• Anger is an emotional response, which can be expressed in a healthy manner to solve problems or dysfunctional way.
• Psychotherapy, behavioral modification, and pharmacotherapy may be used for treatment of aggression or violent behavior.
• A conduct disorder is a repetitive and persistent pattern whereby the child violates the basic rights of others.
• A client’s response to a situation may be expressed by aggression, a behavior that is intended to threaten or injure the victim’s security or self-esteem.

Risk Factors

1. Modeling role: Primary caretakers are the earliest role models for management or mismanagement.
2. Operant conditioning: This is the act of positive or negative reinforcement of a behavior.
3. Socioeconomic factors: Aggressive behavior is found more often in person’s living in conditions of poverty.
4. Environment factors: Factors that are associated with aggressive behaviors include physical crowding of people, discomfort associated with elevated environmental temperature, use of alcohol or drugs, and the availability of weapons with aggression used as a coping method.

Signs and Symptoms

• Intense distress
• Pacing
• Clenched fist
• Change in tone of voice and/or body posturing
• Threatening behavior
• Suicidal ideation
• Self-mutilation
• Substance abuse
• Paranoia
• Carrying a weapon

Nursing Diagnoses

• Anxiety
• Impaired verbal communication
• Impaired social interaction
• Social isolation
• Altered family responses
• Ineffective individual coping
• Self-esteem disturbance
• Personal identity disturbance
• Powerlessness
• Altered thought process
• Risk for violence
• Self-mutilation

Nursing Interventions

• Behavioral contract may be helpful by outlining the expectation and strategies to control aggression and prevent escalation of the behavior.
• Behavior modification and biofeedback focuses on biological response to anger.
• The client may require physical restraints or seclusion.
• Decreasing stimuli may assist client in controlling anger.
• Assist the client in identifying the triggers for his or her anger.
• Use appropriate physical activities as an outlet for anger control.
• Discuss with the client the difference between the appropriate and inappropriate anger and response to anger.
• Provide appropriate choices for the client providing some control for the client.
• De-escalate client with a calm voice. Avoid arguing and give client some choice.
• Document incidents in an objective manner, stating factual information only.
• Use consistent interventions.