The alcohol-aggression relationship and differential sensitivity to alcohol

How Alcohol Influences Mechanisms of Sexual Risk Behavior Change: Contributions of Alcohol Challenge Research to the Development of HIV Prevention Interventions

This paper examines the contributions of laboratory-based alcohol challenge research (ACR) to the development of HIV prevention interventions. Following a brief overview of HIV prevention interventions and related health behavior change models, we discuss how alcohol may influence mechanisms of behavior change. The paper highlights the value of ACR for: (1) elucidating mechanisms of action through which alcohol affects sexual risk behavior, (2) testing how alcohol may influence mechanisms thought to underlie HIV prevention interventions, (3) clarifying moderators of the causal influences of alcohol, (4) identifying novel intervention targets, and (5) developing strategies to reduce sexual risk among those who consume alcohol. We conclude with a discussion of the importance of using experimental research to identify mechanisms of behavior change that are specific to populations at high risk for HIV and outline some key implications for developing HIV prevention interventions that integrate the role of alcohol.

Alterations of Metabolites in the Frontal Cortex and Amygdala Are Associated With Cognitive Impairment in Alcohol Dependent Patients With Aggressive Behavior

BACKGROUND

Alcohol dependence (AD) patients have a high prevalence of aggressive behavior (AB). The frontal cortex and amygdala contains various neurotransmitter systems and plays an important role in AB, which is also associated with cognitive deficits. However, to date, no study has addressed the association of metabolites in the frontal cortex and amygdala with cognitive deficits in Chinese aggressive behavior-alcohol dependent patients(AB-ADs).

METHODS

We recruited 80 male AD and 40 male healthy controls (HCs), who completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Modified Overt Aggression Scale (MOAS), and the proton magnetic resonance spectroscopy (¹H MRS) scan using 3.0T Siemens. The ¹H MRS data were automatically fitted with a linear combination model for quantification of metabolite levels of n-acetyl-aspartate (NAA), glutamate (Glu), Choline (Cho) and creatine (Cr). Metabolite levels were reported as ratios to Cr.

RESULTS

The AB-ADs group scored significantly lower than the non-aggression-alcohol dependent patients (NA-ADs) on these two RBANS subscales (immediate memory and attention function indices). The AB-ADs group showed a significant reduction in NAA/CR ratio in the left frontal cortex and Cho/Cr ratio in the left amygdala, and elevation in Glu/Cr ratio in the bilateral amygdala, compared with the NA-ADs group. The NAA/Cr ratio in the left frontal cortex was positively associated with immediate memory (r=0.60, P<0.05), and the Glu/Cr ratio in the right amygdala was negatively associated with delayed memory (r=-0.44,P<0.05) in AB-ADs group.

CONCLUSIONS

Metabolite alterations in the frontal cortex and amygdala may be involved in the pathophysiology of AB in AD and its associated cognitive impairment, especially immediate memory and delayed memory.

Alcohol, Self-Regulation and Partner Physical Aggression: Actor-Partner Effects Over a Three-Year Time Frame

The question of how individual differences related to self-regulation interact with alcohol use patterns to predict intimate partner aggression (IPA) is examined. We hypothesized that excessive drinking will be related to partner aggression among those who have low self-regulation. In addition, we explored the extent to which differences in self-regulation in one partner may moderate the relationship between alcohol use and partner aggression. A sample of married or cohabitating community couples (N = 280) ages 18–45 was recruited according to their classification into four drinking groups: heavy drinking in both partners (n = 79), husband only (n = 80), wife only (n = 41), by neither (n = 80), and interviewed annually for 3 years. IPA, drinking, and scores on measures of negative affect, self-control, and Executive Cognitive Functioning (ECF) were assessed for both members of the couple. The Actor Partner Interdependence Model (APIM) was used to analyze longitudinal models predicting the occurrence of IPA from baseline alcohol use, negative affect, self-control and ECF. Actor self-control interacted with partner self-control such that IPA was most probable when both were low in self-control. Contrary to prediction, actors high in alcohol use and also high on self-control were more likely to engage in IPA. Partner alcohol use was predictive of actor IPA when the partner was also high in negative affect. Low partner ECF was associated with more actor IPA. These findings suggest that self-regulatory factors within both members of a couple can interact with alcohol use patterns to increase the risk for relationship aggression.

Keep calm and carry on: Maintaining self-control when intoxicated, upset, or depleted

This study tested within-person associations between intoxication, negative affect, and self-control demands and two forms of self-control failure, interpersonal conflict, and neglecting responsibilities. Effortful control was hypothesised to act as a buffer, reducing individual susceptibility to these within-person effects. In contrast, reactivity was hypothesised to potentiate the within-person associations. 274 young adults aged 18-27 (56% women, 93% white) completed experience sampling assessments for up to 49 days over the course of 1.3 years. Results indicated independent within-person effects of intoxication, negative affect, and self-control demands on the outcomes. Hypothesised moderating effects of reactivity were not supported. Effortful control did not moderate the effects of self-control demands as expected. However, effortful control exhibited a protective effect when individuals were intoxicated or upset to reduce the likelihood of maladaptive behavioural outcomes.

Adolescent homicide victimization in Johannesburg, South Africa: incidence and epidemiological characteristics (2001-2009)

This study describes the incidence and epidemiological characteristics of adolescent homicides (15-19 years) in Johannesburg, South Africa. A retrospective population-based study was conducted on cases drawn from the National Injury Mortality Surveillance System. A total of 590 adolescent homicides were registered for 2001-2009 corresponding to an average annual homicide rate of 23.4/100,000. The average annual rate was 39.8/100,000 for males and 7.9/100,000 for females. Black and coloured adolescents had the highest homicide rates. There was a considerable decline in the firearm homicide rates over the study period. In contrast, sharp instrument and blunt force homicides increased. Public places were the predominant scenes for male deaths, while female homicides occurred primarily in residential locations. Most male homicides took place over weekend nights. Alcohol was a prominent feature of homicides. The high homicide rates reported in this study underscore the need to develop interventions directed specifically at adolescents. Prevention efforts are required to pay particular attention to black and coloured adolescent males, and to address the availability of weapons and alcohol use among adolescents.

Alcohol consumption in adolescent homicide victims in the city of Johannesburg, South Africa

AIMS

To describe the blood alcohol concentration (BAC) of adolescent homicide victims in Johannesburg, South Africa and to identify the victim and event characteristics associated with a positive BAC at the time of death.

DESIGN

Logistic regression of mortality data collected by the National Injury Mortality Surveillance System (NIMSS).

SETTING

Johannesburg, South Africa.

PARTICIPANTS

A total of 323 adolescent (15-19 years) homicide victims for the period 2001-9 who had been tested for the presence of alcohol.

MEASUREMENTS

Data on the victims' BAC level, demographics, weapon or method used, scene, day and time of death were drawn from NIMSS.

FINDINGS

Alcohol was present in 39.3% of the homicide victims. Of these, 88.2% had a BAC level equivalent to or in excess of the South African limit of 0.05 g/100 ml for intoxication. Multivariate logistic analysis showed that a positive BAC in homicide victims was associated significantly with the victim's sex [male: odds ratio (OR) = 2.127; 95% confidence interval (CI) = 1.012-4.471], victim's age (18-19 years: OR = 2.364; CI = 1.343-4.163); weapon used (sharp instruments: OR = 2.972; CI = 1.708-5.171); and time of death (weekend: OR = 3.149; CI = 1.842-5.383; night-time: OR = 2.175; CI = 1.243-3.804).

CONCLUSIONS

Excessive alcohol consumption is associated with a substantial proportion of adolescent homicides in Johannesburg, South Africa, and is more prevalent among male and older adolescent victims and in victims killed with sharp instruments over the weekends and during the evenings.

Understanding men's aggression in bars: development of the Beliefs and Attitudes toward Male Alcohol-Related Aggression (BAMARA) inventory

BACKGROUND

While several qualitative studies suggest that beliefs and attitudes are important in explaining men's alcohol-related aggression, no quantitative instrument measuring men's beliefs and attitudes about male alcohol-related aggression has been developed. The purpose of this study was to develop and test a theoretically based multidimensional inventory measuring Beliefs and Attitudes toward Male Alcohol-Related Aggression (BAMARA) consisting of 9 dimensions: (i) expected negative consequences; (ii) expected positive consequences; (iii) personal approval; (iv) perceived male peer approval; (v) perceived female peer approval; (vi) perceived normality; (vii) relaxed norms when drinking; (viii) alcohol as an excuse; and (ix) male honor/protection of masculinity.

METHODS

A random sample of 1,343 young adult male college and university students participated in an online survey. Item analyses using confirmatory factor analytic (CFA) and item-response theory (IRT) procedures were conducted to select a refined pool of items promoting high internal consistency and discriminant validity of the 9 scales. We evaluated the criterion validity of the 9 scales, the BAMARA total score (BAMARA-Total), and a short form of the inventory (BAMARA-SF) in terms of their association with experiences of barroom aggression and other theoretically linked constructs.

RESULTS

CFA and IRT analyses resulted in a 53-item inventory consisting of the 9 scales with adequate model fit and good internal consistency indices. Criterion validity was demonstrated, with the BAMARA scales correlating well with reports of actual experiences of aggression in bars. BAMARA-Total and BAMARA-SF were found to be significantly associated with barroom aggression controlling for a number of important control variables.

CONCLUSIONS

This new instrument is expected to have many important applications in the male aggression literature, with the full BAMARA being employed for the assessment of specific beliefs and attitudes and the BAMARA-SF used as a general attitudinal measure.

Effects of acute alcohol consumption on the perception of eye gaze direction

Alcohol consumption is associated with increases in aggressive behaviour, but the mechanisms underlying this relationship are poorly understood. One mechanism by which alcohol consumption may influence behaviour is via alterations in the processing of social cues such as gaze. We investigated the effects of acute alcohol consumption on the perception of gaze, using a task in which participants determined whether a stimulus face was looking towards or away from them. Gaze direction varied across trials, allowing calculation of a threshold at which participants considered gaze to switch from direct to averted. Target faces varied in both sex and attractiveness. Thirty social drinkers attended three randomized experimental sessions. At each session, participants consumed 0.0, 0.2 or 0.4 g/kg alcohol, and completed the gaze perception task. A significant three-way interaction involving target sex, participant sex and alcohol dose indicated that alcohol increased the cone of gaze for females viewing male targets (i.e. females were biased towards making a direct gaze judgement), but decreased the cone of gaze for males viewing male targets. Our data indicate that alcohol consumption influences gaze perception, but that these effects vary across sex of both stimulus and rater. These effects may have important implications for alcohol-related violence.

The toxicology of homicide offenders and victims: A review

ISSUES

The toxicology of homicide offenders and victims, and homicide as a cause of death among psychoactive substance users.

APPROACH

Review of the toxicology of homicide, and homicide as a cause of death among psychoactive substance users.

KEY FINDINGS

A half or more of offenders are intoxicated by a psychoactive substance at the time of the homicide, with alcohol the most commonly reported substance. Levels of substances among victims are comparable with those seen among perpetrators. Among both offenders and victims, levels of substances far exceed population use. Among substance users, homicide specific mortality rates of substance users far exceed population rates. Reducing rates of alcohol and other drug consumption, at national and individual levels, can be expected to substantially reduce rates of, and risk for, homicide.

CONCLUSIONS AND IMPLICATIONS

Psychoactive substances are strongly associated with homicide. One of the major societal benefits that can be derived from active attempts to reduce alcohol and other drug use are reductions in homicide rates.

Effects of physical and verbal aggression, depression, and anxiety on drinking behavior of married partners: a prospective and retrospective longitudinal examination

In an ethnically diverse sample of 195 married couples, we conducted a latent factor growth analysis to investigate the longitudinal link (4 time points over 4 1/2 years) between marital aggression (physical and verbal aggression self- and partner-reports) and individual internalizing symptoms (depression and anxiety) as they relate to trajectories of alcohol use among husbands and wives. Alcohol use was operationalized as a latent factor with self- and partner reports of problem drinking as measured by the Michigan Alcoholism Screening Test and the Alcohol Dependence Scale. Verbal aggression by husbands or wives, by itself, has no effect on their alcohol use over time. In conjunction with depression, however, verbally aggressive husbands do have elevated drinking levels. The effects of husbands' and wives' physical aggression on their own and their partners' drinking behavior were also significant. This study is one of the first to examine the change over time in alcohol use for marital partners as related to marital aggression and internalizing symptoms. Our results shed light on areas of marital functioning (aggression, internalizing, alcohol use) that have not been investigated in conjunction with each other in a longitudinal design.

Effects of acute alcohol consumption on processing of perceptual cues of emotional expression

Alcohol consumption has been associated with increases in aggressive behaviour. However, experimental evidence of a direct association is equivocal, and mechanisms that may underlie this relationship are poorly understood. One mechanism by which alcohol consumption may increase aggressive behaviour is via alterations in processing of emotional facial cues. We investigated the effects of acute alcohol consumption on sensitivity to facial expressions of emotion. Participants attended three experimental sessions where they consumed an alcoholic drink (0.0, 0.2 or 0.4 g/kg), and completed a psychophysical task to distinguish expressive from neutral faces. The level of emotion in the expressive face varied across trials the threshold at which the expressive face was reliably identified and measured. We observed a significant three-way interaction involving emotion, participant sex and alcohol dose. Male participants showed significantly higher perceptual thresholds for sad facial expressions compared with female participants following consumption of the highest dose of alcohol. Our data indicate sex differences in the processing of facial cues of emotional expression following alcohol consumption. There was no evidence that alcohol altered the processing of angry facial expressions. Future studies should examine effects of alcohol expectancy and investigate the effects of alcohol on the miscategorisation of emotional expressions.

Executive cognitive functioning and the recognition of facial expressions of emotion in incarcerated violent offenders, non-violent offenders, and controls

Violence is a social problem that carries enormous costs; however, our understanding of its etiology is quite limited. A large body of research exists, which suggests a relationship between abnormalities of the frontal lobe and aggression; as a result, many researchers have implicated deficits in so-called "executive function" as an antecedent to aggressive behaviour. Another possibility is that violence may be related to problems interpreting facial expressions of emotion, a deficit associated with many forms of psychopathology, and an ability linked to the prefrontal cortex. The current study investigated performance on measures of executive function and on a facial-affect recognition task in 20 violent offenders, 20 non-violent offenders, and 20 controls. In support of our hypotheses, both offender groups performed significantly more poorly on measures of executive function relative to controls. In addition, violent offenders were significantly poorer on the facial-affect recognition task than either of the other two groups. Interestingly, scores on these measures were significantly correlated, with executive deficits associated with difficulties accurately interpreting facial affect. The implications of these results are discussed in terms of a broader understanding of violent behaviour.

Intimate partner violence by men abusing and non-abusing alcohol in Poland

Alcohol use is to one of the most of risk factors for intimate partner violence. The aim of this study was to check the difference of demographic characteristics and type of violence between of the perpetrators with a history of alcohol abuse (A) versus the perpetrators without a history of alcohol abuse (N). Data were obtained from the survey conducted in the office of the Association for Violence Prevention in the city of Lublin, Poland. 400 perpetrators and their victims (400 subjects) were examined. To collect information from victims a specially designed questionnaire was used (VQ). Besides, another questionnaire (PQ) and The Alcohol Use Disorders Identification Test (AUDIT) was used to measure alcohol use in the perpetrators. About 76% of the perpetrators scored 8 and above (AUDIT). 84.8% of the perpetrators with a history of alcohol abuse (A) versus 9.2% of the perpetrators without a history of alcohol abuse (N) committed acts of violence after alcohol consumption. The A-perpetrators were more likely to be younger, have lower education and break law, and less likely to have permanent jobs than the N- perpetrators. The significant difference in the type of violence was found: the A-perpetrators were more likely to commit physical violence (78.2%) than the Nperpetrators (33.2%) and the N-perpetrators were more likely to commit sexual violence (32.2%) than A-perpetrators (9.14%). We would like to conclude that despite similarities among perpetrators, they are not a homogenous group so different therapeutic approach should be considered.

Heart Rate Response to Alcohol and Intoxicated Aggressive Behavior

BACKGROUND

This study examined the elevated heart rate (HR) response to alcohol intoxication, thought to reflect an increased sensitivity to alcohol-induced reward, as a potential factor in the increased likelihood of alcohol-induced aggression.

METHODS

Three groups, intoxicated high (n=37) and low (n=37) HR responders and sober controls (n=73), participated in a laboratory measure of physical aggression, the Taylor Aggression Paradigm.

RESULTS

Results revealed that intoxicated high HR responders were more aggressive than the intoxicated low HR responders and sober controls.

CONCLUSIONS

These findings are interpreted within a hypothetical model relating increased alcohol-induced aggression to a dysregulation in the motivational system responding to rewards.

Drugs of abuse and the elicitation of human aggressive behavior

The drug-violence relationship exists for several reasons, some direct (drugs pharmacologically inducing violence) and some indirect (violence occurring in order to attain drugs). Moreover, the nature of that relationship is often complex, with intoxication, neurotoxic, and withdrawal effects often being confused and/or confounded. This paper reviews the existing literature regarding the extent to which various drugs of abuse may be directly associated with heightened interpersonal violence. Alcohol is clearly the drug with the most evidence to support a direct intoxication-violence relationship. The literatures concerning benzodiazepines, opiates, psychostimulants, and phencyclidine (PCP) are idiosyncratic but suggest that personality factors may be as (or more) important than pharmacological ones. Cannabis reduces likelihood of violence during intoxication, but mounting evidence associates withdrawal with aggressivity. The literature on the relationship between steroids and aggression is largely confounded, and between 3,4-methylenedioxymethamphetamine (MDMA) and aggression insufficient to draw any reasonable conclusions. Conclusions and policy implications are briefly discussed.