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PubMedDate not supplied

Relationship between psychiatric diagnosis and patient aggression.

Patient aggression is a common problem on psychiatric units. Recent research has focused on the relationship between aggressive behavior and various patient characteristics, including psychopathology. The purpose of this study was to examine the relationship between diagnostic groups and particular types of patient aggression in a state psychiatric hospital. A secondary analysis was performed on existing data. There was no significant difference noted among DSM III diagnoses in total patient aggression. However, there was a significant difference between individuals with organic disorders and individuals with paranoid schizophrenia in the category of physical aggression against other people. Improved ability to identify a particular diagnostic group with the potential for aggression will strengthen efforts to decrease the risk of patient aggression in psychiatric facilities.

Adult↗
PubMedDate not supplied

Early relationships and the development of aggression in children.

The development of abnormally aggressive human behavior is complex and multifactorial. Aggressive patterns of behavior often begin early in life and, once established, are notorious for their resistance to change, which has led some to believe that environmental interventions offer little hope for significant reductions in the prevalence of violent behavior in our society. Recent findings from research in the field of developmental psychopathology, however, have shed some new light on this very old problem. This paper specifically reviews the attachment literature and interprets it in the context of what has already been learned from research in epidemiology and behavioral genetics on environmental contributions to aggression over the life span. Environmental factors may influence the development of aggression by affecting children's early relationships with primary caregivers or by limiting opportunities for children to engage in positive relationships with caring adult figures. Longitudinal studies directly correlating early attachment relationships with levels of aggression in later childhood have been limited in number but suggest that insecure early attachment relationships may predispose children to the development of abnormally aggressive behavior, particularly when such relationships represent the entirety of their early social experience. Interventions aimed at either enhancing parent-child relationships or providing opportunities for alternative relationships with caring adult figures, particularly in high-risk settings, may help to prevent abnormally aggressive behavioral outcome.

Age Factors↗
PubMed1990

The effect of dietary tryptophan on aggressive behavior in developing and mature broiler breeder males.

Broiler breeders display high levels of aggressive activity as a result of feed restriction. The objective of this study was to determine if aggressive activity in developing and mature broiler breeder males is influenced by increased dietary L-tryptophan (Trp). Broiler breeder males were raised using a skip-a-day feed restriction regimen. In Experiment 1, three levels of dietary Trp, .19 (control), .75, and 1.5%, were fed from the start of feed restriction at 4 wk of age and throughout development. All occurrences of aggressive behavior were recorded during three 20-min observation sessions per week on mornings on which feed was not delivered through Week 20. The Trp significantly decreased (P less than .05) aggressive pecking in birds fed supplemental Trp as compared to controls. No differences in threatening behavior were found. In the second part of Experiment 1, the effect of continued Trp supplementation on mature flocks of male broiler breeders and time-of-day effects on aggression were investigated. A depressing effect of supplemental Trp on pecking and threatening was observed. Maximum aggressive activity in all treatment groups occurred on mornings when feed was delivered. In Experiment 2, four levels of Trp, .19 (control), .38, .75, and 1.5%, were fed to developing birds as in Experiment 1. Birds fed supplemental Trp pecked less (P less than .05) than controls and .38% Trp was as effective in decreasing pecking as was 1.5%. It was concluded that increased levels of dietary Trp decrease aggression in both developing and mature, socially stable flocks of broiler breeder males.

Aggression↗
PubMed1996

Decreases in aggression in tryptophan-supplemented broiler breeder males are not due to increases in blood niacin levels.

In previous studies with feed-restricted broiler breeders, it was found that supplementation with dietary Trp decreases aggressive activity more in socially dominant males than in socially subordinate males. Although it is probable that this effect is mediated centrally by serotonin, an alternative possibility is that it is associated with other metabolic products of Trp such as niacin. The objectives of this study were to determine whether 1) supplemental dietary niacinamide decreases aggression in broiler breeder males, 2) elevated blood niacin levels are associated with a decrease in aggression, and 3) social status influences any of these effects on behavior. Using a randomized complete block design, a control (0.19% Trp, 22 mg niacin/kg), Trp (1.5% Trp, 22 mg niacin/kg), or niacinamide (0.19% Trp, supplemented with 140 mg niacinamide/kg) diet was assigned to each pen. There were 16 birds per pen and three pens per treatment. Birds were maintained on skip-a-day feed restriction throughout, and behavioral observations were conducted until the social hierarchy in each pen was determined. Treatment diets were then fed from 15 through 18 wk of age, and the number of aggressive pecks and threats per pen recorded in three 20-min observation periods/wk. Blood samples were collected from dominant and subordinate birds and assayed for niacin using Tetrahymena pyriformis. Supplementing the diet with Trp significantly (P < 0.05) decreased aggression. Niacinamide-treated birds did not differ from either Trp-treated or control-treated birds, and no decreases in aggression were seen in birds with elevated blood niacin levels. Blood levels of niacin were, however, higher in dominant niacin-treated birds than in dominant control birds (P < 0.05), although there were no differences among subordinate or Trp-treated birds. Thus, the modulatory effect of Trp on aggression does not appear to be mediated by increased niacin synthesis.

Aggression↗
PubMed2005

The effect of a training course on nursing students' attitudes toward, perceptions of, and confidence in managing patient aggression.

Patient aggression is a problem in many health care settings, and nursing students are among the most vulnerable to experiencing such aggression. Training courses have been suggested to help nurses better manage patient aggression. Such courses can lead to changes in attitudes toward and perceptions of, as well as greater confidence in managing, aggression. In this quasi-experimental study, we investigated the effect of a training course on nursing students' attitudes toward, perceptions of, and confidence in managing patient aggression. Students in the intervention group demonstrated enhanced confidence but no change in attitude after the training course, while students in the control group remained stable on all measures. The short time frame of the study, the training course itself, and the instruments used for monitoring attitudes toward aggression are possible reasons for these results. We tentatively conclude that it is possible to enhance nursing students' perceived confidence in managing patient aggression without changing their fundamental views of it.

Adaptation, Psychological↗
PubMed2002

Anger and aggression in psychiatric outpatients.

BACKGROUND: This study sought to evaluate the degree of anger and aggression experienced by psychiatric outpatients and to determine whether anger is as prominent an emotional state in these patients as are depression and anxiety. We also sought to determine which Axis I and Axis II disorders were associated with increased rates of subjective anger and aggressive behavior. METHOD: 1300 individuals presenting to a psychiatric outpatient practice underwent semistructured interviews to evaluate current DSM-IV Axis I (N = 1300) and Axis II disorders (N = 687). Levels of subjective anger and aggression during the preceding week were assessed in each patient, and the odds ratios were calculated for each disorder. A multiple regression analysis was performed to determine which psychiatric disorders independently contributed to the presence of subjective anger and aggressive behavior. RESULTS: Approximately one half of our sample reported currently experiencing moderate-to-severe levels of subjective anger, and about one quarter had demonstrated aggressive behavior in the preceding week. This level of anger was found to be comparable to the levels of depressed mood and psychic anxiety reported by our sample. Major depressive disorder, bipolar I disorder, intermittent explosive disorder, and cluster B personality disorders independently contributed to the presence of both anger and aggression. CONCLUSION: Anger and aggression are prominent in psychiatric outpatients to a degree that may rival that of depression and anxiety; it is therefore important that clinicians routinely screen for these symptoms.

Adult↗
PubMed1976

[Aggression].

The aggressiveness is not a drive and has nothing in common with Freudian death instinct, but it is one of the ways to fulfill the possession desires and the narcissistic desires. As the way to achievement, it comes into a conflict with the fear of failure, with the co-operation advantages and with the altruistic human drives. As the latter ones are rather weak in an average person, the co-operation--as a basis of society--is in all its strata imbued with aggression. Each social structure, up to the present day, has contained aggression as an organic component. The hope of creating a society free from aggression is not based on the betterment of the human character, but on the growth of the productive forces. The existence of the interpersonal aggression has been concealed from a child, brought up in the spirit of the centuries-old fallacious educational principles. As a result, the child develops its first neurosis--the Superego neurosis. The Superego is not a structural component of the human psyche, but it is a neurotic formation. In the subsequent years, the confrontation of the child and the youth with the true aggression may affect his or her development in various ways. In some cases, the given individual disregards the Superego commands and pays for it with the neurosis of permanent guilt feelings. In other cases, the individual deals with the Superego as with the ethical values in themselves, and develops an inhibition neurosis (Gehemmtheitsneurose). Still in other cases he or she revolts against the mendacity of the society and develops a pseudopsychopathy. The proper education should strive to awake the nobe feelings in the child, but at the same time to reveal the whole truth about the existence of aggression in the human interrelations. In these conditions, through the conscious choice between the egoistic and the altruistic drives, could the growing person form the moral attitudes fitting his or her own nature. Because the ethics of the values in themselves is but a philosophical fiction, the only real ethics is that which is based on feelings.

Aggression↗
PubMed2000

Aggressive behavior, increased accumbal dopamine, and decreased cortical serotonin in rats.

Dopamine (DA) and serotonin have been implicated in the regulation of aggressive behavior, but it has remained challenging to assess the dynamic changes in these neurotransmitters while aggressive behavior is in progress. The objective of this study was to learn about ongoing monoamine activity in corticolimbic areas during aggressive confrontations in rats. Male Long-Evans rats were implanted with a microdialysis probe aimed at the nucleus accumbens (NAC) or medial prefrontal cortex (PFC); next, 10 min samples were collected before, during, and after a 10 min confrontation. Rats continued to display aggressive behavior while being sampled, and they performed two to six attack bites as well as 140 sec of aggressive acts and postures. Dopamine levels in NAC were significantly increased up to 60 min after the confrontation. Peak levels of 140% were achieved approximately 20-30 min after the confrontation. No concurrent changes in accumbal serotonin levels were seen during or after the confrontation. Dopamine and serotonin levels in PFC changed in the opposite direction, with a sustained decrease in serotonin to 80% of baseline levels during and after the confrontation and an increase in dopamine to 120% after the confrontation. The temporal pattern of monoamine changes, which followed rather than preceded the confrontation, points to a significant role of accumbal and cortical DA and 5-hydroxytryptamine in the consequences as opposed to the triggering of aggressive acts. The increase in accumbal DA in aggressive animals supports the hypothesis that this neural system is linked to the execution of biologically salient and demanding behavior.

Aggression↗
PubMed2001

Antisocial personality disorder, alcohol, and aggression.

Epidemiologic studies and laboratory research consistently link alcohol use with aggression. Not all people, however, exhibit increased aggression under the influence of alcohol. Recent research suggests that people with antisocial personality disorder (ASPD) may be more prone to alcohol-related aggression than people without ASPD. As a group, people with ASPD have higher rates of alcohol dependence and more alcohol-related problems than people without ASPD. Likewise, in laboratory studies, people with ASPD show greater increases in aggressive behavior after consuming alcohol than people without ASPD. The association between ASPD and alcohol-related aggression may result from biological factors, such as ASPD-related impairments in the functions of certain brain chemicals (e.g., serotonin) or in the activities of higher reasoning, or "executive," brain regions. Alternatively, the association between ASPD and alcohol-related aggression may stem from some as yet undetermined factor(s) that increase the risk for aggression in general.

Aggression↗
PubMed2002

[Aggression in the dental office].

In this study on aggression in the dental practice, 8 dentists and 1 dental nurse who had experienced aggression in their dental practice, were interviewed and filled out a questionnaire. They had responded to a call in 2 Dutch dental journals or were contacted through personal communication. The interviews show that aggression in particular can be expected in patients having not paid their expense account, non compliant patients, or in patients who often come too late or even do not show up at their appointments. Aggression also can appear when patients with toothache are told they cannot be helped immediately. Aggression seems predominantly connected to people under influence of alcohol or drugs, psychiatric patients and people having contacts in criminal circuits. Although the incidence seems relatively low, the occurrence of aggression always has a great impact on the dental team. Therefore it seems useful to study how dentists and their auxiliaries could act to prevent aggression.

Aggression↗
PubMed2003

Impulsive aggressive behavior: open-label treatment with citalopram.

BACKGROUND: Results from open-label and placebo-controlled trials suggest that the selective serotonin reuptake inhibitors reduce impulsive aggressive behavior. The objective of this open-label study was to investigate whether citalopram treatment has anti-aggressive effect on impulsive aggressive subjects meeting DSM-IV criteria for a cluster B personality disorder or intermittent explosive disorder. METHOD: In this 8-week trial, subjects were initiated on 20 mg/day of citalopram and titrated up to 60 mg/day by the fourth week, if tolerated. The primary outcome measure was the Overt Aggression Scale-Modified (OAS-M), a scale used to quantify verbal and physical aggression, subjective irritability, and overt irritability. Secondary outcome measures included the Barratt Impulsiveness Scale and Buss-Durkee Hostility Inventory. RESULTS: Of 25 subjects enrolled, 20 completed the study. The mean daily dose was 45.5 mg, and citalopram was generally well tolerated. Statistically significant decreases were found in the OAS-M aggression scores (32.82 +/- 19.76 to 4.73 +/- 7.57, p =.000), subjective irritability scores (3.50 +/- 0.60 to 1.45 +/- 1.18, p =.000), and overt irritability scores (3.23 +/- 0.81 to 0.91 +/- 1.02, p =.000). CONCLUSION: These results suggest that citalopram is an effective treatment for reducing impulsive aggressive behavior.

Adult↗
PubMed2004

[Lorenz was right, or does aggressive energy accumulate?].

Evidence supporting the fact that inherited mechanisms of regulation of aggressive behavior as a result of a repeated experience of aggression ending in victories are transformed into pathological mechanisms based on accumulation of neurochemical shifts in the brain, enhancing aggressiveness, and forming aggressive motivation in aggressive winners. This confirms the concept by Lorenz on the existence of a mechanism (but not instinct) of a spontaneous accumulation of aggressive energy that needs a discharge and formation of permanent attraction to manifestation of aggression.

Aggression↗
PubMed2005

[Aggression towards paediatricians and trainee paediatricians in the Netherlands].

OBJECTIVE: To determine the extent of aggression from the patient or his family to which paediatricians and trainee paediatricians in the Netherlands are exposed. DESIGN: Cross-sectional survey. METHOD: Data were collected using anonymous questionnaires distributed to doctors working in the field ofpaediatrics in the Netherlands during the annual congress of the Paediatric Association of the Netherlands in 2002. RESULTS: A total of 395 usable questionnaires were returned. 78% of the respondents reported that they had, at some time, been confronted with aggression. Verbal aggression was the most common form (75% of the respondents) and was experienced mainly by doctors with little work experience (63% in the preceding year). 20% of the respondents were aware of the existence of training programmes on dealing with aggression in their hospitals, whereas 47% said that they needed such training. CONCLUSION: Aggression in connection with paediatric care was reported by 78% of the respondents, especially verbal aggression directed at doctors with little work experience. Training on how to cope with aggression might be a useful addition to the paediatric curriculum.

Aggression↗
PubMed2004

Suicidal behaviour and aggression in psychiatric inpatients.

OBJECTIVE: Theoretically, suicidal behaviour and aggression are usually said to be correlated. Such relationship is, however, not reliably supported by clinical and experimental evidence. It has been more frequently found when suicidal psychiatric patients are compared with healthy non-suicidal controls rather than when the comparison is done within the group of the psychiatric patients. Therefore we decided to investigate whether such relationship exists in a group with a high risk of suicidal behaviour--psychiatric male inpatients. MATERIAL AND METHODS: 113 male inpatients, mostly with schizophrenia and other psychotic disorders and mood disorders were studied in the first five days after their admission. Using a structured clinical interview and formal rating scales data were collected about the number of suicide attempts and aggressive acts committed throughout their lives, current suicide ideation and suicide planning behaviour, alcohol use, depression and outwardly directed aggression. Correlation analysis and chi-square test were used to analyze the data. RESULTS: There is no significant relation between current aggressivity and current suicide risk, as well as between the lifetime aggression and the lifetime suicide behaviour. The current suicide ideation and suicide planning behaviour are related to previous suicidal behaviour and to the current depression level. The lifetime aggression is related to the alcohol use. CONCLUSIONS: The results of our study do not define aggression as a suicide risk factor within the group of psychiatric inpatients. This findings could benefit the evaluation of the suicidal risk in psychiatric clinic.

Adolescent↗
PubMed2005

Quantitative trait locus analysis of aggressive behaviours in mice.

Quantitative trait locus (QTL) analysis is a forward genetic strategy (phenotype to gene) that enables an investigator to start with a phenotype of interest (e.g. aggressive behaviours), and then identify chromosomal regions (QTLs) and, ultimately, specific gene variants (alleles) within those regions, that influence quantitative variation in the phenotype. QTL analysis is an important complement to reverse genetic strategies (gene to phenotype), such as the generation of knockout and transgenic mice. Although a propensity for aggressive behaviours is partially heritable in mice and other mammals, very few aggression QTLs have been mapped. This slow progress is likely due, in part, to the complexity of aggressive behaviours as phenotypes, which are affected by many nongenetic (environmental and random) factors and gene-environment interactions. This paper reviews the general principles of QTL analysis, as well as the non-genetic factors that can confound aggression QTL studies. Some examples of successfully mapped intermale mouse aggression QTLs are presented, such as QTLs on chromosomes 10 and X. Strategies for fine mapping these loci are discussed, and candidate genes are considered. Finally, newly available mouse genetic resources that may facilitate QTL analysis of aggressive behaviours are suggested, such as consomic mouse strains.

Aggression↗
PubMed2006

[Recognizing and assessing aggressive behaviour in dogs].

Within the population the sensitivity to aggressive behaviour in dogs has increased. The authorities are confronted with a problem: if any incident occurs it is their task to decide whether the dogs involved constitute a threat to other people or whether the charge is only the result of a quarrel between neighbours. For this reason, an examination of the dogs with regard to their aggressive behaviour is necessary. Seen from the biological point of view, aggressive behaviour is one of four possibilities a dog can chose from to solve a conflict. The dog's intention in showing aggressive behaviour is to eliminate disturbances and to maintain a distance in space and time. Aggressive behaviour might also be necessary to acquire or defend resources essential to the dog's life. This is to secure its survival and its success in reproduction. One can see from this that aggressive behaviour is a very important and biologically necessary adjustment factor. However, when living together with man aggressive behaviour might become a problem. For the assessment and the therapy of the problem it is necessary to exa-mine the behaviour shown by the dog with regard to its cause. To be able to do this an exact anamnesis, a medical check, and an examination of the dog on the basis of its display in special situations are necessary. For this reason, exclusively veterinarians with a special further education in the field of behaviour should carry out the examination of dogs.

Aggression↗
PubMedDate not supplied

[Neonatal buspirone modulates the intermale aggression in adult mice].

Mice of two strains with different levels of male aggression (RSB and RLB) were subjected to daily injections of 5-HT1A receptor agonist buspirone (25 microg) on the 2nd - 6th postnatal days. This neonatal treatment augmented the aggressive behavior (tested in the dyadic contests with non-aggressive A/Sn males) in aggressive RSB mice and reduced aggression in less aggressive RLB. Correlations with different signs were found between the 5-HT and 5-HIAA levels in the neocortex, hippocampus, and hypothalamus and behavioral indices of aggression in RSB and RLB males. The remote effects of neonatal buspirone in these two mice strains presumably depend on genotype-related features of ontogeny of the 5-HT system.

Aggression↗
PubMedDate not supplied

[The involvement of brain 5-HT(1A)-receptors in genetically determined aggressive behavior].

The hypothesis was tested that one of the critical mechanisms underlying genetically determined aggressiveness involves brain serotonin 5-HT(1A)-receptors. The expression of 5-HT(1A)-receptor mRNA in brain structures and functional correlate for 5-HT(1A)-receptors identified as 8-OH-DPAT-induced hypothermia were studied in Norway rats bred over the course of 59 generations for the low and high affective (defensive) aggressiveness with respect to man and in highly aggressive (offensive) MAO A-knockout mice (Tg8 strain). Considerable differences between the aggressive and the nonaggressive animals were shown. Agonist of 5-HT(1A)-receptor 8-OH-DPAT (0.5 mg/kg for rats and 2.0 mg/kg for mice, i.p.) produced a distinct hypothermic reaction in nonaggressive rats and mice and did not affect significantly the body temperature in aggressive animals. In aggressive rats, a significant reduction of the expression of 5-HT(1A)-receptor mRNA was found in the midbrain. In Tg8 mice, 5-HT(1A)-receptor mRNA level was increased in the frontal cortex and amygdala and not changed in the hypothalamus and the midbrain. The results provide support for the idea that brain 5-HT(1A)-receptors contribute to the genetically determined individual differences in aggressiveness.

Aggression↗