238 results match your criteria aggressive outbursts

Validation of the Rage Attack Questionnaire-Revised (RAQ-R) in a Mixed Psychiatric Population.

Front Psychiatry 2021 18;12:724802. Epub 2021 Aug 18.

Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany.

Rage Attacks (RA) represent a clinically relevant symptom in patients with different psychiatric disorders. However, only recently the Rage Attack Questionnaire Revised (RAQ-R, 22 items, range, 0-66) has been developed as a new instrument for the assessment of RA. This study aimed to validate the RAQ-R in a large mixed psychiatric and psychosomatic sample. Read More

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Changing talk online: Protocol for a cluster pragmatic trial testing communication education to reduce behavioral and psychological symptoms of dementia in nursing home care.

Contemp Clin Trials 2021 Aug 31;109:106550. Epub 2021 Aug 31.

University of Iowa Interdisciplinary Graduate Program in Health Informatics, 201 Gilmore Hall, Iowa City, IA 52242, USA.

Nursing home (NH) care of persons living with dementia is often made challenging by behavioral and psychological symptoms of dementia (BPSD) such as aggression, vocal outbursts, wandering, and withdrawal that occur due to cognitive and communication changes. Staff frequently communicate to NH residents using "elderspeak" which is patronizing speech similar to baby talk. Residents respond to elderspeak with increased BPSD that prompts use of psychotropic medication to control symptoms. Read More

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Directional Deep Brain Stimulation of the Posteromedial Hypothalamus for Refractory Intermittent Explosive Disorder: A Case Series Using a Novel Neurostimulation Device and Intraoperative Microdialysis.

World Neurosurg 2021 Jul 26. Epub 2021 Jul 26.

LIM 23, Institute of Psychiatry, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil; Division of Neuroscience, Sírio-Libanês Hospital, São Paulo, Brazil.

Background: Intermittent explosive disorder (IED) is a psychiatric disorder characterized by recurrent outbursts of aggressive behavior. Deep brain stimulation (DBS) in the posteromedial nucleus of the hypothalamus (pHyp) is an alternative therapy for extreme cases and shows promising results. Intraoperative microdialysis can help elucidate the neurobiological mechanism of pHyp-DBS. Read More

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Update on Neurodegenerative Diseases and Glutamate: A PMHNP Single Case Study Report of a Diagnostically Complex Adult Patient, Interventions, and Unexpected Outcomes.

J Am Psychiatr Nurses Assoc 2021 Jul 8:10783903211030343. Epub 2021 Jul 8.

Tarah Winter Klinefelter, MSN, APRN, PMHNP-BC, Psychiatric Mental Health Nurse Practitioner in Geriatric Psychiatry, El Paso, TX, USA.

Objective: While dysfunction of serotonin and dopamine neurotransmitters has been studied in depth, in regard to the etiology of mental illness, the neurotransmitter glutamate and its dysfunction is now being explored as contributing to neurodegenerative psychiatric diseases, schizophrenia, autism, depression, and Alzheimer's disease. This article explains its synthesis, neurotransmission, and metabolism within the brain and subsequent dysfunction that is responsible for neurocognitive loss associated with several psychiatric disorders.

Method: The case study will report on the screening for pseudobulbar affective (PBA) disorder in a 29-year-old male with bipolar disorder, autism spectrum disorder, and intellectual developmental disability who was experiencing extreme, uncontrolled emotional outbursts requiring continuous family isolation (pre-COVID-19) for safety. Read More

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The association of phasic irritability (aggressive outbursts) and tonic irritability (irritable mood) to depression occurrences, symptoms, and subtypes.

J Affect Disord 2021 10 11;293:9-18. Epub 2021 Jun 11.

Vanderbilt University, Nashville, Tennessee.

Background: Research among adults has rarely differentiated between tonic irritability (i.e., irritable mood) and phasic irritability (i. Read More

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October 2021

Explosive Outbursts at School.

Child Adolesc Psychiatr Clin N Am 2021 07;30(3):491-503

Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.

Explosive outbursts (EO) by students are an intensely distressing experience for that student as well as for all school staff and students present during the outburst. These EO are characterized by rapid escalations, usually far out of proportion to precipitating events, may include significant verbal and/or physical aggression, require intensive staff intervention, are often difficult for the student to process, and are typically recurrent. These explosions cross multiple psychiatric and educational diagnostic categories and require diverse interventions to address behavioral, emotional, impulsive, and sensory components. Read More

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Regulation of stress-provoked aggressive behavior using endocannabinoids.

Neurobiol Stress 2021 Nov 13;15:100337. Epub 2021 May 13.

Department of Pharmacology, National Cheng-Kung University, Tainan, Taiwan.

Reactive impulsive aggression is characterized by outbursts of rage and violence when subjects encounter threatening stressful events. Although impulsive aggression and violence create a high-cost burden on health and society, relatively little is known about treatment. Early adolescent social isolation (SI) alters brain development and functions. Read More

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November 2021

Mapping aggressive behavior of forensic psychiatric inpatients with self-report and structured staff-monitoring.

Psychiatry Res 2021 Jul 4;301:113983. Epub 2021 May 4.

University of Groningen, University Medical Center Groningen, Department of Psychiatry, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.

Structured assessment of aggressive behavior in forensic psychiatry is needed. This study investigated staff-observed and self-reported measures to map prevalence and characteristics of aggressive behavior in forensic inpatients and aimed to identify early signs of aggressive outbursts. In this longitudinal study, 120 forensic psychiatric inpatients with a history of aggression were included. Read More

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Affective Dysregulation in Children Is Associated With Difficulties in Response Control in Emotional Ambiguous Situations.

Biol Psychiatry Cogn Neurosci Neuroimaging 2021 Apr 17. Epub 2021 Apr 17.

Department of Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany. Electronic address:

Background: Affective dysregulation (AD), or synonymously "irritability," is a transdiagnostic construct that serves as a diagnostic criterion in various childhood mental disorders. It is characterized by severe or persistent outbursts of anger and aggression. Emotional self-regulation is highly dependent on the ability to process relevant and ignore conflicting emotional information. Read More

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The pediatric psychopharmacology of autism spectrum disorder: A systematic review - Part I: The past and the present.

Prog Neuropsychopharmacol Biol Psychiatry 2021 Aug 20;110:110326. Epub 2021 Apr 20.

Child and Adolescent Psychiatry Department, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain.

Autism Spectrum Disorder (ASD) is a severe and lifelong neurodevelopmental disorder, with high social costs and a dramatic burden on the quality of life of patients and family members. Despite its high prevalence, reaching 1/54 children and 1/45 adults in the United States, no pharmacological treatment is still directed to core symptoms of ASD, encompassing social and communication deficits, repetitive behaviors, restricted interests, and abnormal sensory processing. The purpose of this review is to provide an overview of the state-of-the-art of psychopharmacological therapy available today for ASD in children and adolescents, in order to foster best practices and to organize new strategies for future research. Read More

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Y Asieieva

Georgian Med News 2021 Feb(311):125-129

Interregional Academy of Persоnnel Management, Odessa, Ukraine.

The aim of the study is to analyze empirically obtained data to identify psychoemotional states of adolescents with manifestations of cyber addiction. The study, conducted from 2016 to the present, involved 559 respondents, 408 of whom with certain types of cyber addictions made up the main group and 151 were relatively healthy, who were included in the control group. All respondents were diagnosed using a psychodiagnostic technique - Toronto Alexithymia Scale (TAS). Read More

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February 2021

A Unique Case of Valacyclovir Toxicity and Pseudobulbar Affect in a Patient On Peritoneal Dialysis.

Cureus 2021 Feb 22;13(2):e13494. Epub 2021 Feb 22.

Internal Medicine/Nephrology, Virginia Commonwealth University, Richmond, USA.

There are a few cases of valacyclovir-associated neurotoxicity (VAN) reported. This case report documents a case of a 55-year-old male presenting with emotional lability or pseudobulbar affect as the predominant or sole manifestation of VAN. A failure to adjust valacyclovir's dose for herpes simplex infection in the setting of dialysis-dependent end-stage renal disease (ESRD) preceded VAN in this patient. Read More

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February 2021

Emotional and Behavioral Dysregulation in Severe Mental Illness.

Child Adolesc Psychiatr Clin N Am 2021 04 15;30(2):415-429. Epub 2021 Feb 15.

Department of Psychiatry and Behavioral Sciences, University of Washington, 8805 Steilacoom Boulevard Southwest, Lakewood, WA 98498, USA. Electronic address:

Emotional and behavioral dysregulation are common in severe mental illnesses, including schizophrenia, bipolar disorder, and borderline personality disorder. Emotional instability and behavioral outbursts can be driven by internal processes and/or environmental triggers and interpersonal interactions. Understanding the underlying diagnosis is important in determining the best course of treatment. Read More

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Ticked Off: Anger Outbursts and Aggressive Symptoms in Tourette Disorder.

Child Adolesc Psychiatr Clin N Am 2021 04 15;30(2):361-373. Epub 2021 Feb 15.

Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Tourette Association Center of Excellence, University of Miami Miller School of Medicine, 1120 Northwest Fourteenth Street, Suite 1442, Miami, FL 33136, USA.

Tourette disorder is a complex neuropsychiatric syndrome of childhood onset characterized by multiple motor and phonic tics and is associated with high rates of psychiatric comorbidity. Symptoms of impulsive aggression (explosive outbursts or "rage") are commonly encountered in the clinical setting, cause significant morbidity, and pose diagnostic and treatment challenges. These symptoms may be multifactorial in etiology and result from a complex interplay of illness severity and psychosocial factors. Read More

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The Phenomenology of Outbursts.

Child Adolesc Psychiatr Clin N Am 2021 04 15;30(2):307-319. Epub 2021 Feb 15.

Renaissance School of Medicine, Stony Brook University, Putnam Hall-South Campus, 101 Nicolls Road, Stony Brook, NY 11794-8790, USA.

Outbursts (severe temper loss) in children are a common reason for treatment referral. However, the diagnostic system has not classified them in a way that expands knowledge. Outbursts are nested in the concept of irritability, which consists of a feeling and a behavioral dimension. Read More

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The Many Faces (and Names) of Mood Dysregulation.

Child Adolesc Psychiatr Clin N Am 2021 04 15;30(2):299-306. Epub 2021 Feb 15.

Clinical Counseling Psychology Program, Assumption College, Department of Psychiatry, University of Massachusetts School of Medicine, 500 Salisbury Street, Worcester, MA 01609-1296, USA.

Explosive outbursts in children and adolescents have been long identified by clinicians and have been described using many different conceptualizations and terms. The topography of explosive outbursts is complex, heterogeneous, and includes the interactions of different emotional and behavioral constructs. Included here are pre-existing central nervous system vulnerabilities including psychiatric and neurologic diagnoses, various contributing emotions that generally carry a negative valence, and aggressive behaviors that are usually overt and reactive. Read More

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Differential outcomes of tonic and phasic irritability in adolescent girls.

J Child Psychol Psychiatry 2021 Mar 14. Epub 2021 Mar 14.

Department of Psychology, Stony Brook University, Stony Brook, NY, USA.

Background: Irritable mood is a transdiagnostic clinical feature that is present in multiple psychiatric disorders. Although irritability is frequently examined as a unitary construct, two dimensions of irritability, tonic (i.e. Read More

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Editorial: Moving From Concept to Proof in the Distinction Between Phasic and Tonic Irritability.

J Am Acad Child Adolesc Psychiatry 2021 Feb 15. Epub 2021 Feb 15.

Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland. Electronic address:

In child and adolescent psychiatry, irritability is listed as a cardinal or associated symptom in nearly every emotional, behavioral, and neurodevelopmental disorder in the DSM-5. Despite the omnipresence of irritability in distinct psychiatric disorders, its manifestation is highly heterogeneous, across and within individuals. Part of that heterogeneity has to do with its temporal dynamics. Read More

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February 2021

Aggressive outbursts among adults with major depressive disorder: Results from the Collaborative Psychiatric Epidemiological Surveys.

J Psychiatr Res 2021 03 26;135:325-331. Epub 2021 Jan 26.

Vanderbilt University, USA.

Introduction: Little is known about the epidemiology of aggressive outbursts, including physical assault, property destruction, and verbal aggression, among adults with unipolar Major Depressive Disorder (MDD).

Methods: We examined the prevalence and correlates of aggressive outbursts among adults with primary MDD (N = 2539) from the Collaborative Psychiatric Epidemiological Surveys (N = 20,013) using generalized linear models.

Results: The prevalence estimate of any aggressive outbursts was 58. Read More

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Mania Induced by Epidural Steroid Injection in an Elderly Female With No Psychiatric History.

Cureus 2021 Jan 9;13(1):e12594. Epub 2021 Jan 9.

Psychiatry, University of Florida, Gainsville, USA.

The psychiatric risks of epidural steroid injections for chronic pain in a geriatric patient with no prior psychiatric history are presented here. A 76-year old Caucasian female presented to the emergency department with her family for an inability to sleep, confusion, and behavioral outbursts. The mood instability and psychosis were reported as having started a week after her third epidural steroid injection for low-back pain associated with a prior fall. Read More

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January 2021

Utility of oxcarbazepine in the treatment of childhood and adolescent psychiatric symptoms.

Proc (Bayl Univ Med Cent) 2020 Oct 6;34(1):34-39. Epub 2020 Oct 6.

Department of Psychiatry, Baylor Scott & White Health, Central Texas Division, and College of Medicine, Texas A&M University Health Science Center, Temple, Texas.

The primary aims of this study were to determine if oxcarbazepine is a safely tolerated option for treatment of psychiatric symptoms in children and whether its use facilitates dose modification of other psychotropic medications. A retrospective chart review was completed using data extracted from the electronic medical record of a large outpatient child psychiatry clinic. A total of 507 of 740 children prescribed oxcarbazepine for psychiatric indications for 3 months or more had adequate data to assess clinical responses and medication outcomes. Read More

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October 2020

Sertraline as a treatment option for temper outbursts in Prader-Willi syndrome.

Am J Med Genet A 2021 03 27;185(3):790-797. Epub 2020 Dec 27.

Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Hannover, Germany.

Prader-Willi syndrome (PWS) is a rare neurodevelopmental disorder caused by lack of the paternal copy of maternally imprinted, paternally expressed genes at the chromosome 15q11-13 region. In most cases, it is caused by a paternal deletion or a maternal disomy of chromosome 15. Behavioral problems with temper outbursts are common and often combined with physical aggressiveness and self-injury. Read More

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Natural clusters of tuberous sclerosis complex (TSC)-associated neuropsychiatric disorders (TAND): new findings from the TOSCA TAND research project.

J Neurodev Disord 2020 09 1;12(1):24. Epub 2020 Sep 1.

Pediatric Neurology Unit, Department of Pediatrics, UZ Brussel VUB, Brussels, Belgium.

Background: Tuberous sclerosis complex (TSC)-associated neuropsychiatric disorders (TAND) have unique, individual patterns that pose significant challenges for diagnosis, psycho-education, and intervention planning. A recent study suggested that it may be feasible to use TAND Checklist data and data-driven methods to generate natural TAND clusters. However, the study had a small sample size and data from only two countries. Read More

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September 2020

A patient with novel MBOAT7 variant: The cerebellar atrophy is progressive and displays a peculiar neurometabolic profile.

Am J Med Genet A 2020 10 3;182(10):2377-2383. Epub 2020 Aug 3.

Medical Genetics Unit, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy.

Mutations in the MBOAT7 gene have been described in 43 patients, belonging to 18 families, showing nonspecific clinical features (intellectual disability [ID], seizures, microcephaly or macrocephaly, and mild to moderate cerebellar atrophy) that make the clinical diagnosis difficult. Here we report the first Italian patient, a 22.5-year-old female, one of the oldest reported, born to apparently consanguineous parents. Read More

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October 2020

Novel Psychoactive Substances in Custodial Settings: A Mixed Method Investigation on the Experiences of People in Prison and Professionals Working With Them.

Front Psychiatry 2020 26;11:460. Epub 2020 May 26.

Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.

Introduction: Novel Psychoactive Substances (NPS), especially Synthetic Cannabinoid Receptor Agonists (SCRAs), pose a substantial challenge to health and the security of the prison environment. This study analyses the phenomenon from the perspective of people in prison and that of professionals working with them.

Methods: A phenomenological qualitative approach was used to analyze self-reported experiences with 'Spice' (NPS) among users in prison. Read More

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Dr. Carlson et al. Reply.

J Am Acad Child Adolesc Psychiatry 2020 06;59(6):684-685

Stony Brook University, New York.

We appreciate the thoughtful and supportive comments from Dr. Masters and agree that coercive parent-child relationships were often what was addressed and modified during hospitalization. Lowering seclusion and restraint rates by prohibiting them, without lowering rates of aggression, is not the desired outcome. Read More

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MicroRNA-206 Regulates Stress-Provoked Aggressive Behaviors in Post-weaning Social Isolation Mice.

Mol Ther Nucleic Acids 2020 Jun 8;20:812-822. Epub 2020 May 8.

Department of Pharmacology, College of Medicine, National Cheng-Kung University, Tainan 701, Taiwan; Department of Biotechnology and Bioindustry Sciences, National Cheng-Kung University, Tainan 701, Taiwan. Electronic address:

When facing stressful conditions, some people tend to be impulsively aggressive whereas others are not. However, the causes and underlying mechanisms remain elusive. It has been reported that acute stress induces outbursts of aggression in post-weaning social isolation (SI) mice but not in group housing (GH) mice. Read More

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Recurrent Thymoma-Associated Paraneoplastic Encephalitis Resulting From Multiple Antibodies: A Case Report.

Neurohospitalist 2020 Apr 13;10(2):139-142. Epub 2019 Oct 13.

Department of Neurology, MedStar Georgetown University Hospital, Washington, DC, USA.

Few reports describe the clinical course and acute-care management of patients with recurrent multi-antibody paraneoplastic encephalitis. We describe a rare case of a patient having thymoma with multiple paraneoplastic syndromes who was found to have antibodies to α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) followed by -methyl-d-aspartate (NMDA) receptor in the setting of residual thymic tissue. He initially presented to the hospital with severe, rapidly progressive encephalitis with simultaneous antibodies to AMPA and voltage-gated potassium channel complex receptor. Read More

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