Vol. 7, No. 1, 2001 Page 6

Double trouble: Depressed adolescents exhibit
high levels of aggression

Aggressive behavior is very common among adolescents suffering from major depressive disorder, according to a new study by Michele Knox and colleagues.

The researchers studied 74 adolescents, between the ages of 13 and 17, referred to a clinic for depression. The subjects and their parents were asked to rate the teens' aggressive behaviors using several assessment tools.

Of the depressed teens, the researchers say, "70 percent reported a history of 'frequent' verbal aggression at home, 24 percent reported frequent physical aggression in the home, 30 percent reported receiving detentions at school for aggression, and 14 percent reported being arrested for aggressive behavior." Nearly one-quarter of the depressed adolescents reported levels of aggression on at least one test subscale that were higher than the average for adolescents institutionalized for aggressive acts. Surprisingly, the researchers report, results were similar for males and females.

Saying that the reason for a link between aggression and depression is unknown, the researchers speculate that "traits common to both disorders, such as deficits in self-regulation or high emotionality, may predispose youths to the development of comorbid depression and aggressive behavior [or] conduct problems." They also note that research indicates that abnormalities of the brain chemical serotonin are linked to both depression and aggression.

Knox et al. report, in addition, that parents may underestimate the aggression of depressed teens. In this study, parents significantly under- reported the magnitude of their children's aggressive behavior.

The researchers caution that their study is limited by the lack of a control group, and by the fact that their sample was limited to adolescents referred for psychiatric treatment. However, their results are consistent with earlier research by S. R. Pliszka et al. (see related article, Crime Times, 2000, Vol. 6, No. 1, Page 4), who found that depression and mania are very common in juvenile offenders; with a study by Jiri Modestin et al. (see related article, Crime Times, 1997, Vol. 3, No. 4, Page 6) indicating that subjects with a history of hospitalization for affective disorders were far more likely to have criminal records than matched controls; and with research by Maurizio Fava et al. (see related article, Crime Times, 1997, Vol. 3, No. 4, Page 6), who found that 48 percent of the young depressed patients they studied experienced anger attacks, compared to only 21 percent of controls.


"Aggressive behavior in clinically depressed adolescents," Michele Knox, Cheryl King, Gregory L. Hanna, Deirdre Logan, and Neera Ghaziuddin, Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 39, No. 5, May 2000, pp. 611- 618. Address: Michele Knox, Medical College of Ohio, Kobacker Center, 3130 Glendale Avenue, Toledo, OH 43614, mknox@mco.edu.

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