Social goals and conflict strategies of individuals with mild to moderate intellectual disabilities who present problems of aggression

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Social goals and conflict strategies of individuals withmild to moderate intellectual disabilities who presentproblems of aggression

C. Pert & A. Jahoda

Department of Psychological Medicine, University of Glasgow, Scotland

Abstract

Background A few recent studies have adopted asocial cognitive perspective to explore how individu-als with intellectual disabilities (IDs), who presentproblems of aggression, view their social world. Thefocus has mainly been on participants’ perceptionsof others’ behaviour within conflict situations. Thepresent exploratory study aims to compliment exist-ing research by exploring social cognitive factorsthat may influence how individuals respond toconflict.Methods Study was carried out with 20 aggressiveand 20 non-aggressive men and women who have amild to moderate ID.The ‘Social Goals and Strate-gies for Conflict’ (SGASC) assessment was devisedto explore whether group or gender differencescould be found in participants’ expected outcomesof aggressive strategies, their expected outcomes ofsubmissive strategies and their emotional reaction tothese outcomes. Participants’ social goals withinhypothetical situations of conflict were also explored.Results It was found that aggressive and non-aggressive participants have different social goals.

There were no significant differences for expectedoutcomes of aggression or submissiveness. Never-theless, a number of trends suggest that moreaggressive participants expect negative outcomes forsubmissiveness compared with their non-aggressivepeers.Conclusions While the findings of this study aretentative, investigating the social outcomes that arevalued by individuals with ID who present prob-lems of aggression appears to be a promising areafor further research, with possible implications forclinical assessment and treatment.

Keywords aggression, conflict strategies,intellectual disability, social cognition, social goals,submissiveness

Introduction

With the growing use of cognitive-behavioural inter-ventions for people who have an intellectual disabil-ity (ID) and anger problems (Willner et al. 2002;Beail, 2003; Willner 2005; Taylor et al. 2002, 2005;MacMahon et al. 2006), there is a need to under-stand the meaning this population assign to theirexperiences of interpersonal conflict ( Jahoda et al.2001). Recent studies have considered social cogni-tive causes of aggression for this client group, focus-ing mainly on participants’ interpretation of others’

Correspondence: Carol Pert, Department of Psychological Medi-cine, University of Glasgow, Gartnavel Royal Hospital, 1055 GreatWestern Road, Glasgow, Scotland G12 OXH (e-mail: [email protected]).

Journal of Intellectual Disability Research doi: 10.1111/j.1365-2788.2007.01039.x

volume 52 part 5 pp 393–403 may 2008393

© 2008 The Authors. Journal Compilation © 2008 Blackwell Publishing Ltd

intentions and behaviour towards themselves withinhostile situations (Pert et al. 1999; Jahoda et al.1998; Jahoda et al. 2006). These studies have pro-vided some evidence that interpersonal perceptionscan contribute to aggressiveness within this clientgroup.Yet, no studies to date have considered howindividuals with an ID view their own actionswithin conflict situations or what outcomes theyaim to achieve through their actions.

A range of studies have explored the outcomesthat aggressive children expect from aggression.Slaby & Guerra (1988) found that aggressive chil-dren had more favourable beliefs surroundingaggression. Perry et al. (1986) examined children’sbeliefs about pre-defined outcomes of aggressionthat Bandura (1973) had found to be reinforcing foraggressiveness. These outcomes included peerapproval; authority approval; self-condemnation;instrumental reward; reducing future hostility andeffect on victim. Perry et al. (1986) found thataggressive children were more likely than their non-aggressive peers to believe that aggression wouldlead to tangible rewards and the reduction of aver-sive treatment towards themselves in the future.

From a social learning perspective, considerationof outcomes aggressive individuals may seek toavoid could further our understanding of whyaggressive individuals behave as they do. It may bereasonable to assume that some aggressive individu-als could expect submissive responses to lead tooutcomes they wish to avoid, such as being seen asweak. This in turn may influence their behaviour.Given common experiences of powerlessness andlow control it could be argued that individuals withIDs may resist a position of submissiveness.Yet, nostudies to date have considered whether differencesexist in aggressive and non-aggressive individuals’views of submissiveness.

Another significant limitation of the existingresearch literature is that most studies looking atoutcome expectancies fail to consider the valueindividuals place on predicted outcomes of aggres-sion. Boldizar et al. (1989) found some evidencethat aggressive children placed less value than non-aggressive children on some of the negative out-comes expected of aggression including peerrejection, retaliation of the victim and negative self-evaluation. Those outcomes that are valued byaggressive individuals may be reflected in the social

goals that guide their behaviour. To date there hasbeen a lack of research exploring the social goals ofindividuals who have an ID. Rose & Asher (1999)argue that in order to support individuals to estab-lish and maintain friendships, attention should begiven to their social goals as well as their behav-ioural strategies. Renshaw & Asher (1983) point outthat one limitation of the existing studies concern-ing social goals is that the focus is mainly on par-ticipants’ ability to successfully identify strategies tomeet pro-social goals such as staying out of trouble.Yet, whether or not aggressive individuals under-stand how to stay out of trouble tells us little aboutthe social goals that guide their behaviour in reallife situations (Ladd & Olden 1979; Asher et al.1980; Slaby & Guerra 1988).

A number of studies carried out with childrenhave shown that boys expect greater benefits fromaggression than girls. Perry et al. (1986) found thatboys expect aggression to lead to more tangiblerewards, less victim suffering, less peer disapprovaland less guilt than do girls. In keeping with thesefindings, Perry et al. (1989) showed that boys expectless parental disapproval and less guilt to followaggression. Campbell et al. (1985) found gender dif-ferences in the social representations held regardingaggression. They analysed the social talk of menand women and found that women described epi-sodes of their own anger and aggression as ‘losingcontrol’, viewing this as embarrassing or childishand voicing concern that their actions may threatentheir relationships with those involved. In contrast,men often described their own aggression as result-ing from an integrity affront, viewing aggression asa face saving strategy. Moreover, men frequentlyspoke of elation after a good fight with less evidenceof self-condemnation. Given the evidence of genderdifferences in the meaning individuals attach toaggression it is surprising that most studies arecarried out solely with men.

In order to address the absence of research aboutpeople with IDs’ beliefs regarding the outcomes ofaggressive and submissive strategies, this studyaimed to identify whether there are differences inaggressive and non-aggressive participants’ viewsand their emotional responses to these outcomes.Differences in the social goals aggressive and non-aggressive participants’ wish to achieve in situationsof interpersonal conflict were also explored. Lastly,

394Journal of Intellectual Disability Research volume 52 part 5 may 2008

C. Pert & A. Jahoda • Social goals and conflict strategies


the strategies participants propose in order toachieve a range of anti-social and pro-social goalswere considered. Gender differences were also con-sidered with regard to the above aims.

Methods

Participants

This exploratory study was carried out with 20

aggressive and 20 non-aggressive individuals whohave a mild to moderate IDs. Each of the two groupsincluded 10 men and 10 women.Two participantsdropped out of the assessment owing to illness andanother two participants were recruited in theirplace.To ensure comparable levels of verbal andnon-verbal ability across the two groups the BritishPicture Vocabulary Scale II (BPVS II; Dunn & Dunn1997) and the Raven’s Coloured Progressive Matri-ces (RCPM; Raven 1965) were administered to thewhole sample. No differences were shown acrossgroup for BPVS scores (Mann Whitney U-test,Z = -1.394, P = 0.165) or for scores on the RCPM(Mann Whitney U-test, Z = -1.128, P = 0.265). Simi-larly, no differences were shown across gender:BPVS (Mann Whitney U-test, Z = -1.206,P = 0.232); RCPM (Mann Whitney U-test,Z = -0.515, P = 0.613). Scores are shown in Table 1.

The median ages and the age range of partici-pants in each group were very similar (MannWhitney U-test, Z = -0.615, P = 0.55, aggressivegroup = 20–52; non-aggressive group = 22–57;Males = 27–52; Females = 20–57).

Inclusion criteria

The participants who took part in this study wererecruited from a survey of 13 Adult Resource

Centres providing daytime activity for adults withIDs in the West of Scotland, one centre in CentralScotland, and three supported employment ser-vices run by a voluntary agency in Scotland. Theparticipants recruited for this study were a sub-sample of 89 participants, consisting of 46 non-aggressive and 43 aggressive individuals, who tookpart in a larger study. For this further study com-ponent, the first 20 aggressive and 20 non-aggressive participants who agreed to take partswere recruited. In each case, the data wereobtained from a staff member who had been thekey worker for the individual for a minimum of 3

months prior to data gathering. The participantswere required to be over 18 years of age and tohave sufficient receptive and expressive verbal skillsto complete the assessments. To ensure that par-ticipants had sufficient communicative ability thesurvey included assessment questions based on theVineland Adaptive Behaviour Scale (Sparrow et al.1984). An adaptation of Harris’s Checklist of Chal-lenging Behaviour by Harris et al. (1994) wasemployed to inform the selection of participants.The checklist provides strict behavioural definitionsof acts of aggression, thereby reducing the possibil-ity of identifying individuals on the basis of reputa-tion or perceived aggressiveness. Aggressiveparticipants were required to have presented aminimum of four episodes of significant aggressivebehaviour in the previous 3 months. Participants inthe non-aggressive group had presented no inci-dents of aggression. Individuals were not includedif their aggressive behaviour could be linked withproblems of autism, dual diagnosis, tourettes syn-drome or psychosis. Aggressive behaviour wasdefined as physical or verbal aggression that causedharm or the threat or risk of harm to others.

Table 1 British Picture Vocabulary Scale (BPVS) age equivalent and ravens IQ

Participants

BPVS age equivalence Ravens IQ score

Median Inter-quartile range Median Inter-quartile range

Aggressive 7.11 3.03 52.75 20Non-aggressive 6.09 4.92 60.75 18Males 7.06 2.22 55.75 17Females 7.08 4.24 57.5 18




Materials

Development and piloting

The Social Goals and Strategies for Conflict(SGASC) assessment is a novel measure developedfor this study, using coded responses to hypotheticalvignettes. The assessment explores social-cognitivefactors not previously researched with individualswho have an ID, and as such the piloting phase rep-resented an important element of the study, allow-ing the research questions and materials to beselected, developed and refined. Piloting was carriedout with a total of 20 individuals with an ID, con-sisting 12 men and eight women. Those individualswho took part in piloting were not included in thestudy proper. Participants in the piloting phase werenot distinguished with regard levels of aggression,rather the aim of piloting was to ensure the clarityand ecological validity of the language and visualstimuli used in the assessment and to ensure thatthe vignettes used in the study were viewed ashostile.

Physically aggressive strategies in response to conflict.In a first draft, participants were required toimagine themselves behaving in a physically aggres-sive manner in response to a hypothetical situationwhere someone treated them in a hostile fashion.Many participants appeared uncomfortable withthese items, e.g. stating ‘I wouldn’t hit him’, despiteprompting by the researcher to ‘just imagine’ behav-ing in this way. It was noted that participants gave ahigh number of ‘don’t know’ responses to itemsdepicting physically aggressive responses. Owing tothis it was decided to exclude the condition requir-ing participants to imagine themselves using physi-cally aggressive strategies and focus solely on verbalaggression.

Level of provocation and uniformity of vignettes. It wasimportant that participants accurately identified thevignettes as being hostile and provocative. In pilot-ing participants were asked whether they would feelangry if they were involved in a similar situationaccording to three options of ‘a wee bit angry/quitea bit angry/very angry’. The vignettes used wererated ‘very angry’ by most participants (16/20,17/20; 17/20). To maximise uniformity across

vignettes the same information points were writteninto each vignette. Each included informationregarding (1) context; (2) description of the pro-vocative event; and (3) emphasised the deliberateintent of the provocation. To ensure ecological andsocial validity care was taken to use settings andsituations familiar to people with a learning disabil-ity in the scenarios. The content of the vignetteswas influenced by those used in a previous studylooking at cognitive mediators of aggression withindividuals who have a learning disability (Pert et al.1999). Each story was illustrated with a series ofthree photographs to depict the stories. Twovignettes depicting hypothetical situations of inter-personal conflict were used as a basis for questionsregarding predicted outcomes of aggression andsubmissiveness. Two versions of each vignette weredrawn up – one depicting male characters and theother female characters. Participants were read thestory and asked to imagine themselves giving anaggressive response to one of these hostile situa-tions, and a submissive response to the other. Athird vignette was used to explore participants’social goals.

Procedure

The assessment was administered to participantsindividually. The researcher was blind to the partici-pants’ group. Two vignettes were randomly assignedas the aggressive or submissive scenes for each indi-vidual. These vignettes depicted (1) being unfairlyrefused a ticket for the college dance; and (2)someone pushing in front of you to take your chair.

Predicted outcomes of aggression

Participants were asked to imagine themselvesresponding in a verbally aggressive manner to thehypothetical hostile vignette that was read out tothe participant and illustrated by colour photo-graphs shown at the same time. A series of ques-tions were then asked, starting with an open-endedquestion ‘What would happen when you shouted atX?’ Forced choice questions were then askedregarding six predicted outcomes of (1) tangiblereward; (2) self-condemnation; (3) reduction ofaversion in the future; (4) effect on victim; (5) peerapproval; and (6) authority approval.




Predicted outcomes of submissiveness

The procedure was the same as in the aggressivecondition; however, the researcher asked partici-pants to imagine that they reacted in a submissiveway, stating: ‘Imagine that you feel really upset butyou don’t say anything and you don’t do anythingabout it.’ Questions regarding the ‘effect on victim’were not relevant to submissive behaviour and werenot included.

Coding of responses. Responses given to forced-choice questions about the expected outcomes ofaggression and submissiveness were coded into twocategories for each outcome as follows: (1) peerapproval/peer disapproval; (2) authority approval/authority disapproval; (3) tangible gain/no tangiblegain; (4) feel good about self/feel bad about self;and (5) victim upset/victim not upset.

The value placed on outcomes

Immediately following each question regarding pre-dicted outcomes, participants were asked to rate howthe anticipated outcome would make them feel. Anopen-ended question was asked first to reduce thepossibility of acquiescence. If the response given wasambiguous or unclear, participants were asked tochoose one of three options ‘good/not bothered/bad’.To aid understanding participants were shownphotos of two women with happy and sad facialexpressions to depict feeling good and feelingbad.

Coding of responses. Responses to questions regard-ing how participants would feel about the outcomesof aggression and submissiveness were coded as‘feel good, feel bad or not bothered’.

Social goals

In order to elicit participants’ salient goals withinsituations of conflict, a third hypothetical situationwas presented, again depicting the participant beingtreated in a hostile manner by a peer (someonestealing your drink). Participants were first asked topredict what they would do when being treated in ahostile manner and then asked why they would actin that way. A series of prompts guided people

towards giving a response related to their goals aspreviously described (e.g. Why would you do Xinstead of doing something else? Why did you thinkit is a good idea to do X? What were you trying todo when you did X?)

Strategies to meet pre-defined social goals

Participants’ ability to generate strategies to meetfive pre-defined goals within conflict situations wasexplored. These were: to avoid trouble; get back at theperson; show strength; maintain self-esteem; gain peerapproval. Participants were asked to say what strat-egy they would employ to achieve these goals. Toexplore participants’ ability to identify effectivesolutions to meet pre-defined goals they were askedto say whether they thought that (1) a verballyaggressive strategy; and (2) a submissive strategy,would meet each of the above goals. An either/orquestion format was used.

Coding of responses. Participants’ responses regard-ing salient goals were coded into categories of: seekrevenge; show strength; seek a fair outcome; avoid con-flict. Responses to questions regarding the behav-ioural strategies participants would employ to meetexplicit goals were coded into three categories ofpassive, assertive and aggressive. Strategies to meet apre-defined pro-social goal were coded by an inde-pendent blind rater as effective and ineffective. Par-ticipants’ responses for salient social goals werecategorised into four response categories: avoid con-flict; achieving a fair solution; show strength; revenge.The goal of ‘achieving a fair solution’ must beunderstood within the context of the hypotheticalvignette that was used as a basis for questionsregarding social goals. The goal of ‘revenge’ wasdefined as hostile behaviour that aimed to ‘get backat’ the other individual, using strategies that maycause distress or harm. The goal of ‘showingstrength’ was defined as a goal aiming to pushagainst others in order to achieve power or to avoidbeing seen as weak.

Reliability

All open-ended responses were second rated by ablind rater. Kappa coefficients carried out toexplore inter-rater reliability and showed a rating of




0.71 for salient social goals, 0.88 for behaviouralresponses and 0.88 for pre-defined social goals.

Results

As the data were categorical c2-tests were used.Fisher’s exact tests were used in cases where thecategorical data being analysed had lower than theexpected number of responses in any category. Asmore than 20% of nominal categories in the dataset contained less than the expected frequency ofresponses log-linear analysis could not be used. Twotailed tests are used throughout owing to theexploratory nature of the study. Multiple tests werecarried out in the analysis and as such a ‘P value’ of0.01 was adopted. As there was low internal consis-tency found across scenes 1 and 2 for the outcomesof aggression, total scores were not computed forquestions regarding expected outcomes. UsingSpearman’s Rho Correlations test, none of the sixpre-defined outcomes were found to be rated simi-larly across these two scenes. This is not a surpris-ing finding as it would be expected that the contextmight influence participants’ views regarding theappropriateness of aggression.

Comparing aggressive and non-aggressiveparticipants’ responses

Analysis of aggressive and non-aggressive partici-pants’ responses for predicted outcomes of aggres-

sion and submissiveness; feelings regardingoutcomes and social goals are described in thissection.

Expected outcomes of aggression and submissiveness

First, when questioned about their expected out-comes of aggression, no significant differences werefound in aggressive and non-aggressive participants’responses to either scene 1 or scene 2. When askedhow an aggressive response would impact on peeropinion and views of self, and whether aggressionwould reduce hostility from others, both aggressiveand non-aggressive participants’ anticipated asimilar spread of positive and negative outcomes.Most participants in each group anticipated author-ity disapproval and no instrumental reward for aggres-sion. For the outcomes of submissiveness, threetrends towards significance were found acrossaggressive and non-aggressive participants as shownin Table 2.

Table 2 above shows a strong trend in the find-ings for peer opinion, with more aggressive partici-pants expecting submissiveness to lead to peerdisapproval. Another trend suggests that more non-aggressive participants thought that submissivenesswould ‘reduce hostility from others’. Furthermore,when asked about the impact that submissivebehaviour may have on views of self, a trend suggeststhat more aggressive participants would feel badabout themselves if they behaved submissively.

Table 2 Predicted outcomes of submissivenes comparing aggressive (Agg) and non-aggressive (Non-Agg) participants

c2 analysisAgg n = 20, Non-Agg n = 20

Predicted outcomes ofaggressiveness

Predicted outcomes ofsubmissiveness

Peer opinion Sc 1 c2 = 0.400, d.f. = 1, P = 0.527 c2 = 6.465, d.f. = 1, P = 0.011 (t)Sc 2 c2 = 0.902, d.f. = 1, P = 0.342 c2 = 0.404, d.f. = 1, P = 0.525

Authority opinion Sc 1 c2 = 0.533, d.f. = 1, P = 0.465 c2 = 0.921, d.f. = 1, P = 0.337Sc 2 c2 = 0.143, d.f. = 1, P = 0.705 c2 = 0.440, d.f. = 1, P = 0.507

Reduce others hostility Sc 1 c2 = 0.404, d.f. = 1, P = 0.525 Fishers exact, P = 0.028 (t)Sc 2 c2 = 0.440, d.f. = 1, P = 0.507 Fishers exact, P = 0.077

View of self Sc 1 c2 = 0.960, d.f. = 1, P = 0.327 Fishers exact, P = 0.041 (t)Sc 2 c2 = 0.100, d.f. = 1, P = 0.752 c2 = 1.616, d.f. = 1, P = 0.204

Instrumental gain Sc 1 c2 = 0.143, d.f. = 1, P = 0.705 Fishers exact P = 1.000Sc 2 c2 = 0.440, d.f. = 1, P = 0.507 Fishers exact P = 1.000

Effect on victim Sc1 c2 = 0.476, d.f. = 1, P = 0.490 n/aSc2 c2 = 0.476, d.f. = 1, P = 0.490 n/a

(t) = trend towards significance.




How participants feel about the outcomes of aggressionand submissiveness

No differences were found across groups forresponses regarding how participants would feelabout outcomes of aggressive responding when theoverall number of responses for ‘feel good/notbothered/feel bad’ was considered. For feelingsregarding the outcomes of submissiveness a trendtowards significance was obtained with moreaggressive participants stating that they would ‘feelbad’ if the outcome failed to reduce others hostility(c2 = 0.404, d.f. = 2, P = 0.038).

Social goals

Figure 1 shows statistically significant differences inaggressive and non-aggressive participants’ socialgoals when dealing with hostility from others.

More aggressive participants said their goal wasto ‘show strength’ in order to avoid future maltreat-ment from others (c2 = 0.612, d.f. = 3, P = 0.006).aggressive participants’ remaining responses fell inthe categories of ‘achieving a fair outcome’ and‘revenge’. More non-aggressive participants wereconcerned with finding a fair solution. Notably, noaggressive participants gave a goal of ‘avoidingconflict’.

Pre-defined social goals

No differences were found in the strategies identi-fied by aggressive and non-aggressive participants tomeet pre-defined goals.

Table 3 shows that most participants in eachgroup gave a spread of passive, assertive and aggres-sive strategies for the goals of ‘peer approval’; ‘feelgood about self ’; and ‘show strength’. For the socialgoal ‘to get back at them’ most participants in bothgroups gave aggressive strategies. For the goal ‘stayout of trouble’ most participants in both groupsgave a passive strategy. Participants’ responsesregarding the goal ‘to stay out of trouble’ werefurther categorised according to the effectiveness or

Table 3 Social goals: comparing aggressive and non-aggressiveparticipants

Social goals c2 = analysis, n = 20

Feel good about self c2 = 0.157, d.f. = 2, P = 0.627.Peer approval c2 = 0.332, d.f. = 2, P = 0.116Show cannot mess me around c2 = 0.317, d.f. = 2, P = 0.133To get back at them c2 = 0.180, d.f. = 2, P = 0.540To stay out of trouble c2 = 0.244, d.f. = 2, P = 0.303

Figure 1 Social goals aggressive andnon-aggressive participants. ‘Miss’ meansmissing value.




ineffectiveness of the strategy chosen and no differ-ences were shown. Most participants in each groupwere able to generate effective strategies for thisgoal. The majority of participants in each groupgave a passive response of ‘just walk away’.

Predicted behaviour in the face of hostility

A significant difference was found between aggres-sive and non-aggressive participants’ responsesregarding their predicted behaviour in the face ofhostility.

Figure 2 shows that aggressive participants gavesignificantly more aggressive responses (c2 = 0.61,d.f .= 2, P < 0.001). Non-aggressive participantsgave mainly assertive responses indicating that theyshould not be viewed as submissive group despitetheir lack of aggression.

Gender comparisons

When male and female participants’ responses werecollapsed across both aggressive and non-aggressivegroups, no differences were found between theirexpected outcomes of aggressiveness and socialgoals. The only trend towards significance was inrelation to beliefs about submissiveness, with those

women who expected that submissiveness would failto ‘reduce hostility from others’ giving a more nega-tive emotional reaction (c2 = 0.414, d.f. = 2,P = 0.035).

Discussion

When aggressive and non-aggressive participantswere asked to imagine themselves behaving aggres-sively, both groups predicted aggressiveness wouldlead to similar outcomes. They also expected similaremotional reactions to these outcomes. A numberof trends pointed to aggressive participants havingmore negative expectations about the outcomes ofsubmissiveness, than their non-aggressive peers.While these trends must be interpreted withcaution, they suggest that further research ismerited. Significant differences in the social goalsheld by aggressive and non-aggressive participantssuggest that within hostile situations, most of thenon-aggressive participants wished to ‘achieve a fairoutcome’, while most aggressive participantswanted to ‘show strength’. One interpretation ofthis finding is that the aggressive participants wereconcerned with saving face or presenting themselves

Figure 2 Predicted behaviour in the faceof hostility: aggressive and non-aggressiveparticipants.




as being ‘strong’ in the face of conflict. Moreover,such goals may have been linked to the aggressiveparticipants’ wish to establish a position of interper-sonal power or to avoid a position of social vulner-ability. This is in keeping with social constructionisttheories of aggression that emphasises the interper-sonal function of aggression as a way of gainingsocial power (Tedeschi et al. 1977). From a cogni-tive perspective, it might be predicted that partici-pants whose social goal was to ‘show strength’ mayhave become especially vigilant to being demeanedin social situations. This fits with a well-replicatedfinding of Dodge & Frame’s (1982) study with chil-dren, showing that aggressive boys have a cognitivebias, tending to perceive others’ motives towardsthemselves as hostile.

Interestingly, despite this difference in salientgoals, no differences were found in the strategiesthat aggressive and non-aggressive participants gen-erated to meet five pre-defined goals that wereexplored in the assessment. Furthermore, no differ-ences were shown across group for the effectivenessof strategies generated to meet the pre-defined goalof ‘staying out of trouble’. Thus the differencefound in aggressive and non-aggressive participants’social goals cannot be attributed to an inability togenerate more socially acceptable responses. Bothgroups predicted mainly negative outcomes ofaggression, undermining the assumption thataggressive individuals with an ID are influenced bythe expectation of benefits of their aggression,although clearly this may be the case for some indi-viduals. Also, both groups anticipated that theywould ‘feel bad’ about negative outcomes of aggres-sion, which contradicts the argument that aggressiveparticipants may simply not care about the conse-quences of their behaviour.

Trends in the findings offer some indication thataggressive participants may hold more negativeviews of submissiveness. While this clearly requiresfurther research, if confirmed, this pattern of find-ings could suggest that aggressive participants arelikely to shun a social strategy of passivity, believingthat ‘doing nothing’ might lead to negative out-comes. Aggressive participants’ negative views ofsubmissiveness could lead them to establish forcefulsocial goals to avoid undesired outcomes. As previ-ously noted, it is reasonable to assume that indi-viduals with an ID may be particularly aware of the

negative outcomes of submissive behaviour owing tofrequent experiences of domination from others andexperiences of low interpersonal power. However,this explanation does not tell us why aggressive par-ticipants may have more negative views of submis-siveness than their non-aggressive peers, who arelikely to have similar experiences of low power. Toclarify this it would be useful to explore whetherdifferences exist in aggressive participants’ experi-ences of power as well as their expectations ofpower.

Lack of gender differences

No differences were found between male andfemale participants’ social goals, with a similarnumber of each holding goals of ‘showing themthey can’t mess me around’. This is in contrast tothe findings of research carried out with the non-intellectually disabled population, which has shownthat women are less likely to use aggression as aface saving strategy (Campbell et al. 1985). Nogender differences were shown in beliefs about theoutcomes of aggression either, or feelings aboutthese outcomes. This lack of gender differences is incontrast to widely evidenced findings of differencesin non-learning disabled men and women’s beliefsabout aggression, which point to men’s higherexpectation of instrumental reward for aggressionand women’s greater expectation of self-condemnation for aggression (Perry et al. 1989). Inthis study, both male and female participants wereshown to hold generally negative views of aggres-sion. Thus comparison of the findings of this studywith those of the above studies could mean thatmen with an ID expect less positive outcomes ofaggression than non-learning disabled men.However, this is clearly speculative as this study didnot explore differences in intellectually disabled andnon-disabled individuals.

Clinical implications

The need to assess the clients’ motivation to engagein therapy is widely acknowledged, with a particularfocus on the motivational component in anger man-agement treatment approaches (Novaco et al. 1997).The consideration of social goals may help tofurther clarify possible barriers to change. Where




aggression is motivated by social goals which aim to‘show strength’ in the face of hostility from others,individuals may be resistant to behavioural self-control strategies as these may conflict with theirdesire to present themselves as being ‘tough’. Nega-tive views of submissiveness may cause similarresistance to self-control strategies. With a greaterunderstanding of which social goals are importantto the individual, therapists can ensure that they donot fall into the trap of establishing treatment goalswhich conflict with the persons’ valued social out-comes, causing problems of engagement withtherapy. By focusing on the social goals that theindividual wishes to achieve from aggression, it maybe possible to establish more adaptive ways ofachieving those desired goals, or where appropriate,to shape maladaptive goals using cognitive strate-gies. When asked to generate strategies to meet pre-defined goals, no evidence was found thataggressive participants were less able to generate arange of passive and assertive strategies than theirnon-aggressive peers. This highlights that theaggressive group did not have a skills deficit, and assuch, while it may be appropriate to use a skillsteaching approach with some individuals who haveproblems of aggression, clinicians should notassume that this is an appropriate intervention forall individuals.

As well as highlighting the need for sound clini-cal formulations, these findings also underminesome common assumptions presented in the litera-ture regarding the causes of aggression for indi-viduals with an ID. Where aggression is motivatedby social goals, which aim to ‘show strength’ or to‘reduce hostility from others’, there may be a goodargument for using adapted cognitive interventionsthat explore how the person views themselveswithin their social world. Where aggressive indi-viduals believe that aggressive strategies help themachieve their social goals they may be unwilling tochange their behaviour.

Limitations and future research

A limitation of this study is the small sample sizeand a resulting lack of statistical power. For thisreason the findings should be viewed with caution.A larger study is required before clear conclusionsto be drawn. The SGASC assessment explores inci-

dents of reactive aggression, depicting hypotheticalsituations where the participant is at the receivingend of unfair treatment from others and respondsaggressively to the hostile act. It may be that par-ticipants would have identified more negative conse-quences for acts of proactive aggression. Also, theaggressive behaviour depicted in the SGASC assess-ment was limited to verbal aggression as discussedin the method section. Perhaps more differenceswould be shown across aggressive and non-aggressive participants, or across gender, for viewsregarding the outcomes of physical aggression. Thedecision to match the gender of characters in hypo-thetical scenarios with that of the participants mayalso be flawed. Perry et al. (1986) argued thathaving vignette characters of different gender formale and female participants means that theirresponses are not comparable. Thus it may havebeen preferable to question both male and femaleparticipants about hypothetical scenarios depictingmale characters.

Conclusions

The findings of this study suggest that broad clini-cal assessments that reflect the complex causalpathways that lead to aggression should be devel-oped for use with adults with an ID. Thoughtfulassessments that focus on the ‘person’ rather thanthe ‘problem’ will enhance clinical formulations andguide effective interventions. In particular, assess-ments that take account of the interpersonalcontext of aggression, identifying the social out-comes that individuals with problems of aggressionvalue, as well as those social outcomes that theymight seek to avoid, may lead to more effectiveclinical interventions.

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Accepted 13 December 2007




Documents

Social goals and conflict strategies of individuals with mild to moderate intellectual disabilities who present problems of aggression