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Cognitive Behavioral Therapy of Aggressive Children

Effects of Schemas
  • John E. Lochman
  • L. Lenhart

Abstract

Children who are identified as excessively aggressive by peers and teachers display a range of behaviors including verbal provocations and threats, physical fights, poorly controlled anger, low frustration tolerance, bullying, and disruptive behavior. Aggressive children typically have various subsets of these behavioral symptoms, and research and clinical efforts have focused on identifying meaningful subtypes of aggressive children. However, a common characteristic of all aggressive children is that they have intense, negative effects on the people who interact with them. Peers are victimized, teachers are disrupted from their teaching mission, and parents are frustrated with being unable to control these children’s coercive, provocative behavior. Because of these flagrant effects on others, aggressive children are referred for mental health services at higher rates than are children with most other forms of psychopathology.

Keywords

Cognitive Behavioral Therapy Social Goal Social Information Processing Aggressive Child Social Cognitive Model 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Adler, A. (1964). Social Interest: A challenge to mankind. New York: CapricornGoogle Scholar
  2. Ainsworth, M., Blehar, M., Waters, E., and Wall, S. (1978). Patterns of Attachment. Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
  3. Allen, J.P., Leadbeater, B.J., and Aber, J.L. (1990). The relationship of adolescents’ expectations and values to delinquency, hard drug use, and unprotected sexual intercourse. Development and Psychopathology, 2, 85–98.CrossRefGoogle Scholar
  4. Allen, J.P., Aber, J.L., and Leadbeater, B.J. (1990). Adolescent problem behaviors: The influence of attachment and autonomy. Psychiatric Clinics of North America, 13, 455–467.PubMedGoogle Scholar
  5. Asarnow, J.R., and Callan, J. W. (1985). Boys with peer adjustment problems: Social cognitive processes. Journal of Consulting and Clinical Psychology, 53, 80–87.PubMedCrossRefGoogle Scholar
  6. Asher, S.R., and Renshaw, P.D. (1981). Children without friends: Social knowledge and social skills training. In: S.R. Asher and J.M. Gottman (Eds.), The development of children’s friendships (pp. 273–296). New York: Cambridge University Press.Google Scholar
  7. Avery, R.R., and Ryan, R.M. (1988). Object relations and ego development: Comparison and correlates in middle childhood. Journal of Personality, 56, 547–569.PubMedCrossRefGoogle Scholar
  8. Baldwin, M. W. (1992). Relational schémas and the processing of social information. Psychological Bulletin, 112, 461–484.CrossRefGoogle Scholar
  9. Bandura, A. (1989). Regulation of cognitive processes through perceived self-efficacy. Developmental Psychology, 25, 729–735.CrossRefGoogle Scholar
  10. Bierman, K.L., Miller, C.L. and Staub, S.D. (1987). Improving the social behavior and peer acceptance of rejected boys: Effects of social skills training with instructions and prohibitions. Journal of Consulting and Clinical Psychology, 55, 194–200.PubMedCrossRefGoogle Scholar
  11. Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. New York: Basic Books.Google Scholar
  12. Camp, B.W. (1977). Verbal mediation in young aggressive boys. Journal of Abnormal Psychology, 86, 145–153.PubMedCrossRefGoogle Scholar
  13. Coie, J.D., Lochman, J.E., Terry, R., and Hyman, C. (1992). Predicting early adolescent disorder from childhood aggression and peer rejection. Journal of Consulting and Clinical Psychology, 60, 783–792.PubMedCrossRefGoogle Scholar
  14. Conduct Problems Prevention Research Group (In alphabetical order: K. Bierman, J. Coie, K. Dodge, M. Greenberg, J. Lochman, and R. McMahon) (1992). A developmental and clinical model for the prevention of conduct disorder: The FAST Track Program. Development and Psychopathology, 4, 509–527.CrossRefGoogle Scholar
  15. Crick, N.R., and Dodge, K.A. (1994). A review and reformulation of social-information processing mechanisms in children’s social adjustment. Psychological Bulletin, 115, 74–101.CrossRefGoogle Scholar
  16. Crick, N.R., and Ladd, G.W. (1990). Children’s perceptions of the outcomes of aggressive strategies: Do the ends justify the means? Developmental Psychology’, 29, 244–254.CrossRefGoogle Scholar
  17. Deluty, R.H. (1981). Alternative-thinking ability of aggressive, assertive, and submissive children. Cognitive Therapy and Research, 5, 309–312.CrossRefGoogle Scholar
  18. Deluty, R.H. (1983). Children’s evaluation of aggressive, assertive, and submissive responses. Journal of Consulting and Clinical Psychology, 51, 124–129.Google Scholar
  19. DeRubeis, R.J. and Beck, A.T. (1988). Cognitive therapy. In: K.S. Dobson (Ed.), Handbook of cognitive-behavioral therapies. (Pp. 85–135). New York: Guilford.Google Scholar
  20. Dix, T., and Lochman, J.E. (1990). Social cognition and negative reactions to children: A comparison of mothers of aggressive and nonaggressive boys. Journal of Social and Clinical Psychology, 9, 418–438.CrossRefGoogle Scholar
  21. Dodge, K.A. (1993). The future of research on the treatment of conduct disorder. Development and Psychopa thology, 5, 311–319.CrossRefGoogle Scholar
  22. Dodge, K.A., and Coie, J.D. (1987). Social information processing factors in reactive and proactive aggression in children’s peer groups. Journal of Personality and Social Psychology, 53, 1146–1158.PubMedCrossRefGoogle Scholar
  23. Dodge, K.A., Murphy, R.R., and Buchsbaum, K. (1984). The assessment of intention-cue detection skills in children: Implications for developmental psychopathology. Child Development, 55, 163–173.PubMedCrossRefGoogle Scholar
  24. Dodge, K.A., and Newman, J.P. (1981). Biased decision making processes in aggressive boys. Journal of Abnormal Psychology, 90, 375–379.PubMedCrossRefGoogle Scholar
  25. Dodge, K.A., Petit, G.S., McClaskey, C.L., and Brown, M.M. (1986). Social competence in children. Monographs of the Society for Research in Child Development, 51.Google Scholar
  26. Dozier, M. (1989). Working models of attachment for individuals with serious psychiatric disorders. Paper presented at the biennial meeting of the Society for Research in Child Development. Kansas City, Missouri: April, 1989.Google Scholar
  27. Erdley, C.A. (1990). An analysis of children’ attributions and goals in social situations: Implications of children’s friendship outcomes. Unpublished paper, University of Illinois.Google Scholar
  28. Erdley, CA., Dumas-Hines, F., Lomis, C.C., Cain, K.M., Olshekshy, L.M. and Dweck, C.S., (1991). Children’s implicit theories and social goals as mediators of responses to social failure. Manuscript submitted for publication, University of Illinois.Google Scholar
  29. Evans, S.W., and Short, E.J. (1991). A qualitative and serial analysis of social problem-solving in aggressive boys. Journal of Abnormal Child Psychology, 19, 331–340.PubMedCrossRefGoogle Scholar
  30. Feindler, E.L., Ecton, R.B., Kingsley, D., and Dubey, D.R. (1986). Group anger-control training for institution alized psychiatric male adolescents. Behavior Therapy, 17, 109–123.CrossRefGoogle Scholar
  31. Feldman, E., and Dodge, K.A. (1987). Social information processing and sociometric status: Sex age, and situational effects. Journal of Abnormal Child Psychology, 15, 211–227.PubMedCrossRefGoogle Scholar
  32. Fischler, G.L., and Kendall, P.C. (1988). Social cognitive problem solving and childhood adjustment: Qualitative and topological analyses. Cognitive Therapy and Research, 12, 133–153.CrossRefGoogle Scholar
  33. Fiske, S.T., and Taylor, S.E. (1984). Social Cognition. Reading, MA: Addison-Wesley.Google Scholar
  34. Freeman, A. and Leak, R.C (1989). Cognitive therapy applied to personality disorders. In: A. Freeman, K.M. Simm, L.E. Beutler, and H. Arkowitz (Eds.), Comprehensive Handbook of Cognitive Therapy (pp. 403–433). New York: Plenum.CrossRefGoogle Scholar
  35. French, D.C (1988). Heterogeneity of peer rejected boys: Aggressive and nonaggressive subtypes. Child Development, 59, 976–985.PubMedCrossRefGoogle Scholar
  36. Godwin, S.F. and Mahoney, J.J. (1975). Modification of aggression through modelling: An experimental probe. Journal of Behavior Therapy and Experimental Psychiatry, 6, 200–202.CrossRefGoogle Scholar
  37. Gouze, K.R. (1987). Attention and social problem solving as correlates of aggression in preschool males. Journal of Abnormal Child Psychology, 15, 181–197.PubMedCrossRefGoogle Scholar
  38. Graham, S., Hudley, C, and Williams, E. (1992). Attributional and emotional determinants of aggression among African-American and Latino young adolescents. Developmental Psychology, 28, 731–740.CrossRefGoogle Scholar
  39. Greenberg, J.R., and Mitchell, A. (1983). Object relations in psychoanalytic theory. Cambridge, Mass: Harvard University Press.Google Scholar
  40. Guerra, N.G., and Slaby, R.G. (1989). Evaluative factors in social problem solving by aggressive boys. Journal of Abnormal Child Psychology, 17, 277–289.PubMedCrossRefGoogle Scholar
  41. Hart, C.H., Ladd, G.W., and Burleson, B.R. (1990). children’s expectations of the outcomes of social strategies: Relations with sociometric status and maternal disciplinary style. Child Development, 61, 127–137.PubMedCrossRefGoogle Scholar
  42. Higgins, E.T., King, G. A., and Marvin, G.H. (1982). Individual construct accessibility and subjective impressions and recall. Journal of Personality and Social Psychology, 43, 35–47.CrossRefGoogle Scholar
  43. Ingram, R.E., and Kendall, P.C. (1986). Cognitive clinical psychology: Implications of an informational processing perspective. In: R.E. Ingram (Ed.), Information processing approaches to clinical psychol ogy. New York: Academic, pp. 3–21.Google Scholar
  44. Jenkins, V.Y., and Fisher, D.A. (1989). Patterns of adolescent attachment and coping. Paper presented at the biennial meeting of the Society for Research in Child Development. Kansas City, Missouri: April 1989.Google Scholar
  45. Joffe, R.D., Dobson, K.S., Fine, S., Marriage, K., and Haley, G. (1990). Social problem-solving in depressed, conduct-disordered, and normal adolescents. Journal of Abnormal Child Psychology, 18, 565–575.PubMedCrossRefGoogle Scholar
  46. Kazdin, A.E., Bass, D., Siegel, T., and Thomas, C. (1989). Cognitive-behavioral therapy and relationship therapy in the treatment of children referred for antisocial behavior. Journal of Consulting and Clinical Psychology, 57, 522–535.PubMedCrossRefGoogle Scholar
  47. Keane, S.P., and Parrish, A.E. (1992). The role of affective information in the determination of intent. Developmental Psychology, 28, 159–162.CrossRefGoogle Scholar
  48. Kelly, G.A., (1955). The psychology of personal constructs. New York: Norton.Google Scholar
  49. Kendall, P.C. (1991). Guiding theory for therapy with children and adolescents. In: P.C. Kendall (Ed.) Child and adolescent therapy: Cognitive-behavioral procedures (pp. 3–22). New York: Guilford.Google Scholar
  50. Kroger, J. (1989). Ego structuralization in late adolescence as seen through early memories and ego identity status. Paper presented at the biennial meeting of the Society for Research in Child Development. Kansas City, Missouri: April 1989.Google Scholar
  51. Lieberman, A.F. (1977). Preschoolers’ competence with a peer: Relations with attachment and peer experience. Child Development, 48, 1277–1287.CrossRefGoogle Scholar
  52. Lochman, J.E. (1984). Psychological characteristics and assessment of aggressive adolescents. In: CR. Keith (Ed.), The aggressive adolescent: Clinical perspectives. New York: Free Press, pp. 17–62.Google Scholar
  53. Lochman, J.E. (1985). Effects of different treatment lengths in cognitive behavioral interventions with aggressive boys. Child Psychiatry and Human Development, 16, 45–56.PubMedCrossRefGoogle Scholar
  54. Lochman, J.E. (1987). Self and peer perceptions and attributional biases of aggressive and nonaggressive boys in dyadic interactions. Journal of Consulting and Clinical Psychology, 55, 404–414.PubMedCrossRefGoogle Scholar
  55. Lochman, J.E. (1990). Modification of childhood aggression. In: M. Hersen, R. Eisler, and P.M. Miller (Eds.), Progress in behavior modification (Vol 25). Newbury Park, CA: Sage.Google Scholar
  56. Lochman, J.E. (1992). Cognitive-behavioral interventions with aggressive boys: Three year follow-up and preventive effects. Journal of Consulting and Clinical Psychology, 60, 426–432.PubMedCrossRefGoogle Scholar
  57. Lochman, J.E., Burch, P.R., Curry, J.F. and Lampron, L.B. (1984). Treatment and generalization effects of cognitive-behavioral and goal-setting interventions with aggressive boys, Journal of Consulting and Clinical Psychology, 52, 915–916.PubMedCrossRefGoogle Scholar
  58. Lochman, J.E. and the Conduct Problems Prevention Research Group (in alphabetical order: K. Bierman, J. Coie, K. Dodge, M. Greenberg, J. Lochman, R. McMahon), (in press). Screening of child behavior problems for prevention programs at school entry. Journal of Consulting and Clinical Psychology. Google Scholar
  59. Lochman, J.E. and Craven, S.V. (March 1993). Family conflict associated with reactive and proactive aggression at two age levels. Paper presented at the biennial meeting of the Society for Research in Child Development, New Orleans.Google Scholar
  60. Lochman, J.E., and Curry, J.F. (1986). Effects of social problem solving training and self-instruction training with aggressive boys. Journal of Clinical Child Psychology, 15, 159–164.CrossRefGoogle Scholar
  61. Lochman, J.E., and Dodge, K.A. (under review). Distorted perceptions in dyadic interactions of aggressive and non-aggressive boys: Effects of prior expectations and boys’ age.Google Scholar
  62. Lochman, J.E., and Dodge, K.A. (1994). Social cognitive processes of severely violent, moderately aggressive, and nonaggressive boys. Journal of Consulting and Clinical Psychology, 62, 366–374.PubMedCrossRefGoogle Scholar
  63. Lochman, J.E., Dunn, S.E., and Klimes-Dugan, B. (1993). An intervention and consultation model from a social cognitive perspective: A description of the Anger Coping Program. School Psychology Review, 22, 458–471.Google Scholar
  64. Lochman, J.E., and Lampron, L.B. (1986). Situational social problem-solving skills and self-esteem of aggressive and nonaggressive boys. Journal of Abnormal Child Psychology, 14, 605–617.PubMedCrossRefGoogle Scholar
  65. Lochman, J.E., Lampron, L.B., Buren, P.R., and Curry, J.F. (1985). Client characteristics associated with behavior change for treated and untreated boys. Journal of Abnormal Child Psychology, 13, 527–538.PubMedCrossRefGoogle Scholar
  66. Lochman, J.E., Lampron, L.B., Gemmer, T.V., and Harris, R. (1987). Anger coping interventions for aggressive children: Guide to implementation in school settings. In: P.A. Keller and S.R. Heyman (Eds.), Innovations in clinical practice: A source book (Vol. 6, pp. 339–356). Sarasota, FL: Professional Resource Exchange.Google Scholar
  67. Lochman, J.E., Lampron, L.B., Gemmer, T.V., Harris, R., and Wyckoff, G.M. (1989). Teacher consultation and cognitive behavioral interventions with aggressive boys. Psychology in the Schools, 26, 230–136.CrossRefGoogle Scholar
  68. Lochman, J.E., Lampron, L.B., and Rabiner, D.L. (1989). Format and salience effects in the social problem-solv ing of aggressive and nonaggressive boys. Journal of Clinical Child Psychology, 18, 230–236.CrossRefGoogle Scholar
  69. Lochman, J.E., and Lenhart, L.A. (1993). Anger coping intervention for aggressive children: Conceptual models and outcome effects. Clinical Psychology Review, 13, 785–805.CrossRefGoogle Scholar
  70. Lochman, J.E., Meyer, B.L., Rabiner, D.L., and White, K.J. (1991). Parameters influencing social problem solving of aggressive children. In: R. Prinz (Ed.), Advances in behavioral assessment of children and families (Vol. 5, pp. 31–63). Greenwich, CT: JAI Press.Google Scholar
  71. Lochman, J.E., Nelson, W.M., and Sims, J.P. (1981). A cognitive behavioral program for use with aggressive children. Journal of Clinical Child Psychology, 13, 146–148.CrossRefGoogle Scholar
  72. Lochman, J.E. and Wayland, K.K. (1992). Aggression, social acceptance, and race as predictors of negative outcomes. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 1026–1035.CrossRefGoogle Scholar
  73. Lochman, J.E., Wayland, K.K. and Sczcepanski, R. (under review). The relationship between attributional bias and behavior of aggressive and nonaggressive boys in dyadic interaction. Manuscript under review, Duke University.Google Scholar
  74. Lochman, J.E., Wayland, K.K., and White, K.J. (1993). Social goals: Relationship to adolescent adjustment and to social problem solving. Journal of Abnormal Child Psychology, 21, 135–151.PubMedCrossRefGoogle Scholar
  75. Lochman, J.E., White, K.J., and Wayland, K.K., (1991). Cognitive-behavioral assessment and treatment with aggressive children. In: P.C. Kendall (Ed.), Child and Adolescent Therapy (pp. 25–65).Google Scholar
  76. Loeber, R. (1990). Development and risk factors of juvenile antisocial behavior and delinquency. Clinical Psychology Review, 10, 1–41.CrossRefGoogle Scholar
  77. Mackinnon, C.E., Lamb, M.E., Belsky, J., and Baum, C. (1990). An affective-cognitive model of mother-child aggression. Development and Psychopathology, 2, 1–13.CrossRefGoogle Scholar
  78. Matas, L., Arend, R.A., and Sroufe, L.A. (1978). Continuity of adaptation in the second year: The relationship between quality of attachment and later competence. Child Development, 49, 547–556.CrossRefGoogle Scholar
  79. McMahon, R.J., and Wells, K.C. (1989). Conduct disorders. In: E.J. Mash and R.A. Barkley (Eds.), Treatment of childhood disorders. New York: Guilford Press, pp. 73–134.Google Scholar
  80. Milich, R., and Dodge, K.A. (1984). Social information processing in child psychiatric populations. Journal of Abnormal Child Psychology, 12, 471–490.PubMedCrossRefGoogle Scholar
  81. Mischel, W. (1990). Personality disposition revisited and revised: A view after three decades. In: L. Pervin (Ed.)., Handbook of Personality: Theory and research (pp. 111–134). New York: Guilford.Google Scholar
  82. Nasby, W., Hayden, B., and DePaulo, B.M. (1979). Attributional bias among aggressive boys to interpret ambiguous social stimuli as displays of hostility. Journal of Abnormal Psychology, 89, 459–468.CrossRefGoogle Scholar
  83. Novaco, R.W. (1978). Anger and coping with stress: Cognitive behavioral interventions. In: J.P. Foreyet and D.P. Rathjen (Eds.) Cognitive behavioral therapy: Research and application. New York: Plenum.Google Scholar
  84. Ollendick, T.H., and Hersen, M. (1979). Social skills training for juvenile delinquents. Behavior Research and Therapy, 17, 547–554.CrossRefGoogle Scholar
  85. Olweus, D. (1979). Stability of aggressive behavior patterns in males: A review. Psychological Bulletin, 86, 852–875.PubMedCrossRefGoogle Scholar
  86. Patterson, G.R. (1986). Performance models for antisocial boys. American Psychologist, 41, 432–444.PubMedCrossRefGoogle Scholar
  87. Perry, D.G., Perry, L.C., and Kennedy, E. (1992). Conflict and the development of antisocial behavior. In: C.U. Shantz, and W.W. Hartup (Eds.), Conflict in child and adolescent development (pp. 301–329). Cam bridge: Cambridge University Press.Google Scholar
  88. Perry, D.G., Perry, L.C., and Rasmussen, P. (1986). Cognitive social learning mediators of aggression. Child Development, 57, 700–711.PubMedCrossRefGoogle Scholar
  89. Perry, D.G., Perry, L.C., and Weiss, R.J. (1989). Sex differences in the consequences that children anticipate for aggression. Developmental Psychology, 25, 312–319.CrossRefGoogle Scholar
  90. Putallaz, M., and Sheppard, B.H. (1992). Conflict management and social competence. In: C.U. Shantz and W.W. Hartup (Eds.), Conflict in child and adolescent development (pp. 330–355). Cambridge: Cambridge University Press.Google Scholar
  91. Rabiner, D.L., Lenhart, L., and Lochman, J.E. (1990). Automatic vs. reflective problem solving in relation to children’s sociometric status. Developmental Psychology, 71, 535–543.Google Scholar
  92. Reinhold, D.P. (1990). Attributions and affect in the parent-child context of childhood aggression. Unpublished doctoral dissertation, Duke University.Google Scholar
  93. Richard, B.A., and Dodge, K.A. (1982). Social maladjustment and problem-solving in school-aged children. Journal of Consulting and Clinical Psychology, 50, 226–233.PubMedCrossRefGoogle Scholar
  94. Rotter, J.B., Chance, J.E., and Phares, E.J. (1972). Applications of a social learning theory of personality. New York: Holt, Rinehart, and Winston.Google Scholar
  95. Rubin, K.H., Bream, L.A., and Rose-Krasnor, L. (1991). Social problem solving and aggression in childhood. In: D.J. Pepler and K.H. Rubin (Eds.), The development and treatment of childhood aggression (pp. 219–248). Hillsdale, NJ: Erlbaum.Google Scholar
  96. Sancilio, M, Plumert, J.M., and Hartup, W.W. (1989). Friendship and aggressiveness as determinants of conflict outcomes in middle childhood. Developmental Psychology, 25, 812–819.CrossRefGoogle Scholar
  97. Slaby, R.G., and Guerra, N.G. (1988). Cognitive mediators of aggression in adolescent offenders: 1. Assessment. Developmental Psychology, 24, 580–588.CrossRefGoogle Scholar
  98. Smith, C.A. and Lazarus, R.W. (1990). Emotion and adaptation. In: L. Previn (Ed.), Handbook of personality: Theory and research (pp. 609–637). New York: Guilford.Google Scholar
  99. Steinberg, M.D., and Dodge, K.A. (1983). Attributional bias in aggressive adolescent boys and girls. Journal of Social and Clinical Psychology, 1, 312–321.CrossRefGoogle Scholar
  100. Sczcepanski, R. (1994). The association between marital disturbance, problematic parenting practices, and child aggression: The role of emotion-linked personality traits. Unpublished major area paper. Duke University.Google Scholar
  101. Vitaro, F., and Tremblay, R.E. (1994). Impact of a prevention program on aggressive children’s friendships and social adjustment. Journal of Abnormal Child Psychology, 22, 457–475.PubMedCrossRefGoogle Scholar
  102. Waas, G.A. (1988). Social attributional biases of peer-rejected and aggressive children. Child Development, 59, 969–975.PubMedCrossRefGoogle Scholar
  103. Waas, G.A., and French, D.C. (1989). Children’s social problem solving: Comparison of the open middle interview and children’s assertive behavior scale. Behavioral Assessment, 11, 219–230.Google Scholar
  104. Weiner, B. (1990). Attribution in personality psychology. In: L. Pervin, (Eds.). Handbook of personality: Theory and research (pp. 609–637). New York: Guilford.Google Scholar
  105. Westen, D. (1991). Social cognition and object relations. Psychological Bulletin, 109, 429–455.CrossRefGoogle Scholar
  106. Westen, D., Klepser, J., Ruffins, S., Silverman, M, Lifton, N., and Boekamp, J. (1991). Object relations childhood and adolescence: The development of working representations. Journal of Consulting and Clinical Psychology, 59, 400–409.PubMedCrossRefGoogle Scholar
  107. Wyer, R.S., Jr., Lambert, J.A., Budesheim, T.L. and Greenfield, D.H. (in press). Theory and research on person impression information: A look to the future. In: L. Martin and A. Tesser (Eds.), The construction of social judgement. Hillsdale, N.J.: Erlbaum.Google Scholar

Copyright information

© Springer Science+Business Media New York 1995

Authors and Affiliations

  • John E. Lochman
    • 1
  • L. Lenhart
    • 1
  1. 1.Department of PsychologyDuke University Medical CenterDurhamUSA

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