Covariation of self- and other-directed aggression among inpatient youth: continuity in the transition to treatment and shared risk factors.

Although other- and self-directed aggression covary in very high-risk youth, these forms of aggression infrequently are studied simultaneously. Understanding better their covariation is an important task for improving services to high-risk youth. In this study, data from the clinical records of 476 youth admitted to secure inpatient treatment were analyzed to examine relations among self- and other-directed aggression exhibit before and during inpatient treatment. Analyses tested the hypotheses that self- and other-directed aggression would tend to covary and display continuity from pre-treatment to in-treatment. Also tested were the hypotheses that youth with histories of co-occurring self- and other-directed aggression would show the highest levels of aggression during treatment and the greatest degree of personal and contextual risk on entering treatment. These hypotheses were largely supported. Exploratory analyses revealed interesting discontinuities in aggression (aggression emitted only before or during treatment) with critical implications for research and practice with youth receiving clinical care, especially those in institutional placements. (c) 2010 Wiley-Liss, Inc.