title: Aggressive Behavior Problems in Children with Autism Spectrum Disorders: Prevalence and Correlates in a Large Clinical Sample.
abstract: Aggressive behavior problems (ABP) are frequent yet poorly understood in children with Autism Spectrum Disorders (ASD) and are likely to co-vary significantly with comorbid problems. We examined the prevalence and sociodemographic correlates of ABP in a clinical sample of children with ASD (N= 400; 2-16.9 years). We also investigated whether children with ABP experience more intensive medical interventions, greater impairments in behavioral functioning, and more severe comorbid problems than children with ASD who do not have ABP. One in four children with ASD hadChild Behavior Checklistscores on the Aggressive Behavior scale in the clinical range (T-scores ≥ 70). Sociodemographic factors (age, gender, parent education, race, ethnicity) were unrelated to ABP status. The presence of ABP was significantly associated with increased use of psychotropic drugs and melatonin, lower cognitive functioning, lower ASD severity, and greater comorbid sleep, internalizing, and attention problems. In multivariate models, sleep, internalizing, and attention problems were most strongly associated with ABP. These comorbid problems may hold promise as targets for treatment to decrease aggressive behavior and proactively identify high-risk profiles for prevention.
authors.affiliation: Center for Spoken Language Understanding, Department of Pediatrics, Oregon Health & Science University, 840 SW Gaines Street, Portland, OR 97239 ; Institute on Development and Disability, Oregon Health & Science University, 707 SW Gaines Street, Portland, OR 97239.
authors.forename: Alison Presmanes
authors.initials: AP
authors.lastname: Hill
authors.affiliation: Division of General Pediatrics and Child & Adolescent Health Measurement Initiative, Department of Pediatrics, 707 SW Gaines Street, Oregon Health & Science University, Portland, OR 97239.
authors.forename: Katharine E
authors.initials: KE
authors.lastname: Zuckerman
authors.affiliation: Institute on Development and Disability, Oregon Health & Science University, 707 SW Gaines Street, Portland, OR 97239 ; Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239.
authors.forename: Arlene D
authors.initials: AD
authors.lastname: Hagen
authors.affiliation: Institute on Development and Disability, Oregon Health & Science University, 707 SW Gaines Street, Portland, OR 97239.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Kriz
authors.affiliation: Institute on Development and Disability, Oregon Health & Science University, 707 SW Gaines Street, Portland, OR 97239.
authors.forename: Susanne W
authors.initials: SW
authors.lastname: Duvall
authors.affiliation: Center for Spoken Language Understanding, Department of Pediatrics, Oregon Health & Science University, 840 SW Gaines Street, Portland, OR 97239 ; Institute on Development and Disability, Oregon Health & Science University, 707 SW Gaines Street, Portland, OR 97239.
authors.forename: Jan
authors.initials: J
authors.lastname: van Santen
authors.affiliation: Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239.
authors.forename: Joel
authors.initials: J
authors.lastname: Nigg
authors.affiliation: Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239 ; Department of Behavioral Neuroscience, Oregon Health & Science University, 3181 SW Sam Jackson Park Road L470, Portland, OR 97239.
authors.forename: Damien
authors.initials: D
authors.lastname: Fair
authors.affiliation: Institute on Development and Disability, Oregon Health & Science University, 707 SW Gaines Street, Portland, OR 97239 ; Department of Behavioral Neuroscience, Oregon Health & Science University, 3181 SW Sam Jackson Park Road L470, Portland, OR 97239.
authors.forename: Eric
authors.initials: E
authors.lastname: Fombonne
keywords: aggression; attention problems; autism spectrum disorders; internalizing problems; psychotropic drugs; sleep