Background <p>Aggression is a growing issue, ranking among the top causes of mortality in youth and is a frequent reason for referral to child psychiatry clinics. The presence psychological causes, like emotion dysregulation, has been confirmed.</p> Methodology <p>The authors adapted Dialectical Behavior Therapy (DBT) skills for children’s developmental level, as well as the Arabic language and culture. The study sample included 66 children with a diagnosis of ADHD and impulsive aggression who had not previously taken medication for their condition. They were randomized into two groups: an intervention group (Group A) that, along with their parents, attended a weekly Arabic DBT-C skills training program, and a control group (Group B) that received primary ADHD medication and regular psychoeducation sessions.</p> Results <p>The Arabic DBT-C skills training significantly reduced the severity of impulsive aggression. This was associated with improvements in the children’s executive functions, psychological resilience, ADHD symptoms (particularly impulsivity and hyperactivity), and their parents’ emotion dysregulation. These effects were maintained at a 3-month follow-up. Regression analysis identified that the reduction in aggression severity was primarily associated with improvements in self-motivation and response inhibition executive functions, improved parental emotion dysregulation, and an increased resilience i.e. use of adaptive skills by the children.</p> Conclusions <p>The Arabic DBT-C skills training is a proven, acceptable, and effective therapeutic tool for impulsive aggression in children with ADHD, and it was found to be superior to the combination of Atomoxetine and psychoeducation.</p>