Riverside’s Premier Treatment Center for Aggressive Behaviors

Aggression refers to any behavior that is hostile, forceful, destructive, and/or violent. More specifically, aggressive behaviors have the potential or threat of causing physical or emotional harm to another individual or group of individuals. Aggressive behaviors can range from verbal abuse, in which an individual verbally attacks another, to physical aggression, in which a person executes a physical attack on another individual or group of individuals. Additionally, aggression may include the destruction of a victim’s personal property. This type of behavior can be the result of certain stimuli, or can be done in retaliation. Aggression can be done in a blatant or secretive manner and may be used as a means to provoke a victim.

While occasional outbursts of anger are common, aggressive behavior is a problem because it usually occurs on a more frequent basis and can hurt or threaten others. Additionally, aggression violates social norms and can lead to the destruction of personal relationships. Aggressive behavior can be displayed in a number of different direct and indirect ways, some of which are listed below:

Direct aggressive behaviors may include the following:

  • Hitting
  • Pinching
  • Hair-pulling
  • Biting
  • Spiting
  • Kicking
  • Pushing

Aggression can also take a more indirect approach and may be combined with physical aggression. Indirect aggression may include:

  • Gossiping
  • Excluding others
  • Name-calling
  • Willful destruction of objects or items
  • Bullying
  • Passive-aggressive behaviors
  • Spreading rumors
  • Ignoring
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What Causes Aggression?

Specific causes of aggression are still not known, but some studies have shown that abnormal brain chemistry or structural changes may play a role, in addition to environmental and genetic factors. Aggressive behavior can be a symptom of a disease, mental health disorder, or other condition that interferes with thought processes, such as dementia, PTSD, and a number of other personality disorders. Additionally, there are a number of different theories that may explain the development of aggressive behaviors.

The most common and accepted theory is the social-learning theory for aggression. This theory states that people learn to behave aggressively through environmental exposures and use aggression as a way to accomplish their goals. Most people believe that the way in which you specifically express your frustration will depend upon the ways in which you have learned to behave through examples in your life. Another theory is the frustration-aggression theory, which suggests that when people feel frustration and are unable to achieve their goals, they become angry and hostile, which causes them to exhibit aggressive behaviors toward others.

Additionally, years of research have been spent trying to explain why one person behaves aggressively while another does not. It has been concluded that there are a number of subcortical structures and circuits that play a role in controlling and regulating aggressive behaviors. The exact roles of these pathways appear to vary based upon the precipitating aggression trigger. Researchers in the field believe that the prefrontal cortex of the brain is key to regulating aggression and other types of emotional responses. Lowered activity in the medial and orbitofrontal areas of the prefrontal cortex has been linked to antisocial behaviors and aggression. Additionally, a deficiency of the neurotransmitter serotonin has been linked to aggression and impulsive behaviors.

What Causes Aggression in Adults?

Aggression in adults can develop as a result of negative life experiences or mental illnesses. In some cases, individuals who suffer from mental health disorders such as depression, anxiety, or PTSD unintentionally display aggressive behaviors as a result. For adults who don’t have an underlying medical or emotional disorder, aggression is usually thought to be the result of frustration. Additionally, aggression can occur when an individual stops caring about the consequences of their behaviors and how it impacts others. The most common disorders that have aggression as a symptom include:

Antisocial Personality Disorder (ASPD): This personality disorder is characterized by a long-term pattern of a violation and disregard for the rights of others. This may be the result of decreased conscience or moral values, or a history of criminality, incarceration, legal problems, or impulsive and overly aggressive acts.

Bipolar disorder: During the manic or depressive cycle of bipolar disorder, some individuals become irritable and may end up acting in an aggressive manner, lashing out at those around them physically, verbally, or both.

Borderline personality disorder (BPD): People who have BPD are more likely to experience severe emotional instability, especially during a time when they feel a threat of abandonment, which can lead to aggressive acts.

Histrionic personality disorder (HPD): Individuals who have HPD exhibit many attention-seeking behaviors and emotional instability. When a person with this disorder isn’t getting the attention they want, they may lash out aggressively to gain the needed attention.

Intermittent explosive disorder (IED): People who struggle with IED have a pattern of impulsive, violent, angry, and aggressive behaviors that are greatly out of proportion to the situations they occur in. People with IED may attack other people who they see as a threat or may destroy others’ possessions during a bout of aggressive behaviors.

Schizoaffective disorder: This disorder combines the symptoms of schizophrenia and a mood disorder, including hallucinations and delusions. When a person with schizoaffective disorder has a psychotic break, he or she may act out aggressively in response to internal stimuli and faulty perceptions.

Schizophrenia: Most individuals with schizophrenia are not violent, however, sometimes these individuals experience breaks in reality. During this time, the hallucinations and delusions they experience may cause them to behave in an aggressive manner out of fear or in response to internal stimuli.

Substance abuse: Those who abuse certain drugs or alcohol are at an increased risk for developing addiction. Many psychoactive drugs cause aggression and during withdrawal states, aggression is common.

Treatment for Aggression in Adults

In order to work through aggressive behaviors, one must first identify the primary cause and underlying factors. The most common way to treat and reduce aggressive behavior in an adult is some form of psychotherapy, such as cognitive behavioral therapy (CBT). Through psychotherapy methods, an individual can learn how to control their behaviors, develop better coping skills, and develop the ability to understand the consequences of their behavior.

Any adult with episodes of aggression significant enough to interfere with their daily lives should seek the treatment of a qualified therapist for a complete diagnosis and care plan. Treatment for aggression in adults will help promote interpersonal relationships, increase satisfaction at home and at work, and positively increase self-image and self-esteem. Treatment options may include:

Medication: While there is no specific medication to treat aggression, medication may be used to treat and manage physical and mental disorders that may be causing these behaviors. This can lead to a reduction in symptoms and aggressive behavior.

Individual therapy: Allows adults who struggle with aggression to discuss ways in which the behavior impacts their daily lives. Individual therapy will help adults learn how to regulate emotions, identify triggers, and develop better coping strategies.

Group therapy: Working with others who are similarly struggling with aggression and other mental or physical problems can be a great relief for those who have aggressive tendencies. Through group, you will learn anger management skills, coping mechanisms, relaxation exercises, and guided imagery to help you learn new ways of expressing your feelings.

Family therapy: Family therapy can be a big help for adults struggling with aggression to mend broken bonds with loved ones that may have occurred as a result of their aggressive behavior. Family sessions can also help loved ones discuss the ways in which aggression has impacted their lives.

If you feel that you are in crisis, or are having thoughts about hurting yourself or others, please call 9-1-1 or go to the nearest emergency room immediately.

What Causes Aggression in Older Adults?

Older adults face many challenges not generally experienced by younger people that can lead to the development of aggressive – and even violent – behaviors. Aggression in older adults can be a symptom of an acute illness or it can be related to a chronic medical problem. The most common reasons for aggression include those listed for aggression in adults and may also include:

Alzheimer’s disease: Alzheimer’s disease is the most common cause for dementia among older adults. This disease destroys areas of the brain involved in emotional regulation. Many people in the later stages of the disease have personality changes, which can cause them to become violent and aggressive.

Dementia: Dementia is a group of syndromes that lead to marked changes in personality, behavior, and brain function. Many older adults who have dementia may experience drastic changes in personality and behavior, causing them to lash out at others in a violent, aggressive manner.

Psychosis: Psychosis is a general term that refers to an altered mental status and a break from reality. Senior adults, who are more prone to psychosis, may react to internal stimuli and lash out due to fear or paranoia.

Stroke: When a blood clot forms and lodges in one of the blood vessels of the brain, that part of the brain is cut off from oxygen and may die. Depending upon the area of the brain that becomes hypoxic, a person can develop aggressive tendencies.

Treatment of Aggression in Older Adults

Treatment of aggression in older adults is complicated by additional medical conditions. In some cases, caregivers can prevent aggressive behaviors by reducing demands on the person, eliminating possible causes of stress, and making sure they are comfortable. However, preventable methods are not always possible. A comprehensive, multidisciplinary approach to aggression treatment in older adults can help to ensure that all needs are met and all conditions are being treated. Treatment for aggression in older adults may include:

Medication management: Many symptoms of aggression in older adults can be managed through medication to treat underlying medical concerns and any co-occurring conditions. Once the symptoms of the presenting disorder are under control, the treatment team can work together to create ways to prevent and reduce the aggressive behaviors.

Individual therapy: Individual therapy provides older adults the time to speak with a therapist one-on-one to discuss anger management, coping skills, and ways to reduce aggressive behaviors.

Group therapy: Group can also be very helpful for older adults as it allows the opportunity to bond with others, time for socialization, and may offer insight into various topics such as anger management, relaxation techniques, and ways to express emotions in a healthier manner.

Family therapy: Working with their family in therapy is crucial for older adults and their loved ones. Long-term placement options may need to be discussed as aggression and violence may escalate over time and cause significant problems in daily functioning.

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