From causes of aggression to interventions: The importance of context

This chapter reviews several strands from recent research concerning the causes of aggression, including neurological and psychosocial factors. There is some support for the commonly held assumptions linking aggressiveness and social-cognitive problems associated with people’s cognitive deficits. However, this explanation fails to account for the fact that most people with intellectual disabilities are not aggressive. There is a significant danger in simplifying the aggressive behavior of people with intellectual disabilities to a single causative factor. Even if one factor was found to predispose an individual to be aggressive, it is improbable that the other aspects of a person’s life (such as the social and environmental context in which they live) would not also influence the individual’s actions. Moreover, there are different kinds of aggression, including acts that are categorized as reactive and instrumental or planned. An interaction of cognitive, communicative, genetic, and sociocultural factors may influence aggressive behavior. However, aggression is usually a social act and concerns the dynamic relationship between the person and his or her social environment. This means taking seriously how more able people negotiate their social identities in the world and how those with more significant impairments communicate their needs and wishes. Although there is limited evidence for the effectiveness of pharmacological treatments, there are promising findings for the use of behavioral approaches for people with more severe impairments and anger management treatments for those with milder disabilities. In addition to individual interventions, recent attempts have also been made to foster positive change in individuals’ wider lives. It is proposed that promoting a formulation-based approach to interventions might help professionals to take account of the range of intrapsychic and interpersonal factors that can contribute to the person’s difficulties.