Appraising risk factors of aggression in children and adolescents at psychiatric inpatient units

James Rufus John; Vignesh Thavalingam; Michelle Tye; Kimberlie Dean; Drew Barzman; Michael Sorter; Ping-I Lin

doi:10.1016/j.psychres.2023.115368

Appraising risk factors of aggression in children and adolescents at psychiatric inpatient units

Psychiatry Res. 2023 Sep:327:115368. doi: 10.1016/j.psychres.2023.115368. Epub 2023 Jul 24.

Authors

James Rufus John¹, Vignesh Thavalingam², Michelle Tye³, Kimberlie Dean⁴, Drew Barzman⁵, Michael Sorter⁵, Ping-I Lin⁶

Affiliations

¹ School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia; Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia.
² School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.
³ School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia.
⁴ School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia; Justice Health and Forensic Mental Health Network, Sydney, NSW, Australia.
⁵ Department of Psychiatry and Behavioural Neuroscience, University of Cincinnati, Ohio, United States; Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Ohio, United States.
⁶ School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia; Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia; Department of Mental Health, School of Medicine, Western Sydney University, Penrith, NSW, Australia. Electronic address: daniel.lin@unsw.edu.au.

PMID: 37506586
DOI: 10.1016/j.psychres.2023.115368

Abstract

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.

Keywords: Aggressive incidents; Cluster analysis; Predictors; Psychiatric unit.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Aggression / psychology
Child
Hospitalization
Humans
Inpatients* / psychology
Male
Mental Disorders* / epidemiology
Mental Disorders* / psychology
Risk Factors