Browsing by Subject "aggression"
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Item Evolution of Irritability, Anger, and Aggression after Traumatic Brain Injury: Identifying and Predicting Subgroups(Liebert, 2021) Miles, Shannon R.; Hammond, Flora M.; Neumann, Dawn; Silva, Marc A.; Tang, Xinyu; Kajankova, Maria; Dillahunt-Aspillaga, Christina; Nakase-Richardson, Risa; Physical Medicine and Rehabilitation, School of MedicineThe current prospective, multi-center, longitudinal cohort study examined how veterans/service members (V/SM) changed in their irritability, anger, and aggression (IAA) scores from admission to discharge in post-acute rehabilitation settings. The goals were to identify trajectory subgroups, and explore if there were different predictors of the subgroups. V/SM (n = 346) from five Veterans Affairs TBI Model Systems Polytrauma Rehabilitation Centers participated. The sample was mostly men (92%) and identified as white (69%), black (13%), and other races (18%). Median age was 28 years, and 78% had sustained a severe TBI. Staff rated IAA at admission and discharge using the Mayo-Portland Adaptability Inventory-4 item#15. Four IAA trajectory subgroups were identified: (1) no IAA at admission or discharge (n = 89, 25.72%), (2) resolved IAA (n = 61, 17.63%), (3) delayed onset IAA (n = 31, 8.96%), and (4) persistent IAA (n = 165, 47.69%). Greater post-traumatic stress disorder (PTSD) symptoms were the only consistent predictor of belonging to all the subgroups who had IAA compared with the no IAA subgroup. We conclude that IAA had different trajectories after a TBI. The majority of V/SM had persistent impairment from IAA, a quarter of the sample had no impairment from IAA, and fewer participants had resolving or worsening IAA. Findings emphasize the importance of educating providers and family of the different ways and times that IAA can manifest after TBI. Timely diagnosis and treatment of PTSD symptoms during and after rehabilitation are critical treatment targets.Item Is Cyberloafing More Complex than we Originally Thought? Cyberloafing as a Coping Response to Workplace Aggression Exposure(Elsevier, 2019) Andel, Stephanie A.; Kessler, Stacey R.; Pindek, Shani; Kleinman, Gary; Spector, Paul E.; Psychology, School of ScienceEmployees spend approximately 2 h per day engaging in cyberloafing (i.e., using the internet at work for nonwork purposes) behaviors, costing organizations almost $85 billion dollars per year. As a result, cyberloafing is often considered a counterproductive type of withdrawal behavior. However, recent research suggests that cyberloafing may have some unexpected positive workplace outcomes. Therefore, we argue that the role of workplace cyberloafing is more complex than previously assumed and posit that cyberloafing may provide employees with a way to cope with workplace stress such as exposure to workplace aggression. To examine this proposition, we used a heterogeneous sample of 258 employees to test whether cyberloafing buffers the detrimental effects of workplace aggression exposure on two outcome variables: employees’ turnover intentions and job satisfaction. Overall, results supported the notion that employees use cyberloafing as a workplace coping mechanism, which runs counter to the majority of research that conceptualizes cyberloafing as a counterproductive workplace behavior. These findings suggest that managers may consider allowing some degree of cyberloafing so that employees can better cope with work stress. Moreover, managers should directly target stressful workplace conditions (e.g., aggression) that serve as the impetus for cyberloafing behaviors.Item Is the relationship between alexithymia and aggression context-dependent? Impact of group membership and belief similarity(2012-08) Konrath, Sara H.; Novin, Sheida; Li, TaoPrevious research finds positive relationships between alexithymia and aggression. This study examined potential interpersonal factors that might elicit aggressiveness among people with high levels of alexithymia. College student participants completed the Toronto Alexithymia Scale online prior to interacting with their partners in the laboratory. Participants interacted with a partner who (i) was from their in-group versus out-group, and (ii) held similar versus different beliefs on an important topic. Results show that compared to low-alexithymic individuals, individuals with high levels of alexithymia reported increased anger after interacting with out-group members. This corresponded to increased trait aggressiveness when interacting with out-group members. No differences emerged regarding behavioral aggression. Implications for the association between alexithymia and aggression are discussed.Item Minimal Clinically Important Difference for the Rasch Neuropsychiatric Inventory Irritability and Aggression Scale for Traumatic Brain Injury(Elsevier, 2017) Malec, James F.; Hammond, Flora M.; Physical Medicine and Rehabilitation, School of MedicineObjective To determine the minimal clinically important difference (MCID) for a Rasch measure derived from the Irritability/Lability and Agitation/Aggression subscales of the Neuropsychiatric Inventory (NPI)—the Rasch NPI Irritability and Aggression Scale for Traumatic Brain Injury (NPI-TBI-IA). Design Distribution-based statistical methods were applied to retrospective data to determine candidates for the MCID. These candidates were evaluated by anchoring the NPI-TBI-IA to Global Impression of Change (GIC) ratings by participants, significant others, and a supervising physician. Setting Postacute rehabilitation outpatient clinic. Participants 274 cases with observer ratings; 232 cases with self-ratings by participants with moderate-severe TBI at least 6 months postinjury. Interventions Not applicable. Main Outcome Measure NPI-TBI-IA. Results For observer ratings on the NPI-TBI-IA, anchored comparisons found an improvement of 0.5 SD was associated with at least minimal general improvement on GIC by a significant majority (69%–80%); 0.5 SD improvement on participant NPI-TBI-IA self-ratings was also associated with at least minimal improvement on the GIC by a substantial majority (77%–83%). The percentage indicating significant global improvement did not increase markedly on most ratings at higher levels of improvement on the NPI-TBI-IA. Conclusions A 0.5 SD improvement on the NPI-TBI-IA indicates the MCID for both observer and participant ratings on this measure.Item Posttraumatic Stress Disorder Symptoms Contribute to Staff Perceived Irritability, Anger, and Aggression After TBI in a Longitudinal Veteran Cohort: A VA TBI Model Systems Study(Elsevier, 2019) Miles, Shannon R.; Brenner, Lisa A.; Neumann, Dawn; Hammond, Flora M.; Ropacki, Susan; Tang, Xinyu; Eapen, Blessen C.; Smith, Austin; Nakase-Richardson, Risa; Physical Medicine and Rehabilitation, School of MedicineObjective To examine the relationship between staff perceived irritability, anger, and aggression and posttraumatic stress disorder (PTSD) in veterans with traumatic brain injury (TBI) of all severity levels. Design Longitudinal cohort design. Setting Veterans Affairs Polytrauma Transitional Rehabilitation Programs. Participants Veterans and service members with TBI of all severity levels enrolled in the Veterans Affairs Polytrauma Rehabilitation Centers’ Traumatic Brain Injury Model System national database (N=240). Interventions Not applicable. Main Outcome Measure Univariable and multivariable logistic regression modeling was used to examine the association between irritability, anger, and aggression and potential risk factors, including PTSD symptoms. Irritability, anger, and aggression was measured as a single construct using an item from the Mayo-Portland Adaptability Inventory-4 that was rated by program staff at admission and discharge from the inpatient rehabilitation program. PTSD symptoms were assessed using the PTSD Checklist–Civilian Version. Results PTSD symptoms uniquely predicted program staff-rated irritability, anger, and aggression at discharge even after controlling for severity of TBI, age, male sex, education, and annual earnings. The model explained 19% of the variance in irritability, anger, and aggression. Conclusions When TBI severity and PTSD symptoms were considered simultaneously in a sample of veterans, only PTSD symptoms predicted staff-rated irritability, anger, and aggression. Given the negative outcomes linked with irritability, anger, and aggression, veterans may benefit from assessment and treatment of PTSD symptoms within rehabilitation settings.Item Potential Impact of Amantadine on Aggression in Chronic Traumatic Brain Injury(Wolters Kluwer, 2017) Hammond, Flora M.; Malec, James F.; Zafonte, Ross D.; Sherer, Mark; Bogner, Jennifer; Dikmen, Sureyya; Whitney, Marybeth P.; Bell, Kathleen R.; Perkins, Susan M.; Moser, Elizabeth A.; Physical Medicine and Rehabilitation, School of MedicineObjective: To assess the effects of amantadine on anger and aggression among individuals with a chronic traumatic brain injury (TBI). Methods: A cohort of 118 persons with chronic TBI (>6 months postinjury) and moderate-severe aggression selected from a larger cohort of 168 participants enrolled in a parallel-group, randomized, double-blind, placebo-controlled trial of amantadine 100 mg twice daily (n = 82) versus placebo (n = 86) for treatment of irritability were studied. Anger and aggression were measured at treatment days 0, 28, and 60 using observer-rated and participant-rated State-Trait Anger Expression Inventory-2 (STAXI-2) and Neuropsychiatric Inventory-Agitation/Aggression domain (NPI-A) Most Problematic and Distress scores. Results: Participant-rated day 60 NPI-A Most Problematic (adjusted P = .0118) and NPI-A Distress (adjusted P = .0118) were statistically significant between the 2 groups, but STAXI-2 differences were not significant after adjustment for multiple comparisons. Substantial improvements were noted in both amantadine and placebo groups (70% vs 56% improving at least 3 points on day 60 Observer NPI-A; P = .11). Conclusion: Amantadine 100 mg twice daily in this population with chronic TBI appears to be beneficial in decreasing aggression from the perspective of the individual with TBI. No beneficial impact on anger was found.Item Rasch Analysis, Dimensionality, and Scoring of the Neuropsychiatric Inventory Irritability and Aggression Subscales in Individuals With Traumatic Brain Injury(Elsevier, 2017) Malec, James F.; Stump, Timothy E.; Monahan, Patrick O.; Kean, Jacob; Neumann, Dawn; Hammond, Flora M.; Physical Medicine and Rehabilitation, School of MedicineObjectives To develop, for versions completed by individuals with traumatic brain injury (TBI) and an observer, a more precise metric for the Neuropsychiatric Inventory (NPI) Irritability and Aggression subscales using all behavioral item ratings for use with individuals with TBI and to address the dimensionality of the represented behavioral domains. Design Rasch and confirmatory factor analyses of retrospective baseline NPI data from 3 treatment studies. Setting Postacute rehabilitation clinic. Participants NPI records (N = 525) consisting of observer ratings (n = 287) and self-ratings (n = 238) by participants with complicated mild, moderate, or severe TBI at least 6 months postinjury. Interventions Not applicable. Main Outcome Measures Frequency and severity ratings from NPI Irritability/Lability and Agitation/Aggression subscales. Results Confirmatory factor analyses of both observer and participant ratings showed good fit for either a 1-factor or a 2-factor solution. Consistent with this, the Rasch model also fit the data well with aggression items indicating the more severe end of the construct and irritability items populating the milder end. Conclusions Irritability and aggression appear to represent different levels of severity of a single construct. The derived Rasch metric offers a measure of this construct based on responses to all specific items that is appropriate for parametric statistical analysis and may be useful in research and clinical assessments of individuals with TBI.Item The Relations of Self-Reported Aggression to Alexithymia, Depression, and Anxiety After Traumatic Brain Injury(Wolters Kluwer, 2017-05) Neumann, Dawn; Malec, James F.; Hammond, Flora M.; Physical Medicine and Rehabilitation, School of MedicineObjectives: To compare self-reported aggression in people with and without traumatic brain injury (TBI) and examine the relations of aggression to alexithymia (poor emotional insight), depression, and anxiety. Setting: Rehabilitation hospital. Participants: Forty-six adults with moderate to severe TBI who were at least 3 months postinjury; 49 healthy controls (HCs); groups were frequency matched for age and gender. Design: Cross-sectional study using a quasi-experimental design. MainMeasures:Aggression (Buss-Perry Aggression Questionnaire); alexithymia (Toronto Alexithymia Scale-20); depression (Patient Health Questionnaire-9); and trait anxiety (State-Trait Anxiety Inventory). Results: Participants with TBI had significantly higher aggression scores than HCs. For participants with TBI, 34.2% of the adjusted variance of aggression was significantly explained by alexithymia, depression, and anxiety; alexithymia accounted for the largest unique portion of the variance in this model (16.2%). Alexithymia, depression, and anxiety explained 46% of the adjusted variance of aggression in HCs; in contrast to participants with TBI, depression was the largest unique contributor to aggression (15.9%). Conclusion: This was the first empirical study showing that poor emotional insight (alexithymia) significantly contributes to aggression after TBI. This relation, and the potential clinical implications it may have for the treatment of aggression, warrants further investigation.Item Reply to Comments on SPSSI Research Summary on Media Violence by Cupit (2016), Gentile (2016), Glackin & Gray (2016), Gollwitzer (2016), and Krahé (2016)(Wiley, 2016-12) Bushman, Brad J.; Anderson, Craig A.; Donnerstein, Edward; Hummer, Tom A.; Warburton, Wayne; Department of Psychiatry, IU School of MedicineIn responding to the published comments on our SPSSI Research Summary on Media Violence, we note that several key themes emerge. In assessing the media violence research evidence, it is more informative and less biased to draw conclusions based on the full range of findings than to emphasize findings from individual studies. Using the full range of studies, it is clear that consuming violent media influences the way people think and feel, and increases the likelihood of aggressive behavior. However, when placing such findings into real world settings, it is important to consider media violence exposure as one of many risk factors for violence and aggression rather than as a sole factor. This acknowledgment of multiple causal factors does not make media violence unimportant––it is one of the few risk factors for aggression that can be addressed relatively easily and inexpensively. To this end, researchers are encouraged to now focus their efforts on finding those factors that moderate the media violence exposure–aggression link, and policy makers and professionals who work with children are encouraged to incorporate media violence science into their practices and decision-making.