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Evaluation and treatment of rage in children and adolescents


Rage is characterized by an unpredictable and primitive display of violence that is out of proportion to the provoking event and often threatens serious self-injury or harm to others. New insight into the pathogenesis of unpredictable violent behavior has been gained largely as a result of neurochemical, neuropsychological and brain imaging studies. This article examines episodic rage from a neuropsychiatric perspective. Three cases illustrating the evaluation and treatment of rage in childhood and adolescence are presented.

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  1. 1.

    Elliott FA: The neurology of explosive rage.Practitioner 217:51–60, 1976.

  2. 2.

    Elliott FA: Neuroanatomy and neurology of aggression.Psychiatr Ann 17(6): 385–388, 1987.

  3. 3.

    Elliott FA: Neurological findings in adult minimal brain dysfunction and the dyscontrol syndrome.J Nerv Ment Dis 170:680–687, 1982.

  4. 4.

    Bhatia MS, Dhar NK, Singhal PK, et al: Temper tantrums prevalence and etiology in a non-referral outpatient setting.Clin Pediatr 29:311–315, 1990.

  5. 5.

    Yeudall LT, Fromm-Auch D, and Davies P: Neuropsychological impairment of persistent delinquency.J Nerv Ment Dis 170: 257–265, 1982.

  6. 6.

    Williams DT: Neural factors related to habitual aggression: considerations of differences between those habitual aggressives and others who have committed crimes of violence.Brain 92:503–520, 1969.

  7. 7.

    Krieger L: Brain damage linked to violent behavior.Am Med News 19–22, Oct. 25, 1985.

  8. 8.

    Volkow ND and Tancredi L: Neural substrates of violent behaviour a preliminary study with positron emission tomography.Br J Psychiat 151:668–673, 1987.

  9. 9.

    Lewis DO, Shanok SS, and Pincus JH: Violent juvenile delinquents: psychiatric, neurological, psychological, and abuse factors.J Am Acad Child Psychiat 18:307–319, 1979.

  10. 10.

    Lewis DO, Moy E, Jackson LD, et al: Biopsychosocial characteristics of children who later murder: a prospective study.Am J Psychiat 142:1161–1167, 1985.

  11. 11.

    Lewis DO, Pincus HJ, Feldman M, et al: Psychiatric, neurological, and psychoeducational characteristics of 15 death row inmates in the United States.Am J Psychiat 143:838–845, 1986.

  12. 12.

    Mark V, Ervin F:Violence and the Brain, New York: Harper and Row, 1970.

  13. 13.

    Monroe R: Brain dysfunction in prisoners. InViolence and the Violent Individual, (eds) Hays, R. Roberts, T & Sokway, D. New York: Medical and Scientific Books, 1981.

  14. 14.

    Lorimer FM: Violent behavior and the electroencephalogram.Clin Electroencephalogr 3,193, 1972.

  15. 15.

    Lewis DO: Neuropsychiatric vulnerabilities and violent juvenile delinquency.Psychiatr Clin North Am 6:707–714, 1983.

  16. 16.

    Lewis D, Pincus J, Shanok, S, et al: Psychomotor epilepsy and violence in a group of incarcerated adolescent boys.Am J Psychiat 139:882–887, 1982.

  17. 17.

    Mungas D: Psychometric correlates of episodic violent behavior a multidimensional neuropsychological approach.Br J Psychiat 152:180–187, 1988.

  18. 18.

    Eichelman B: Neurochemical bases of aggressive behavior.Psychiatr Ann 17:371–374, 1987.

  19. 19.

    Brown GL, Goodwin FK, Ballenger JC, et al: Aggression in humans correlates with cerebrospinal fluid amine metabolites.Psychiat Res 1:131–139, 1979.

  20. 20.

    Linnoila M, Virkkunen M, Scheinin M, et al: Low cerebrospinal fluid 5-hydroxyindoleacetic acid concentration differentiates impulsive from non-impulsive violent behavior.Life Sci 33:2609–2614, 1983.

  21. 21.

    Lewis D, Shanok S: Medical histories of delinquent and nondelinquent children: an epidemiological study.Am J Psychiat 134:1020–1025, 1977.

  22. 22.

    Lewis DO: Conduct disorder. InPsychiatry, ed. Cavenar JO Jr. Philadelphia: Lippincott, 2:1–10, 1985

  23. 23.

    Pincus JH, Tucker GJ:Behavioral Neurology. Second Edition. New York: Oxford Press, 1978.

  24. 24.

    DeLisi LE: Use of clinical laboratory. In:Biomedical Psychiatric Therapeutics, ed. Sullivan JL & Sullivan PD. Boston: Butterworths, 1984.

  25. 25.

    Rosse RB, Owen CM, Morihisa JM: Brain imaging and laboratory testing in neuropsychiatry. In:Textbook of Neuropsychiatry, ed. Hales RE & Yudofsky SC. Washington DC: American Psychiatric Press, 1987.

  26. 26.

    Tramontana MG, Hooper SR: Neuropsychology of child psychopathology. In:Handbook of Clinical Child Neuropsychology, eds. Reynolds, CR & Fletcher-Janzen, E. New York: Plenum Press, 87–106, 1989.

  27. 27.

    Yudofsky SC, Silver JM, Jackson W, et al: The overt aggression scale for the objective rating of verbal and physical aggression.Am J Psychiat 143 (1):35–39, 1986.

  28. 28.

    Yudofsky SC, Silver JM and Schneider SE: Pharmacologic treatment of aggression.Psychiatr Ann 17(6): 397–407, 1987.

  29. 29.

    Schildkraut JJ, Kety SS: Biogenic amines and emotion.Science 156:21–37, 1967.

  30. 30.

    Vetro A, Szentistvanyi L, Pallag M, et al: Therapeutic experience with lithium in childhood aggression.Pharmacopsychiatry 14:121–127, 1985.

  31. 31.

    Popper C: Child and Adolescent Psychopharmacology. In:Psychiatry, ed. Michael, R. Philadelphia: J.B. Lippincott Co., 1985.

  32. 32.

    Williams DT, Mele R, Yudofsky S, et al: The effects of propranolol on uncontrolled rage outbursts in children and adolescents with organic brain dysfunction.J Am Acad Child Psychiat 21:129–135, 1982.

  33. 33.

    Eames P, Wood R: Rehabilitation after severe brain injury: a follow-up study of a behavior modification approach.J Neurol Neurosurg Psychiat 48:613–619, 1985.

  34. 34.

    Franzen MD, Lovell MR: Behavioral treatments of aggressive sequelae of brain injury.Psychiatr Ann 17(6):389–396, 1987.

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Correspondence to Miguel W. Mandoki MD.

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Mandoki, M.W., Sumner, G.S. & Matthews-Ferrari, K. Evaluation and treatment of rage in children and adolescents. Child Psych Hum Dev 22, 227–235 (1992). https://doi.org/10.1007/BF00707665

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Key words

  • Rage
  • dyscontrol
  • violence
  • children and adolescents