Program Details

Presentations

Opening Remarks by the Past President of AACAP: The Trouble With Outbursts
Gabrielle A. Carlson, MD
Stony Brook University, East Setauket, NY

Aggression as a Transdiagnostic Symptom: Oppositional Defiant Disorder, Intermittent Explosive Disorder, and Aggression Unspecified
James J. McGough, MD
University of California, Los Angeles, Los Angeles, CA
Learn the classification of types of aggression that occur across several psychiatric disorders, describe psychosocial approaches to management of aggressive symptoms, and examine evidence-based strategies for addressing aggressive symptoms occurring in oppositional defiant disorder, intermittent explosive disorder, and disruptive mood dysregulation disorder.

Ticked Off!! Explosive Outbursts in Tics/Tourette's Disorder
Barbara J. Coffey, MD, MS
University of Miami, Miami, FL
In this presentation, find out about how excessive anger and aggressive symptoms have been reported in 25-70% of individuals with Tourette’s disorder worldwide in both clinical and community samples. In clinical samples, explosive outbursts are among the most difficult symptoms to treat. Symptoms range in intensity from persistent angry verbal outbursts and intense argumentativeness to severe verbal or physical outbursts. There is a lack of research on treatment of explosive outbursts in Tourette’s disorder, but behavioral intervention and pharmacotherapy should be considered. There is some data to suggest anger control behavioral training may be helpful. For pharmacotherapy, since comorbid ADHD is likely, pharmacotherapy to address ADHD symptoms is a reasonable first line medication. As OCD symptoms are also likely, another option is to consider an SSRI. Mood disorder symptoms may also be present, so an SSRI can be helpful here as well, but there is limited data to suggest that neuroleptics may ameliorate both tics and explosive outbursts.

An Update on Management of Impulsive Aggression in Children With Attention-Deficit/Hyperactivity Disorder
Raman Baweja, MD, MS
Penn State College of Medicine, Hershey, PA
Around 50% of children with ADHD with appreciable impulsivity present with clinically significant impulsive aggression. This presentation describes the most common reason for the initial referral for mental health evaluation and focuses on the assessment and management of impulsive aggression in children with ADHD.

Clinical Approach to the Treatment of Pediatric Depression
Leslie R. Miller, MD
Johns Hopkins University, Baltimore, MD
Depression is a common and important public health challenge during adolescence, where more than 10% of youth will experience a depressive episode prior to age 18 years. While just over half of affected youth will be offered treatment, only a small fraction receive depression specific treatments meeting existing care standards. With an average episode length of 27 weeks, depression is an important remediable risk factor for suicide, the 2nd leading cause of death in adolescents and young adults. Dr. Leslie Miller discusses best practices in the treatment of adolescent depression, focusing on evidence-based pharmacologic interventions and on approaches to treatment resistant depression, and information on impulsive aggression and depression.

Advanced Psychopharmacology for Pediatric Anxiety Disorders
Jeffrey R. Strawn, MD
University of Cincinnati, Cincinnati, OH
This presentation focuses on anxiety disorders in pediatric patients and specifically on pharmacologic treatments. Learn about the differences in treatment response and medication tolerability as well as predictors of treatment response.

Pharmacogenetics of Second-Generation Antipsychotics and Mood Stabilizer Medications
Laura B. Ramsey, PhD
Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
Find out how pharmacogenetics influences tolerability to second generation antipsychotics and mood stabilizing medications. The presentation focuses on the influence of CYP2D6 on risperidone and aripiprazole tolerability in youth, as well as the association of HLA genes with hypersensitivity reactions to carbamazepine and oxcarbazepine.

Psychopharmacologic Approaches in Autism
Jean A. Frazier, MD
University of Massachusetts Chan Medical School, Worcester, MA
Learn what the updates are regarding the use of medications to treat various symptoms and psychiatric comorbidities in youth autism spectrum disorder (ASD). A key focus is on evidence-based practices and on the treatment of aggression in those with ASD.
 

Addressing Impulsivity and Aggression in Adolescents With Substance Use Disorders
Timothy E. Wilens, MD
Massachusetts General Hospital, Boston, MA
Come learn about the basic comorbidity of impulsivity and/or aggression in SUD and the pharmacological treatment strategies for managing youth with SUD and impulsivity, aggression, or severe mood dysregulation.

Treating Aggression in Early Onset Schizophrenia and Bipolar Disorder
Manpreet K. Singh, MD, MS
Stanford University, Stanford, CA
Learn how dopamine antagonists or partial agonists and other pharmacological treatments may be used to manage aggression in patients with early onset psychotic or bipolar disorders. Limiting the duration of untreated psychosis or mania by initiating pharmacological treatment early along with psychotherapeutic and educational interventions can improve functioning and prevent relapse. When selecting an appropriate treatment, clinicians must weigh the benefits of symptom improvement with the potential adverse effects of available treatments such as sedation, akathisia, weight gain, and dyslipidemia. These risk-benefit discussions are critical given widespread trial-and-error prescribing in the absence of comparative effectiveness trials or biomarkers for personalization.

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