Theory of Mind Deficits and Reactive Aggression in Child Psychiatric Inpatients: Indirect Effects Through Emotion Dysregulation

Abstract

Nationwide, there is a pressing need to develop more efficacious treatment regimens for reactively aggressive youth receiving inpatient psychiatric services. Identifying the relevant clinical characteristics of youth with reactive aggression is an important first step in this process. Past research findings and theoretical formulations have suggested that deficits in both social skills and emotional regulation abilities are significantly associated with the development of reactive aggression in children. Utilizing a highly aggressive child inpatient sample (65 males and 36 females) receiving crisis-stabilization services, we tested the hypothesis that emotion dysregulation statistically mediated the relationship between theory of mind deficits and reactive aggression. As hypothesized, results of bootstrapped mediational analyses indicated that theory of mind deficits were associated with higher levels of reactive aggression via the indirect influence of dysregulated affect. These findings suggest that intervention programs for reactively aggressive children should promote both theory of mind skills and emotion regulation abilities. Children that develop more thoughtful styles of perspective taking coupled with an enhanced ability to modulate their emotions may develop a greater ability to employ the rational conflict resolution skills that underlie peaceful social relationships.