Omega-3 (ω-3) and social skills interventions for reactive aggression and childhood externalizing behavior problems : a randomized, stratified, double-blind, placebo-controlled, factorial trial

• Main Authors: Raine, Adrian, Ang, Rebecca P., Choy, Olivia, Hibbeln, Joseph R., Ho, Ringo Moon-Ho, Lim, Choon Guan, Lim-Ashworth, Nikki S. J., Ling, Shichun, Liu, Jean C. J., Ooi, Yoon Phaik, Tan, Yi Ren, Fung, Daniel S. S.
• Other Authors: School of Social Sciences
• Format: Article
• Language: English
• Published: 2020
• Subjects: Social sciences::Psychology; Antisocial Behavior; Nutrition
• Online Access: https://hdl.handle.net/10356/144791
• Institution: Nanyang Technological University

Background: While studies suggest that nutritional supplementation may reduce aggressive behavior in children, few have examined their effects on specific forms of aggression. This study tests the primary hypothesis that omega-3 (ω-3), both alone and in conjunction with social skills training, will have particular post-treatment efficacy for reducing childhood reactive aggression relative to baseline. Methods: In this randomized, double-blind, stratified, placebo-controlled, factorial trial, a clinical sample of 282 children with externalizing behavior aged 7–16 years was randomized into ω-3 only, social skills only, ω-3 + social skills, and placebo control groups. Treatment duration was 6 months. The primary outcome measure was reactive aggression collected at 0, 3, 6, 9, and 12 months, with antisocial behavior as a secondary outcome. Results: Children in the ω-3-only group showed a short-term reduction (at 3 and 6 months) in self-report reactive aggression, and also a short-term reduction in overall antisocial behavior. Sensitivity analyses and a robustness check replicated significant interaction effects. Effect sizes (d) were small, ranging from 0.17 to 0.31. Conclusions: Findings provide some initial support for the efficacy of ω-3 in reducing reactive aggression over and above standard care (medication and parent training), but yield only preliminary and limited support for the efficacy of ω-3 in reducing overall externalizing behavior in children. Future studies could test further whether ω-3 shows promise in reducing more reactive, impulsive forms of aggression.