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Psychopathology, trauma and delinquency: subtypes of aggression and their relevance for understanding young offenders

Hans Steiner1*, Melissa Silverman1, Niranjan S Karnik2, Julia Huemer3, Belinda Plattner4, Christina E Clark5, James R Blair6 and Rudy Haapanen7

Author Affiliations

1 Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, 401 Quarry Road, Stanford, California, 94305, USA

2 University of Chicago, Department of Psychiatry & Behavioral Neuroscience, Chicago, Illinois, USA

3 Medical University of Vienna, Department of Child and Adolescent Psychiatry, Vienna, Austria

4 Kinder- und Jugendpsychiatrischer Dienst des Kantons Zürich, Zürich, Switzerland

5 University of Washington, Seattle, Washington, USA

6 National Institute of Mental Health, Washington, District of Columbia, USA

7 University of California, Davis, California, USA

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Child and Adolescent Psychiatry and Mental Health 2011, 5:21  doi:10.1186/1753-2000-5-21

Published: 29 June 2011



To examine the implications of an ontology of aggressive behavior which divides aggression into reactive, affective, defensive, impulsive (RADI) or "emotionally hot"; and planned, instrumental, predatory (PIP) or "emotionally cold." Recent epidemiological, criminological, clinical and neuroscience studies converge to support a connection between emotional and trauma related psychopathology and disturbances in the emotions, self-regulation and aggressive behavior which has important implications for diagnosis and treatment, especially for delinquent populations.


Selective review of preclinical and clinical studies in normal, clinical and delinquent populations.


In delinquent populations we observe an increase in psychopathology, and especially trauma related psychopathology which impacts emotions and self-regulation in a manner that hotly emotionally charged acts of aggression become more likely. The identification of these disturbances can be supported by findings in cognitive neuroscience. These hot aggressive acts can be delineated from planned or emotionally cold aggression.


Our findings support a typology of diagnostic labels for disruptive behaviors, such as conduct disorder and oppositional defiant disorder, as it appears that these acts of hot emotional aggression are a legitimate target for psychopharmacological and other trauma specific interventions. The identification of this subtype of disruptive behavior disorders leads to more specific clinical interventions which in turn promise to improve hitherto unimpressive treatment outcomes of delinquents and patients with disruptive behavior.