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PubMed2005

Aggression in Asian patients with first-episode psychosis.

AIMS: The aims of this study were to examine the prevalence and severity of aggression in patients with first-episode psychosis and to identify the association between aggression and sociodemographic and clinical factors. METHODS: Consecutive patients with first-episode psychosis admitted to the Early Psychosis Intervention Programme, Singapore, were assessed for a history of aggressive acts. Diagnosis was confirmed using the Structured Clinical Interview for DSM-IV and psychopathology was assessed using PANSS. RESULTS: Of the 146 patients, 63.0% had no history of aggressive acts, 13.7% demonstrated severe aggression (defined as weapon use, sexual assault or victim injury) and 23.3% had lesser aggression (all other acts of aggression). Patients with aggression had a significantly longer duration of untreated psychosis (DUP) than those with no history of aggression (p = .01). The mean total PANSS scores did not differ significantly among the three groups. However, the General Psychopathology scores and the scores for 'hostility', 'poor impulse control', 'lack of insight and judgement' and 'somatic concern' were all significantly elevated in patients with aggression (p < .05). CONCLUSION: The significant association between aggression and longer DUP once again reiterates the need for early detection and effective management of first-episode psychosis.

Adult↗
PubMed1996

Pharmacotherapy of aggressive behavior.

OBJECTIVE: To review the definition, clinical characteristics, prevalence, etiology, neurochemistry, and pharmacologic treatment of aggressive behavior, and provide recommendations regarding the use of specific pharmacologic agents for treating aggressive behavior. DATA SOURCES: Data from the scientific literature were analyzed, interpreted, and summarized. An English-language MEDLINE search yielded clinical trials, case reports, letters, and review articles addressing the etiology and pharmacotherapy of aggression. STUDY SELECTION: Because few well-controlled studies are available in aggression research, all literature addressing the pharmacologic treatment of aggressive behavior, as well as the neurochemistry and psychobiology of aggressive behavior, was reviewed. DATA EXTRACTION: The literature was reviewed on the basis of the particular pharmacotherapy and the specific population used. A separate review of the treatment of aggressive behavior in the elderly was included. DATA SYNTHESIS: The literature was assessed for applicability to clinical practice and usefulness to the general clinician. Recommendations were made from the primary literature in conjunction with trends in clinical practice. Pharmacotherapy is a primary mainstay of treatment for aggressive patients. In individuals for whom behavioral intervention alone is unsuccessful, drug therapy should be initiated along with continued nonpharmacologic intervention. Short-acting benzodiazepines and high-potency antipsychotic agents are effective in treating acute aggression on a short-term or as needed basis. Agents such as lithium, beta adrenergic blockers, carbamazepine, valproic acid, buspirone, trazodone, serotonin reuptake inhibitors, and clozapine may be useful in the chronic management of aggressive behavior. Every attempt should be made to streamline drug therapy in patients with chronic aggression and comorbid psychiatric disorders. CONCLUSIONS: On the basis of available research and extensive clinical experience, lithium or propranolol should be considered as first-line antiaggressive agents in patients without comorbid psychiatric disorders. A minimum trial period for assessing drug efficacy should last at least 6-8 weeks at maximum tolerated dosages. Patients responding to pharmacotherapy should be reevaluated every 3-6 months, and periodic medication tapers and/or drug-free periods should be attempted.

Aggression↗
PubMed2004

Anabolic androgenic steroids and aggression: studies using animal models.

The use of anabolic androgenic steroids (AASs) has escalated in teenagers and is associated with increased violence. Adolescent exposure to chronic high levels of AASs is of particular concern because puberty is a hormonally sensitive period during which neural circuitry for adult male patterns of behavior develop. Thus, teenage AAS use may have long-term repercussions on the potential for displaying aggression and violence. Animal models have contributed valuable information on the effects of AAS use. For example, studies in rodents confirmed that exposure to the AASs testosterone and nandrolone, but not stanozolol, does indeed increase aggression. A side effect of AAS use reported in humans is "'roid rage," characterized by indiscriminate and unprovoked aggression. Results of animal studies demonstrated that pubertal rats receiving AASs respond appropriately to social cues as they are more aggressive toward intact males than are castrates. Also, testosterone-treated males recognize appropriate environmental cues as they are most aggressive in their home cage. Thus, adolescent AAS exposure increases aggressive behaviors, but does not induce indiscriminate aggression. To assess whether AAS exposure increases aggression after provocation, rats were tested following a mild tail-pinch. In adolescent males, provocation increased aggression after withdrawal from testosterone, nandrolone, and stanozolol, an effect which persisted for many weeks. The data suggest that AASs sensitize animals to their surroundings and lower the threshold to respond to provocation with aggression. Thus, in humans, pubertal AAS exposure may not cause violent behaviors, but may increase the likelihood that aggressive acts will result in violence. This may persist into adulthood.

Adolescent↗
PubMed2006

Interactions between the neural regulation of stress and aggression.

Socially aggressive interaction is stressful. What is more, social aggression is stressful for both dominant and subordinate animals. Much of the neurocircuitry for stress and aggression overlap. The pattern of neurochemical and hormonal events stimulated by social interaction make it clear that subtle differences in this pattern of response distinguish social rank. The neurotransmitter serotonin (5-HT) responds rapidly to stress, and also appears to play the most important role for inhibitory regulation of aggressive interactions. In addition, the adrenocortical/interrenal steroid hormones corticosterone and cortisol are responsive to stress and influence aggression. However, while 5-HT and glucocorticoids can both be inhibitory to aggression, the relationship between 5-HT and glucocorticoids is not straightforward, and much of the distinctions in function depend upon timing. Neither is inhibitory during the early stressful phase of aggression. This transmitter-hormone combination follows and influences a four-stage functional pattern of effect: (1) predisposed (positively or negatively) toward aggression, (2) motivated toward behavior, (3) responsive to stress (including aggression) and passively allowing aggression, and finally (4) chronically applied 5-HT and glucocorticoids inhibit aggression.

Aggression↗
PubMed1995

Alcohol and human physical aggression: pharmacological versus expectancy effects.

OBJECTIVE: Research has demonstrated that there is a relationship between alcohol consumption and aggressive behavior. Two basic theoretical positions have been proposed to account for this relationship: the pharmacological perspective and the expectancy perspective. This study examined these two competing explanations of the alcohol-aggression relationship. METHOD: Subjects were 40 males selected from a pool of 233 potential subjects who were interviewed by telephone regarding their alcohol expectancies. Subjects who believed that alcohol increases their aggression and subjects who believed that alcohol decreases their aggression were selected to participate. These subjects were randomly assigned to one of two dose conditions: active-placebo or high dose of alcohol. Subjects were given the opportunity to behave in an aggressive manner within the context of a competitive reaction time task. Aggression was operationalized as the intensity of electric shock subjects set for their opponent during the task. RESULTS: It was found that the high dose of alcohol resulted in significantly higher levels of aggression than the active-placebo dose regardless of subjects' alcohol-aggression expectancies. For the intoxicated subjects, the expectancy that alcohol increases aggressiveness tended to facilitate intense levels of aggression during conditions of high provocation. CONCLUSIONS: The results suggest that the pharmacological effects of alcohol play a primary role in the relationship between alcohol ingestion and aggression.

Adult↗
PubMed1980

Escape as a factor in the aggressive behavior of two retarded children.

This study sought to identify some of the variables controlling the severely aggressive behavior of two retarded children. In Experiment 1, each child was presented with several demand and nondemand situations. Aggression was frequent in the demand situations and rare in the nondemand situations. When a stimulus correlated with the termination of demands was introduced, aggression fell to a near zero level. In Experiment 2, for one child, a variety of preferred reinforcers was introduced into the demand situation contingent on correct responding. Aggression abruptly decreased to a low level. Experiments 3 and 4 involved the second child. In Experiment 3, this child was permitted, in one condition, to leave the demand situation if he emitted a nonaggressive response. Aggression decreased to a low level. In Experiment 4, he was prevented, in one condition, from leaving the demand situation in spite of high levels of aggression. Aggression fell to a near zero level. In Experiments 3 and 4, he was permitted, in several conditions, to leave the demand situation following aggressive behavior. Aggression increased to a high level. The results suggested that: (1) aggression can sometimes function as an escape response; and (2) escape-motivated aggression can be controlled by: (a) introducing strongly preferred reinforcers to attenuate the aversiveness of the demand situation; (b) strengthening an alternative, nonaggressive escape response; or (c) using an escape-extinction procedure.

Adolescent↗
PubMed1996

A prospective study of aggression among psychiatric patients in rehabilitation wards.

OBJECTIVE: The aim of the study was to determine, among patients in rehabilitation wards, the prevalence and nature of aggressive behaviour and the relationship between aggressive behaviour and patient characteristics and ward factors. METHOD: The aggressive behaviour of all 220 inpatients within the rehabilitation program of a large psychiatric hospital in Victoria was assessed using the Staff Observation Aggression Scale. RESULTS: Physical assaults occurred at a rate of 97.6 per 100 patients per year. About 40% of all incidents appeared to be unprovoked. Most physical incidents involved use of body parts and use of a weapon was uncommon. Aggression was most often directed at a staff member. Serious injury was rare. Aggressive behaviour was correlated with gender and duration of admission for the whole sample; however, there were different correlates of aggressive behaviour for different ward populations and different types of aggression. As for ward variables, time of day but not patient/staffing level was associated with aggressive behaviour. CONCLUSIONS: There was a high rate of aggressive behaviour among patients in rehabilitation wards; this should be taken into consideration in the planning of their community placement. The findings also caution against aggregating different ward populations and types of aggressive behaviour for research.

Adult↗
PubMed2006

Perceptions of one's attacker's intentions following an aggressive interaction involving alcohol.

The authors investigated and assessed the perceptions of one's attacker's intentions following an aggressive interaction involving alcohol. Participants were 328 (163 men and 165 women) healthy social drinkers between 21 and 35 years of age. After participants had consumed a beverage containing either alcohol or a placebo, the authors tested them on a modified version of the Taylor Aggression Paradigm (TAP; S. Taylor, 1967) in which participants received mild electric shocks from, and administered shocks to, a fictitious opponent (the attacker) under the guise of a competitive task. Aggressive behavior was operationalized as the shock intensities administered to the fictitious opponent. The authors queried participants about their perceptions of their opponents' intentions toward them on the task. Overall, participants who were least aggressive on the TAP perceived their opponent to have the most aggressive intentions and those who were the most aggressive perceived their opponent to have the least aggressive intentions. Alcohol only seemed to play a role for women. It appeared to decrease aggressive perceptions for the least aggressive women and to increase such perceptions for the most aggressive women. The authors discuss results according to L. Huesmann's (1988) cognitive script model of aggression.

Adult↗
PubMed2005

Development and analysis of the effects of caregiver training program on aggressive behavior in elders with cognitive impairment.

PURPOSE: The purposes of this study were to 1) describe the type and frequency of aggressive behavior of cognitively impaired nursing home resident, 2) develop a caregiver training program on prevention and management of aggressive behavior, 3) examine the effects of caregiver training program on the incidence of aggressive behavior of cognitively impaired nursing home resident, and 4) examine the effects of caregiver training program on nursing staff's aggressive behavior management skills. METHODS: One-group, time series, quasi-experimental design with a pre-test and two post-tests was used. Data were collected from cognitively impaired home residents (N=32) and nursing staff (N=36) in a proprietary nursing home using Ryden Aggression Scale I, II, and Aggressive Behavior Management Scale. Data were entered and analyzed by descriptive statistics and repeated measures ANOVA. RESULTS: Incidence of aggressive behavior was high with a mean score of 3.09 (SD=3.11) at baseline. Caregiver training program was developed based on Progressively Lowered Stress Threshold (PLST) model and gerontological and psychiatric literature. The mean scores of aggressive behavior at baseline, Post I, and II did not differ significantly although the difference approached to the significant level (F=2.925, p=.066). Nursing staff's aggressive behavior management skills increased at Post I, and at Post II when compared to baseline, and the difference was significant (F=12.736, p=<.001). CONCLUSION: Caregiver training program showed potential impact on reduction of aggressive behavior in elders with cognitive impairment and was effective in increasing nursing staff's aggressive behavior management skills.

Adult↗
PubMed2003

Hostility during admission interview as a short-term predictor of aggression in acute psychiatric male inpatients.

BACKGROUND: A critical step for improving the prediction of on-ward violence is the identification of variables that are not only consistently associated with an increased risk of aggression but also easily evaluated during the admission interview. The goal of this prospective study was to assess the predictive utility of hostility during admission interview. METHOD: The sample consisted of 80 newly admitted male patients with heterogeneous DSM-IV psychiatric diagnoses recruited from the psychiatric ward of an urban public hospital. Psychiatric symptoms at admission were assessed with the Brief Psychiatric Rating Scale (BPRS). Aggressive behavior during the first week of hospitalization was measured with the Modified Overt Aggression Scale. Data were collected between January and June 1998. RESULTS: In a multiple regression model, BPRS items hostility and tension-excitement emerged as significant predictors of verbal aggression, whereas thinking disturbance (high) and suspiciousness-uncooperativeness (low) emerged as significant predictors of aggression against objects. In contrast, when aggression was treated as a binary dependent variable in a logistic model, hostility during the admission interview had no utility in predicting on-ward aggressive behavior. CONCLUSION: This study confirms the importance of distinguishing between different types of aggression to improve the accuracy of predictions of violence. The findings suggest that the question whether hostility is a useful short-term predictor of aggression in psychiatric inpatients cannot be answered conclusively. The predictive utility of hostility was relatively high for predicting verbal aggression but was negligible for predicting other types of aggressive behavior.

Acute Disease↗
PubMed2002

[An analysis of the relationship between aggressiveness and personality traits of children].

The purpose of the present study was to understand the concept of aggressiveness of children through an analysis of the relationship between aggressiveness and personality traits. A total of 1,206 elementary school children were enrolled in the study. In order to investigate the correlation, a path analysis was performed using multiple regression analyses in which 4 variables of aggressiveness (irritability, hostility, physical aggression and verbal aggression) were employed as dependent variables and 5 variables of personality traits (agreeableness, conscientiousness, emotionality, openness and extroversion) were used as independent variables. The results of the analysis indicated that significantly positivepath was observed from extroversion to all four variables of aggressiveness. Extroversion indicated especially strong influence on irritability and physical aggression. A significantly negativepath was observed from agreeableness to irritability and hostility. From conscientiousness, a negative path was observed towards physical aggression and a positive path towards verbal aggression. A significantly negative path was observed from emotionality only towards verbal aggression. It was assumed that each of the four inferior characteristics of aggressiveness of children had a complex nature to be influenced by multiple personality traits.

Aggression↗
PubMed1999

Elimination of aggressive behavior in male mice lacking endothelial nitric oxide synthase.

Male mice with targeted deletion of the gene encoding the neuronal isoform of nitric oxide synthase (nNOS(-/-)) display increased aggressive behavior compared with wild-type (WT) mice. Specific pharmacological inhibition of nNOS with 7-nitroindazole also augments aggressive behavior. We report here that male mice with targeted deletion of the gene encoding endothelial NOS (eNOS(-/-)) display dramatic reductions in aggression. The effects are selective, because an extensive battery of behavioral tests reveals no other deficits. In the resident-intruder model of aggression, resident eNOS(-/-) males show virtually no aggression. Latency for aggression onset is 25-30 times longer in eNOS(-/-) males compared with WT males in the rare instances of aggressive behaviors. Similarly, a striking lack of aggression is noted in tests of aggression among groups of four mice monitored in neutral cages. Although eNOS(-/-) mice are hypertensive ( approximately 14 mmHg blood pressure elevation), hypertension does not appear responsible for the diminished aggression. Reduction of hypertension with hydralazine does not change the prevalence of aggression in eNOS(-/-) mice. Extensive examination of brains from eNOS(-/-) male mice reveals no obvious neural damage from chronic hypertension. In situ hybridization in WT animals reveals eNOS mRNA in the brain associated exclusively with blood vessels and no neuronal localizations. Accordingly, vascular eNOS in the brain appears capable of influencing behavior with considerable selectivity.

Aggression↗
PubMedDate not supplied

[Neurobiological correlates premeditated (learned) aggression: seeking new experimental approaches].

Theoretical possibility of experimental modeling of learned (premediated) aggression developing in human after experience of aggression is considered. The sensory contact technique increases aggressiveness in male mice and allows aggressive type of behavior to be formed as a result of repeated experience of victories in daily agonistic confrontations. Some behavioral domains confirm the development of learned aggression in males similar to those in humans. The features are: repeated experience of aggression reinforced by victories; elements of learned behavior after period of confrontations; intent, measured by increase of the aggressive motivation prior agonistic confrontation; decreased emotionality estimated by parameters of open field behavior. Relevant stimuli provoke demonstration of aggression. This review summarized data on the influence of positive fighting experience in daily intermale confrontations on the behavior, neurochemistry and physiology of aggressive mice (winners). This sort of experience changes many characteristics in individual and social behaviors, these having been estimated in different tests and in varied situations. Some physiological parameters are also changed in the winners. Neurochemical data confirm the activation of brain dopaminergic systems and functional inhibition of serotonergic system in winners under influence of repeated experience of aggression. The expression of the neurochemical and behavioral changes observed in winners has been found dependent on the mouse strain and on the duration of their agonistic confrontations. Similarities in mechanisms of learned aggression in humans and mice are considered.

Aggression↗
PubMed2003

Effects of antidepressants on the exploration, spontaneous motor activity and isolation-induced aggressiveness in mice.

OBJECTIVE: To study the role of different antidepressants on exploration, spontaneous motor activity and isolation-induced aggressiveness in mice, further to discuss different mechanisms of their anti-aggression. METHODS: With an aggressive model induced by isolation housing in mice, antagonism of different antidepressants against isolation-induced aggression was evaluated. In the group-housed mice given the same treatment as aggressive test, exploration and spontaneous motor activity were measured. RESULTS: (1) Mianserin (0.5-5 mg/kg-1), buspirone (2.5-10 mg.kg-1) and meclobemide (2.5-10 mg.kg-1) significantly inhibited the exploration in the group-housed mice, but not fluoxetine (2.5-10 mg.kg-1), imipramine (2.5-10 mg.kg-1) and DOI (0.5-2 mg.kg-1); (2) Both mianserin and buspirone, but not fluoxetine, imipramine, meclobemide and DOI, obviously reduced spontaneous motor activity; (3) Fluoxetine, miaserin, imipramine and buspirone significantly and dose-dependently antagonized isolation-induced aggressive behavior, whereas meclobemide failed to attenuate aggression. DOI dual-regulated aggressiveness in isolation mice. CONCLUSION: Our findings suggest that the effects of fluoxetine, mianserin, buspirone, imipramine, meclobemide and DOI on exploration, spontaneous motor activity and isolation-induced aggression in mice are different, which may involve different pharmacological mechanisms underlying their anti-aggression in isolation mice. 5-HT1A and 5-HT2A/2C receptors may mediate isolation-induced aggressive behavior in mice. The involvement of 5-HT receptor subtypes needs further clarification.

Aggression↗
PubMedDate not supplied

Aggression in suicide among adults age 50 and over.

OBJECTIVE: Aggression confers risk for suicide in younger adults, but there is a paucity of research in middle and older adults. The authors examined the link between aggression and suicide in individuals age 50 and over. METHODS: Scores on general aggression and aggression in the past month were compared in 85 cases and 85 community-comparison subjects matched on age, gender, race, and county of residence. Bivariate and multivariate tests controlling for mood disorders were conducted, along with analyses to examine age- or gender-related patterns. RESULTS: General aggression distinguished Suicide from Control subjects in men and women and in younger (50-64 years) and older (65-plus) subjects. General aggression was more strongly related to suicide in individuals under age 65. Aggression in the past month was also higher in Suicide than in Control subjects from the total sample but was not consistently higher across age and gender strata. General aggression and past-month aggression were not associated with suicide after controlling for mood disorders. CONCLUSIONS: The association of general aggression and suicide extends to middle and older adulthood, and aggression may serve as a marker for suicide risk before the onset of depression.

Aged↗
PubMed2005

Testosterone and aggressiveness.

Aggressiveness is an ancestral behavior common to all animal species. Its neurophysiological mechanisms are similar in all vertebrates. Males are generally more aggressive than females. In this review, aggressive behavior in rodents, monkeys, and man and the role of testosterone and brain serotonin levels have been considered. Interspecific aggressiveness in rats has been studied considering the mouse-killing behavior; the neonatal androgenization of females increases adult mouse-killing as does the administration of testosterone in adults. Intraspecific aggressiveness was studied by putting two or more male rats (or mice) in the same cage; the condition of subjection or dominance is influenced by testosterone. In monkeys, testosterone is related to aggressiveness and dominance and, during the mating season, increases in testosterone levels and aggressive attitude are observed. In men, higher testosterone levels were obtained in perpetrators of violent crimes, in men from the army with antisocial behaviors, in subjects with impulsive behaviors, alcoholics and suicidals, in athletes using steroids, and during competitions. Aggressive and dominant behavior are distinguished. Testosterone influences both of these, even if man is usually inclined to affirm his power without causing physical damage. Testosterone receptors are mainly in some hypothalamic neurons, where it is aromatized into estrogens, which determine the increase in aggressiveness. A relation between testosterone levels and diencephalic serotonin has been shown: in fact, the lack of serotonin increases aggressive behaviors both in animals and man. Testosterone also increases ADH levels in the medial amygdala, lateral hypothalamus, and preoptical medial area, involved in aggressive behaviors.

Adult↗
PubMedDate not supplied

[The role of dopamine receptors in controlling mouse aggressivity: the genotype dependence].

Significant genotypic differences in shock-induced aggression were found in mice of eight inbred strains. Aggression was evaluated in test with the action of low electric current through the cage floor. Low aggressive strains C3H/He, DD, BALB/c, AKR and highly aggressive strains CBA, DBA/2. CC57Br were singled out by the number of aggressive attacks. Selective stimulation of dopamine D2 receptors by bromocriptine considerably increased the shock-induced aggressiveness in mice of low-aggressive strains. Blockade of D2-receptors by the injection of antagonist sulpiride decreased or prevented the manifestation of aggression in highly-aggressive mice. At the same time selective agonist of dopamine (D1) receptors SKF 38393 and administration of selective antagonist of D1-receptors SCH 23390 did not influence significantly shock-induced aggression. Thus, shock-induced aggression, depends on the animal genotype and activation of D2-receptors.

Aggression↗
PubMed1982

Social cognitive biases and deficits in aggressive boys.

3 studies are reported which assess the nature and limits of a known bias on the part of aggressive boys to overattribute hostile intentions to peers. The first study determined that this bias is restricted to attributions of a peer's behavior toward an aggressive boy, and not to attributions of a peer's behavior toward a second peer. Biased attributions were implicated as a direct precedent to aggressive responses. The second study assessed the role of selective attention to and recall of hostile social cues in the formation of a biased attribution. It was found that selective recall of hostile cues did lead to a biased attribution, but that selective recall did not fully account for the attributional differences between aggressive and nonaggressive boys. Also, specific deficits in recall by aggressive boys were identified. The third study involved naturalistic observation of the peer-directed aggressive behaviors of boys in a controlled setting. It was found that the biased attributions of aggressive boys may have some basis in their experience, in that they were frequently the targets of peers' aggressive behavior. Their own aggressive behavior toward peers, however, occurred at a much higher rate than the rate at which they were the targets of aggression. These findings led to the formation of a social-information-processing model of aggressive behavior.

Aggression↗