgin MP particles or to MPs previously immersed in one of two environmentally relevant concentrations of 17‐alpha ethinyl estradiol (EE2; 5 ng/L and 25 ng/L) to evaluate the independent and synergistic effects of exposure to MPs and a common environmental estrogen on male–male aggression and competitive territory acquisition in a freshwater fish, Pimephales promelas. Short‐term (30 days) dietary exposure to MPs did not impair the ability of males to successfully compete for and obtain a breeding territory. Overall levels of aggression in control and exposed males were also similar across trial series. These results help to fill a critical knowledge gap regarding the direct and indirect (vector‐borne) effects of MPs on the reproductive behavior of aquatic vertebrates in freshwater systems.

Problem: Aggressive behavior is common on psychiatric inpatient units. Seclusion and restraint interventions to manage patients' aggressive behavior may have the consequence of being traumatizing for patients. Pediatric psychiatric patients' perspective on the use of seclusion and restraint interventions is not present in the literature., Methods: This hermeneutic nursing research study asked the question, "How might we understand children's experiences of seclusion and restraints on an inpatient psychiatric unit?" Four past pediatric psychiatric inpatients shared their hospitalization experiences that occurred within the previous year when they were 10 years old. The texts of the research interviews were compared to Attachment Theory for a deeper understanding of the meaning of the message., Findings: Participants commonly described experiences with seclusion and restraints as feeling trapped and alone in a dark room. They recommended the nurses step into the room with them to help them heal. Interpretively, the rooms on inpatient units could be considered as actual and metaphorical spaces of possible harm or healing., Conclusion: The participant's voices expand understanding of nurse's use of discernment at the doorway of a patient room to ensure the most therapeutic care is provided to the patient in these spaces through a secure nurse-patient relationship., (© 2024 Wiley Periodicals LLC.)

Abstract Objective Post‐traumatic stress disorder (PTSD) is a chronic, disabling condition. Our main objective is to investigate the association between trait mindfulness and PTSD over a period of 54 months. The secondary objective is to provide an exhaustive description of PTSD trajectories after the Bataclan attack. Methods We designed a prospective cohort study of 133 subjects present in the Bataclan concert hall during the November 2015 terrorist attack in Paris, France. Data were recorded 6, 18, 30, and 54 months after the attack. The primary endpoint was evaluated using the PTSD Check List Scale. Trait mindfulness was measured by the 14‐item Freiburg Mindfulness Inventory. Results FMI scores were consistently, significantly, and negatively associated with PCL‐5 scores. Adjusted odds ratios were at 0.81 (6 months), 0.88 (18 months) 0.82 (30 months), and 0.81 (54 months). PTSD prevalence 6 months after the event was 77%; it remained at 41% after 54 months. PTSD status of subjects is fluctuating. Latent class analysis divided the cohort into 3 groups: 21% of subject who remained below PTSD threshold throughout, 30% who remained above throughout, and 49% who steadily reduced their PTSD scores over time. Conclusion In our cohort, mindfulness is negatively associated with PTSD. Mindfulness programs are designed to improve global resilience and treat anxiety and mood disorders. Further research is needed to investigate if improving trait mindfulness is possible and beneficial for patients suffering from PTSD.

Abstract Background Although aggression is conceptualized as a dimensional construct with violent behavior representing the extreme end of a spectrum, studies on the involvement of personality traits in human aggression have typically only included data representing a restricted spectrum of aggressive behaviors. Methods In the current study, we therefore examine whether trait aggression is associated with five‐factor model personality traits in an enriched sample of 259 men with a broad continuum of trait aggression, ranging from very low to very high including 39 incarcerated aggressive violent offenders. All participants completed the NEO Personality Inventory‐Revised (NEO PI‐R) and the Buss–Perry Aggression Questionnaire (BPAQ). The association between each of the five NEO PI‐R personality traits and trait aggression (BPAQ) was investigated using five linear regression models, covarying for group status, age and educational level. Results Higher BPAQ scores were positively associated with Neuroticism and negatively associated with Agreeableness and Conscientiousness. Conclusion Our results indicate that those high in Neuroticism and low in Agreeableness and Conscientiousness are at higher risk of exhibiting aggressive behavior, underlining the relevance of these higher order personality traits in understanding aggressive behavior. We argue that studying individual personality differences should be offered a greater attention within violent and criminal behaviors.

Abstract To meet future global demand for fish protein, more fish will need to be farmed using fewer resources, and this will require the selection of nonaggressive individuals that perform well at high densities. Yet, the genetic changes underlying loss of aggression and adaptation to crowding during aquaculture intensification are largely unknown. We examined the transcriptomic response to aggression and crowding in Nile tilapia, one of the oldest and most widespread farmed fish, whose social structure shifts from social hierarchies to shoaling with increasing density. A mirror test was used to quantify aggression and skin darkening (a proxy for stress) of fish reared at low and high densities, and gene expression in the hypothalamus was analysed among the most and least aggressive fish at each density. Fish reared at high density were darker, had larger brains, were less active and less aggressive than those reared at low density and had differentially expressed genes consistent with a reactive stress‐coping style and activation of the hypothalamus–pituitary–interrenal (HPI) axis. Differences in gene expression among aggressive fish were accounted for by density and the interaction between density and aggression levels, whereas for nonaggressive fish differences in gene expression were associated with individual variation in skin brightness and social stress. Thus, the response to crowding in Nile tilapia is context dependent and involves different neuroendocrine pathways, depending on social status. Knowledge of genes associated with the response to crowding may pave the way for more efficient fish domestication, based on the selection of nonaggressive individuals with increasing tolerance to chronic stress necessary for aquaculture intensification.

Abstract Reintegration of ex‐combatants involves multiple challenges. In addition to the trauma‐related psychological sequelae, social obstacles in the community can aggravate psychopathological aggressive tendencies and lead to the continuation of violence in civilian life. However, the association between others’ negative attitudes and ex‐combatants’ ongoing perpetration of violence remains largely unexplored. Between September 2018 and May 2019, we assessed a representative community sample of adults in Eastern DR Congo (N = 1,058) and measured trauma exposure, perpetration, mental health problems (PTSD, depression, and appetitive aggression), perceived stigma (shame, perceived lack of social acknowledgement), experienced stigma, and skepticism toward reintegration with ex‐combatants. Male ex‐combatants (12%, n = 129) had more past trauma and violence perpetration than other community members and a greater number of recent conflicts (including both victimization and perpetration) within the community and with strangers/organized violence. They reported more experienced stigma, more severe PTSD symptoms but were less skeptical about reintegration. Ex‐combatants’ ongoing violence was predicted by an interplay of the community's skepticism toward reintegration and ex‐combatants’ perceived and recently experienced stigma (often attributed to the armed group history) and mental health problems, in addition to lifetime traumatization. These findings promote the need for combined interventions that address individual mental health problems including aggression and collective discriminatory attitudes and behaviors.

Abstract Objective We aim to provide a publicly available Hungarian version of the BPAQ; compare the BPAQ factors to other personality traits; and compare both the original BPAQ factor structure provided by Buss and Perry (J. Pers. Soc. Psychol., 63, 1992, 452), the revised BPAQ‐SF factor structure by Bryant and Smith (J. Res. Pers., 35, 2001, 138), and the BAQ by Webster et al. (Aggress. Behav., 40, 2014, 120). Methods The validation of the Hungarian version of the BPAQ was carried out on a Hungarian university sample (N = 841). There were three main focuses of data analysis: descriptive statistics, correlations, and confirmatory factor analyses. Results CFA‐related statistics showed an adequate fit for the BPAQ 4 factors; however, contrary to prior validations of BPAQ, we were not able to clearly define the verbal aggression factor. We found that the shorter form of the BPAQ has a better model fit on our sample than the original form, while the model fit of the BAQ was in‐between these. BPAQ scales showed low to moderate relationship with the Barratt Impulsivity Scale and Hospital Anxiety and Depression Scale. Conclusion Both the BPAQ and the BPAQ‐SF, also the BAQ provide acceptable model fitting on a Hungarian sample of university students. While most of BPAQ items provided adequate loadings on their hypothesized factors, two items (21 and 27) did not. We argue this is the result of conceptual inaccuracy of the original items.

Abstract Introduction Experimental models of neuropsychiatric disorders, for example, ADHD, are used to mimic specific phenotypic traits of a complex human disorder. However, it remains unresolved to what extent the animal phenotype reflects the specific human trait. The null mutant mouse of the serotonin‐synthesizing tryptophan hydroxylase‐2 (Tph2‐/‐) gene has been proposed as experimental model for ADHD with high face validity for impulsive, aggressive, and anxious behaviors. To validate this ADHD‐like model, we examined the Tph2‐/‐ phenotype in humans when considering allelic variation of TPH2 function (“reverse phenotyping”). Methods 58 participants (6 females, 8–18 years) were examined, of whom 32 were diagnosed with ADHD. All participants were phenotyped for impulsivity, aggression, and anxiety using questionnaires, behavioral tests, and MRI scanning while performing the 4‐choice serial reaction time task. Additionally, participants were genotyped for the TPH2 G‐703T (rs4570625) polymorphism. To analyze the relation between TPH2 G‐703T variants and the impulsive/aggressive/anxious phenotype, mediation analyses were performed using behavioral and MRI data as potential mediators. Results We found that the relation between TPH2 G‐703T and aggression as part of the reverse Tph2‐/‐ phenotype was mediated by structure and function of the right middle and inferior frontal gyrus. Conclusion At the example of trait aggression, our results support the assumption that the Tph2 null mutant mouse reflects the TPH2 G‐703T‐dependent phenotype in humans. Additionally, we conclude that “reverse phenotyping” is a promising method to validate experimental models and human findings for refined analysis of disease mechanisms.

Abstract Introduction The aim of this study is to identify the association between Attention Deficit Hyperactivity Disorder (ADHD) proneness and aggressive propensity in adolescents. Methods A quantitative, large‐scale, cross‐sectional study was performed from April to May 2016 in Korea. The survey questionnaire included overall health behaviors, as well as scales for assessing ADHD proneness (revised short form of the Conners‐Wells Adolescent Self‐Report Scale; CASS[S]) and aggressive behavior (Buss‐Perry Aggression Questionnaire; BPAQ) in adolescents. Area under the receiver operator characteristic (AUROC) curves was constructed to determine the cut‐off value of total aggression score for discriminating ADHD proneness. Results A total of 2,432 students participated in the survey, and 1,872 of them completed the questionnaire, indicating a response rate of 77.0%. Based on CASS(S), 33 (1.8%) subjects were classified as the ADHD group. AUROC curve analysis showed that a score of 68.5 points had higher sensitivity (83.3%) and specificity (69.4%) to discriminate ADHD proneness. ADHD proneness was significantly associated with higher aggression subdomain scores (physical, verbal, anger, and hostility). Especially, anger and hostility had a stronger relationship with ADHD proneness than did physical and verbal aggression. A multivariable analysis demonstrated that ADHD proneness was significantly related to body mass index in the top 10% of the study population, alcohol consumption, gastrointestinal trouble, daytime sleepiness, and total aggression score of 68.5 points or higher. Adolescents who had total aggression scores of 68.5 points or higher showed a 9.8‐fold (95% confidence interval [CI] 3.3–28.8) higher risk of ADHD compared with those who had scores less than 68.5 points. Conclusions Our results demonstrated that ADHD proneness was significantly associated with aggression propensity. In particular, anger and hostility were more closely associated with ADHD proneness than were other aggression subdomains.

Treating perpetrators of aggressive behavior, like verbal aggression, intimidation, and bullying behavior resulting in aggressive incidents with others, is difficult. This group is often diagnosed with personality disorders and when legal measures applied, they are more often treated in a forensic setting for their problems. This article presents the case of a 54-year-old man, diagnosed with Borderline personality disorder, narcissistic and antisocial traits, mild depressive symptoms, and loss and grief, who has voluntarily had treatment in a forensic outpatient center to reduce aggression and change destructive patterns in relationships. Hating, judging, and self-defeating were the main reasons why the patient found himself ending up in the same situation repeatedly. The client received individual drama therapy sessions. The drama therapeutic approach included schema therapeutic elements, such as schema mode work with cards, as well as roleplay, imagery (with rescripting), improvisation, and psycho drama elements. As a result of drama therapy, the client reported less (active) aggression, less aggression in his relationships (partners/children/friends), but also an increased level of loneliness, and mild depressive symptoms. The client was more in touch with his vulnerability and was able to behave in a more adequate healthy way in relationships. Although self-esteem was still building up, there was a decrease of aggression and less conflict-seeking behavior as a result. Risk assessment tools (FARE-2 & HONOS) and Schema therapy scales (YSQ and SMI) were used pre- and posttreatment confirming the improvements. This case promotes the use of dramatherapy in forensic outpatient care to be valuable in lowering risk recidivism and changing deeply rooted behavioral patterns., (© 2024 Wiley Periodicals LLC.)

Background: Behavioural and psychological symptoms of dementia are a group of non-cognitive symptoms such as agitation, physical aggression, depression, sexual disinhibition and psychosis. Therapeutic approaches vary because of the multifactorial and complex symptomology. The researchers of this study aimed to systematically review the nonpharmacological interventions for BPSD used by nurses in acute and subacute hospital settings., Design: The PRISMA guidelines guided this systematic review. The review was registered with PROSPERO (CRD42020184015)., Method: The databases Cumulative Index of Nursing and Allied Health Literature (CINAHL) complete, Medline complete, Excerpta Medica (Embase®) and PsycINFO published by the American Psychological Association (APA) were searched for studies published in English to October 2021. Quality appraisal was performed independently by three reviewers using the Critical Appraisal Skills Program tools. Data were synthesized using a narrative approach., Results: Two studies were identified that focused on interventions used by nurses; findings were positive for the use of nonpharmacological interventions to manage BPSD., Conclusion: Current evidence suggests that nonpharmacological interventions are the best practices to manage BPSD. However, limited, and low-quality evidence suggests that further investigation is required to understand the factors contributing to the lack of use of nonpharmacological interventions by nurses in acute and subacute hospital settings., (© 2023 The Authors. International Journal of Nursing Practice published by John Wiley & Sons Australia, Ltd.)

Abstract Objective Low total cholesterol has been linked with adverse mental symptoms such as aggression and impulsivity in severe mental disorders (SMDs). This putative association may affect the clinician's decision making about cholesterol lowering in this patient group. Here, we investigated the associations between cholesterol levels, aggression, and impulsivity in a large representative sample of in‐ and outpatients with SMD. Methods Patients with schizophrenia‐ or bipolar spectrum disorders (N = 1 001) underwent thorough clinical characterization and blood sampling (total cholesterol, low‐density lipoprotein cholesterol, high‐density lipoprotein cholesterol). Aggression was characterized by the Positive and Negative Syndrome Scale Excited Component. Impulsivity was measured with the Barratt Impulsiveness Scale in a subsample of patients (N = 288). We used a multinomial logistic regression model to analyze the association between cholesterol and aggression and a multiple linear regression model to analyze the association between cholesterol and impulsivity, while controlling for confounders. Results We found no significant associations between cholesterol levels and aggression or impulsivity. There were no significant interactions between cholesterol and diagnostic group or inpatient versus outpatient status. Controlling for medication use, body mass index, alcohol or illicit substance use did not affect the results. Conclusion In this large sample of patients with schizophrenia‐ and bipolar spectrum disorders, we found no associations between cholesterol levels and aggression or impulsivity. This has clinical implications as patients with SMD are at increased CVD risk and currently undertreated with statins.

Objective: This study aimed to investigate the interrelations between emotion regulation strategies and different types of anger using network analysis., Method: Data were drawn from a cross-sectional sample of 538 adults (55% females; mean age = 39.8 years, SD = 12.3) seeking treatment for anger. Data were collected between March and November 2019 in Sweden. Participants completed measures of anger problems (anger expression, anger suppression, angry reactions, anger rumination, trait anger, hostility, physical aggression, and verbal aggression) and emotion regulation (cognitive reappraisal, expressive suppression, anger relaxation, and five mindfulness strategies). To determine whether distinct clusters of anger nodes would emerge, exploratory graph analysis was employed. Based on clustering of nodes, we estimated separate networks including all measures of emotion regulation., Results: Two clusters emerged: one consisting primarily of cognitive components of anger, and another of behavioral. Across networks, anger nodes were strongly interconnected, and anger rumination and anger suppression were especially influential. Several direct links were found between specific emotion regulation strategies and cognitive components of anger, whereas most strategies were only indirectly related to angry behavior. Cognitive reappraisal showed no direct link with any of the anger nodes., Conclusions: Our findings reveal potential pathways by which different emotion regulation strategies may influence different types of anger, which could serve as therapeutic targets., (© 2023 The Authors. Journal of Clinical Psychology published by Wiley Periodicals LLC.)

The lives of people in conflict areas are often characterized by the experience of traumatic events frequently accompanied by loss and separation. These can equally trigger symptoms of posttraumatic stress disorder (PTSD) and complicated grief (CG). The aim of the present study was to investigate whether affected individuals could be assigned to distinct classes at symptom-cluster levels of these two disorders. Moreover, we aimed to identify event-related and sociodemographic predictors associated with membership in these pathological classes. Participants were Iraqi internally displaced persons (IDPs; N = 199) who fled their hometowns due to the ISIS conflict and reported having lost an important person within the past 5 years. Based on the PTSD Checklist for DSM-5 (PCL-5) and Inventory of Complicated Grief (ICG), a latent class analysis (LCA) was applied to examine different classes of symptom clusters. Multinomial logistic regression was used to determine which variables predicted assignment to these symptom classes. The impact of loss and separation among IDPs in Iraq manifested in CG symptoms in more than half of the affected population and was often accompanied by PTSD. LCA identified a low-symptoms class (17.6%), CG class (33.7%), PTSD class (12.1%), and comorbid PTSD+CG class (36.7%). The sudden or violent death of a loved one was identified as a distinguishing factor for PTSD. Furthermore, separation was associated with comorbidity. Aid agencies should take these specific factors into account to improve effective and economic aid delivery to IDPs continuously affected by terror., (© 2023 The Authors. Journal of Traumatic Stress published by Wiley Periodicals LLC on behalf of International Society for Traumatic Stress Studies.)