All About ADHD with Aggression

According to the United States Census Bureau, approximately 7.5% of school-aged children in the United States have Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD). About half of those with ADHD will also develop “oppositional defiance disorder [ODD] or a conduct disorder which will involve aggression,” according to Dr. L. Eugene Arnold, professor emeritus of psychiatry and behavioral health at the Nisonger Center at Ohio State University’s Wexner Medical Center. Arnold adds that it is most common in the hyperactive-impulsive and combined types of ADHD.

There are three types of ADHD: Inattentive Type, which involves an inability to pay attention; Hyperactive-Impulsive Type, involving the need to move frequently and having challenges managing impulse control; and the Combined or Combination Type, including feeling the need to move constantly in addition to the inability to pay attention.

ODD is diagnosed when there is a pattern of anger, outbursts, irritability, and defiance. Examples of this type of behavior include crying, whining, throwing something, hitting someone, cursing, stomping off, or tearing up a homework assignment. Arnold explains that these behaviors are not a result of being willfully defiant, but of having poor control over emotional regulation. Ellen Braaten, director of the Learning and Emotional Assessment Program at Massachusetts General Hospital goes on to explain that children with ADHD “have more things to be frustrated about…and they are more inclined to act on something with immediacy and a degree of intensity the moment the urge strikes.”

As with other types of ADHD, as stated by a study funded by the National Institute of Mental Health, the best outcomes are a result of medication plus behavior therapy. Behavior therapy can improve the child’s behavior, self-control, and self-esteem. But because some ADHD medications are stimulants, while they “can often be helpful in managing impulsive behaviors…[they can,] at the same time, actually increase irritability that can lead to aggression,” according to Braaten. Studies are underway to assess the effectiveness of non-stimulant medications.

An article in the Journal of Child and Adolescent Psychopharmacology states that ADHD with impulsive aggression is a serious clinical and public health problem because it is “strongly predictive of a highly unfavorable developmental trajectory characterized by the potential for persistent ADHD, increasing psychosocial burden, accumulating comorbidities, serious lifelong functional deficits across a broad range of domains, delinquency/ criminality and adult antisocial behavior.”

Research is critical to help reduce these risks and improve the quality of life for children diagnosed with ADHD with aggression, and their loved ones. Meridien Research has studies that are enrolling now. For more information or to see if you or someone you know may qualify to participate, please contact us today at 888-777-8839 or visit our individual study pages.