Multiple definitions of aggression have been proposed by social scientists (Baron and Richardson, 1994). This reflects both the diverging views regarding the nature and determinants of ag-gressive behavior and the social norms that provide a context for evaluating whether or not an aggressive behavior is socially sanc-tioned. For this discussion, aggressive action is defined as any verbal or physical behavior or set of behaviors emitted with the intention to harm or damage someone or something. Biological, affective, social cognitive, social learning, personality and socio-cultural influences on aggressive behavior are reviewed here in the table (Table 17.9).
Aggressive behavior has implications both for overall public health and individual health. For instance, aggression as it relates to interpersonal violence has obvious public health im-plications. One clear example of this is family violence, which threatens the physical health and lives of those toward whom this behavior is directed. At the individual level, anger and hostil-ity, which play some role in aggression (though are distinct from aggressive behavior), have been associated with specific health effects. The most well-known example is research showing in-creased risk of subsequent coronary heart disease in individu-als with high levels of anger and hostility (Salovey et al., 1998; Contrada et al., 1999). Hypothesized mechanisms for these health effects include psychophysiological processes (e.g., blood
pressure, stress hormone secretion, heart rate), health-compro-mising lifestyle patterns (e.g., poor self-care, cigarette smoking, limited exercise), and reactions to illness (e.g., compromises in adherence to medical treatment).
Multiple clinical techniques have been developed for helping individuals effectively modulate and manage aggres-sion. These include exploring interpersonal patterns in which aggression arises, teaching cognitive restructuring techniques to address attribution processes (e.g., hostile attribution bias) that make aggressive behavior more likely to occur, employ-ing family therapy approaches (e.g., functional family therapy; Alexander et al., 1990) and parent management training, and utilizing cognitive–behavioral therapy techniques (e.g., problem-solving skills training, social skills training and aggression-re-lated reinforcement contingencies). These techniques may be used individually or in combination, depending upon the clini-cal indications derived from a multidimensional assessment of factors contributing to aggressive behavior. Where indicated, addressing the role of psychoactive substance use in aggressive behavior is also important, given research suggesting that use of substances such as alcohol can be an antecedent to aggression (Baron and Richardson, 1994)