Aggression: Clinical Features and Treatment Across the Diagnostic Spectrum

Written by renowned expert Emil F. Coccaro, Aggression: Clinical Features and Treatment Across the Diagnostic Spectrum delves into the complex and multifaceted phenomenon of aggression, exploring its role in various psychiatric disorders, including intermittent explosive disorder (IED), autism, and posttraumatic stress.

Aggression is a well-studied, multidimensional phenomenon that can be parsed by cognition, affect, and behavior. It can occur as primary aggression and as a symptom of other psychiatric disorders, making it both common and destructive – of property, relationships, and the social order.

The Evolution of Diagnostic Criteria

The editors of this comprehensive volume were instrumental in the development of the DSM classification for IED, and the book discusses the evolution of the diagnostic criteria from the 1950s to the current DSM-5. This long-range perspective informs the volume and provides a firm foundation for the clinical content, which is case-based and accessible.

Clinical Relevance and Structure

Each chapter is consistent in structure, moving from phenomenology to psychobiology to clinical approach and treatment. The book emphasizes that although abnormal psychobiological systems, including neurochemistry and neural circuits, may increase the risk of behavioral aggression, influences associated with genetics, epigenetics, and environmental forces are also extremely important, and these are discussed in-depth in each chapter.

Chapter Topics and Clinical Insights

Chapter topics were selected for their clinical relevance, covering primary aggression, disruptive behavioral disorders, eating disorders, and anxiety disorders. Two chapters are devoted to primary aggression, distinguishing form (verbal and physical) and type (direct or indirect), and exploring current treatment options, both psychopharmacological and psychotherapeutic.

The chapter on disruptive behavioral disorders, including attention-deficit/hyperactivity disorder, emphasizes prevention, assessment, and treatment, such as self-regulation, skill-building, improved support systems, and medication.

The chapter on eating disorders addresses aggression, both self- and other-directed, and provides measures with sound psychometric properties for assessing eating disorder psychopathology and aggression. The chapter on anxiety disorders highlights the prevalence of aggression, hostility, irritability, and anger in patients with these disorders, noting that these individuals may be at increased risk due to genetic sensitivity to stress.

The role of aggression in social anxiety disorder, panic disorder, and generalized anxiety disorder is explored in-depth, and current treatment recommendations are discussed.

A Comprehensive Resource

This cogent, compelling, and clinically rich volume is an invaluable resource for mental health professionals, researchers, and students. It employs chapter-ending summaries and key clinical points, and is replete with tables presenting information such as rating scales and summaries of pharmacological management, making it an indispensable guide for understanding and addressing aggression in its myriad forms and manifestations.