Introduction to a Special Series on Aggressive Behavior as a Focus of Psychiatric Attention.

Aggressive behavior in children and adolescents is a frequent complication of numerous psychiatric, developmental, environmental, and medical factors. When present, aggression often is of paramount importance regardless of the underlying disturbances or environmental factors from which it stems. From a clinical standpoint, aggression influences important decisions about emergency service use, hospitalization, pharmacotherapy, and safety for the patient and others. Socially, children with frequent lack of control of their aggressive behaviors experience rejection by peers and exclusion from settings that are part of ordinary development and socialization. The burden on families can be significant and may curtail their opportunities for enjoyable and beneficial activities to the detriment of other children in the household. When the underlying disorders are severe enough to warrant special settings to remediate them (eg, partial hospitalization, specialized educational or recreational settings), aggressive behavior often leads to a child's ineligibility to benefit from them. None of these consequences are conducive to a satisfying childhood or to a gratifying self-image. The risk for long-term maladjustment is high, in many contexts exceeding what the same underlying psychiatric condition would incur without aggression.