title: Consensus report on impulsive aggression as a symptom across diagnostic categories in child psychiatry: implications for medication studies.
abstract: OBJECTIVE
  To determine whether impulsive aggression (IA) is a meaningful clinical construct and to ascertain whether it is sufficiently similar across diagnostic categories, such that parallel studies across disorders might constitute appropriate evidence for pursuing indications. If so, how should IA be assessed, pharmacological studies designed, and ethical issues addressed?
  
  
  METHODS
  Experts from key stakeholder communities, including academic clinicians, researchers, practicing clinicians, U.S. Food and Drug Administration, National Institute of Mental Health, industry sponsors, and patient and family advocates, met for a 2-day consensus conference on November 4 and 5, 2004. After evaluating summary presentations on current research evidence, participants were assigned to three workgroups, examined core issues, and generated consensus guidelines in their areas. Workgroup recommendations were discussed by the whole group to reach consensus, and then further iterated and condensed into this report postconference by the authors.
  
  
  RESULTS
  Conference participants agreed that IA is a substantial public health and clinical concern, constitutes a key therapeutic target across multiple disorders, and can be measured with sufficient precision that pharmacological studies are warranted. Additional areas of consensus concerned types of measures, optimal study designs, and ethical imperatives.
  
  
  CONCLUSIONS
  Derived from scientific evidence and clinical experience, these consensus-driven recommendations can guide the design of future studies.
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred. Electronic address: pj131@columbia.edu.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Jensen
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Youngstrom
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
authors.forename: Hans
authors.initials: H
authors.lastname: Steiner
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Findling
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
authors.forename: Roger E
authors.initials: RE
authors.lastname: Meyer
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
authors.forename: Richard P
authors.initials: RP
authors.lastname: Malone
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
authors.forename: Gabrielle A
authors.initials: GA
authors.lastname: Carlson
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
authors.forename: Emil F
authors.initials: EF
authors.lastname: Coccaro
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Aman
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
authors.forename: James
authors.initials: J
authors.lastname: Blair
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
authors.forename: Donald
authors.initials: D
authors.lastname: Dougherty
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
authors.forename: Craig
authors.initials: C
authors.lastname: Ferris
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
authors.forename: Laurie
authors.initials: L
authors.lastname: Flynn
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Green
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Hoagwood
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
authors.forename: Janice
authors.initials: J
authors.lastname: Hutchinson
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
authors.forename: Tom
authors.initials: T
authors.lastname: Laughren
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
authors.forename: Leslie D
authors.initials: LD
authors.lastname: Leve
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Novins
authors.affiliation: Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
authors.forename: Benedetto
authors.initials: B
authors.lastname: Vitiello
mesh_terms: D000374:Aggression / Q000523:psychology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology; D001321:Autistic Disorder / Q000175:diagnosis / Q000453:epidemiology; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D002665:Child Psychiatry / Q000379:methods*; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D004358:Drug Therapy / Q000379:methods*; D006801:Humans; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology