Expanding contingency learning models of aggression in youth: Conceptual and methodological considerations to enhance clinical utility

Abstract

Aggression in youth is a transdiagnostic indicator that permeates nearly all psychiatric disorders and is one of the most common reasons for mental health referrals. Contingency learning theories provide a framework for conceptualizing factors that elicit (antecedents) and maintain aggressive (consequences) behavior. For decades, theoretical and etiological models of aggression have emphasized individual differences in neurobiological reactivity during contingency learning as predictors of aggression in youth. However, our ability to predict precisely when aggression will occur and why aggression persists over time remains limited, ultimately hindering our capacity to tailor and personalize interventions to maximize effectiveness. The current review summarizes research examining individual differences in neurobiological reactivity during stimulus-response (antecedents) and response-outcome (consequences) contingencies as predictors of aggression in youth. It then offers concrete recommendations for expansions of this work with an eye toward optimizing the prediction of aggression via the identification of proximal individual- and dyad-level antecedents and consequences. These include conceptual considerations such as examining aggression as a transdiagnostic construct, considering alternative internal and external antecedents and consequences of aggression, and explicating aggression within the dyadic context. Additionally, recommendations for methodological advancements are presented, including enhancing ecological validity of study designs, incorporating ambulatory assessments, and utilizing advanced analytic approaches that allow us to empirically test and identify proximal antecedents and consequences of aggression. Finally, we discuss how these advancements have the potential to increase the precision of intervention efforts to reduce aggression by creating a framework for systematically mapping within-individual and within-dyad processes that elicit and maintain aggressive behavior over time.