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Authors’ Note: This study was carried out by researchers and instructors from the FIAM (Federazione
Italiana di Arti Marziali—Italian Federation of Martial Arts) the Center for the Scientific Study of
Karate—Yo Sho Kan, AFAR—Associazione Fatebenefratelli per la Ricerca, and the Department of
Neurology, Medical College of Wisconsin.
International Journal of
Offender Therapy and
Comparative Criminology
Volume 50 Number 6
December 2006 1-7
© 2006 Sage Publications
10.1177/0306624X06293522
http://ijo.sagepub.com
hosted at
http://online.sagepub.com
Externalizing and Oppositional
Behaviors and Karate-do:
The Way of Crime Prevention
A Pilot Study
Mark T. Palermo
Massimo Di Luigi
Italian Federation of Martial Arts
Gloria Dal Forno
Medical College of Wisconsin
Cinzia Dominici
David Vicomandi
Augusto Sambucioni
Luca Proietti
Italian Federation of Martial Arts
Patrizio Pasqualetti
Associazione Fatebenefratelli per la Ricerca
Childhood disruptive behaviors can be precursors to later deviance. To verify the efficacy of
karate, a complex psychomotor activity that enhances self-regulation and executive skills,
as an intervention for externalizing behaviors, 16 children, ranging in age from 8 to 10
years, and meeting diagnostic criteria for oppositional defiant disorder were studied. Eight
were randomly assigned to a 10-month wa do ryu karate program, whereas 8 children
received no intervention. The children were assigned to a larger karate class, composed of
typically developing youngsters. Three domains of temperament, intensity, adaptability, and
mood regulation, were measured at the beginning and the end of the training period in all
16 participants. A significant improvement in temperament scale scores was measured in
the karate group for all tested items compared to controls. Karate, when properly taught, can
be a useful adjunct in multimodal programs aimed at externalizing behavior reduction.
Keywords: karate; aggression; disobedience
2 International Journal of Offender Therapy and Comparative Criminology
E
xternalizing and disruptive behaviors in childhood, which include disobedience
(Kalb & Loeber, 2003), oppositional defiant disorder (ODD), conduct disorder, and
attention deficit/hyperactivity disorder (ADHD; American Psychiatric Association,
1994), are a common cause for psychiatric referral and may be a precursor of later
developing deviant behaviors (Frick, 2006). Furthermore, oppositionality, which may
affect from 2% to 16% of the childhood population (Diagnostic and Statistical Manual
of Mental Disorders, DSM-IV; American Psychiatric Association, 1994) positively
correlates with later antisocial behavior (Lahey, McBurnett, & Loeber, 2000; Loeber,
Burke, Lahey, Winters, & Zera, 2000). Noncompliance with rules and regulations may
be likewise associated with both aggression and antisocial behavior throughout child-
hood (Hämäläinen & Pulkkinen, 1996; Parrish, Cataldo, Kolko, Neef, & Egel, 1986).
All these disorders benefit from multidisciplinary interventions, including behavioral
approaches and medication administration, for the treatment of extreme overactivity or
comorbid conditions.
Common sense would indicate that an activity teaching self-control, such as karate,
a martial art that requires compliance and obedience during practice, should be effec-
tive in reducing a number of problem behaviors so common in the classroom or in
the modern household. However, this is not documented by the scientific literature
because of a lack of studies addressing the impact of such sport activities in the treat-
ment of externalizing behaviors and overactive syndromes of childhood. Green activ-
ities (outdoor activities; Kuo & Taylor, 2004) have been advocated for the reduction of
symptoms of ADHD in children, and sport is commonly used in the rehabilitation of
people with disabilities (Allison, Basile, & MacDonald, 1995). The fear of many is that
karate may induce aggressive behaviors. One study does not seem to support this
notion (Reynes & Lorant, 2004) and may indeed suggest that karate practice is pro-
tective against aggressive behavior, although the instrument used in the study to mea-
sure a propensity for aggression (Buss & Perry, 1992) may not be as adequate for use
in a childhood population. In fact, the instrument required the presence of an adult to
explain some of the questions in the inventory. Furthermore, children in this study were
not aggressive at baseline because the purpose was to determine whether karate
induces aggressive behaviors in otherwise typically developing children.
To verify the efficacy of karate as an effective intervention for disruptive behavior,
we followed a group of 16 children with externalizing conditions for a period of 10
months. All children met DSM-IV criteria for ODD, characterized by persistent defi-
ance, disobedience, hostility toward authority figures (parents, teachers, and other
adults in general), fighting, arguing and loss of temper, refusal to comply with requests
or rules, limit testing, and stubbornness. In addition, these children had manifested, at
least once, serious interpersonal aggression as evidenced by historical information of
fist fighting, throwing objects at peers, or, in two cases, jabbing a peer with a pencil.
Because of the relatively nonspecific and dimensional nature of many of the behav-
iors that fall under the rubric of ODD and the lack of specificity for interpersonal
aggressive acts of many of the scales used in the assessment of externalizing problems
Palermo et al. / Karate and Externalizing Behaviors 3
and aggression, we chose to look at three domains of temperament, intensity, adapt-
ability, and mood regulation, in our referred children rather than at a diagnostic cate-
gory in itself. These areas of social emotional development were chosen as they may
represent specific vulnerabilities in some children with externalizing behaviors.
Participants and Method
Sixteen children participated in the study. Children were referred to the Federazione
Italiana di Arti Marziali (FIAM) project Dal Dojo alla Famiglia alla Società (From
the Dojo to the Family to Society; www.fiamsport.it, July 2006), a karate program
developed to include in the ordinary dojo, the training hall for practicing karate and
other martial arts, children with social cognitive disorders and disruptive behaviors.
Ages ranged from 8 to 10 years (M = 8.5); 13 were male and 3 were female. Children
were of a mixed socioeconomic background and were all attending regular elemen-
tary school classes. Three children required an aid in class for behavior-management
purposes.
At the beginning of the study, all children were screened for the presence of an anx-
iety or mood disorder using the TAD (Test of Anxiety and Depression; Newcomer,
Barenbaum, & Bryant, 1996), a multidimensional, standardized diagnostic question-
naire for anxiety and depressive disorders in childhood and youth composed of child,
parent, and teacher scales. The Carey Temperament Scale (Carey Temperament Scales,
B-DI 14636 N. 55th St., Scottsdale, AZ 85254) was used to determine the child’s tem-
peramental style on the domains of intensity, defined as the energy level of behavior
responses, regardless of quality or direction; adaptability, or the ease or difficulty with
which reactions to stimuli can be modified in a desired way; and mood, that is, the
amount of pleasant or unpleasant behavior observed in various situations. The scale
was administered to all children at the beginning and end of the 10-month program.
Half of the participants (8 children) were randomly assigned to take part in karate
training sessions. These children participated in a 10-month wa do ryu karate program
with a frequency of three lessons per week. They were assigned to a larger class of typ-
ically developing youngsters free of behavioral problems who were unaware of any
clinical diagnosis of the participants or their enrollment in a study. Because of the
children’s age and the FIAM federal regulations, none of the children participated in
actual combat situations, beyond stereotyped ippon kumite, a set of movements of attack
and defense aimed at preparing young athletes for later controlled contact bouts. Classes
are taught following a rigorous framework that includes a warm-up period followed by
methodical practice of the kihon (fundamentals) and kata (a set of internationally rec-
ognized standard movements, representing the mimicking of a combat situation). The
kihon portion of the session is part of group practice, and in addition to developing the
necessary technical skills, in our program it is designed to stimulate executive compe-
tence development. It involves a set of progressively more complex motor sequences
carried out on command, approximately 30% of which is designed following a go-no-
go format, where verbal commands alternate rapidly, stimulating auditory attention and
gross visual-motor skills at once. The kata practice takes place in small groups and indi-
vidually, allowing the child to practice under direct observation of his or her peers. The
beginning and the end of each training session are marked by a formal salutation of the
teacher and the dojo by all participants and between athletes and by a brief period of
breathing techniques aimed at promoting concentration and attention.
Results
To verify whether the children participating in the karate program differed at base-
line from the 8 children not exposed to the training program, and because the range of
values obtained in the whole sample was limited to either one or two standard devia-
tions (1 SD or 2 SD), the Fisher’s exact test was applied to the score distribution of the
three variables studied. No differences were noted at baseline between study groups
(p = 1.00 for each of the three scales; see Table 1).
To study the behavioral changes between the beginning (T0) and the end of the
study (T1) occurring in the two groups (karate intervention vs. no karate interven-
tion) as measured by the three scales, the nonparametric Mann-Whitney’s test was
applied. Statistically significant differences were noted in all three scales, with evi-
dence of improvement in all scores in the karate intervention group, as opposed to
the control participants. This was particularly noticeable for the intensity scale
scores (see Table 2).
Discussion
In this small study, 8 children with severe disruptive behaviors taking part in a
10-month program of traditionally taught karate aimed at determining whether partic-
ipation in this activity leads to behavioral improvement showed a substantial reduction
4 International Journal of Offender Therapy and Comparative Criminology
Table 1
T0 Evaluation of Temperamental Variables
Intensity Mood Adaptability
Karate
a
1 SD 13 3
2 SD 75 5
No karate
a
1 SD 04 4
2 SD 84 4
p (Fisher’s exact test) 1.000 1.000 1.000
a. n = 8.
in problem behaviors when compared to controls receiving no intervention. These
improvements were evident at home, in the dojo, and in school with improved self-
regulation, a significant reduction in overactive behavior, and improved adaptive and
organizational behaviors.
Karate is, from a neuropsychological perspective, a very sophisticated and com-
plex activity, which, when traditionally and methodically taught and practiced, leads
to improvement in self-regulation, executive skills, goal-directed attention, and
capacity for concentration. Likewise, it introduces children and adolescents to effec-
tive social skills, fostering self-confidence and mutual respect, primarily through
behavior mirroring.
The fact that these children were regularly accompanied by parents or other care-
givers most likely had an impact on the overall improvement. In fact, in regular karate
dojos, there is typically a dropout rate of 5% to 10% during the first 3 months of
practice. Our program’s insistence on regularity and rigorous attendance, and active
involvement of parents, besides fostering much-needed tenacity, is also stressed in
light of the association between inconsistent discipline and child conduct problems
(Chamberlain & Patterson, 1995). Indeed, most treatment programs include parent
training approaches. Although these are very effective in allowing families to receive
needed parenting skills (Dretzke et al., 2005), they are obviously parent centered and
do not allow for guided group work with identified children. Behaviors, however,
respond best to peer groups (Plumer & Stoner, 2005) and clearly are affected by
example, whether it is that of a peer or of an adult with whom the child has a long-
standing relationship. It may be likewise important for this modelling and mirroring to
occur outside of the household, particularly when family functioning is under stress
and during the initial stages of reorganizing a family system.
Although the frequency of physical aggression may itself decrease naturally after the
4th year after birth (Brame, Nagin, & Tremblay, 2001), we believe that a number of
other factors may have contributed to the clinical improvement noted in our study.
Direct commands, typical of the karate dojo, where participants relate to only one
Palermo et al. / Karate and Externalizing Behaviors 5
Table 2
T0 to T1 Changes in Temperamental Variables
Intensity Mood Adaptability
Mdn 1.5 0.5 1.5
Min 0.5 0.0 0.0
Max 2.0 2.0 2.0
Mdn 0.0 0.0 0.75
Min 0.0 0.0 –1.0
Max 0.0 0.0 1.0
Z (based on Mann-Whitney U) –3.608 –2.21 –2.095
p .000 .027 .036
instructor, have been shown to improve compliance, as compared to indirect instruction
(Schaffer & Cook, 1980). Furthermore, long maintenance of interpersonal eye contact,
such as that seen in karate practice, has been shown to decrease noncompliance in
children with ADHD (Kapalka, 2004). Although karate has been compared to “moving
meditation” (Deshimaru, 1995; Tokitsu, 1992), and Zen practices may indeed enhance
attention (Austin, 1999), we believe that in children, the regular participation in a disci-
pline emphasizing loyalty and respect through example may promote moral standard
internalization in situations where this has been unavailable (Kochanska & Askan,
1995). This may significantly help in altering a behavioral trajectory that could other-
wise deviate toward delinquency (Nagin & Tremblay, 1999). There clearly is a need for
better ways to operationalize aggressive behavior in childhood (Tremblay, 2000), and
the interchangeable use of aggression and deviance-related terminology (crime, delin-
quency, violence, aggression) reduces any specificity of the existing scales.
Furthermore, although much emphasis is placed on academic failure, nonschool
socialization failure seems to be more important as a causal agent in allowing certain
temperamental and cognitive vulnerabilities to promote the development of antisocial
conduct (Lahey, Waldman, & McBurnett, 1999). Improved socialization through a sport
that is practiced in a group setting, yet is individually based, could be effective in the
gradual transitioning of a previously socially peripheral child into the mainstream, min-
imizing typically inhibiting group responsibilities intrinsic in team sports (Palermo,
2006) and promoting self-regulation and self-efficacy.
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