Pediatric Aggression and Violence

Study Overview
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Brief Summary
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Violence and aggression on pediatric psychiatry units has led to staff and patient injuries and even deaths around the country. In an effort to improve safety, the investigators have developed a method (with the Brief Rating of Child and Adolescent Aggression) of identifying children and adolescents at a higher risk for aggression and violence on the units. In order to improve this prediction, the investigators plan to study salivary hormones in low risk children and high risk children. The salivary hormones to be studied include cortisol, testosterone, and dehydroepiandrosterone sulfate (DHEAS). The investigators expect to improve the investigators current ability to predict the severity and type of pediatric aggression and violence on the inpatient units by combining information from the Brief Rating of Child and Adolescent Aggression (BRACHA), the Predatory-Affective Aggression Scale (Vitiello et al., 1990), and salivary hormones.

Official Title
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Salivary Hormones and Pediatric Aggression and Violence: A Feasibility Study

Conditions
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Pediatric Aggression and Violence

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Prepubescent males (per parent report), African American or Caucasian, between 7 and 9 years old Ability of the subject to provide assent Ability of the guardian to give parental permission Completion of the BRACHA questionnaire Completion of the Predatory-Affective Aggression Scale (PAAS) Exclusion Criteria: Viral or bacterial infection or treatment with antibiotics within two weeks of screening Recent surgery (within 8 weeks of screening) Bleeding gums (within 8 weeks of screening) Currently detained in a juvenile detention Currently taking medications such as antipsychotic medications (besides Aripiprazole), steroids and beta adrenergic agonists that affect hormones If it is the investigator's clinical judgment that the subject should be excluded if it is in the subject's best interest or due to any other factor that may interfere with study results

Ages Eligible for Study
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Minimum Age: 7 Years
Maximum Age: 9 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| inpatient high aggression<br> | |
| inpatient low aggression<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Salivary Hormone Correlation With Brief Rating of Aggression by Children and Adolescent (BRACHA) Score | We collected three saliva samples from each participant over a 24-hour period on one of the initial three hospital days to determine the peripheral concentrations of cortisol, dehydroepiandrosterone (DHEA), and testosterone. We then compared these levels with the participants BRACHA score. We wanted to determine if hormone concentrations could improve the BRACHA's accuracy of predicting pediatric aggression during psychiatric hospitalization. | Collected on one or two days | 
| Salivary Hormone Correlation With Brief Rating of Aggression by Children and Adolescent (BRACHA) Score. | We collected three saliva samples from each participant over a 24-hour period on one of the initial three hospital days to determine the peripheral concentrations of cortisol, dehydroepiandrosterone (DHEA), and testosterone. We then compared these levels with the participants BRACHA score. We wanted to determine if hormone concentrations could improve the BRACHA's accuracy of predicting pediatric aggression during psychiatric hospitalization. | Collected on one or two days |