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Theory of Mind Deficits and Reactive Aggression in Child Psychiatric Inpatients: Indirect Effects Through Emotion Dysregulation

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Abstract

Nationwide, there is a pressing need to develop more efficacious treatment regimens for reactively aggressive youth receiving inpatient psychiatric services. Identifying the relevant clinical characteristics of youth with reactive aggression is an important first step in this process. Past research findings and theoretical formulations have suggested that deficits in both social skills and emotional regulation abilities are significantly associated with the development of reactive aggression in children. Utilizing a highly aggressive child inpatient sample (65 males and 36 females) receiving crisis-stabilization services, we tested the hypothesis that emotion dysregulation statistically mediated the relationship between theory of mind deficits and reactive aggression. As hypothesized, results of bootstrapped mediational analyses indicated that theory of mind deficits were associated with higher levels of reactive aggression via the indirect influence of dysregulated affect. These findings suggest that intervention programs for reactively aggressive children should promote both theory of mind skills and emotion regulation abilities. Children that develop more thoughtful styles of perspective taking coupled with an enhanced ability to modulate their emotions may develop a greater ability to employ the rational conflict resolution skills that underlie peaceful social relationships.

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Author Contributions

K.K.S. designed and executed the study, conducted the data analysis, and wrote the paper. P.K.K. collaborated with all aspects of the study.

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  1. Department of Psychology, Eastern Washington University, 153 Martin Hall, Cheney, WA, 99004-2423, USA

    Kurt K. Stellwagen

  2. Department of Psychology, University of Utah, Salt Lake City, UT, USA

    Patricia K. Kerig

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  1. Kurt K. Stellwagen
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  2. Patricia K. Kerig
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Correspondence to Kurt K. Stellwagen.

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All procedures involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent of legal guardians and voluntary assent of children were obtained prior to children’s involvement in the study and the protocol was approved by the IRBs of the University of North Carolina at Chapel Hill and John Ulmstead State Hospital. Children’s attending psychiatrists gave informed consent, as did teachers.

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Stellwagen, K.K., Kerig, P.K. Theory of Mind Deficits and Reactive Aggression in Child Psychiatric Inpatients: Indirect Effects Through Emotion Dysregulation. J Child Fam Stud 27, 3385–3394 (2018). https://doi.org/10.1007/s10826-018-1161-x

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