Severe Aggression Research Articles

Deep brain stimulation for aggressiveness: long-term follow-up and tractography study of the stimulated brain areas.

Initial studies applying deep brain stimulation (DBS) of the posteromedial hypothalamus (PMH) to patients with pathological aggressiveness have yielded encouraging results. However, the anatomical structures involved in its therapeutic effect have not been precisely identified. The authors' objective was to describe the long-term outcome in their 7-patient series, and the tractography analysis of the volumes of tissue activated in 2 of the responders. This was a retrospective study of 7 subjects with pathological aggressiveness. The findings on MRI with diffusion tensor imaging (DTI) in 2 of the responders were analyzed. The authors generated volumes of tissue activated according to the parameters used, and selected those volumes as regions of interest to delineate the tracts affected by stimulation. The series consisted of 5 men and 2 women. Of the 7 patients, 5 significantly improved with stimulation. The PMH, ventral tegmental area, dorsal longitudinal fasciculus, and medial forebrain bundle seem to be involved in the stimulation field. In this series, 5 of 7 medication-resistant patients with severe aggressiveness who were treated with bilateral PMH DBS showed a significant long-lasting improvement. The PMH, ventral tegmental area, dorsal longitudinal fasciculus, and medial forebrain bundle seem to be in the stimulation field and might be responsible for the therapeutic effect of DBS.

Structural brain correlates of irritability and aggression in early manifest Huntington's disease.

In Huntington's disease (HD), irritability and aggressive behavior represent highly prevalent and disabling neuropsychiatric symptoms. However, their structural brain correlates have not been extensively explored. Here, we rated the severity of irritability and aggression (IAs) using the Problem Behaviors Assessment for HD (PBA-s) in 31 early HD participants. The IAs score was computed as the mean severity score for the irritability plus the mean severity aggression PBA-s items. Seventeen patients were classified as IAs (IAs score > 2) and 14 as non-IAs. All participants had available T1-MRI data. A grey matter volume voxel-based morphometry group comparison was performed, using age, motor status, severity of other PBA-s items and disease burden as covariates. Aside from irritability, aggression and obsessive-compulsive behavior, both groups were comparable in terms of other clinical and sociodemographic variables. In the IAs group, a significant reduction of grey-matter volume (GMV) was found in the bilateral caudate, putamen and globus pallidus, left pulvinar nucleus, right superior temporal pole (BA 38), left mid temporal gyrus (BA 21), right inferior temporal gyrus (BA 20) and left medial OPFC (BA 11). Lower GMV in the left pulvinar nucleus was significantly associated with higher anxiety and lower GMV in the left medial OPFC was significantly associated with higher suicidality. In sum, IAs in HD is associated with structural brain damage in a set of key nodes involved in the expression and down-regulation of negative emotions.

Fearlessness and low social affiliation as unique developmental precursors of callous-unemotional behaviors in preschoolers.

Early callous-unemotional (CU) behaviors identify children at risk for severe and persistent aggression and antisocial behavior. Recent work suggests that fearlessness and low social affiliation are implicated in the etiology of CU behaviors, although more research is needed to clarify these etiological pathways, as well as the role of parenting. Using a sample of preschoolers (N = 620), we examined pathways between observed fear in response to social and non-social stimuli and observed social affiliation during social interactions at age 3 and increases child CU behaviors and oppositional-defiant behaviors from ages 3 to 5. To elucidate the role of parenting in exacerbating or buffering the relationships between low fear and social affiliation and CU behaviors, we tested whether parental harshness or low warmth moderated these pathways. Fearlessness and low social affiliation uniquely predicted increases in CU behaviors, but not oppositional-defiant behaviors, from ages 3 to 5. Moreover, there was evidence for differential moderation of the fear pathway by harsh parenting, such that harsh parenting predicted increases in CU behaviors in fearless children but increases in oppositional-defiant behaviors in fearful children. Fearlessness and low social affiliation contribute to the development of CU behaviors. Harsh parenting can exacerbate the risky fearlessness pathway. Preventative interventions aimed at reducing risk for CU behaviors and persistent aggression and antisocial behavior should target socioaffiliative processes and provide parents with strategies and training to manage and scaffold rule-compliant behavior when children show low fearful arousal.

Increased produce enrichment reduces trauma in socially-housed captive rhesus macaques (Macaca mulatta).

Due to primate adaptations for sociality, captive rhesus macaques have optimal welfare and utility as a biomedical model when they can be maintained in outdoor social groups. As a despotic species; however, aggression can result in costly injuries and may result in temporary or permanent removal of specific individuals from social housing. Enrichment items, such as toys, climbing structures, and foraging material, are employed to keep captive animals occupied. We hypothesized that produce enrichment that requires more processing to extract may reduce socially-derived injuries by keeping animals occupied. We tested the effects of additional weekly produce (corn-in-husk, whole melon, or whole squash) on trauma incidence in an outdoor social group of rhesus macaques across two distinct seasons (mating and birthing seasons) at the California National Primate Research Center. Aggression and status behavioral data, food resource use and proximity, and trauma incidence were collected over two 16-week periods, with eight control and treatment conditions alternating biweekly. Mixed-effects regression modeling was used to determine the best predictors of trauma risk and severe aggression at the group level and at an individual level. We found that food resource use was an important predictor of trauma risk at both group and individual levels; greater use of food resources reduced trauma risk. Produce enrichment did not; however, reduce severe aggression. We suggest that other captive social groups of rhesus macaques with high levels of trauma may benefit from supplemental produce enrichment that increases animal engagement with food resources.

Standardized Observation Analogue Procedure in the Treatment of Severe Childhood Aggression Study.

Objective: To explore blinded observational outcomes in the Treatment of Severe Childhood Aggression (TOSCA) study. Methods: During a 9-week acute trial, children with severe physical aggression and attention-deficit/hyperactivity disorder received parent training + titrated psychostimulant for 3 weeks, and those who failed to show an optimal response during Week 4 through Week 6 received in addition either randomly assigned placebo (Basic treatment) or titrated risperidone (Augmented treatment). Child and parent behaviors were videotaped in a Standardized Observation Analogue Procedure (SOAP) designed to elicit problems and strengths in child and parent interactions. SOAPs were collected at baseline and Week 9 and 52 follow-up. Results: During the acute 9-week trial, augmented treatment was associated with better outcomes than basic treatment for 3 of 13 measures: increased Child Compliance (p = 0.004; significant after correction for multiple tests), greater use of positive Parent Reinforcement (p = 0.03), and more Shared Enjoyment (p = 0.04). At follow-up, when medication was no longer by randomized assignment, parents used more Alpha Commands and displayed fewer Parent Negative Behaviors, and the dyads showed more Shared Enjoyment regardless of original randomization. Thus, there were better parent-child interactions with Augmented treatment, and interactions improved overall at follow-up regardless of original treatment assignment. Conclusions: The SOAP demonstrated sensitivity to behavior changes between short-term treatments for a few (but not most) measures. The acute treatment differences for Child Compliance and Child Negative Behavior are generally consistent with the moderate superiority of Augmented over Basic treatment previously reported for the primary study outcome.

"Stealthing": Factors associated with young men's nonconsensual condom removal.

The purpose of this study was to investigate the rates, predictors, and associated sexual risk indices of young men's nonconsensual condom removal (also known as stealthing). Participants were 626 male inconsistent condom users aged 21-30 years recruited from an urban area in the Pacific Northwest. Participants completed survey measures assessing sexual aggression history, sexual aggression-related attitudes, sexually transmitted infection history, unplanned pregnancies, and nonconsensual condom removal experiences. Almost 10% of the participants (n = 61) reported engaging in nonconsensual condom removal since the age of 14 years, with an average of 3.62 times (SD = 3.87) and range of 1-21 times (maximum possible). After controlling for condom use self-efficacy, men with greater hostility toward women (odds ratio = 1.47) and more severe sexual aggression history (odds ratio = 1.06) had significantly higher odds of engaging in nonconsensual condom removal behavior. χ2 analyses demonstrated that men who had a history of nonconsensual condom removal were significantly more likely to have had a sexually transmitted infection diagnosis (29.5% vs. 15.1%) or have had a partner who experienced an unplanned pregnancy (46.7% vs. 25.8%). Nonconsensual condom removal, which involves elements of both sexual risk and sexual aggression, confers multiple sexual risks to its recipients, thus meriting increased clinical and research attention. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

9.2 PARENTING AND CHILD CALLOUS UNEMOTIONAL TRAITS

Callous-unemotional (CU) traits (ie, deficits in empathy and prosocial behavior, as well as reduced interpersonal responsivity to others) increase the risk for severe childhood aggression and conduct disorder (CD). CU traits typically are described as highly heritable, and the debate continues about whether the parenting environment matters in their etiology. Strong genetically informed study designs are needed to establish nonheritable environmental pathways to CU traits to inform interventions and treatment. The objective of this study was to determine whether parental harshness and parental warmth were related to children’s aggression or CU traits when accounting for genetically mediated effects.

Critical Illness Polyneuromyopathy and Physical Rehabilitation

Critical illness polyneuropathy occurs in patients with severe acute aggression that is life-threatening and is managed in an intensive care unit. It most often affects patients free from any previous neurological pathology. The two main risk factors are severe multi-organ failure and muscle immobilization. This complication can be prevented by early passive and active rehabilitation programs even in ventilated patients.

Interventions to prevent aggression against doctors: a systematic review

ObjectiveTo find out if there is evidence on interventions to prevent aggression against doctors.DesignThis systematic review searched the literature and reported in accordance with Preferred Reporting Items for Systematic Reviews...

Behavior Modification Is Associated With Reduced Psychotropic Medication Use in Children With Aggression in Inpatient Treatment: A Retrospective Cohort Study

There are few data to guide management of agitated and aggressive psychiatrically hospitalized children. Available studies do not account for setting, age, sex, diagnosis, admission reason, or clinical intervention. Seclusion, restraint, and physical holds (S/R/H) are usually the only outcome measure. In this study, we examine changes in PRN (pro re nata, or "as needed") psychotropic medication use to manage severe aggression on a children's psychiatric inpatient unit, comparing rates before and after a behavior modification program (BMP) was discontinued. We compare 661 children (aged 5-12 years) in 5 cohorts over 10 years, 510 (77%) of whom were admitted for aggressive behavior. PRN use per 1,000 patient-days was the primary outcome measure, but S/R/H was also examined. We use the following as predictors: BMP status, full- or half-time child and adolescent psychiatrist (CAP) oversight, diagnosis, age, length of stay, and neuroleptic use. Children admitted for aggression had high rates of externalizing disorders (79%), low rates of mood (27%) and anxiety (21%) disorders, and significantly higher rates of PRN and S/R/H (p< .001) use. Rate of PRN use was significantly lower (p< .001) when the BMP was present (mean [SD], 163 [319] per 1,000 patient-days) than when it was absent (483 [569]; p< .001). Higher PRN use was predicted by BMP absence, neuroleptic treatment, and young patient age (p< .001), and by half-time CAP oversight (p= .002). In this sample of young children with primarily externalizing disorders, data support the effectiveness of a BMP in lowering rates of PRN and S/R/H use.

Clinical Features of Heterosexual Intimate Partner Violence Victims With Escalating Injury Severity.

Intimate partner violence (IPV) is largely recognized to have a cyclical pattern and violence escalation in terms of frequency and intensity over time. However, there is a lack of systematic investigation of the profiles of victims and quantification of the patterns of injury of the victims associated with the first time versus repeated violence episodes. This study aimed to fill this knowledge gap by medical chart review of 878 victims in a 5-year period from 2010 to 2014 in Accident and Emergency Department (AED) of two public general hospitals in Hong Kong. The differences in injury patterns between the first IPV episode (FE) and recurrent IPV episodes (REs) experienced by male and female victims in heterosexual relationship were evaluated. The results indicated the violence escalation occurred in recurrent IPV in both genders. In female victims, there was significant increase in the number of injury locations (mean [M] = 2.0 vs. 2.2, p < .05), number of causes of injury (M = 1.7 vs. 2.2, p < .001) and police escort (15.2% vs. 22.1%, p < .05) in RE compared to FE. In male victims, however, only the increase in the number of causes of injury was significant (M = 1.6 vs. 2.1, p < .05) in RE compared to FE. In summary, our results highlight the escalation in the severity of harm of IPV victims in heterosexual relationship, and the gender differences in severity aggression and injury and help-seeking behavior change in recurrent IPV. Preventive measures are indicated to intervene the IPV occurrence and recurrence with rising morbidity and a potential of mortality.

A Cross-Cultural Comparison of the Role of Sexual Objectification in the Relationship Between Alcohol Use and Sexual Assault Perpetration.

In this study, we examined how sexual objectification can help explicate the relationship between alcohol use and sexual assault perpetration. Specifically, we examined a mediation and a moderation model. Moreover, given that gender roles and sexual norms vary across cultures, we also examined the structural invariance of the models between a U.S. male (n = 404) and Philippines male (n = 100) college sample. Path analyses were used to examine the mediation and the moderation model, and multiple groups analysis was utilized to examine model differences between samples. Sexual objectification fully mediated the relationship between alcohol use severity and sexual aggression. Furthermore, the mediation model was invariant between the U.S. sample and Philippines sample. A significant alcohol use severity by sexual objectification interaction effect was found for both samples. Simple slopes analysis indicated that alcohol use severity was not associated with sexual aggression among those with high sexual objectification scores. Among men with low sexual objectification scores, alcohol use severity was associated with higher likelihood toward sexual assault. For the Filipino sample, the impact of alcohol consumption on sexual aggression is more pronounced compared with the U.S. sample. Sexual objectification is a key variable in understanding the alcohol use-sexual aggression relationship. Country differences in alcohol use, cultural meanings of Filipino masculinity, and sexual norms and behaviors accounts for noninvariance in the moderation model. Implications for sexual assault reduction programs were also discussed.

Aggregation Partitioning and Study of Demographic, Medical, and Psychological Predictors Related to Derived Clusters in Cardiac Rehabilitation Patients: A Cross-Sectional Study

Background: Classification of high-risk behaviors such as aggression and identifying social, medical, and psychological factors related to it can help the emergence and development of the strategies to prevent these destructive behaviors. Objectives: Thus, the present study was done with two objectives: (i) cluster analysis of the aggression components and partitioning cardiac rehabilitation (CR) patients and (ii) determining the demographic, medical, and psychological correlations of each cluster. Methods: The sample of this cross-sectional study was 167 CR patients in western Iran examined from June to December 2017. Demographic and risk factors checklist, Beck anxiety inventory (BAI), Beck depression inventory (BDI), and Buss-Perry aggression questionnaire (BPAQ) were used for data collection. The data were analyzed using hierarchical and k-means cluster analysis, Cramer-V test, analysis of variance (ANOVA), and analysis of binary logistic regression. Results: The mean age of the participants (66.5% male) was 59.14 ± 9.03. The model proposed two clusters: (i) patients with mild aggression and (ii) patients with severe aggression. Occupation (P = 0.048), marital status (P = 0.048), anxiety (P = 0.006), and depression (P = 0.001) were the most essential predictors of the unhealthy cluster. Our model could explain 30.7% to 41% of the variance of the unhealthy cluster. Conclusions: Cluster analysis divided patients into two groups with mild and severe aggression. Marital status and occupation are the most important demographic correlates, and depression and anxiety are the most important psychological predictors of the cluster with high aggression. The results of the present study can provide a map of the focus of attention on harm reduction interventions by health professionals.

Towards an integrated understanding of aggression in the general population: Findings from an epidemiological catchment area study

The goal of this study is to identify patterns of various forms of aggression in the general population and their psychosocial and environmental correlates. Data from the Montreal Epidemiological Catchment Area study (N = 1855) were analyzed using latent class analysis and multinomial logistic regression. Four classes were identified: a ‘Low Aggression’ profile (91.4%) – individuals were older, more likely to be women, and had greater quality of life – and three profiles with individuals displaying aggression. The ‘Acting out’ profile (4.3%) reported property and mild verbal aggression, and profile membership was associated with impulsivity. The ‘Violent’ profile (2.0%) reported severe verbal aggression and physical aggression, and membership was associated with posttraumatic stress disorder and substance use disorders. Finally, the ‘Self-injuring’ profile (2.2%) reported self-harming behaviors along with mild verbal aggression and property destruction and were psychologically distressed. Findings are consistent with the risk factors in violence risk assessment instruments. They also shed light on how different types of aggression are interrelated and may help in the development of a psychological formulation of individuals for whom different types of aggression co-occur so that integrated prevention strategies may be put in place.

Association between psychosocial stressors with emotional and behavioral problems among children of low-income addicted families living in Brazil.

Children exposed to substance use in their families are vulnerable to multiple risk factors in their development and at increased risk for emotional and behavioral problems. The aims of the study were as follows 1) estimate the prevalence of emotional and behavioral problems among children aged 6-11 years old, living with addicted family members in a low-income urban community of São Paulo, Southeastern Brazil; 2) evaluate the children's exposure to family psychosocial stressors and substance use; and 3) investigate the factors related to the increased risk of emotional and behavioral problems and substance use. A cross-sectional study was conducted among 101 children aged 6-11 years old (M = 9.16 years, SD = 1.61). The instruments used were a sociodemographic questionnaire, the Child Behavior Checklist (CBCL) and the Psychosocial Stress Factors (PSF). High prevalence of problems was found for this sample: the CBCL showed 26.7% of clinical scores for Internalizing Problems, 40.6% for Externalizing Problems, and 40.6% for Total Problems. Exposure to family psychosocial stressors was also high, including severe disease (33%), physical aggression (28.9%), death (27.8%), psychiatric hospitalization (16.7%), suicide attempts (15.5%), and suicide (9.3%). Exposure to these family stressors was associated with an increase of two to four times in the prevalence of internalizing and externalizing problems. Children exposed to substance abusers have more mental health problems than general population, even when compared to peers living in similar low-income areas. This is a group that should be target of a selective preventive intervention.

Aggressiveness and violence in psychiatric patients: a clinical or social paradigm?

Psychiatric disorders are often considered the leading cause of violence. This may be due to a stereotype created by media and general opinion. The Modified Overt Aggression Scale (MOAS) was used to evaluate the severity of aggressive and violent behaviors in 400 patients who attended a post-acute psychiatric service in Milan from 2014 to 2016 and suffered from different psychiatric disorders. The psychopathological clinical picture was evaluated by Clinical Global Impression (CGI). The study also assessed the possible correlation between epidemiologic and sociodemographic factors, clinical variables, and aggression and violence. Of the total number of subjects, 21.50% showed a MOAS score >0, 11.50% presented mild aggression (0-10 MOAS weighted score), 9% moderate aggression (11-20), and 1% severe aggression (MOAS >20). With respect to violent behaviors, 16% of patients showed a score >0 in one MOAS subscale other than verbal aggression according to violence definition. The severity of clinical picture seemed to be related to higher weighted MOAS score. Multivariate testing of different sociodemographic and clinical variables showed that violence was related to unemployment status, and significantly correlated to compulsory admission (TSO), suicide attempts (TS), and personality disorders, while the severity of clinical psychiatric picture seemed to play a secondary role. Results have shown that personality disorders and sociodemographic factors, including economic factors, seem to be major determinants of violence among patients diagnosed with mental disorders.

Contribuição para estimativa do grau de saturação a partir das condições ambientais aplicada à análise de confiabilidade de estruturas de concreto sujeitas ao ataque por cloretos

A durabilidade de elementos estruturais de concreto armado sujeitos a condições ambientais de severa agressividade apresenta-se como um dos principais problemas enfrentados na construção civil. Dentre os agentes de deterioração dessas estruturas destacam-se os íons cloretos, amplamente difundidos em ambiente marinho, que causam a corrosão de armaduras. A estimativa de vida útil de elementos de concreto armado surge como uma temática fundamental na avaliação da durabilidade das estruturas. Embora outros processos causem penetração de íons cloreto no concreto, é praticamente consenso que a difusão é o mecanismo predominante. Um modelo clássico de caracterização da penetração de cloretos é a 2ª Lei de Fick. Guimarães (2000) demonstrou que o grau de saturação (GS) do concreto é um parâmetro que exerce forte influência sobre o coeficiente de difusão de cloretos (D). Embora tenham sido desenvolvidas metodologias de medição do GS, estas se apresentam onerosas em termos de tempo e recursos. O objetivo deste trabalho é apresentar estimativas de GS com base nas condições ambientais a que o material é exposto e posteriormente analisar a influência deste parâmetro na avaliação da estimativa de vida de elementos estruturais através da confiabilidade. São utilizados dados meteorológicos e de medição do GS obtidas em duas regiões litorâneas: Rio Grande, Brasil e Santa Pola, Espanha. Obteve-se modelos de estimativa do GS a partir das variáveis ambientais de cada região e também de ambas em conjunto. Avaliou-se então a influência destes modelos na estimativa de vida útil através da probabilidade de falha da estrutura.

Serious violent behavior and antisocial outcomes as consequences of exposure to ethnic-political conflict and violence among Israeli and Palestinian youth.

We examine whether cumulative-past and concurrent exposure to ethnic-political violence among Israeli and Palestinian youth predict serious violent behavior and antisocial outcomes toward the in-group and the out-group. We collected four waves of data from 162 Israeli Jewish and 400 Palestinian youths (three age cohorts: 8, 11, and 14 years old) and their parents. The first three waves were consecutive annual assessments, and the fourth was conducted 4 years after the third wave, when the three age cohorts were 14, 17, and 20 years old, respectively. Based on social-cognitive-ecological models of the development of aggression (Dubow et al., 2009, Clinical Child and Family Psychology Review, 12, 113-126; Huesmann, 1998) and models of the development of beliefs about the "other," (Bar-Tal, 2004, European Journal of Social Psychology, 34, 677-701; Tajfel & Turner, 1986), we predicted that serious violent outcomes directed toward both the in-group and the out-group would be related to both concurrent and to persistent-past exposure to ethnic political violence. Bivariate regression models (prior to including covariates) indicated that both early cumulative exposure to ethnic-political violence during childhood and adolescence and concurrent exposure during late adolescence/early adulthood predicted all six serious violent and antisocial outcomes. When we added to the models the covariates of ethnic subgroup, age, sex, parents' education, and youths' prior physical aggression, concurrent exposure to ethnic-political violence was still significantly associated with a greater likelihood of concurrently perpetrating all six serious violent and nonviolent forms of antisocial behavior, and earlier cumulative exposure remained significantly related to three of these: severe physical aggression, participating in violent demonstrations, and our overall index of violent/antisocial behavior.

A review of N‐acetylcysteine in the treatment of grooming disorders

Pathologic grooming disorders can lead to clinically significant distress and functional impairment. Studies on treatment of these disorders with selective serotonin reuptake inhibitors (SSRIs) and anticonvulsants have led to inconsistent findings. N-acetylcysteine (NAC) has shown promise in treatment of obsessive-compulsive and related disorders. The objective of this article is to perform an updated review of NAC in the treatment of grooming disorders. PubMed was searched from inception to October 2017 to identify literature on the use of NAC in the management of trichotillomania, onychophagia, and pathological skin picking. Case reports, case series, and randomized controlled trials were included. Data on study design, dosing regimens, comorbidities, concurrent treatment, and side effects were extracted from the included articles. Fifteen articles were included in this review, which consisted of 10 case reports, one case series, and four randomized controlled trials. Dosing of oral NAC ranged from 450 to 2,400mg per day, and treatment periods lasted from 1 to 8months. Side effects were uncommon, mild, and usually gastrointestinal in nature, with severe aggression reported in one child. While there are multiple reports of the safety and efficacy of NAC in the treatment of grooming disorders, there are currently few randomized controlled trials on this topic, and more research is needed to develop a formal treatment algorithm. While current data should be considered very preliminary, case reports have demonstrated mostly positive results and a lack of significant side effects. A trial of NAC may be a viable option for pathologic grooming disorders, especially in patients who have failed prior psychologic or pharmacologic treatment.

Awareness and perceptions of clinical guidelines for the diagnostics and treatment of severe behavioural problems in children across Europe: A qualitative survey with academic experts

BackgroundSevere behavioural problems (SBPs11Severe behavioural problems (SBPs) were defined in this study as persistent and frequent oppositional, aggressive, and destructive behaviours (ie. severe aggression, hostility, disobedience or fighting) occurring in more than one life area, and interfering with functioning in the major life domains, such as home, school and peer relationships. This definition was formulated by the authors (A.L., A.R.G, L.vD., and R.V.) based on descriptions of ODD, CD, disruptive behaviour disorders, and aggressive behaviours in childhood in the literature. SBPs is an umbrella dimensional term for such diagnostic categories and is virtually equivalent to other known umbrella terms such as‘disruptive behaviour disorders’.) in childhood are highly prevalent, impair functioning, and predict negative outcomes later in life. Over the last decade, clinical practice guidelines for SBPs have been developed across Europe to facilitate the translation of scientific evidence into clinical practice. This study outlines the results of an investigation into academic experts’ perspectives on the current prevalence, implementation, and utility of clinical guidelines for SBPs in children aged 6–12 across Europe. MethodsAn online semi-structured questionnaire was completed by 28 psychiatry and psychology experts from 23 countries. ResultsExperts indicated that approximately two thirds of the included European countries use at least an unofficial clinical document such as textbooks, while nearly half possess official guidelines for SBPs. Experts believed that, although useful for practice, guidelines’ benefits would be maximised if they included more specific recommendations and were implemented more conscientiously. Similarly, experts suggested that unofficial clinical documents offer a wide range of treatment options to individualise treatment from. However, they stressed the need for more consistent, evidence-based clinical practices, by means of developing national and European clinical guidelines for SBPs. ConclusionsThis study offers a preliminary insight into the current successes and challenges perceived by experts around Europe associated with guidelines and documents for SBPs, acting as a stepping stone for future systematic, in-depth investigations of guidelines. Additionally, it establishes experts’ consensus for the need to develop official guidelines better tailored to clinical practice, creating a momentum for a transition towards European clinical guidelines for this population.