Adrian Raine1, Rose A Cheney2, Ringo Ho3, Jill Portnoy4, Jianghong Liu5, Liana Soyfer4, Joseph Hibbeln6, Therese S Richmond5. 1. Departments of Criminology, Psychiatry, and Psychology, University of Pennsylvania, Philadelphia, PA, USA. 2. Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. 3. Division of Psychology, Nanyang Technological University, Singapore City, Singapore. 4. Department of Criminology, University of Pennsylvania, Philadelphia, PA, USA. 5. School of Nursing, University of Pennsylvania, Philadelphia, PA, USA. 6. Section on Nutritional Neuroscience, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA.
Abstract
BACKGROUND: While some studies suggest that nutritional supplementation may reduce aggressive behavior in children, they have not examined whether its efficacy may be enhanced in conjunction with other treatment approaches. This study tests the hypothesis that a nutritional supplementation of omega-3, multivitamins, and minerals over 3 months, combined with cognitive behavior therapy, will reduce childhood aggression. METHODS: In this randomized, single-blind, stratified, factorial trial, a high-risk community sample of 290 children aged 11-12 years were randomized into Nutrition only, cognitive behavioral therapy (CBT) only, Nutrition + CBT, and Control groups. The primary outcome measures of child- and parent-reported aggressive and antisocial behavior were collected at 0 months (baseline), 3 months (end of treatment), 6 months (3 months posttreatment), and 12 months (9 months posttreatment). The trial ('Healthy Brains & Behavior: Understanding and Treating Youth Aggression (HBB)' was registered at ClinicalTrials.gov at https://clinicaltrials.gov/ct2/show/NCT00842439 RESULTS: For child self-reports, children in the Nutrition only group showed reduced externalizing behavior compared to Controls at 3 months. At 6 months, the Nutrition + CBT group scored lower on externalizing behavior compared to both CBT only and Control groups. Findings were more in evidence for an Aggressive-Reactive form of antisocial behavior than for a Callous-Proactive form. Effect sizes were in the small-to-medium range (d = -.33 to -.37). Group differences were not sustained 9 months posttreatment, and no other effects were significant. CONCLUSIONS: Findings provide some limited support for the efficacy of omega-3, vitamin, and mineral supplementation in reducing aggressive behavior in children, and represent the first evaluation of nutritional supplements in conjunction with CBT.
RCT Entities:
BACKGROUND: While some studies suggest that nutritional supplementation may reduce aggressive behavior in children, they have not examined whether its efficacy may be enhanced in conjunction with other treatment approaches. This study tests the hypothesis that a nutritional supplementation of omega-3, multivitamins, and minerals over 3 months, combined with cognitive behavior therapy, will reduce childhood aggression. METHODS: In this randomized, single-blind, stratified, factorial trial, a high-risk community sample of 290 children aged 11-12 years were randomized into Nutrition only, cognitive behavioral therapy (CBT) only, Nutrition + CBT, and Control groups. The primary outcome measures of child- and parent-reported aggressive and antisocial behavior were collected at 0 months (baseline), 3 months (end of treatment), 6 months (3 months posttreatment), and 12 months (9 months posttreatment). The trial ('Healthy Brains & Behavior: Understanding and Treating Youth Aggression (HBB)' was registered at ClinicalTrials.gov at https://clinicaltrials.gov/ct2/show/NCT00842439 RESULTS: For child self-reports, children in the Nutrition only group showed reduced externalizing behavior compared to Controls at 3 months. At 6 months, the Nutrition + CBT group scored lower on externalizing behavior compared to both CBT only and Control groups. Findings were more in evidence for an Aggressive-Reactive form of antisocial behavior than for a Callous-Proactive form. Effect sizes were in the small-to-medium range (d = -.33 to -.37). Group differences were not sustained 9 months posttreatment, and no other effects were significant. CONCLUSIONS: Findings provide some limited support for the efficacy of omega-3, vitamin, and mineral supplementation in reducing aggressive behavior in children, and represent the first evaluation of nutritional supplements in conjunction with CBT.
Authors: Nienke J de Bles; Nathaly Rius-Ottenheim; Johanna M Geleijnse; Ondine van de Rest; Jan P A M Bogers; Anke Schat; Henk L I Nijman; David van den Berg; Lucas Joos; Annelies van Strater; Tine de Ridder; Joost J Stolker; Wilbert B van den Hout; Albert M van Hemert; Erik J Giltay Journal: BJPsych Open Date: 2022-02-03
Authors: Nienke J de Bles; David A A Gast; Abe J C van der Slot; Robert Didden; Albert M van Hemert; Nathaly Rius-Ottenheim; Erik J Giltay Journal: J Eval Clin Pract Date: 2022-01-17 Impact factor: 2.336