Hidden Hate, Hidden Violence: Dismantling Myths and Identifying Fresh Challenges for Research and Policy.

Hate crime has become an increasingly familiar term within global scholarship, with advancements in conceptual understanding and empirical knowledge helping to generate improved policy responses across many parts of the world. However, the continued demonization of 'other' identities, the escalating volume of hate incidents worldwide and the prevailing climate of rising tensions, decreasing resources and political de-prioritization all suggest that many urgent challenges remain. Contributors to this special issue have dismantled common stereotypes and misperceptions which hamper our collective capacity to address contemporary expressions of hate and violence. In doing so, they draw from their research evidence to identify "hidden" challenges which should be at the forefront of attempts to address the causes, effects, and prevention of all forms of violence. This call for reconfiguration is the unifying theme which runs through each article, and which paves the way for more nuanced analyses that offer new frameworks for responding to the diverse and changing patterns of violence. These are challenges which straddle disciplinary boundaries, geographical borders, and the physical/digital world, and which demand the international, intersectional, and interdisciplinary perspectives evident within this special issue.

Beyond the Binary: The Issue of Intra-Minority Hostility and the Need to Challenge Conventional Victim/Perpetrator Frameworks Within Hate Studies.

It is well-established within the hate studies literature that the majority of hate crimes and incidents of targeted hostility are perpetrated by those in the "majority" society. In the UK, academic and official research consistently shows that young White, British males are most commonly the culprits of all forms of targeted victimization, especially racist hate. However, urban areas of "super-diversity" offer researchers an opportunity to understand hate crime victimization and perpetration in a more nuanced and comprehensive way. Hate studies research has slowly begun to highlight instances of people from marginalized and stigmatized groups being targeted on the basis of their identity by individuals who are also members of minority groups, sometimes even the same minority group as the victim. Very little is understood about this particular victimizing dynamic other than it appears to be an attempt by minority group members to "fit in" by adopting what they perceive to be majority group values and attitudes. By drawing from 44 qualitative in-depth interviews exploring the experiences of new migrants and refugees and observations from 20 months of grassroots engagement, this article challenges established theories of "othering" that overwhelmingly refer to binary, static majority/minority tensions. The stories of these too-often "hidden" victims of targeted hostility offer a fresh perspective on the relationships between victims of hate and perpetrators. The article also contributes new explanations as to why those who are often targeted go on to target others.

The Hostile Hospital: Exploring Hospitality, Violence, and the Doctor-Patient Relationship.

Lévinas and Derrida speak of the ontological context of human relationships in the context of the absolute priority of the Other and the unconditional law of hospitality. This has direct implications for doctor-patient relationships in the context of health care. This paper explores these philosophical and practical implications in light of a paradox that exists in all hospitality: that hostility is inevitably intertwined with hospitality. The paper explores three ways hostility can present in doctor-patient relationships: in physical violence, through paternalism, and through the violence of categorisation. While acknowledging the paradox, and the complexity of solutions, the paper considers ways to minimize this hostility. In so doing, it encourages HCPs to overcome whatever is possible so as to do the impossible: provide unconditional hospitality.

Predicting hostility towards women: incel-related factors in a general sample of men.

Hostility towards women is a type of prejudice that can have adverse effects on women and society, but research on predictors of men's hostility towards women is limited. The present study primarily introduced predictors associated with misogynist involuntary celibates (incels), and then investigated whether loneliness, rejection, attractiveness, number of romantic and sexual partners, right-wing authoritarianism, and gaming predicted hostility towards women among a more general sample of men. A total of 473 men (aged 18-35, single, heterosexual, UK residents) recruited via Prolific answered the hostile sexism subscale, the misogyny scale, the self-perceived sexual attractiveness scale, the right-wing authoritarianism scale, the game addiction scale for adolescents, the adult rejection-sensitivity scale, the UCLA loneliness scale, and self-developed questions regarding number of sexual and romantic partners, and time spent gaming. We found a strong positive relationship between right-wing authoritarianism and hostility towards women, as well as a strong convex curvilinear relationship between attractiveness and hostility towards women. The number of sexual partners showed a moderate concave relationship with hostility towards women. We did not find sufficient support for a relationship between gaming and hostility towards women, and there was no support that loneliness, rejection, or romantic partners predicted hostility towards women among a general sample of men. Our study supports right-wing authoritarianism and self-perceived attractiveness as potential strong predictors in understanding men's hostility towards women in the wider community. Pre-registration: https://osf.io/ms3a4.

Integrating the family stress model within a longitudinal sibling-adoption study of adolescent externalizing behavior.

Using a sample of linked adopted children, adoptive and birth parents (N = 561), and biological siblings residing in the birth parent home (N = 191), we examined the role of genetics within family stress processes. We tested parental hostility (7 years) as a mediator of the associations between socioeconomic strain and rearing parent psychopathology (4 years) and adolescent externalizing behaviors (11 years) in adoptive and biological parent homes. Next, we examined parent social support (4 years) as a moderator of paths from socioeconomic strain and parent psychopathology to parental hostility. Parental hostility significantly mediated effects of socioeconomic strain and parent psychopathology on adolescent externalizing behaviors in biological and adoptive parent homes, respectively. Equivalence testing of the paths to adolescent externalizing behaviors across family types indicated a negligible role of passive gene-environment correlation. Parent social support significantly attenuated the effect of parent psychopathology on parental hostility in biological families. Birth parent externalizing behaviors were not significantly associated with adoptee externalizing behaviors nor adoptive parent hostility, suggesting negligible heritable risk or evocative gene-environment processes. Full- and half-sibling correlations indicated that children's unique rearing contexts contributed to the parenting they received and the externalizing behavior they exhibited. Implications for intervention are discussed.

How do victims of bullying develop depression? Testing interpersonal style to explain the victimization-depression link.

This study tested to what extent the relation between bullying victimization and future symptoms of depression could be explained by victims being more hostile and less assertive than non-involved individuals. Data came from waves 2-4 of the Dutch TRacking Adolescents' Individual Lives Survey (TRAILS). Participants' bullying experiences were assessed at age 13, interpersonal style at age 16, and depression symptoms at age 19. Mediation analyses were performed primarily on 274 self-reported victims and 1498 non-involved peers. Self-reported victims had an increased risk for depression symptoms. About a third of that risk could be explained by victims' hostile style, which was also higher than those of non-involved peers. Although victims also reported lower levels of assertiveness than non-involved peers, this interpersonal style did not mediate the link between bullying victimization and depression. Our findings suggest that high hostility, but not low assertiveness, partly explains the increased depression risk of self-reported victims. Therefore, interventions could focus on addressing hostility, to help reduce the likelihood that adolescents who have experienced bullying victimization will have more interpersonal conflicts and mental health problems in the future. Supplementary materials also include analyses for bullies and bully-victims, and for peer-reported measures.

Understanding Shame-Driven Aggression: The Roles of Externalization of Blame and Hostility in Chinese Adolescents.

Background: Shame-proneness, particularly in adolescence, is a critical psychological construct linked to aggressive behavior. This study addresses the gap in understanding the specific mechanisms of this relationship within the cultural context of Chinese adolescents. Aim: The study aims to explore the mediating roles of hostility and externalization of blame in the connection between shame-proneness and aggression among Chinese adolescents. Methods: A comprehensive sample of 1489 Chinese adolescents participated in the study. They completed the Test of Self-Conscious Affect for Adolescents to assess shame-proneness and an aggression questionnaire to measure aggressive behaviors. The study utilized network analysis and mediational analysis, to unravel the complex interactions between shame-proneness, externalization of blame, hostility, anger, and aggression. Results: The results identified two distinct pathways linking shame-proneness to aggression: one mediated by hostility and the other by externalization of blame. The pathway via hostility was particularly pronounced, marking it as a central node in the shame-aggression relationship. Interestingly, the study also revealed a direct, though less pronounced, inhibitory effect of shame-proneness on aggression, indicating a dualistic role of shame in adolescent behavior. These findings were consistent across different demographic subgroups, suggesting a generalizable pattern in the studied population. Conclusion: The dual nature of shame-proneness, as both an inhibitor and a facilitator of aggression, underscores the need for culturally sensitive approaches in psychological interventions and future research. The central role of hostility in this relationship points to potential targets for therapeutic interventions aimed at mitigating aggression in adolescents.

In-party love spreads more efficiently than out-party hate in online communities.

In this article, we present the findings of a comprehensive longitudinal social network analysis conducted on Twitter across four consecutive election campaigns in Spain, spanning from 2015 to 2019. Our focus is on the discernible trend of increasing partisan and ideological homogeneity within interpersonal exchanges on this social media platform, alongside high levels of networking efficiency measured through average retweeting. This diachronic study allows us to observe how dynamics of party competition might contribute to perpetuating and strengthening network ideological and partisan homophily, creating 'epistemic bubbles' in Twitter, yet showing a greater resistance to transforming them into 'partisan echo-chambers.' Specifically, our analysis reveals that the rise of a new radical right-wing party (RRP), Vox, has heightened ideological homogeneity among users across the entire ideological spectrum. However, this process has not been uniform. While users aligned with mainstream political parties consistently share content that reinforces in-party affinity, resulting in highly efficient 'epistemic bubbles,' the emergence of the RRP has given rise to a distinct group of users associated with the most extreme partisan positions, characterized by a notable proportion of out-partisan hostility content, which has fostered the creation of low-efficient 'partisan echo-chambers.'

Understanding the moral cognition of aggression: Longitudinal serial effects of personal relative deprivation and hostility on within-person changes in civic moral disengagement.

Moral disengagement is an important aggressive and moral cognition. The mechanisms of changes in moral disengagement remain unclear, especially at the within-person level. We attempted to clarify this by exploring the serial effects of personal relative deprivation and hostility on civic moral disengagement. We conducted a three-wave longitudinal survey with 1058 undergraduates (63.61% women; mean age = 20.97). The results of the random intercept cross-lagged panel model showed that personal relative deprivation at Wave 1 and hostility at Wave 2 formed a serial effect on the within-person changes in civic moral disengagement at Wave 3, and the longitudinal indirect effect test showed that the within-person dynamics in hostility at Wave 2 acted as a mediator. The results of multiple group analysis across genders further showed that the longitudinal indirect role of hostility at Wave 2 was only observed for men, but not for women, which indicates the moderating effect of gender. These findings facilitate an understanding of the mechanisms of aggressive cognitions at the within-person level and offer implications for the prevention and intervention of aggression from the perspective of moral cognition.

Paranoia and Social Anxiety: Predicting Aggressive Behavior.

Aggression is a transdiagnostic behavior that is associated with poor clinical outcomes. As such, it is important to understand factors that contribute to various manifestations of aggressive behavior. Recent research has revealed a subtype of individuals with social anxiety disorder (SAD) who tend to display relatively high amounts of aggression and experience more severe social anxiety and dysfunction compared to individuals in the prototypical SAD group. The current study used a status threat manipulation along with behavioral indices of aggression to examine the impact of paranoia and social anxiety symptom severity on aggression in a sample of undergraduates with social anxiety (N = 220). Analyses indicated that paranoia uniquely predicted indirect aggression whereas an interaction between social status threat, paranoia, and social anxiety severity uniquely predicted direct aggression. These findings suggest that paranoia may be a particularly important contributor to aggression among individuals with social anxiety.

Posttraumatic stress disorder symptomology as measured by PCL-5 and its relationships to resilience, hostility and stress among paramedics and social professionals.

This survey study aimed to contribute to the extensive debate on the dimensionality of the Posttraumatic Stress Disorder Checklist for the DSM-5 (PCL-5) questionnaire by examining the psychometric properties and construct validity of its Hungarian version and relying on the inspection of a conceptual network of related variables, that is, perceived stress, hostility, and resilience. Confirmatory factor analysis (CFA), exploratory structural equation modelling (ESEM) and path analysis were applied on data collected from 177 paramedics and 66 professionals from the social field (58.4% male; Mage = 43.5 ± 9.96 years). Despite the acceptable fit indices gained with CFA when testing the original four-factor DSM-5 model of PCL-5, strong associations (r = 0.69-0.90) between subscales were found. Thus, ESEM was applied and as a result a new, three-factor version of the DSM-5 model of PCL-5 was proposed due to significant crossloadings that was theoretically also supported. The Reexperiencing and Avoidance subscales were merged and named Difficulty with Assimilation of Experience (DAE). In the path analysis only two of the tested associations were not significant using the new factor structure, in which stress fully mediated the relationship between resilience and DAE, and resilience and Hyperarousal. Overall, the hypothesised pathways between variables fit the collected data well. (weighted least squares mean-and variance-adjusted χ2 = 503.750 (df = 270), comparative fit index = 0.948, Tucker-Lewis index = 0.939, root mean square error of approximation (90% confidence interval) = 0.064 (0.055-0.073), weighted root mean square residual = 1.024). Our analysis of the Hungarian version of PCL-5 contributes to the testing of a DSM-5-based questionnaire measuring posttraumatic stress disorder symptomology.

Influence of early childhood parental hostility and socioeconomic stress on children's internalizing symptom trajectories from childhood to adolescence.

Introduction: Children and adolescents with elevated internalizing symptoms are at increased risk for depression, anxiety, and other psychopathology later in life. The present study examined the predictive links between two bioecological factors in early childhood-parental hostility and socioeconomic stress-and children's internalizing symptom class outcomes, while considering the effects of child sex assigned at birth on internalizing symptom development from childhood to adolescence. Materials and Methods: The study used a sample of 1,534 children to test the predictive effects of socioeconomic stress at ages 18 and 27 months; hostile parenting measured at child ages 4-5; and sex assigned at birth on children's internalizing symptom latent class outcomes at child ages 7-9, 10-12, 13-15, and 16-19. Analyses also tested the mediating effect of parenting on the relationship between socioeconomic stress and children's symptom classes. Other covariates included parent depressive symptoms at child ages 4-5 and child race and ethnicity. Results: Analyses identified three distinct heterogenous internalizing symptom classes characterized by relative symptom levels and progression: low (35%); moderate and increasing (41%); and higher and increasing (24%). As anticipated, higher levels of parental hostility in early childhood predicted membership in the higher and increasing symptom class, compared with the low symptom class (odds ratio (OR) = .61, 95% confidence interval (CI) [.48,.77]). Higher levels of early childhood socioeconomic stress were also associated with the likelihood of belonging to the higher-increasing symptom class compared to the low and moderate-increasing classes (OR = .46, 95% CI [.35,.60] and OR = .56, 95% CI [.44,.72], respectively). The total (c = .61) and direct (c' = .57) effects of socioeconomic stress on children's symptom class membership in the mediation analysis were significant (p <.001). Discussion: Study findings suggest that intervening on modifiable bioecological stressors-including parenting behaviors and socioeconomic stressors-may provide important protective influences on children's internalizing symptom trajectories.

Peer Victimization and Callous-Unemotional Traits: The Impact of Parents and Teachers.

Research on the link between peer victimization and callous-unemotional (CU) traits has primarily relied on cross-sectional designs and yielded equivocal findings. In light of the poor outcomes related to peer victimization and CU traits, it is important to determine whether this link is reciprocal in nature and to identify factors that may influence its strength. Accordingly, the current study investigated the bidirectional association between peer victimization and CU traits over a 6-month period, accounting for the moderating effects of parents (i.e., support and hostility) and teachers (i.e., support and conflict). Participants included 284 third- through fifth-grade students (ages 7-12; 51.8% boys; 51.1% Hispanic) and their homeroom teachers. Children provided ratings of peer victimization, parental hostility, and parent and teacher support. Teachers provided ratings of CU traits and student-teacher conflict. A series of cross-lagged panel models were estimated. Results revealed that, at higher levels of parental hostility, peer victimization predicted increases in CU traits over time; in contrast, peer victimization predicted decreases in CU traits at lower levels of parental hostility. Surprisingly, at higher levels of teacher conflict, peer victimization predicted decreases in CU traits over time. CU traits did not interact with parent or teacher variables to predict subsequent peer victimization. Moreover, parental hostility was positively associated with subsequent peer victimization, whereas teacher support predicted decreases in victimization over time. These findings build on previous research examining environmental influences on the expression of CU traits by highlighting peer victimization and parental hostility as potential risk factors.

Developmental Trajectories Leading to Hostility Toward Women: A Structural Equation Modeling Study.

Hostility toward women is frequently examined as a risk factor for violence against women, but research on its antecedents is sparse. The aim of this study was to explore the developmental and psychological antecedents associated with hostility toward women in a Canadian sample of sexual aggressors of women. Drawing on Malamuth's confluence model of sexual aggression, we developed a multifactorial model of hostility toward women, using structural equation modeling. The results indicate the presence of three trajectories, all starting from childhood victimization and leading to hostility toward women, involving antisocial characteristics, emotional negativity, anxiety, and depression.

Violent and prosocial music: Evidence for the impact of lyrics and musical tone on aggressive thoughts, feelings, and behaviors.

Although there is a large research base on the psychological impacts of violent and prosocial visual media, there is little research addressing the impacts of violent and prosocial music, and which facets of the music have the greatest impact. Four experiments tested the impact of lyrics and/or musical tone on aggressive and prosocial behavior, and on underlying psychological processes, using purpose-built songs to avoid the effect of music-related confounds. In study one, where mildly aggressive, overtly aggressive and violent lyrics were compared to neutral lyrics, any level of lyrical aggression caused an increase in behavioral aggression, which plateaued for all three aggression conditions. Violent lyrics were better recalled than other lyrics one week later. In studies two-three no significant effects of lyrics, or of aggressive versus nonaggressive musical tone, were found on aggressive or prosocial behavior. In terms of internal states, violent lyrics increased hostility/hostile cognitions in all studies, and negatively impacted affective state in three studies. Prosocial lyrics decreased hostility/hostile cognitions in three studies, but always in tandem with another factor. Aggressive musical tone increased physiological arousal in two studies and increased negative affect in one. In study four those who listened to violent lyrics drove more aggressively on a simulated drive that included triggers for aggression. Overall, violent lyrics consistently elicited hostility/hostile cognitions and negative affect, but these did not always translate to aggressive behavior. Violent music seems more likely to elicit behavioral aggression when there are aggression triggers and a clear way to aggress. Implications are discussed.

Introversion, Alexithymia, and Hostility: A Path Analysis From Personality to Suicidal Ideation Among University Students.

PURPOSE: The aim of the current study was to investigate the relationship between state (i.e., hostility) and trait (i.e., social detachment, alexithymia) psychological constructs associated with suicidal ideation among university students. METHODS: A group of 190 university students was consecutively recruited in the period between September 2022 and March 2023. After a clinical interview, a series of psychological tests were administered: the Cattell's 16-Personality Factors Questionnaire (16PF), the Toronto Alexithymia Scale (TAS-20), the Symptom Checklist-90-R (SCL-90-R), and the anamnestic form of the Cognitive Behavioral Assessment (CBA2.0), which contains a specific question regarding the suicidal ideation. RESULTS: The analyses demonstrated that alexithymia fully mediated the relationship between a particular aspect of introversion (social detachment or low warmth) and hostility which, in turn, seemed to be a significant predictor of suicidal ideation. CONCLUSIONS: The path analysis conducted seemed to highlight the importance of personality traits, such as social detachment and the ability to recognize and express one's internal states, on the mental health of university students in terms of hostility and suicidal ideation. Considering that the reduction of suicide mortality has been prioritized as a global target in the 15-19 age group, identifying the psychological factors associated with it is fundamental.

Perceived social competencies as moderators: examining the relationship between psychological distress and aggression, hostility, and anger in Lebanese adults.

INTRODUCTION: The majority of people experience anger at some point in their lives when confronted with unpleasant situations. In social settings, anger can lead to aggressive and hostile in the absence of adequate social competences. Our study aims to examine the moderating role of perceived social competences in the association between psychological distress and anger expression (trait anger, hostility, physical aggression, and verbal aggression) among a sample of Lebanese adults. METHODS: 403 participants above 18 years (the mean age was 24.56 ± 8.46) were enrolled in the cross-sectional study with 73% female participants. The candidates were asked to complete a structured questionnaire including the following scales: (1) Buss-Perry Aggression Questionnaire-Short Form (BPAQ-SF), (2) the Depression Anxiety Stress Scale (DASS-8), (3) Perceived Social Competencies (PSC), and (4) The De Jong-Gierveld Loneliness Scale. RESULTS: The interaction psychological distress by perceived social competence was not significantly associated with physical aggression, verbal aggression, or hostility but was significantly associated with anger. After adjusting the results over variables that showed a p <.25 in the bivariate analysis, this association was significant at low (Beta = 0.24; p <.001), moderate (Beta = 0.20; p <.001) and high (Beta = 0.16; p <.001) levels of perceived social competencies, where higher psychological distress was significantly associated with more anger. On another note, with higher perceived social competence, we find a decrease in levels of psychological distress in our sample. CONCLUSION: This study provided evidence that perceived social competencies such as communication skills, empathy and prosocial behaviors act as moderators in the association between psychological distress and anger. In future works, investigating and building advanced program in order to develop social competences of individuals might prove important. It is crucial to implement such strategies and projects in schools: this educational setting could be fruitful in a way that social skills could be instilled during childhood and anger-aggressive behaviors could be managed throughout adulthood.

Links between Couples' Cynical Hostility and Mental Health: A Dyadic Investigation of Older Couples.

Whereas sharing a life with someone with high cynical hostility can be straining, little is known about how partner's cynical hostility is associated with one's mental health. In this paper, we report the findings from a longitudinal dyadic study using two waves of a large and representative American sample of older adults and their spouses to examine how one's own and their spouse's cynical hostility longitudinally affect anxiety and depressive symptoms. Results from APIM analyses suggest that both husbands' and wives' anxiety and depressive symptoms were negatively associated with their own cynical hostility, both within each time point and longitudinally. Partners' cynical hostility, however, predicted only husbands' mental health cross-sectionally. Furthermore, a moderating effect was identified, although it was not consistently observed across all analyses. Specifically, when a partner's cynical hostility was high, the association between one's own cynical hostility and their mental health was stronger, especially for women. Theoretical and practical implications are discussed.

Stress, interpersonal and inter-role conflicts, and psychological health conditions among nurses: vicious and virtuous circles within and beyond the wards.

BACKGROUND: The increasing costs of nurses' occupational-stress, conflicts, and violence within healthcare services have raised international interest. Yet, research/interventions should consider that perceived stress and conflicts- but also potential resources- within the wards can crossover the healthcare settings, impacting nurses' private lives and viceversa, potentially creating vicious circles exacerbating stress, conflicts/violence or, conversely, virtuous circles of psychological/relational wellbeing. Based on the Demands-Resources-and-Individual-Effects (DRIVE) Nurses Model, and responding to the need to go in-depth into this complex dynamic, this study aims to explore potential vicious circles featured by the negative effects of the interplay (main/mediating effects) between perceived stressors in nursing linked to interpersonal conflicts (Conflicts-with-Physicians, Peers, Supervisors, Patients/their families), work-family inter-role conflicts (Work-Family/Family-Work-Conflicts), and work-related stress (Effort-Reward-Imbalance) on nurses' psychological/relational health (Anxiety, Depression, Somatization, Interpersonal-Sensitivity, Hostility). The potential moderating role of work-resources (Job-Control, Social-Support, Job-Satisfaction) in breaking vicious circles/promoting virtuous circles was also explored. METHOD: The STROBE Checklist was used to report this cross-sectional multi-centre study. Overall, 265 nurses completed self-report questionnaires. Main/mediating/moderating hypotheses were tested by using Correlational-Analyses and Hayes-PROCESS-tool. RESULTS: Data confirmed the hypothesized detrimental vicious circles (main/mediating effects), impairing nurses' psychological health conditions at individual level (Anxiety, Depression, Somatization), but also at relational level (Hostility and Interpersonal-Sensitivity). The moderating role of all work resources was fully supported. CONCLUSION: Findings could be used to implement interventions/practices to effectively prevent the maintenance/exacerbation of vicious circles and promote psychological/relational wellbeing in healthcare settings and beyond.

Effects of cariprazine on reducing symptoms of irritability, hostility, and agitation in patients with manic or mixed episodes of bipolar I disorder.

BACKGROUND: Hostility, irritability, and agitation are common in patients with bipolar I disorder. Post hoc analyses evaluated the effect of cariprazine on these symptoms in patients with bipolar I mania. METHODS: Data were pooled from three randomized, double-blind, placebo-controlled phase 3 cariprazine trials in adults with bipolar I manic/mixed episodes (NCT00488618, NCT01058096, NCT01058668); pooled cariprazine doses (3-12 mg/d) were analyzed. Patients were categorized into hostility/irritability and agitation subgroups by baseline scores: Young Mania Rating Scale (YMRS) irritability and disruptive-aggressive behavior items score ≥ 2; Positive and Negative Syndrome Scale (PANSS) hostility item ≥ 2; PANSS-Excited Component (PANSS-EC) total score ≥ 14 and score ≥ 4 on ≥ 1 individual item. Changes from baseline to week 3 in hostility/irritability- and agitation-related outcomes were evaluated. Adjustments were made for the presence of other manic symptoms, sedation, and akathisia. RESULTS: Most patients met subgroup inclusion criteria (YMRS hostility = 930; PANSS hostility = 841, PANSS-EC agitation = 486). In the YMRS subgroup, least squares mean differences in change from baseline were statistically significant for cariprazine versus placebo on YMRS hostility/irritability-related items (irritability [-0.93], disruptive-aggressive behavior [-0.79], combined [-1.75]; P ≤ 0.001 each), YMRS total score (-5.92, P ≤ 0.0001), and all individual YMRS items (-0.25 to -0.93, P ≤ 0.0001); differences remained significant after adjustment for other manic symptoms, sedation, and akathisia. Differences in PANSS hostility and PANSS-EC subgroups were significant for cariprazine versus placebo (P ≤ 0.001). LIMITATIONS: Post hoc analysis. CONCLUSION: Cariprazine demonstrated specific antihostility/irritability and anti-agitation effects in patients with manic/mixed episodes of bipolar I disorder and baseline hostility, irritability, or agitation.