Aggression and psychological problems in juvenile male delinquents versus controls in russia

Aggression and Violent Behavior, Vol. 5, No. 2, pp. 217–225, 2000 Copyright  1999 Elsevier Science Ltd Printed in the USA. All rights reserved 1359-1789/00/$–see front matter

PII S1359-1789(98)00037-8

AGGRESSION AND PSYCHOLOGICAL PROBLEMS IN JUVENILE MALE DELINQUENTS VERSUS CONTROLS IN RUSSIA: ALTERNATIVE WAYS OF “LETTING OFF STEAM”? Vladislav V. Ruchkin Arkhangelsk State Medical Academy

Martin Eisemann Umea˚ University

ABSTRACT. The purpose of this study is to investigate possible relationships between various subtraits of aggression and psychological symptoms in a sample of male delinquents. One hundred eighty-nine subjects from a juvenile correction center for delinquent adolescents and 117 control subjects from secondary schools in Arkhangelsk, Russia, were assessed by means of the Aggression Questionnaire and the Youth Self-Report. Significant correlations between hostility, anger, and some psychological problems (e.g., Withdrawn, Anxious/ Depressed, Thought Problems) were found in both groups. At the same time, physical and verbal aggression was almost exclusively related to aggressive and delinquent behavior. The findings lend support to our proposed interactional model in which excitation, as a result of the interplay between cognitions and emotions, could be expressed either as socially accepted behavior, aggressive behavior, or psychological and somatic symptoms.  1999 Elsevier Science Ltd. All rights reserved. KEY WORDS. Adolescents, aggression, psychological symptoms IT IS POSTULATED THAT the content of an individual’s thoughts affects his feelings and leads to a definite behavioral response (Perris, 1989). The term “behavioral” in this context includes possible psychopathological manifestations. Buss and Perry (1992) assumed that aggression, as any other type of behavior, consists of three main components (i.e., cognitive, emotional, and behavioral). The cognitive component of aggression is

Correspondence should be addressed to Martin Eisemann, Department of Psychiatry and WHO Collaborating Center, Umea˚ University, S-90185, Umea˚, Sweden.

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represented by hostility, consisting of the feelings of ill-will and injustice. Anger represents an emotional component, which involves physiological arousal and preparation for aggression. Verbal and physical aggression represents an instrumental or motor component, comprising any actions aimed at hurting or harming others. At this juncture, it should be pointed out that the relations between cognitions, emotions, and behavior are not exclusively unidirectional, but are controlled by feedback mechanisms, thus forming an interactional circuit (Perris, 1989). Anger is often a prelude to aggression, and it is obvious that people are more likely to be aggressive when they are angry. At the same time, anger is a state of high arousal that diminishes over time. Presumably, after anger has decreased, there is a cognitive residue of ill-will, resentment, and perhaps suspicion of others’ motives (Buss & Perry, 1992). Further, the residual arousal must not be neglected, as it can transfer from one situation to another in a way that determines the likelihood of the person’s interpretation of the situation in an aggressive way (Zillman, 1979, 1988). Further, the occurrence of anger might be preceded by hostile thoughts which act as a facilitator. According to Zillman (1979, 1988), any event which markedly increases the level of overall excitation, especially when behavioral reaction to the event is blocked, might lead to unintended consequences, including aggression. The manifestation of aggression requires a certain threshold of excitation to be crossed, which can occur in two ways: (a) immediately, if the intensity of an event is rather high, and (b) cumulatively, in which residual arousal tranfers from one situation to another. By engaging in aggressive acts the urge for further aggression is reduced (abreaction), a process also labeled “catharsis.” However, this hypothesis was challenged quite recently by Heckhausen (1980), who suggested that the abreaction is only of short duration. Instead, in the long run, aggressive behavior is reinforced if it is crowned with success. On the other hand, if the individual’s threshold level for expressing excitation in aggressive behavior is relatively high, due to his personality traits and negative experiences in the past, the feelings just “boil” inside without any possibility to be overtly expressed. Presumably, unexpressed aggression (excitation) may find another mode of expression and could finally lead to different pathological manifestations. Based on the classical psychoanalytic theories of Abraham (1953/1911) and Freud (1925/ 1917), the concept of inner-directed hostility has for many decades played a prominent role as a key explanation in the psychodynamics of depressive disorders. Further, hostility and anger often have been considered by various authors as etiological factors in somatization and/or hypochondriasis. Alexander (1939) was one of the first who hypothesized that essential hypertension might be related to the suppression of hostile feelings. Brown and Vaillant (1981) defined hypochondriasis as a “transformation of . . . unacceptable aggressive impulses into . . . complaints of pain or somatic illness.” Kellner et al. (1985) found somatic symptoms positively correlated with anger-hostility. These assumptions were also partly confirmed by Lange et al. (1995), who in a sample of young adults, found that covert (i.e., inner-directed) aggression was significantly correlated with agoraphobic avoidance, somatization, anxiety, depression, insufficiency, sensitivity, and general neuroticism, whereas overt aggression was not. According to Lange et al. (1995), covert aggression is also comparable with Buss and Perry’s description (1992) of hostility and anger, and overt aggression with their definition of physical and verbal aggression. Based on the above-mentioned findings, the authors suggest that if suppressed, hostility and anger could lead to psychological and somatic problems. At the same time, when expressed outwardly as overt aggression, pathological manifestations might be avoided. Presumably, similar mechanisms might be functional concerning socially accepted behavior as well.

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The present study was aimed at investigating possible relationships between various behavioral problems (as possible ways of expressing behavior) and subtraits of aggression (according to the description of Buss & Perry, 1992) in samples of delinquent adolescents and control subjects. The rationale for choosing delinquent subjects for our study was two fold. First, since all of them were placed in a correctional institution for crimes, it is obvious that they had failed in behaving in a socially acceptable way. Second, we suggest that, in the correction center, some of their habitual ways of dealing with different situations could not be used, since such an environment is novel and unexpected to them (most of the subjects were imprisoned for the first time). Further, opportunities to express their excitation in socially accepted activities or overt aggression are limited. Consequently, we assume that such an environment forces them to adapt by more or less convenient behaviors to the present situation and distorts their habitual ways of expressing behavior. In that sense, the control group was interesting for comparison as an “untouched” group in that relations between aggression and various problems might represent a completely different picture.

METHOD

Subjects The delinquent subjects were voluntarily recruited from about 200 detainees in the only juvenile correction center for the Arkhangelsk region of Northern Russia, which represents the catchment area with a population of 1.5 million inhabitants. The population of the area is very homogenous and consists in 98% of European ethnic groups. All delinquents were referred to this institution by a court decision. The reasons for correction were repeated thefts (about 80%), hooliganism, robbery, and some cases of rape and murder. It should be mentioned that, generally, in case of theft, youngsters were referred to the correction center only if they had commited another theft during the period of probation. The terms of confinement in correction ranged from six months (in case of theft) to eight years (in case of murder). No separation between violent and non violent offenders is provided. Data were obtained during the winter and spring 1996, from a total population of the institution (i.e., 192 youths) (with the exception of refusals and adolescents with mild cases of mental retardation—totaling about 8% of the population). The age within the present group ranged from 15–18 years (mean age 5 16.5, SD 5 0.8). Comparative data were obtained in the same area in a group of 121 male schoolchildren from secondary schools. The age in this group ranged from 14–18 years (mean age 5 15.3, SD 5 0.9). For the present study, only those subjects were retained in the analysis for whom no missing data existed on any of the measures of interest (189 delinquents and 117 controls). All subjects were informed about the voluntary participation in the study. Further, they were assured that the staff would not obtain any information about results. The investigation was individually performed in questionnaire format by paper-pencil test in small group sessions (5–7 subjects) conducted by the first author.

Instruments Aggression Questionnaire (AQ). This questionnaire was designed by Buss and Perry (1992) based on the well-known Buss-Durkee Hostility Inventory (Buss & Durkee, 1957) to assess the level of different subtraits of aggression. It consists of 29 items divided into four subscales: Hostility, Anger, Verbal Aggression, and Physical Aggression, which have to be answered on a scale ranging from 1 (extremely uncharacteristic of me) to 5 (extremely characteristic of me).

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Youth Self-Report (YSR). This instrument was designed by Achenbach (1991) to obtain standardized self-reports on youth’s competencies and behavioral/emotional problems. The problem scoring part contains 112 items that describe specific behavioral/emotional problems. Items are scored 0 if they are not true of the child, 1 if they are somewhat or sometimes true, and 2 if they are very true or often true. Instrument scores for eight crossinformant syndromes, plus Internalizing (includes Withdrawn, Somatic Complaints and Anxious/Depressed syndromes) and Externalizing (Delinquent Behavior and Aggressive Behavior syndromes) grouping of the syndromes, which are based on the analyses of syndromes’ interrelations. A total problems score is computed, with higher scores indicating endorsement of greater behavioral and emotional problems. The YSR has been widely used in research and clinical services (Brown & Achenbach, 1996). The translation of these scales into Russian followed established guidelines, including appropriate use of independent back translations (Sartorius & Kuyken, 1994). The translations into Russian were made by the first author, followed by discussion of the translated questionnaires with Russian monolingual colleagues to comment on them in an articulate way. Finally, independent back translations were made by an official interpreter. The obtained versions were compared with originals and inconsistencies were analyzed and corrected.

Statistical Analysis Data were analyzed using the Statistical Package for Social Sciences (SPSS-Mac) (Nie et al., 1970). Means and standard deviations (SD) were calculated for describing the variables under investigation. Differences between variables were tested by t-test for independent samples. The Pearson product moment correlation coefficient was used to assess the relationship between sets of variables. Multiple regression analyses were carried out with problem scores as dependent variables and aggression scores as independent variables.

RESULTS Delinquents scored higher in all the aggression subtraits and problem scores (Table 1). The mean ages in the delinquent and comparison groups were found to be significantly different from one another (p , .000). Nevertheless, no significant correlations were obtained between age and any other variable under investigation. In both groups, aggression subtraits were found widely correlated with problem scores. However, when applying Bonferroni corrections (controlling for the possibility of chance relationships) some of these correlations did not reach the supposed level of significance (a 5 (1/44) (0.2) 5 0.0054) (Table 2). In delinquent adolescents, we found hostility related to Withdrawn, Anxious/Depressed, Thought Problems, Attention Problems, and Internalizing syndromes. Anger and Verbal Aggression did not correlate with problem scores. Physical aggression was correlated with Aggressive Behavior and Externalizing syndromes (Table 2). In the control group we found hostility correlated with Anxious/Depressed, Social Problems, Aggressive Behavior, Internalizing and Externalizing syndromes, and total problem score. Anger was related to Anxious/Depressed, Social Problems, Thought Problems, Attention Problems, Delinquent and Aggressive Behavior, Internalizing and Externalizing syndromes, and total problems score. Verbal aggression was correlated with Aggressive Behavior and Externalizing syndromes, and total problem score. Physical

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TABLE 1. Means (SD) of Aggression Subtraits and Problem Scores in Delinquents and Controls Scale

Delinquents (n 5 189)

Controls (n 5 117)

AQ

Hostility Anger Verbal Aggression Physical Aggression

23.9 6 5.9* 20.1 6 5.1* 17.0 6 3.9** 29.0 6 6.4*

20.1 6 4.4 16.1 6 5.6 15.3 6 3.6 23.2 6 6.0

YSR

Withdrawn Somatic Complaints Anxious/Depressed Social Problems Thought Problems Attention Problems Delinquent Behavior Aggressive Behavior Internalizing Externalizing Total Problem Score

5.05 6 2.5** 4.9 6 3.2* 10.0 6 5.6* 4.5 6 2.5* 3.5 6 2.6* 7.6 6 3.0* 9.4 6 3.7* 13.8 6 6.1* 19.5 6 9.1* 23.3 6 8.9* 66.6 6 23.4*

4.1 6 2.5 2.8 6 2.6 5.9 6 4.7 3.6 6 2.2 1.8 6 2.1 5.7 6 3.1 3.7 6 2.9 10.4 6 5.3 12.5 6 8.0 14.1 6 7.4 42.8 6 20.6

* p , .001. ** p , .01. Abbreviations: AQ 5 Aggression Questionnaire; SD 5 Standard deviation; YSR 5 Youth Self-Report.

aggression was related to Thought Problems, Delinquent and Aggressive Behavior, Externalizing syndromes and total problem score. Further, results from multiple regression analyses confirmed initially established relationships between aggression and problem scores and further substantiated them (Table 3). In delinquents Withdrawn, Anxious/Depressed, Social Problems and Internalizing syndromes were correlated with Hostility and negatively correlated with Physical Aggression. Thought Problems, Attention Problems and total problems score were related to hostility, whereas Aggressive and Delinquent Behavior and Externalizing syndromes were related to Physical Aggression. In control subjects, Withdrawn and Social Problems were also related to Hostility; however, a predominant role was played by Anger, which was related to Somatic Complaints, Anxious/Depressed, Thought Problems, Attention Problems and Internalizing syndromes, and total problems score. Delinquent Behavior was found exclusively related to Physical Aggression. Aggressive Behavior was related to Anger, while Verbal and Physical Aggression and Externalizing problems were correlated with Anger and Physical Aggression (see Table 3).

DISCUSSION Our results confirmed previous findings of relationships between anger/hostility and psychological problems. At the same time, it should be noticed that patterns of relationships were different among the groups. In delinquents, most of the problems were related to hostility (cognitive subtrait of aggression); in control subjects, the problems were mostly related to anger (emotional subtrait of aggression). In our opinion, this could be explained

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TABLE 2. Pearson Correlation Coefficients Between Aggression Subtraits and Problem Scores in Delinquents and Controls

Withdrawn Delinquents Controls Somatic Complaints Delinquents Controls Anxious/Depressed Delinquents Controls Social Problems Delinquents Controls Thought Problems Delinquents Controls Attention Problems Delinquents Controls Delinquent Behavior Delinquents Controls Aggressive Behavior Delinquents Controls Internalizing Delinquents Controls Externalizing Delinquents Controls Total Problem Score Delinquents Controls

Hostility

Anger

Verbal Aggression

Physical Aggression

0.27* 0.24

0.05 0.20

0.07 0.06

20.07 0.01

0.10 0.23

0.01 0.25

20.02 0.17

20.11 0.20

0.20** 0.34*

0.10 0.39*

0.02 0.18

20.10 0.16

0.17 0.37*

0.08 0.31*

0.07 0.22

20.08 0.12

0.26* 0.20

0.12 0.40*

0.11 0.21

0.13 0.27**

0.25* 0.19

0.17 0.42*

0.14 0.24

0.03 0.21

0.06 0.11

0.15 0.34*

0.13 0.12

0.19 0.49*

0.00 0.33*

0.18 0.63*

0.17 0.51*

0.28* 0.60*

0.22** 0.33*

0.08 0.35*

0.02 0.16

0.03 0.28**

0.18 0.59*

0.17 0.41*

0.27* 0.63*

0.17 0.34*

0.17 0.54*

0.11 0.31*

0.09 0.42*

20.11 0.16

* p , .001. ** p , .005.

by the fact that delinquents have limited opportunity to express their negative feeling outwardly when situation is a correction environment. It is also possible that the restricted range of scores in the delinquent group (most subjects were likely to have high levels of anger and aggression) may have affected the magnitude and pattern of correlations. Surprisingly, the level of correlations between problems and aggression scores in the control group in general was statistically more pronounced, whereas the levels of problems and aggression scores were lower, compared to the delinquent group. So far, we cannot offer an explanation of this finding. The obtained relationships between aggressive and delinquent behavior and physical

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TABLE 3. Multiple Regression Analyses with Problem Scores as Dependent Variables and Aggression Subtraits as Independent Variables in Delinquents and Controls Significant Variables in Equation (R2/b/p) Delinquents Withdrawn Somatic Complaints Anxious/Depressed Social Problems Thought Problems Attention Problems Delinquent Behavior Aggressive Behavior

Internalizing

H (0.11/0.36/0.000) PhA (0.11/20.21/0.005) — H (0.08/0.28/0.000) PhA (0.08/20.21/0.007) H (0.05/0.24/0.002) PhA (0.05/20.17/0.025) H (0.07/0.26/0.000) H (0.06/0.25/0.001) PhA (0.04/0.19/0.008) PhA (0.08/0.28/0.000)

Externalizing

H (0.10/0.31/0.000) PhA (0.10/20.24/0.002) PhA (0.07/0.27/0.000)

Total Problems

H (0.03/0.17/0.017)

Controls H (0.06/0.24/0.008) A (0.06/0.25/0.006) A (0.15/0.39/0.000) H (0.13/0.37/0.000) A (0.16/0.40/0.000) A (0.18/0.42/0.000) PhA (0.24/0.49/0.000) PhA (0.51/0.34/0.001) A (0.51/0.33/0.001) VA (0.51/0.19/0.025) A (0.12/0.35/0.000) PhA (0.47/0.43/0.000) A (0.47/0.34/0.000) A (0.29/0.54/0.000)

Abbreviations: H 5 hostility; A 5 anger; VA 5 Verbal Aggression; PhA 5 physical aggression.

aggression were expected, since they measure the same construct and are not conceptually distinct. However, the lack of relationships between hostility and delinquent/aggressive behavior was somewhat surprising and possibly may imply that the latter types of behavior do not have negative cognitions as a basis. Further, the absence of any relationships between verbal/physical aggression and psychological problems was also interesting. Our results of significant correlations between hostility and anger (i.e., cognitive and emotional subtraits of aggression) on one side, and most of the problems on the other, may confirm our suggestion of a possible pathway of expressing behavior. Correspondingly, the established relationship between anger, verbal and physical aggression (i.e., emotional and behavioral subtraits of aggression) on the one hand, and aggressive and delinquent behavior on the other, offers an alternative way for excitation to be expressed, which is unrelated to psychosomatic pathology. These relationships were further substantiated by multiple regression analyses, implying that being expressed as aggressive behavior, excitation does not follow a pathological pathway, (i.e., does not produce psychological and somatic complaints). These findings are partly supported by Perris et al. (1983), who, in their study of depressive patients, found depressive symptoms positively correlated with covert aggression, whereas psychic anxiety negatively correlated with overt aggression. Consequently, they suggested that overt aggression might be considered as a possible adaptive mechanism for coping with frustration and loss. As we suggested above, similar mechanisms might be functional concerning socially accepted behavior as well. “Channelled in the proper direction, human aggression is the force that enables a person to be healthfully self-assertive and independent and to achieve mastery of the environment and the self” (Blustein, 1996). According to our understanding, after the influence of any meaningful event, a state

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FIGURE 1. A model of the interactive relationship between cognition, emotion, and behavior in aggression.

of increased arousal occurs, which needs behavioral expression. If the individual’s threshold level for expressing behavior is high (e.g., due to personality factors), or if there are any obstacles to behavior (e.g., by circumstances), the increased excitation (by circuit reinforcement of cognitive mechanisms) finally might find another form for its expression and lead to various psychological and somatic problems. So far, excitation might be “channelled” in three ways, which often coexist or overlap each other: (a) by socially acceptable behavior (e.g., working hard, sports), (b) by aggressive behavior, and (c) by psychological and somatic pathology (Figure 1). Some authors (Bennet, 1991) questioned the idea that hostile feelings can be catharted from the psyche by playing football or other aggressive sports and even concluded that sport actually increases aggression. However, other findings (Begg et al., 1996) provide an opposite view and emphasize that although an individual’s high involvement in sport activities may be associated with a subsequent increase in delinquent behavior, team sport is not, thus, implying that sport activities should be properly structured. Probably, by providing some kind of tension reduction, the described pathways might become established patterns of behavior and even a way of life. Finally, they might result in the development of delinquent and aggressive, or neurotic, hypochondriacal, and related personality features. Contrary to other investigators (Kellner et al., 1985), and in spite of some possible influence of anxiety and depression, we would not consider the psychological symptoms per se as a cause of somatic symptoms. In our opinion, it is the interplay between cognitions (e.g., hostility) and basic emotions (e.g., anger) that result in both psychological and somatic symptoms. More explicitly, anxiety and depression symptoms may occur here as a result of a “treadmill” and provided that the stressful situation remains unresolved, intensify the emotional reaction and possibly result in somatization. We are well aware of the limitations of our study in terms of exclusively using selfrating scales in a cross-sectional study design. We also understand that the generalizability of the findings and proposed causal relationships might appear to be questionnable. A further methodological issue is that a relationship of neuroticism or negative affectivity to reporting of physical symptomatology is commonly observed. However, there are still doubts as to whether this reflects actual physical disease, and the evidence is often against this (Cohen & Williamson, 1991; Watson & Pennebaker, 1989). In order to elucidate these issues and possibly establish causal relationships between aggression and psychopathology, longitudinal studies seem imperative within an interactive framework of biological, cultural, and psychological variables.

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Acknowledgments—The project was in part supported by a scholarship from the Swedish Institute to Dr. Ruchkin and a grant from the East-European Committee at Umea˚ University to Dr. Eisemann.

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