The relation of ADHD and violent aggression: What can we learn from epidemiological and genetic studies?

Disruptive behavior includes psychopathological and behavioral constructs like aggression, impulsivity, violence, antisociality and psychopathy and is often closely related with diagnostic categories like conduct disorder (CD), attention deficit disorder (ADHD) and antisocial personality disorder (ASP). There is now clear evidence that neurobiological and environmental factors contribute to these phenotypes. A mounting body of evidence also suggests interactive effects of genetic and environmental risks.In this selective review we give an overview over epidemiological aspects of the relation between ADHD and antisocial behavior, including violent aggression and psychopathy. Moreover, we summarize recent findings from molecular genetic studies and particularly discuss pleiotropic effects of a functional polymorphism of the serotonin transporter promoter gene (5HTTLPR) and childhood adversity on ADHD and violent behavior. The reported gene–environment interactions are not only informative for understanding the neurobiological underpinnings of disruptive behavior, but also throw some light on the relation between ADHD and violent behavior from a genetic perspective. The impact of genetic research on forensic psychiatry and future directions of neurobiological research are discussed.     

Domestic violence and panic attacks – common neural mechanisms?

Purpose. This paper combines material from domestic violence, animal aggression and neuropsychology research to construct a model to account for some domestic violence offending. The basic hypothesis is that some incidents of domestic violence can be understood in terms of the operation of primitive defence mechanisms, which are also implicated in panic attack. Perceptions of threat from an intimate partner could potentially trigger these same neuronal circuits thus releasing violent and emotionally charged responses at the spouse. Arguments . The hypothesis is based on:

• (a) the marked anatomical/physiological overlap of the neural substrates underlying defensive aggression and those implicated in panic attack,
• (b) reports of panic attack‐like symptoms experienced by perpetrators during domestic violence assaults,
• (b) experimental evidence that demonstrates that standard physiological challenges can elicit panic/anger attacks in some domestic violence offenders ( George et al., 2000 ).

Conclusions . Panic/anger attack represents inappropriate activation of affective defensive responses due to inappropriate control of critical midbrain sites by the amygdala and/or prefrontal cortex. Panic attacks could be potentially suppressed by increasing the capacity of the prefrontal cortex to inhibit the midbrain affective defence mechanisms. However, learnt associations between stimuli and panic responses are difficult to extinguish and panic responses typically show sensitization overtime. The same may be true of the behaviour of domestic violence offenders. There is a need to establish the typology of the subgroup of offenders who perpetrate panic attack related domestic violence.     

Understanding human aggression: New insights from neuroscience

The present paper reviews and summarizes the basic findings concerning the nature of the neurobiological and behavioral characteristics of aggression and rage. For heuristic purposes, the types of aggression will be reduced to two categories — defensive rage (affective defense) and predatory attack. This approach helps explain both the behavioral properties of aggression as well as the underlying neural substrates and mechanisms of aggression both in animals and humans. Defensive rage behavior is activated by a threatening stimulus that is real or perceived and is associated with marked sympathetic output. This yields impulsivity with minimal cortical involvement. Predatory attack behavior in both animals and humans is generally planned, taking minutes, hours, days, weeks, months, or even years (with respect to humans) for it to occur and is directed upon a specific individual target; it reflects few outward sympathetic signs and is believed to require cortical involvement for its expression. Predatory attack requires activation of the lateral hypothalamus, while defensive rage requires activation of the medial hypothalamus and midbrain periaqueductal gray (PAG). Both forms of aggressive behavior are controlled by components of the limbic system, a region of the forebrain that is influenced by sensory inputs from the cerebral cortex and monoaminergic inputs from the brainstem reticular formation. Control of aggressive tendencies is partly modifiable through conditioning and related learning principles generated through the cerebral cortex.     

Differentiation between drug use and environmental contamination when testing for drugs in hair

Personality disorders are associated with criminality and antisocial and borderline personalities as strong predictors of violence. Nevertheless antisocial patients show more instrumental violence, while borderline patients more emotional violence. We surveilled medical records of a personality disorder facility, searching data of aggression and crimes against property among 11 patients with antisocial personality disorder and 19 borderline personality disorder. We found that there are differences regarding engagement in violence and lawbreaking according to the personality disorder: antisocial patients statistically engage more in crimes against property than the borderline patients, and more in this kind of crime than in aggression, whilst borderline patients show a tendency to engage more in episodes of aggression and physical violence than antisocial patients, and less in crimes against property. We conclude that the distinct personality leads to a distinct pattern of crimes and violence: antisocial patients are cold and get more involved in crimes requiring more detailed planning, whilst borderline patients are impulsive and engage in explosive episodes of physical violence. Further studies on the association among personality disorder, behavior pattern and violence type may be useful for both treatment and criminal profiling.     

Linking marital violence,mother-child/father-child aggression,and child behavior problems

Previous research indicates that observation of marital violence has a deleterious impact on children's adjustment. However, little is known about the mechanisms underlying this relationship. The present study examined the relationships between observation of marital violence, mother-child aggression, father-child aggression, and child behavior problems in a sample of 185 children (ages 7 to 13) and their mothers who were residing at battered women shelters. A significant positive association was found between amount of marital violence witnessed and father-child aggression. However, the correlation between the amount of marital violence witnessed and mother-child aggression was not significant. Hierarchical regression analyses revealed that both the amount of marital violence witnessed as well as mother-child aggression were significantly related to child behavior problems, even when controlling for the effects of child age, race, and father status (i.e., whether the mother's partner was the biological father or stepfather/cohabitee). Family violence variables were better predictors of girls' rather than boys' behavior problems, particularly externalizing behavior problem scores. The lack of significance between father-child aggression and child behavior problems, as well as the implications of the findings, are discussed.     

Psychotic Domestic Murder: Neuropsychological Differences Between Homicidal and Nonhomicidal Schizophrenic Men

There is substantial evidence that individuals with schizophrenia are at increased risk for violent criminal behavior and an even higher risk for committing murder, relative to the general population. Neuropsychological features of seven schizophrenic men who murdered family members were compared to neuropsychological features of seven schizophrenic men with no history of violence, criminal offenses or antisocial behavior. The two groups were matched for age, education, race, gender, handedness, and diagnosis, and had similar psychotic symptom profiles and substance abuse histories. The schizophrenic murderers demonstrated significantly worse neuropsychological impairment, involving executive dysfunction and memory dysfunction, relative to nonviolent schizophrenic men. Implications include: (1) specific neuropsychological deficits may increase the likelihood of some schizophrenic men to murder family members due to an impaired capacity to inhibit impulsive violent aggression; (2) neuropsychological status of schizophrenic defendants who commit domestic homicide should be considered by the trier-of-fact when they are tried for murder.     

Predicting Conduct Problems from Community and Family Violence: The Moderating Effects of Hurricane Katrina

Although the devastation was immediately apparent, the effects of Hurricane Katrina on the behavior of youth are just now being revealed. Much post-disaster research targets adjustment of adults, but ample evidence indicates that youth experience a variety of psychological symptoms following a disaster, including depressive symptoms, aggression, and symptoms of posttraumatic stress. The aim of the current study was to determine whether hurricane exposure serves as a risk factor for developing conduct problems among violence-exposed youth. Results indicate that hurricane exposure had differential effects on the relations between conduct problems and community violence versus corporal punishment in the home. Though not statistically significant, there was an unexpected trend for youth with high hurricane exposure to show decreased conduct problems and those with low hurricane exposure to show increased conduct problems as violence exposure increased. Hurricane exposure played the predicted role in the relation between corporal punishment and conduct problems, such that high levels of hurricane exposure predicted increased conduct problems among youth experiencing high levels of corporal punishment, but not among those experiencing low levels of corporal punishment. Implications for future research and practice are discussed.     

Psychopathy and instrumental aggression: Evolutionary, neurobiological, and legal perspectives

In the study of aggression, psychopathy represents a disorder that is of particular interest because it often involves aggression which is premeditated, emotionless, and instrumental in nature; this is especially true for more serious types of offenses. Such instrumental aggression is aimed at achieving a goal (e.g., to obtain resources such as money, or to gain status). Unlike the primarily reactive aggression observed in other disorders, psychopaths appear to engage in aggressive acts for the purpose of benefiting themselves. This is especially interesting in light of arguments that psychopathy may represent an alternative life-history strategy that is evolutionarily adaptive; behaviors such as aggression, risk-taking, manipulation, and promiscuous sexual behavior observed in psychopathy may be means by which psychopaths gain advantage over others. Recent neurobiological research supports the idea that abnormalities in brain regions key to emotion and morality may allow psychopaths to pursue such a strategy—psychopaths may not experience the social emotions such as empathy, guilt, and remorse that typically discourage instrumentally aggressive acts, and may even experience pleasure when committing these acts. Findings from brain imaging studies of psychopaths may have important implications for the law.     

BOLD—fMRI在肇事肇祸精神分裂症研究中综述

综述了肇事肇祸精神病患者脑功能异常区以及异常区之间的相互关系。主要采用事件相关的图片线索诱导一中性线索反应模式的fMRI扫描，对司法鉴定为精神病患者进行的探索实验性研究。结果表明，双侧大脑额叶、颞叶区域存在多个脑功能激活区。因此，脑功能成像（fMRI）可以作为肇事肇祸精神病司法鉴定的一个有效手段。     

Aggression, psychopathy and brain imaging — Review and future recommendations

Violent behavior appears to result from a complex web of interacting genetic as well as environmental factors. Psychopathy is a strong predictor for relapse in violent acts. The current review shed light on rapidly expanding knowledge in brain imaging related to violent behavior and psychopathy. A literature search was performed in PubMed, Cochrane and PsycInfo combining the key words: mentally disordered offender/aggression/violence/ crime/forensic psychiatry/brain imaging neuroimaging/fMRI/MRI/PET/SPECT/lack of empathy/psychopathy and antisocial personality disorder. The reviewed material, which consisted of 48 articles, indicates a rather strong consensus on the connection between dysfunctional parts of the frontal and temporal lobes and violent antisocial behavior and psychopathy. In future studies, it would be useful to focus on the limbic system and to investigate which parts of the frontal lobes and cerebral networks that are of interest in the psychopathic personality. Moreover, the reviewed material highlights some of the methodological difficulties in this area of research such as selection bias in the recruitment of patients, inadequate matching of control subjects, and sometimes incongruous results. In the future we hope that brain imaging can be used to map biological deviations in different offenders in order to try to learn more about the different mechanisms behind violent behaviors.     

Investigation of a typology of alcohol‐related violence defined by ultimate goals

Purpose. Alcohol‐related violence is a serious problem and treatments for high‐risk individuals need to be developed. Classification helps to route people into appropriate treatments. Drawing on animal research, we define alcohol‐related violence in relation to ultimate goals. We propose three types of violence: (1) violence in the pursuit of material goals, (2) violence in pursuit of social dominance goals, and (3) violence as defence in response to threat. The aim is to explore factors that we expect to relate to this tripartite typology, with the aim of providing a preliminary validation. Method. Participants were 149 young male prisoners who had committed an offence of violence that was alcohol related. Semi‐structured interviews elicited information about the offence that enabled classification into one of the three types. Differences between groups were examined at the event level – level of violence during the offence and alcohol consumption before the offence – and at group level – trait aggression, trait anxiety, anger control, and alcohol–aggression outcome expectancies. Results. No differences were found in levels of violence or alcohol consumption. Those whose violence was in the pursuit of material goals were high on trait aggression, trait anger, trait anxiety, and anger suppression. Those who used violence in the pursuit of social dominance showed high trait aggression and trait anger. Those whose violence was a defence in response to threat showed lower trait aggression and trait anger. Conclusion. The findings are discussed in relation to differential group profiles and treatment needs.     

Does Controlling Behavior Predict Physical Aggression and Violence to Partners?

Using data obtained from women’s shelter residents, male and female students, and male prisoners, this study investigated the association between non-violent controlling behaviors, physical aggression, and violence towards a spouse (N = 264). It was predicted that only men and women involved in intimate terrorism (Johnson, Violence Against Women, 11(12):1003–1018, 2006) would use controlling aggression, and that physical aggression used by those involved in situational couple violence would be unrelated to controlling behavior. Contrary to predictions derived from Johnson’s theory, regression analysis showed that control accounted significant proportions of the variance in the use of physical aggression for all three relationship categories. Some support was provided, however, as it was found that the pattern of both interrelationships of the five types of controlling behaviors, and control and physical aggression, supported Johnson’s distinction.     

IS AGE IMPORTANT? TESTING A GENERAL VERSUS A DEVELOPMENTAL THEORY OF ANTISOCIAL BEHAVIOR*

We tested competing hypotheses derived from Gottfredson and Hirschis (1990) general theory and Moffitt's (1993a) developmental theory of antisocial behavior. The developmental theory argues that different factors give rise to antisocial behavior at different points in the life course. In contrast, the general theory maintains that the factor underlying antisocial behavior (i.e., criminal propensity) is the same at all ages. To test these competing predictions, we used longitudinal data spanning from age 5 to age 18 for the male subjects in the Dunedin Multidisciplinary Health and Development Study. Using reports from three sources (parents, teachers, and the boys themselves), we estimated second-order confirmatory factor models of antisocial behavior. These models provided consistent support for the developmental theory, showing that separate latent factors underlie childhood and adolescent antisocial behavior. Moreover, we found that these childhood and adolescent factors related in ways predicted by Moffitt's developmental theory to four correlates of antisocial behavior: Childhood antisocial behavior was related more strongly than adolescent antisocial behavior to low verbal ability, by per activity, and negative/impulsive personality, whereas adolescent antisocial behavior was related more strongly than childhood antisocial behavior to peer delinquency. The two underlying latent factors also showed the predicted differential relations to later criminal convictions: Childhood antisocial behavior was significantly more strongly associated with convictions for violence, while adolescent antisocial behavior was significantly more strongly associated with convictions for nonviolent offenses.     

Personality Correlates of Aggression: Evidence From Measures of the Five-Factor Model, UPPS Model of Impulsivity, and BIS/BAS

Although many studies of personality and aggression focus on multidimensional traits and higher order personality disorders (e.g., psychopathy), lower order, unidimensional traits may provide more precision in identifying specific aspects of personality that relate to aggression. The current study includes a comprehensive measurement of lower order personality traits in relation to three forms of aggression: reactive, proactive, and relational. Traits related to interpersonal antagonism and impulsivity, especially impulsive behavior in the context of negative affect, were consistently related to aggression across multiple indices. These findings suggest that certain lower order traits are of critical importance to understanding who engages in aggressive behavior and why this behavior occurs.     

Personal Experience and Perceived Acceptability of Sibling Aggression

The perceived acceptability of sibling aggression as a function of personal experience was investigated. Participants read a scenario depicting sibling aggression and rated the perceived acceptability of the hypothetical siblings’ behaviors. Following ratings, participants completed a measure to describe their childhood experience of sibling aggression and violence. Findings supported the hypotheses that men were more accepting of sibling aggression, and that being a perpetrator of sibling aggression was associated with increased perceived acceptability of such behavior, especially for women. For men, being the victim of sibling violence was also associated with higher rates of perceived acceptability.     

Developmental Pathways in Youth Sexual Aggression and Delinquency: Risk Factors and Mediators

Childhood exposure to violence against females and male-modeled antisocial behavior were examined as risk factors for sexual aggression, and nonsexual aggression and delinquency, in a sample of 182 adolescent male sex offenders using structural equation modeling. Both risk factors produced direct and indirect effects on nonsexual aggression and delinquency with Psychosocial Deficits and Egotistical–Antagonistic Masculinity playing important mediating roles. Exposure to violence against females helped explain sexual aggression through the mediating role of Psychosocial Deficits. As hypothesized, youth who sexually offended against prepubescent children manifested greater deficits in psychosocial functioning, committed fewer offenses against strangers, and demonstrated less violence in their sexual offending than offenders against pubescent females. Findings are discussed within the context of two major evolutionary psychological concepts for explaining human sexual behavior: intrasexual selection and intersexual selection.     

Implicit attitudes toward violence and their relation to psychopathy,aggression, and socially adaptive behaviors in forensic psychiatric inpatients

In order to investigate the relation between implicit attitudes toward violence and different aspects of violent and social behavior in Dutch forensic psychiatric inpatients, an implicit association test was related to measures of psychopathy, aggression, and socially adaptive behaviors. Results indicated that all patients had negative implicit attitudes toward violence. Although implicit attitudes toward violence were unrelated to several self-report measures of aggression, there was a significant positive relation between these attitudes and the antisocial facet of psychopathy. Furthermore, it was found that implicit attitudes toward violence were significantly negatively associated with coping behaviors and the level of moral awareness, indicating that patients with more negative implicit attitudes toward violence more often reported these behaviors, which can be assumed to inhibit aggression. As the present study was only correlational in nature, our findings need to be further explored in prospective research.     

Violence and Aggression in the Lives of Homeless Children

The present research examined the role of violence and aggression in the lives of children in homeless families, focusing on possible connections among family violence, children's aggression, and children's problems with social isolation and rejection. Measures were obtained from structured interviews with 93 sets of mothers and children. Consistent with past research, average estimates of specific violent incidents experienced by mothers (as adults) were quite high. Measures of this family violence were reliably correlated with children's behavior problems as well as with measures of aggression in peer relationships (victimization, ease of resolving fights with friends).Finally, results of regression analyses were most consistent with a model in which family violenceand economic distress contributed to problematic aggressive behaviors among children; that aggression, in turn, appeared to lead to social isolation and avoidance. The overall results emphasized the need to address violence and aggression in any intervention programs for homeless children and families.     

Continuity and Pathways from Aggression in Childhood to Family Violence in Adulthood: A 30-year Longitudinal Study

Literature suggests that early patterns of aggressive behavior in both girls and boys are predictive of later violent behavior, including violence that takes place within family contexts. Utilizing the Concordia Longitudinal Risk Project, a study of individuals recruited as children in the 1970s from inner-city schools in Montreal, this study examined different pathways whereby aggressive behavioral styles in childhood may place individuals at risk for continuing patterns of violence towards children and spouses. Childhood aggression directly predicted self-reported violence towards spouse for both sexes, with indirect routes through lowered educational attainment and marital separation. Aggression in childhood was also found to predict parents’ self-reports of using violence with their children. For mothers, educational attainment and current absence of the biological father from the child’s home also played important roles in predicting violent behavior towards offspring. These findings provide evidence of both continuity of aggressive behavior and indirect risk paths to family violence, via lower educational attainment and parental absence. In both men and women, childhood aggression may be an identifiable precursor of family violence and child abuse.     

Relational Violence in Women's Prison: How Women Describe Interpersonal Violence and Gender

Using data from interviews with former female inmates, I focus on how women describe aggression and violence in prison. Interviewees outline the connection between prison violence, gender, and interpersonal relationships. Similar to in previous studies on adolescent girls, women describe ostracism and rumors as a form of aggression. Furthermore, they detail how some inmates fight over correctional officers as the only men in their lives. I define this form of aggression as relational violence, which is commonly described as adolescent behavior. This article broadens the current work on gender and inmate conflict by focusing on violence used by adult female offenders. Moreover, it extends understanding of inmate culture by allowing interviewees to verbally construct the social reality of prison violence from their perspective to evaluate how they connect violence to gender roles.