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Ciesinski NK, McCloskey MS, Coccaro EF. A latent class analysis of cognitive-affective heterogeneity in current intermittent explosive disorder. J Affect Disord 2024; 363:230-238. [PMID: 39047949 DOI: 10.1016/j.jad.2024.07.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 06/11/2024] [Accepted: 07/12/2024] [Indexed: 07/27/2024]
Abstract
Intermittent Explosive Disorder (IED) is a common, chronic, and impairing psychological condition characterized by recurrent, affective aggressive behavior. IED is associated with a host of cognitive and affective symptoms not included in the diagnostic criteria which may be a valuable indicator of heterogeneity in IED-such information can be useful to enhance understanding and treatment of this disorder in mental health settings. A preliminary investigation conducted on cognitive-affective symptom heterogeneity in individuals with a history of IED demonstrated that level of emotional dysregulation primarily differentiated IED subgroups, however the sample size was limited, and almost half of the individuals did not have current IED (only lifetime IED). The present study addressed these limitations by conducting a latent class analysis of cognitive-affective symptoms among a large (n = 504) sample of individuals diagnosed with current IED. The latent IED classes were then externally validated on several adverse outcomes, historical precursors, and demographic variables. Statistical and clinical indicators supported a four-class model, with classes primarily distinguished by patients' severity of emotion dysregulation. The two moderate emotion-dysregulated classes both endorsed callous-unemotional traits and low empathy relative to other classes, a finding which differs from the initial investigation. An external validation of the four classes revealed that they significantly differed on severity outcomes (e.g., aggression, suicide attempts, antisocial behavior, global functioning, comorbidities) and historical precursors (e.g., aversive parental care, childhood maltreatment). These findings provide further insight into the heterogeneity within IED and the associations of such variability with important precursors and clinical outcomes.
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Affiliation(s)
- Nicole K Ciesinski
- Department of Psychology and Neuroscience, Temple University, United States of America.
| | - Michael S McCloskey
- Department of Psychology and Neuroscience, Temple University, United States of America
| | - Emil F Coccaro
- Wexner Medical Center, Ohio State University, United States of America
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Menzies RE, Richmond B, Sharpe L, Skeggs A, Liu J, Coutts-Bain D. The 'revolving door' of mental illness: A meta-analysis and systematic review of current versus lifetime rates of psychological disorders. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2024; 63:178-196. [PMID: 38197576 DOI: 10.1111/bjc.12453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVES Therapists have long observed a phenomenon referred to as the 'revolving door' of mental health services, in which individuals often develop, seek treatment for, and recover from multiple mental illnesses across their life. However, this has not been systematically examined. If this phenomenon is widespread, one would expect that the number of lifetime disorders would exceed that of current disorders. The aim of this meta-analysis was to test this hypothesis. METHODS A search was conducted of the following databases: MEDLINE, PsycINFO and Web of Science. In total, 38 studies were included in the current review; 27 of these contained sufficient quantitative data to be included in the meta-analysis, addressing the primary research aim. The remaining 11 studies were included in the systematic review only. RESULTS Meta-analyses of the 27 studies indicated that the average number of lifetime disorders was 1.84 times that of current disorders. Previous treatment significantly moderated this relationship, while the clinical nature of the sample did not. Examination of the remaining studies revealed common temporal sequences, indicating disorders which typically develop first or consequently to other disorders. CONCLUSIONS These findings provide support for the revolving door of mental illness, suggesting a need for transdiagnostic treatments and broader conceptualisation of relapse prevention.
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Affiliation(s)
| | | | - Louise Sharpe
- The University of Sydney, Sydney, New South Wales, Australia
| | - Amira Skeggs
- The University of Sydney, Sydney, New South Wales, Australia
| | - Janessa Liu
- The University of Sydney, Sydney, New South Wales, Australia
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Kronberg G, Ceceli AO, Huang Y, Gaudreault PO, King SG, McClain N, Alia-Klein N, Goldstein RZ. Naturalistic drug cue reactivity in heroin use disorder: orbitofrontal synchronization as a marker of craving and recovery. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.11.02.23297937. [PMID: 37961156 PMCID: PMC10635268 DOI: 10.1101/2023.11.02.23297937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Movies captivate groups of individuals (the audience), especially if they contain themes of common motivational interest to the group. In drug addiction, a key mechanism is maladaptive motivational salience attribution whereby drug cues outcompete other reinforcers within the same environment or context. We predicted that while watching a drug-themed movie, where cues for drugs and other stimuli share a continuous narrative context, fMRI responses in individuals with heroin use disorder (iHUD) will preferentially synchronize during drug scenes. Results revealed such drug-biased synchronization in the orbitofrontal cortex (OFC), ventromedial and ventrolateral prefrontal cortex, and insula. After 15 weeks of inpatient treatment, there was a significant reduction in this drug-biased shared response in the OFC, which correlated with a concomitant reduction in dynamically-measured craving, suggesting synchronized OFC responses to a drug-themed movie as a neural marker of craving and recovery in iHUD.
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Affiliation(s)
- Greg Kronberg
- Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Ahmet O Ceceli
- Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Yuefeng Huang
- Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | | | - Sarah G King
- Icahn School of Medicine at Mount Sinai, New York, NY 10029
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Singer J, Cummings C, Coccaro EF. Parental separation and death during childhood as predictors of adult psychopathology: An examination of racial differences. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2024; 16:184-192. [PMID: 35737525 PMCID: PMC10262299 DOI: 10.1037/tra0001291] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Parental separation and parental death during childhood are common but understudied forms of adverse childhood events (ACEs), thus little is known about the impact on psychological functioning in adulthood. We examined whether parental death and parental separation during childhood was associated with risk of diagnostic criteria for depressive disorders, anxiety disorders, posttraumatic stress disorder (PTSD), or personality disorders during adulthood. Second, we compared parental separation and parental death and psychopathology across African Americans (N = 499) and Whites (N = 782). METHOD The sample consists of 1,211 participants (n = 669 females). Diagnostic interviews were administered by master's or doctorate-level degree holders in Clinical Psychology or Social Work. There was good to excellent interrater reliabilities (mean kappa of .84 ± .05; range: .79-.93) spanning anxiety, mood, anxiety, trauma, and personality disorders. RESULTS White participants reporting parental separation during childhood were more likely to report depressive disorders (OR = 2.151, p < .001), PTSD (OR = 2.218, p < .01) and personality disorders (OR = 1.764, p < .001) during adulthood. African American endorsement of parental separation during childhood did not predict depressive disorders (OR = 1.21, p = .357), anxiety disorders (OR = 1.107, p = .659), PTSD (OR = 1.351, p = .425) or personality disorders (OR = 1.432, p = .098) during adulthood. Overall, participants who reported parental death did not have significantly higher rates of depressive disorders (OR = 1.100, p = .668), anxiety disorders (OR = 1.357, p = .207), PTSD (OR = 1.351, p = .425), and personality disorders (OR = 1.432, p = .098). CONCLUSIONS Parental separation was a significant risk factor for adult psychopathology, but only for White participants. Parental death was not a risk factor for adult psychopathology no matter the person's race. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | | | - Emil F Coccaro
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center
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5
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Lynch S, Becker T, Shanker P, Martin D, Staudenmaier P, Leong A, Rice T. Predictors and Correlates of Positive Urine Drug Screening in a Retrospective Cohort Analysis of Child and Adolescent Psychiatry Inpatients Throughout the COVID-19 Pandemic. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:33-43. [PMID: 38258854 DOI: 10.1177/29767342231210711] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND AND OBJECTIVES Youth substance use is associated with significant psychological, neurological, and medical complications. Risk factors for substance use among children and adolescents in the general population include peer and/or parental substance use, certain psychiatric illnesses (eg, Attention-Deficit/Hyperactivity Disorder, depression), and history of maltreatment. Co-occurring substance use and psychiatric illness have been associated with increased suicidality, but few prior studies have characterized substance use among child/adolescent inpatients. As such, it remains unclear how substance use contributing to acute psychiatric presentations has changed since the start of the COVID-19 pandemic. METHODS This is a retrospective cohort study of 816 unique child/adolescent psychiatry inpatients with urine drug screening (UDS) results from a diverse urban setting. Charts of patients hospitalized between June 1, 2018 and November 30, 2021 were reviewed for sociodemographic characteristics, indication for admission, psychiatric history, hospital course, treatment plan, and discharge diagnosis. Differences in sociodemographic and clinical characteristics, such as age, race, and diagnoses, between patients with and without positive UDS were explored throughout various periods of the COVID-19 pandemic. Descriptive and comparative statistics were performed, as well as a logistic regression model to identify the predictors of positive UDS. RESULTS Of the study sample, 18% had a positive UDS. Older age, diagnosis of impulsive or behavioral disorder, and a history of violence were found to be predictors of positive UDS. Asian/South Asian or Hispanic/LatinX race and history of a developmental or intellectual disability were found to be negative predictors. The frequency of positive UDS in this population did not change based on COVID-19. DISCUSSION AND CONCLUSIONS Multiple factors may predispose children and adolescents to substance use. Though no impact of COVID-19 was found in this sample, longer-term studies are needed. SCIENTIFIC SIGNIFICANCE This study identifies independent predictors of active substance use in the child and adolescent psychiatric inpatient population.
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Affiliation(s)
- Sean Lynch
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY, USA
| | - Timothy Becker
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, NY, USA
| | - Parul Shanker
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY, USA
| | - Dalton Martin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Morningside, New York, NY, USA
| | - Paige Staudenmaier
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY, USA
| | - Alicia Leong
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Timothy Rice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Morningside, New York, NY, USA
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Şeker FD, Akgür SA. The role of aggression in substance use: The prison case. J Ethn Subst Abuse 2023:1-15. [PMID: 37860985 DOI: 10.1080/15332640.2023.2268564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
OBJECTIVES Substance use and aggressive behaviour pattern is considered as a serious criminal behaviour threat. This analytical cross-sectional study was designed to determine the level of aggression of convicts with substance use and to determine the variables predicting the substance use characteristics of convicts. METHODS The study was carried out with 255 male convicts in 2 different closed penal execution institutions in Izmir province. In order to measure demographic variables, data were collected using the Information Form, Buss Perry Aggression Questionnaire and Addiction Profile Index. RESULTS When convicts were examined according to demographic variables, it was found that there was a significant difference between the groups in terms of variables such as age, marital status, domestic violence, history of psychological treatment and self-harm behaviour. The results showed that 85.5% of convicts had used cannabis more than three times in their lifetime. Also there was a significant difference between the total score obtained from the aggression scale and the number of substance types used. CONCLUSIONS Multidisciplinary approach in the field of addiction can go a long way in solving the problem and will play an important role in the protection of society, individuals and victims.
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Affiliation(s)
| | - Serap Annette Akgür
- Ege University Institute on Drug Abuse, Toxicology and Pharmaceutical Science, Izmir, Turkey
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Ramezani E, Bougar MR, Khodarahimi S, Forghani MD, Mazraeh N. Men’s opiate-derived drug abuse and psychopathology in their wives: a systematic review and meta-analysis. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04412-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
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Johnston EL, Gliser CP, Haney JP, Formon DL, Hashimoto N, Rossbach N. Extreme emotional disturbance: Legal frameworks and considerations for forensic evaluation. BEHAVIORAL SCIENCES & THE LAW 2022; 40:733-755. [PMID: 35674311 DOI: 10.1002/bsl.2580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 04/13/2022] [Accepted: 04/27/2022] [Indexed: 06/15/2023]
Abstract
A significant minority of jurisdictions in the United States offer extreme emotional disturbance (EED) as a partial defense to murder. The form of this defense, as established by statute and case law, varies widely among jurisdictions. Empirical research on EED is scant with little guidance to forensic mental health professionals on how to approach and conceptualize potential EED cases. This paper addresses these issues by being the first known published work to (1) set forth a contemporary map of the varying definitions and scope of EED across the United States, (2) translate legal terminology into constructs accessible to forensic evaluators, and (3) provide legal and clinical analyses of sample EED cases to highlight key differences in the form of the defense and the admissibility of evidence between jurisdictions.
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Affiliation(s)
- E Lea Johnston
- University of Florida Research Foundation Professor, Professor of Law, University of Florida Levin College of Law, Gainesville, Florida, USA
| | | | - Jonathan P Haney
- J.D. Candidate, University of Florida Levin College of Law, Gainesville, Florida, USA
| | | | - Naoko Hashimoto
- Colorado Department of Human Services, Court Services Division, Office of Behavioral Health, Pueblo, Colorado, USA
| | - Nadia Rossbach
- J.D. Candidate, University of Florida Levin College of Law, Gainesville, Florida, USA
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Ciesinski NK, Drabick DAG, McCloskey MS. A latent class analysis of intermittent explosive disorder symptoms. J Affect Disord 2022; 302:367-375. [PMID: 35101522 DOI: 10.1016/j.jad.2022.01.099] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 08/29/2021] [Accepted: 01/26/2022] [Indexed: 10/19/2022]
Abstract
Intermittent explosive disorder (IED), the sole diagnosis in the DSM-5 for which the cardinal symptom is recurrent affective aggressive outbursts, is a common and substantially impairing disorder. IED is also associated with several cognitive and affective impairments. However, little is known about the heterogeneity of the disorder and how this may correspond to aggression severity and related adverse outcomes. The current study employed a latent class analysis (LCA) among individuals diagnosed with lifetime DSM-5 IED to derive distinct subgroups that differed in the quality and/or frequency of cognitive-affective symptoms. These subgroups were then externally validated on a number of adverse outcomes. Statistical and clinical indicators supported a four-class model. Classes were distinguished mainly by the level of emotion dysregulation participants endorsed, with two moderate emotion dysregulation classes differing on their emotional information processing and impulsive tendencies. The external validation analysis revealed that classes differed in terms of various adverse outcomes (e.g., interpersonal problems, life satisfaction, suicide risk). Overall, the present study suggests distinct cognitiveaffective symptom profiles among those with IED that differ meaningfully with regard to risk for adverse outcomes. These findings provide evidence of the heterogeneity within IED and may suggest a more personalized therapeutic approach to patients with IED.
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Affiliation(s)
- Nicole K Ciesinski
- Department of Psychology, Temple University, Weiss Hall Room 551, 1701 N. 13th St., Philadelphia, PA 19122, Pennsylvania.
| | - Deborah A G Drabick
- Department of Psychology, Temple University, Weiss Hall Room 551, 1701 N. 13th St., Philadelphia, PA 19122, Pennsylvania
| | - Michael S McCloskey
- Department of Psychology, Temple University, Weiss Hall Room 551, 1701 N. 13th St., Philadelphia, PA 19122, Pennsylvania
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Tifft ED, Roberts MZ, Underwood SB, Forsyth JP. Acceptance and Commitment Therapy (ACT) for Problematic Anger: A Case Study. Clin Case Stud 2022. [DOI: 10.1177/15346501221080931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Though anger is a common human emotion, the unfettered behavioral expression of anger is often costly, contributing to a range of functional impairments, poor quality of life, and both physical and mental health problems. The current case illustrates how a third-generation cognitive behavioral therapy, Acceptance and Commitment Therapy (ACT), may be effective in reducing suffering linked with problematic anger. The client (“Robert”), a treatment-naïve man of low socioeconomic status, presented to a university training clinic reporting problematic anger outbursts that interfered with his relationships at work and with his girlfriend. The therapist conceptualized Robert’s problematic anger through the ACT psychological flexibility model, wherein Robert’s anger appeared to function as experiential avoidance to distance him from underlying emotional hurt. The therapist used ACT over 27 sessions to reduce Robert’s psychological inflexibility while promoting more psychological flexibility. Early sessions highlighted the unworkability of Robert’s anger, whereas subsequent sessions focused on clarifying values, loosening cognitive fusion, facilitating present moment awareness, and cultivating mindful acceptance in the service of living a meaningful life. The therapist monitored treatment progress using quantitative measures and qualitative reports. Collectively, the client showed notable gains. The case study adds to the growing body of literature supporting ACT for problematic anger.
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Affiliation(s)
- Eric D. Tifft
- Department of Psychology, University at Albany, Albany, NY, USA
| | - Max Z. Roberts
- Department of Psychology, University at Albany, Albany, NY, USA
| | | | - John P. Forsyth
- Department of Psychology, University at Albany, Albany, NY, USA
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Shima C, Lee R, Coccaro EF. Associations of agression and use of caffeine, alcohol and nicotine in healthy and aggressive individuals. J Psychiatr Res 2022; 146:21-27. [PMID: 34942448 DOI: 10.1016/j.jpsychires.2021.10.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 09/05/2021] [Accepted: 10/18/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Caffeine, alcohol, and nicotine are the three most commonly used psychoactive substances in the world. Given the known propensity of these substances to influence behavior, the relationship between these substances and aggressive and impulsive behaviors, in particular is of interest. METHODS 1062 adult individuals participated in this study including those with Intermittent Explosive Disorder (IED) and non-aggressive healthy (HC) and psychiatric (PC) controls. Data regarding current and life use of caffeine, alcohol, and nicotine were recorded as were responses on measures of aggression, anger, and impulsivity. RESULTS Dimensional measures of aggression, anger, and impulsiveness were variably but significantly related to the consumption of these commonly used psychoactive substances. These findings were generally mirrored when using the categorical construct of IED. Finally, these findings were not due to comorbidity with other psychiatric disorders. CONCLUSIONS These data confirm a link between these externalizing behaviors and these three legal and commonly consumed psychoactive substances in clinically relevant individuals.
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Affiliation(s)
- Carolyn Shima
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral, Neuroscience, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Royce Lee
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral, Neuroscience, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Emil F Coccaro
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner, Medical Center, Columbus, OH, USA.
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Closing the gap: unmet needs of individuals with impulsive aggressive behavior observed in children and adolescents. CNS Spectr 2021; 26:448-456. [PMID: 32228725 DOI: 10.1017/s1092852920001224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Impulsive aggressive (IA, or impulsive aggression) behavior describes an aggregate set of maladaptive, aggressive behaviors occurring across multiple neuropsychiatric disorders. IA is reactive, eruptive, sudden, and unplanned; it provides information about the severity, but not the nature, of its associated primary disorder. IA in children and adolescents is of serious clinical concern for patients, families, and physicians, given the detrimental impact pediatric IA can have on development. Currently, the ability to properly identify, monitor, and treat IA behavior across clinical populations is hindered by two major roadblocks: (1) the lack of an assessment tool designed for and sensitive to the set of behaviors comprising IA, and (2) the absence of a treatment indicated for IA symptomatology. In this review, we discuss the clinical gaps in the approach to monitoring and treating IA behavior, and highlight emerging solutions that may improve clinical outcomes in patients with IA.
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Prevalence and psychiatric comorbidities of intermittent explosive disorders in Metropolitan São Paulo, Brazil. Soc Psychiatry Psychiatr Epidemiol 2021; 56:687-694. [PMID: 32285139 DOI: 10.1007/s00127-020-01869-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 03/25/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To estimate the prevalence of intermittent explosive disorder (IED) in comorbidity with other psychiatric disorders and to describe the temporal sequencing of disorders in the São Paulo Metropolitan Area, Brazil. METHODS Data from the São Paulo Megacity Mental Health Survey, a population-based study of 5037 adult individuals, were analyzed. The World Health Organization Composite International Diagnostic Interview (CID 3.0) was used to assess lifetime DSM-IV disorders, including IED, with a response rate of 81.3%. RESULTS The majority (76.8%) of respondents with IED meet the criteria for at least one other psychiatric disorder, with a prevalence almost twice as high as that observed in individuals without IED. The prevalence of any anxiety, mood, impulse control or substance use disorders in respondents with IED was more than two times higher compared to those without IED, with prevalence ratios ranging from 2.1 (95% CI 1.74-2.48) to 2.9 (95% CI 2.12-4.06). The diagnosis of IED occurred earlier than most of the other mental disorders, except for those with usual onset in early childhood, as Specific and Social Phobias and Attention Deficit Disorder. CONCLUSION Considering that IED is a highly comorbid disorder and has an earlier onset than most other mental comorbidities in the Brazilian general population, these results may be useful in guiding governmental mental health actions.
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Eriksson L, Bryant S, McPhedran S, Mazerolle P, Wortley R. Alcohol and drug problems among Australian homicide offenders. Addiction 2021; 116:618-631. [PMID: 32562295 DOI: 10.1111/add.15169] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/05/2020] [Accepted: 06/13/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Most homicide studies focus upon 'acute' situational intoxication as opposed to 'chronic' substance misuse. The aims of the study were to: (1) determine the extent of homicide offenders' alcohol and drug use in the year preceding the homicide; (2) compare the individual characteristics of homicide offenders across levels of problematic substance use; and (3) compare homicide incident characteristics across levels of problematic substance use. DESIGN AND SETTING Observational study using data collected through face-to-face interviews in custodial and community correctional settings across Australia. Participants were recruited through an opt-in process. PARTICIPANTS The data consist of 302 individuals convicted of murder or manslaughter. MEASUREMENTS We used the Alcohol Use Disorder Identification Test and Drug Abuse Screening Test to determine problematic alcohol or drug use. We also used a range of self-report measures to ascertain offender characteristics [socio-demographics, developmental experiences, criminal history, personality] and incident characteristics (who was killed, and situational intoxication). FINDINGS Of the sample, 38.8% displayed high levels of alcohol problems and 30.8% displayed high levels of drug problems. Those displaying high levels of alcohol and/or drug problems were more likely than those without high levels of alcohol and/or drug problems to report adverse developmental experiences, low education, financial difficulties, extensive criminal histories and high levels of trait anger, impulsivity and risk-seeking. In addition, offenders with problematic substance use were more likely to have killed non-family and to have used substances at the time of the homicide. CONCLUSIONS High proportions of homicide offenders in Australia appear to have problematic substance use in the year preceding the homicide offence, and such use appears to be associated with a range of other challenging factors, including adverse childhoods, criminal involvement, low socio-economic factors and low self-regulation.
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Affiliation(s)
- Li Eriksson
- Griffith Criminology Institute, Griffith University, Mt Gravatt, QLD, Australia
| | - Sarah Bryant
- Centre for Youth Substance Abuse Research, University of Queensland, St Lucia, QLD, Australia
| | - Samara McPhedran
- Pro-Vice Chancellor's (Arts, Education, Law) Office, Griffith University, Mt Gravatt, QLD, Australia
| | - Paul Mazerolle
- Vice-Chancellor's Office, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Richard Wortley
- Jill Dando Institute for Security and Crime Science, University College London, London, UK
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Liu Q, Cole DA. Aggressive outbursts among adults with major depressive disorder: Results from the Collaborative Psychiatric Epidemiological Surveys. J Psychiatr Res 2021; 135:325-331. [PMID: 33556687 DOI: 10.1016/j.jpsychires.2021.01.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 01/02/2021] [Accepted: 01/22/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Little is known about the epidemiology of aggressive outbursts, including physical assault, property destruction, and verbal aggression, among adults with unipolar Major Depressive Disorder (MDD). METHODS We examined the prevalence and correlates of aggressive outbursts among adults with primary MDD (N = 2539) from the Collaborative Psychiatric Epidemiological Surveys (N = 20,013) using generalized linear models. RESULTS The prevalence estimate of any aggressive outbursts was 58.7% among adults with MDD. MDD was associated with aggressive outbursts independent of other psychiatric diagnoses. The prevalence of aggressive outbursts differed significantly by age, race/ethnicity, sex, education, marital status, and employment status, and psychiatric diagnoses. Aggressive outbursts were associated with greater severity and earlier age of onset for MDD. Positive associations were also found between the frequency of aggressive outbursts and depressive symptoms including weight/appetite change, fatigue, recurrent thoughts of death. Moreover, aggressive outbursts significantly multiplied the odds of experiencing more severe functional impairment, suicidal ideation, suicide plan, and suicide attempt. CONCLUSION Aggressive outbursts are much more common than previously recognized among adults with MDD. The significant association of aggressive outbursts with MDD characteristics, increased functional impairment, and suicidal thoughts and behaviors make them an important target for assessment and treatment for adults with MDD.
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Bush E, Cupery T, Turner RW, Sonnega A, Weir D, Whitfield KE, Jackson JS. The Price of Playing Through Pain: The Link Between Physical and Behavioral Health in Former NFL Athletes. Am J Mens Health 2020; 14:1557988320975541. [PMID: 33251947 PMCID: PMC7705796 DOI: 10.1177/1557988320975541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Over the past decade, media outlets have drawn attention to some of the health consequences of playing in the National Football League (NFL), including how wear-and-tear and injuries accumulated during athletes’ playing years can affect their physical, emotional, and behavioral health after retirement from professional sports. Through a secondary analysis of a cross-sectional telephone survey of former NFL athletes, this study estimated logistic regression models to assess the relationship between several forms of physical pain and anger attacks, controlling for binge drinking, signs of depression, functional limitations, NFL career duration, religious service attendance, and demographic characteristics (age, marital status, race, education, income, and wealth). The analytic sample included 1030 former NFL players. Neck pain, lower back pain, headaches/migraines, and the number of sites of pain were positively and significantly related to anger attacks. There was no significant association between joint pain and anger attacks. NFL career duration was negatively associated with anger attacks, as was religious service attendance. Future research should focus on factors that protect against affective aggression in former professional athletes and how protective factors can be adapted to the broader population.
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Affiliation(s)
- Evelyn Bush
- Department of Sociology and Anthropology, Fordham University, Bronx, NY, USA
| | - Tim Cupery
- Department of Sociology, College of Social Sciences, California State University, Fresno, CA, USA
| | - Robert W Turner
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
| | - Amanda Sonnega
- Survey Research Center of the Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - David Weir
- Survey Research Center of the Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | | | - James S Jackson
- Department of Psychology, College of Literature, Sciences, and the Arts, University of Michigan, Ann Arbor, MI, USA
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17
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Li Q, Xiao M, Song S, Huang Y, Chen X, Liu Y, Chen H. The personality dispositions and resting-state neural correlates associated with aggressive children. Soc Cogn Affect Neurosci 2020; 15:1004-1016. [PMID: 32991698 PMCID: PMC7647379 DOI: 10.1093/scan/nsaa134] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 09/03/2020] [Accepted: 09/24/2020] [Indexed: 11/16/2022] Open
Abstract
Despite aggression being detrimental to children's physical health, mental health and social development, the dispositional and neurological antecedents of aggression in the child are poorly understood. Here we examined the relationship between trait aggression as measured by Buss and Warren's Aggression Questionnaire and personality traits measured with Big Five Questionnaire for Children in 77 primary-school children and recorded resting-state brain activity (fractional amplitude of low-frequency fluctuations [fALFF]) and resting-state functional connectivity (rsFC) using functional magnetic resonance imaging. The present results showed that trait aggression was negatively correlated with agreeableness and positively correlated with neuroticism. The brain analyses showed that children with a higher propensity for aggression had a lower fALFF mainly in the left superior temporal gyrus, right parahippocampal gyrus and left supramarginal gyrus. Physical and total aggressions were negatively associated with rsFC between the right parahippocampal gyrus and the right putamen. Further analysis revealed that this rsFC could moderate the influence of neuroticism on total aggression. Moreover, the results suggest the presence of a sex difference in the neurodevelopmental mechanisms underlying aggression in middle childhood. Overall, our findings indicate that aggressive children have lower agreeableness and higher neuroticism, and the underlying neural systems are mainly implicated in social judgment and empathy.
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Affiliation(s)
- Qingqing Li
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | | | | | | | | | | | - Hong Chen
- Correspondence should be addressed to: Hong Chen, Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Tiansheng Road No.2, Beibei District, Chongqing, China. E-mail:
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18
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de Abreu MS, C V V Giacomini A, Genario R, Fontana BD, Parker MO, Marcon L, Scolari N, Bueno B, Demin KA, Galstyan D, Kolesnikova TO, Amstislavskaya TG, Zabegalov KN, Strekalova T, Kalueff AV. Zebrafish models of impulsivity and impulse control disorders. Eur J Neurosci 2020; 52:4233-4248. [PMID: 32619029 DOI: 10.1111/ejn.14893] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/25/2020] [Accepted: 06/18/2020] [Indexed: 12/22/2022]
Abstract
Impulse control disorders (ICDs) are characterized by generalized difficulty controlling emotions and behaviors. ICDs are a broad group of the central nervous system (CNS) disorders including conduct disorder, intermittent explosive, oppositional-defiant disorder, antisocial personality disorder, kleptomania, pyromania and other illnesses. Although they all share a common feature (aberrant impulsivity), their pathobiology is complex and poorly understood. There are also currently no ICD-specific therapies to treat these illnesses. Animal models are a valuable tool for studying ICD pathobiology and potential therapies. The zebrafish (Danio rerio) has become a useful model organism to study CNS disorders due to high genetic and physiological homology to mammals, and sensitivity to various pharmacological and genetic manipulations. Here, we summarize experimental models of impulsivity and ICD in zebrafish and highlight their growing translational significance. We also emphasize the need for further development of zebrafish ICD models to improve our understanding of their pathogenesis and to search for novel therapeutic treatments.
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Affiliation(s)
- Murilo S de Abreu
- Bioscience Institute, University of Passo Fundo, Passo Fundo, Brazil.,The International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, LA, USA
| | - Ana C V V Giacomini
- Bioscience Institute, University of Passo Fundo, Passo Fundo, Brazil.,Postgraduate Program in Environmental Sciences, University of Passo Fundo, Passo Fundo, Brazil
| | - Rafael Genario
- Bioscience Institute, University of Passo Fundo, Passo Fundo, Brazil
| | - Barbara D Fontana
- Brain and Behaviour Laboratory, School of Pharmacy and Biomedical Sciences, University of Portsmouth, UK
| | - Matthew O Parker
- Brain and Behaviour Laboratory, School of Pharmacy and Biomedical Sciences, University of Portsmouth, UK
| | - Leticia Marcon
- Bioscience Institute, University of Passo Fundo, Passo Fundo, Brazil
| | - Naiara Scolari
- Bioscience Institute, University of Passo Fundo, Passo Fundo, Brazil
| | - Barbara Bueno
- Bioscience Institute, University of Passo Fundo, Passo Fundo, Brazil
| | - Konstantin A Demin
- Institute of Experimental Medicine, Almazov National Medical Research Center, Ministry of Healthcare of Russian Federation, St. Petersburg, Russia.,Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia
| | - David Galstyan
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia
| | - Tatyana O Kolesnikova
- Institute of Experimental Medicine, Almazov National Medical Research Center, Ministry of Healthcare of Russian Federation, St. Petersburg, Russia
| | | | | | - Tatyana Strekalova
- Laboratory of Psychiatric Neurobiology, Institute of Molecular Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.,School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands.,Division of Molecular Psychiatry, Center of Mental Health, University of Würzburg, Würzburg, Germany.,Institute of General Pathology and Pathophysiology, University of Würzburg, Moscow, Russia
| | - Allan V Kalueff
- School of Pharmacy, Southwest University, Chongqing, China.,Laboratory of Petrochemistry, Ural Federal University, Ekaterinburg, Russia
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19
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Puhalla AA, Berman ME, Coccaro EF, Fahlgren MK, McCloskey MS. History of childhood abuse and alcohol use disorder: Relationship with intermittent explosive disorder and intoxicated aggression frequency. J Psychiatr Res 2020; 125:38-44. [PMID: 32203738 DOI: 10.1016/j.jpsychires.2020.02.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 02/23/2020] [Accepted: 02/24/2020] [Indexed: 01/12/2023]
Abstract
Intermittent Explosive Disorder (IED), the only psychiatric diagnosis for which affective aggression is the cardinal symptom, is uniquely associated with both a history of childhood abuse and a diagnosis of an alcohol use disorder (AUD). Moreover, both childhood abuse and AUD are associated with increased general aggression and aggression while intoxicated. Yet, no study to date has examined the relative contributions of childhood abuse and AUD to IED, nor their effects on overall and intoxicated aggression among those with and without IED. The following study aimed to fill these gaps. Participants were 493 individuals (68% female; Age M = 26.65) either with (n = 265) or without (psychiatric control group; n = 228) IED. All participants completed a clinical interview to (a) diagnose AUD, IED, and other comorbid psychiatric disorders; (b) assess childhood abuse history; and (c) determine lifetime frequency of overall and intoxicated aggression. Results indicated that a history of childhood abuse, but not AUD status, was uniquely predictive of IED status. With regard to aggression frequency, IED, AUD and childhood abuse were all independently associated with overall aggression, although only those with IED showed increased intoxicated aggression as a function of AUD severity. Overall, these results suggest that a history of childhood abuse may increase the chances of engaging in overall aggression and developing IED, which in turn may increase the association between AUD severity and intoxicated aggression.
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Affiliation(s)
| | - Mitchell E Berman
- Department of Psychology, Mississippi State University, Starkville, MI, USA
| | - Emil F Coccaro
- Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
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20
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Radwan K, Coccaro EF. Comorbidity of disruptive behavior disorders and intermittent explosive disorder. Child Adolesc Psychiatry Ment Health 2020; 14:24. [PMID: 32514306 PMCID: PMC7257202 DOI: 10.1186/s13034-020-00330-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 05/13/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Aggressive behavior in children and adolescents may be accounted for by several disruptive behavioral disorders (DBD) including attention-deficit/hyperactive (ADHD), conduct (CD), and oppositional defiant (ODD), disorders and intermittent explosive disorder (IED). The comorbidity among the DBDs is well known, but not its comorbidity with IED. METHOD We reanalyzed data from the National Comorbidity Studies (adolescents and adults), and from a large clinical research adult sample, to estimate the comorbidity of IED with each of the DBDs and to explore correlates of these comorbidities. RESULTS The rate of current comorbidity between IED and the DBDs ranged from 10 to 19%, in adolescents (5-14% in adults) with odds ratios of about five. The onset of ADHD typically appeared before onset of IED while onset ODD and CD more typically appeared before that of IED in adolescents and about equally before or after IED in adults but IED persisted outside the duration window in many (ADHD) or most (ODD, CD) cases. Measures of impulsive aggression severity were highest in those with IED+DBD but relatively low in those with DBD alone while measures of DBD severity were highest in those with DBD alone and in those with IED+DBD. CONCLUSION Despite the comorbidity of IED with the DBDs, IED can be separated from the DBDs over time and in terms of severity measures of IED and of DBD. Overall, impulsive aggression varies with IED while DBD behaviors vary with DBD. Based on this, clinicians should consider IED in their differential in the workup of impulsively aggressive children and adolescents.
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Affiliation(s)
- Karam Radwan
- grid.170205.10000 0004 1936 7822Section of Child & Adolescent Psychiatry, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, University of Chicago, Chicago, IL USA
| | - Emil F. Coccaro
- grid.412332.50000 0001 1545 0811Clinical Neuroscience and Psychotherapeutics Research Unit, Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 1670 Upham Drive, Columbus, OH USA
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21
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Impulsivity and Impulsivity-Related Endophenotypes in Suicidal Patients with Substance Use Disorders: an Exploratory Study. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-020-00259-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AbstractSuicidal behavior (SB) is a major problem in patients with substance use disorders (SUDs). However, little is known about specific SB risk factors in this population, and pathogenetic hypotheses are difficult to disentangle. This study investigated some SB and SUD-related endophenotypes, such as impulsivity, aggression, trait anger, and risk-taking behaviors (RTBs), in forty-eight patients with SUDs in relation to lifetime history of suicide attempts (SAs). Disorders related to alcohol, cannabis, cocaine, opiates, and hallucinogenic drugs were included. Lifetime SAs was significantly associated with both higher impulsivity and higher aggression, but not with trait anger. A higher number of RTBs were associated with lifetime SAs and higher impulsivity, but not with aggression and trait anger. Assessing these endophenotypes could refine clinical SB risk evaluation in SUDs patients by detecting higher-risk subgroups. An important limitation of this study is exiguity of its sample size. Its primary contribution is inclusion of all SUD types.
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22
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Jeong H, Lee HK, Kwon YS, Yim HW, Lee SY. Gaming disorder and bidirectional relationships with aggression and impulsivity. Curr Opin Behav Sci 2020. [DOI: 10.1016/j.cobeha.2019.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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23
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Cao Q, An J. Boredom Proneness and Aggression Among People With Substance Use Disorder: The Mediating Role of Trait Anger and Impulsivity. JOURNAL OF DRUG ISSUES 2019. [DOI: 10.1177/0022042619886822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Boredom proneness has been linked to aggressive behaviors; however, the relationship between them is not well understood. To better understand the mechanism underlying the relationship between boredom proneness and aggression, a serial multiple mediator model was built, where boredom proneness impacted aggression simultaneously through (a) impulsivity, (b) trait anger, and (c) impulsivity to trait anger. Using data collected among Chinese substance users, a battery of interview questionnaires was completed. Results from this study indicate a positive relationship between boredom proneness, impulsivity, trait anger, and aggression. Moreover, the mediating role of impulsivity, trait anger, and both impulsivity and trait anger in serial were found. This study reflects that the link from boredom proneness to aggression among substances users could be partially explained via impulsivity and anger.
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Affiliation(s)
- Qilong Cao
- Changzhou University, People’s Republic of China
| | - Jing An
- Changzhou Institute of Technology, People’s Republic of China
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24
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Walker SC, Duong M, Hayes C, Berliner L, Leve LD, Atkins DC, Herting JR, Bishop AS, Valencia E. A tailored cognitive behavioral program for juvenile justice-referred females at risk of substance use and delinquency: A pilot quasi-experimental trial. PLoS One 2019; 14:e0224363. [PMID: 31697698 PMCID: PMC6837457 DOI: 10.1371/journal.pone.0224363] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/13/2019] [Indexed: 01/20/2023] Open
Abstract
This pilot quasi-experimental trial tested a gender-responsive cognitive behavioral group intervention with 87 court-involved female adolescents (5 juvenile courts) who were at indicated risk for substance use disorder. Participants in the intervention (n = 57) received twice weekly group sessions for 10 weeks (20 sessions) focused on building emotional, thought and behavior regulation skills and generalizing these skills to relationally-based scenarios (GOAL: Girls Only Active Learning). Youth in the control condition (n = 30) received services as usual, which included non-gender-specific aggression management training, individual counseling and no services. The GOAL program was found to be acceptable to youth and parents and feasible to implement within a juvenile court setting using skilled facilitators. Compared to services as usual, the program significantly and meaningfully reduced self-reported delinquent behavior (β = 0.84, p < 0.05) over 6 months, and exhibited trend level effects for reduced substance use (β = 0.40, p = 0.07). The program had mixed or no effects on family conflict and emotion regulation skills. These findings are discussed in light of treatment mechanisms and gender-responsive services.
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Affiliation(s)
- Sarah C. Walker
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, United States of America
- * E-mail:
| | - Mylien Duong
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, United States of America
| | - Christopher Hayes
- Snohomish County Juvenile Court, Everett, Washington, United States of America
| | - Lucy Berliner
- Harborview Center for Sexual Assault and Trauma, Seattle, Washington, United States of America
| | - Leslie D. Leve
- College of Education, University of Oregon, Eugene, Oregon, United States of America
| | - David C. Atkins
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, United States of America
| | - Jerald R. Herting
- Department of Sociology, University of Washington, Seattle, Washington, United States of America
| | - Asia S. Bishop
- Department of Social Work, University of Washington, Seattle, Washington, United States of America
| | - Esteban Valencia
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, United States of America
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25
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Coccaro EF. Psychiatric comorbidity in Intermittent Explosive Disorder. J Psychiatr Res 2019; 118:38-43. [PMID: 31487607 DOI: 10.1016/j.jpsychires.2019.08.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/16/2019] [Accepted: 08/23/2019] [Indexed: 01/11/2023]
Abstract
This study examined aspects of psychiatry comorbidity in Intermittent Explosive Disorder (IED) in order to explore the validity of IED in the context of other psychiatric disorders. Data from the National Comorbidity Study - Revised (NCS-R: n = 9,282 adults) and its Adolescent Supplement (NCS-AS: n = 10,148 adolescents) and a large clinical research data set (n = 1640) were analyzed in this study. Mean number of comorbid disorders among current IED participants was similar to that among other Non-IED disorders and comorbidity of IED with Non-IED disorders was similar to comorbidity among Non-IED disorders. When examined together, current IED was significantly comorbid with current bipolar, depressive, anxiety, substance use, and post-traumatic stress disorder, and age of onset of IED generally preceded that of the comorbid disorders. Finally, mean aggression scores were generally highest among those with IED and the comorbid disorder while scores among those with the comorbid disorder alone were generally less than that with IED or with IED and the comorbid disorder. Comorbidity in IED is similar to that in other, more established, Non-IED disorders. The observation that the development of IED precedes the onset of most comorbid disorders and that aggression scores in those with IED and a comorbid disorder are often higher than those with IED alone supports the rationale that a diagnosis of both IED and the comorbid disorder should be made when both are present.
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Affiliation(s)
- Emil F Coccaro
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA.
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26
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Manchia M, Comai S, Pinna M, Pinna F, Fanos V, Denovan-Wright E, Carpiniello B. Biomarkers in aggression. Adv Clin Chem 2019; 93:169-237. [PMID: 31655730 DOI: 10.1016/bs.acc.2019.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Aggressive behavior exerts an enormous impact on society remaining among the main causes of worldwide premature death. Effective primary interventions, relying on predictive models of aggression that show adequate sensitivity and specificity are currently lacking. One strategy to increase the accuracy and precision of prediction would be to include biological data in the predictive models. Clearly, to be included in such models, biological markers should be reliably associated with the specific trait under study (i.e., diagnostic biomarkers). Aggression, however, is phenotypically highly heterogeneous, an element that has hindered the identification of reliable biomarkers. However, current research is trying to overcome these challenges by focusing on more homogenous aggression subtypes and/or by studying large sample size of aggressive individuals. Further advance is coming by bioinformatics approaches that are allowing the integration of inter-species biological data as well as the development of predictive algorithms able to discriminate subjects on the basis of the propensity toward aggressive behavior. In this review we first present a brief summary of the available evidence on neuroimaging of aggression. We will then treat extensively the data on genetic determinants, including those from hypothesis-free genome-wide association studies (GWAS) and candidate gene studies. Transcriptomic and neurochemical biomarkers will then be reviewed, and we will dedicate a section on the role of metabolomics in aggression. Finally, we will discuss how biomarkers can inform the development of new pharmacological tools as well as increase the efficacy of preventive strategies.
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Affiliation(s)
- Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Department of Pharmacology, Dalhousie University, Halifax, NS, Canada.
| | - Stefano Comai
- San Raffaele Scientific Institute and Vita Salute University, Milano, Italy; Department of Psychiatry, McGill University, Montreal, QC, Canada.
| | - Martina Pinna
- Forensic Psychiatry Unit, Sardinia Health Agency, Cagliari, Italy
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Vassilios Fanos
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy; Puericulture Institute and Neonatal Section, University Hospital Agency of Cagliari, Cagliari, Italy
| | | | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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27
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Essau CA, de la Torre-Luque A. Comorbidity profile of mental disorders among adolescents: A latent class analysis. Psychiatry Res 2019; 278:228-234. [PMID: 31226549 DOI: 10.1016/j.psychres.2019.06.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 06/05/2019] [Accepted: 06/06/2019] [Indexed: 01/18/2023]
Abstract
The aim of this study was to identify the number of comorbidity profiles among adolescents. Sociodemographic factors associated with the comorbidity profiles were also examined. Latent class analysis was conducted using data from the National Comorbidity Survey Adolescent Supplement (NCS-A), a representative sample of adolescents (N = 10,123) in the United States. Latent classes were derived from 26 lifetime mental disorders which were assessed using the World Health Organization Composite International Diagnostic Instrument (CIDI). A three-class solution provided the best fit for the data, with classes labelled as comorbid emotional disorders (Class I), comorbid behavioural disorders (Class II), and normative (Class III). Class I (15.62% of the participants) included adolescents with a high probability of having anxiety, depressive, and intermittent explosive disorder. Class II (6.97%) was characterised by adolescents with a high probability of having substance use, behavioural disorders, and major depression. Class III (77.41%) was characterised by adolescents with a low probability of having any mental disorders. Characterising comorbid profile of mental disorders using person-based approach yields a higher-order classification that could have important clinical implications.
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Affiliation(s)
- Cecilia A Essau
- Department of Psychology, Whitelands College, University of Roehampton, Holybourne Avenue, London SW15 4JD, UK.
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28
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Erlyana E, Reynolds GL, Fisher DG, Pedersen WC, Van Otterloo L. Arrest and Trait Aggression Correlates of Emergency Department Use. JOURNAL OF CORRECTIONAL HEALTH CARE 2019; 25:253-264. [PMID: 31179818 DOI: 10.1177/1078345819854373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined the associations between arrest and incarceration, trait aggression, and emergency department (ED) use. Data were collected from 525 clients who visited the Center for Behavioral Research and Services in Long Beach, CA, using the following instruments: Risk Behavior Assessment, Risk Behavior Follow-Up Assessment, the Aggression Questionnaire (AQ), the Displaced AQ, and the parole and Legal Status section of the Addiction Severity Index. The bivariate analysis suggested that ED use was significantly associated with trait aggression and trait-displaced aggression among those with a history of incarceration. In the logistic regression, weapons offenses, manslaughter/homicide, being male, and being Black were significantly associated with ED use. Identification and management of aggressive trait personality are important in improving the management of postrelease care in transition to clinical networks and community-based health care settings.
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Affiliation(s)
- Erlyana Erlyana
- 1 Department of Health Care Administration, Center for Behavioral Research and Services, California State University, Long Beach, CA, USA
| | - Grace L Reynolds
- 1 Department of Health Care Administration, Center for Behavioral Research and Services, California State University, Long Beach, CA, USA
| | - Dennis G Fisher
- 2 Department of Psychology, Center for Behavioral Research and Services, California State University, Long Beach, CA, USA
| | - William C Pedersen
- 3 Department of Psychology, California State University, Long Beach, CA, USA
| | - Lucy Van Otterloo
- 4 School of Nursing, California State University, Long Beach, CA, USA
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29
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Coccaro EF, Shima CK, Lee RJ. Comorbidity of personality disorder with intermittent explosive disorder. J Psychiatr Res 2018; 106:15-21. [PMID: 30240963 DOI: 10.1016/j.jpsychires.2018.08.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 08/06/2018] [Accepted: 08/09/2018] [Indexed: 11/16/2022]
Abstract
There is ambiguity in how recurrent anger and aggression are accounted for by psychiatric nosology. One area of uncertainty is the extent to which Intermittent Explosive Disorder (IED) overlaps with and is distinct from Personality Disorder (PD). Accordingly, we conducted a study of individuals with IED and PD in order to understand the nature of comorbidity relationships seen across these two areas of psychopathology. One-thousand-five-hundred-twenty-one adults were studied (441 Healthy Controls (HC), 430 Psychiatric Controls (PC), and 650 IED subjects) and assessed for DSM-5 psychiatric disorders, life history of aggressive behavior, trait aggression, state and trait anger reactivity, and impulsivity. While nearly half of IED study participants had a comorbid PD diagnosis, nearly half with a Cluster B PD, almost as many had other personality disorders. IED predicted anger symptoms and history of aggressive behavior above and beyond a PD diagnosis. Comorbidity between IED and either Antisocial (AsPD) or Borderline (BPD) PD was associated with the highest levels of aggressive behavior. However, having IED comorbid with either AsPD and/or BPD PD was not associated with higher levels of impulsivity. Underlying personality traits related to anger, affect, and social behavior, but not identity disturbance, contribute to the shared symptom profile of IED and PD. IED is usually comorbid with PD, but does not have a unique relationship with any single PD. When comorbid with PD, a diagnosis of IED predicts more severe anger and aggression, but not necessarily increased impulsivity. These results suggest that IED and PD diagnoses retain clinical utility when made in cases meeting criteria for both.
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Affiliation(s)
- Emil F Coccaro
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
| | - Carolyn K Shima
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Royce J Lee
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
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Schmits E, Glowacz F. Delinquency and drug use among adolescents and emerging adults: The role of aggression, impulsivity, empathy, and cognitive distortions. JOURNAL OF SUBSTANCE USE 2018. [DOI: 10.1080/14659891.2018.1531945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Emilie Schmits
- Psychologie de la délinquance, des inadaptations sociales et des processus d’insertion, Unité de Recherche Adaptation, Résilience et Changement (ARCh), Université de Liège, Liège, Belgique
| | - Fabienne Glowacz
- Psychologie de la délinquance, des inadaptations sociales et des processus d’insertion, Unité de Recherche Adaptation, Résilience et Changement (ARCh), Université de Liège, Liège, Belgique
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Rynar L, Coccaro EF. Psychosocial impairment in DSM-5 intermittent explosive disorder. Psychiatry Res 2018; 264:91-95. [PMID: 29627702 PMCID: PMC5983894 DOI: 10.1016/j.psychres.2018.03.077] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 03/28/2018] [Accepted: 03/29/2018] [Indexed: 10/17/2022]
Abstract
The purpose of this study was to document the functional severity of DSM-5 IED in a clinical research sample. IED and control groups were compared on psychosocial functioning, life satisfaction, and on a variety of cognitive and behavioral issues. IED study participants reported significantly worse psychosocial function, quality of life, and higher job dysfunction than both psychiatric and healthy control study participants. The presence of DSM-5 IED is associated with significant psychosocial and functional impairment. Early intervention may aid in minimizing the consequences of impulsive aggressive behavior, and improving psychosocial functioning and quality of life.
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Affiliation(s)
- Lauren Rynar
- Department of Psychology, Rosalind Franklin University of Medicine and Science
| | - Emil F. Coccaro
- Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago
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Chester DS, DeWall CN. Aggression is associated with greater subsequent alcohol consumption: A shared neural basis in the ventral striatum. Aggress Behav 2018; 44:285-293. [PMID: 29417595 DOI: 10.1002/ab.21751] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 10/26/2017] [Accepted: 12/19/2017] [Indexed: 02/06/2023]
Abstract
Alcohol use and abuse (e.g., binge drinking) are among the most reliable causes of aggressive behavior. Conversely, people with aggressive dispositions (e.g., intermittent explosive disorder) are at greater risk for subsequent substance abuse. Yet it remains unknown why aggression might promote subsequent alcohol use. Both aggressive acts and alcohol use are rewarding and linked to greater activity in neural reward circuitry. Through this shared instantiation of reward, aggression may then increase subsequent alcohol consumption. Supporting this mechanistic hypothesis, participants' aggressive behavior directed at someone who had recently rejected them, was associated with more subsequent beer consumption on an ad-lib drinking task. Using functional MRI, both aggressive behavior and beer consumption were associated with greater activity in the bilateral ventral striatum during acts of retaliatory aggression. These results imply that aggression is linked to subsequent alcohol abuse, and that a mechanism underlying this effect is likely to be the activation of the brain's reward circuitry during aggressive acts.
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Affiliation(s)
- David S. Chester
- Department of Psychology; Virginia Commonwealth University; Richmond Virginia
| | - C. Nathan DeWall
- Department of Psychology; University of Kentucky; Lexington Kentucky
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Harvey ST, Henricksen A, Bimler D, Dickson D. Addressing Anger, Stress, and Alcohol-Related Difficulties in the Military: An ACT Intervention. MILITARY PSYCHOLOGY 2017. [DOI: 10.1037/mil0000173] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
| | | | - David Bimler
- School of Psychology and Institute of Education, Massey University
| | - Doug Dickson
- Acorn Counselling Services, Palmerston North, New Zealand
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Airagnes G, Lemogne C, Gueguen A, Hoertel N, Goldberg M, Limosin F, Zins M. Hostility predicts alcohol consumption over a 21-year follow-up in the Gazel cohort. Drug Alcohol Depend 2017; 177:112-123. [PMID: 28586715 DOI: 10.1016/j.drugalcdep.2017.03.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/28/2017] [Accepted: 03/31/2017] [Indexed: 01/26/2023]
Abstract
BACKGROUND Hostility has been found to be positively associated with alcohol intake in cross-sectional studies. Our aim was to examine prospectively the long-lasting association of hostility with alcohol consumption. METHODS We included 10,612 men and 3834 women from the French Gazel cohort with mean ages in 1993 of 48.6 (SD=2.9) and 45.7(SD=4.2), respectively. Hostility (i.e., total, cognitive and behavioral) was assessed in 1993 with the Buss and Durkee Hostility Inventory. Alcohol consumption was self-reported annually from 1994 to 2014. Hostility scores were introduced successively in general linear mixed models with annual alcohol consumption in drinks per week as dependent variable. Multivariable analyses were adjusted for age, occupational status, marital status, retirement status and depression score. All the analyses were stratified by sex. RESULTS Among men (women), 83.0% (76.2%) completed at least 75% of all annual assessment of alcohol consumption over a 21-year follow-up. In univariate analysis, alcohol consumption was associated with total and behavioral hostility in both sex (all p<0.001). In multivariable analyses, these associations remained significant with a greater size effect for behavioral hostility. Estimated means of alcohol consumptions ranged from 10.50 [95CI%: 10.01-10.92] drinks per week to 13.32 [95%CI: 12.90-13.74] in men and from 4.09 [95%CI: 3.71-4.46] to 5.78 [95%CI: 5.39-6.17] in women, for the first and last quartiles respectively (p trends<0.001 and all pairwise comparisons<0.01). Similar effects were observed among participants with at-risk alcohol consumption at baseline. CONCLUSIONS In both men and women, behavioral hostility predicted alcohol consumption over a 21-year follow-up. Interventions aiming at modulating behavioral hostility may help reducing its long-lasting influence on alcohol consumption.
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Affiliation(s)
- Guillaume Airagnes
- AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Psychiatry, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, France; Inserm, UMS 011, Population-based Epidemiological Cohorts, Villejuif, France; Inserm UMR 1168, VIMA, Villejuif, France.
| | - Cédric Lemogne
- AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Psychiatry, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, France; Inserm, U894, Centre Psychiatrie et Neurosciences, Paris, France
| | - Alice Gueguen
- Inserm, UMS 011, Population-based Epidemiological Cohorts, Villejuif, France; Inserm UMR 1168, VIMA, Villejuif, France
| | - Nicolas Hoertel
- AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Psychiatry, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, France; Inserm, U894, Centre Psychiatrie et Neurosciences, Paris, France
| | - Marcel Goldberg
- Inserm, UMS 011, Population-based Epidemiological Cohorts, Villejuif, France; Inserm UMR 1168, VIMA, Villejuif, France
| | - Frédéric Limosin
- AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Psychiatry, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, France; Inserm, U894, Centre Psychiatrie et Neurosciences, Paris, France
| | - Marie Zins
- Inserm, UMS 011, Population-based Epidemiological Cohorts, Villejuif, France; Inserm UMR 1168, VIMA, Villejuif, France
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Flanigan M, Aleyasin H, Takahashi A, Golden SA, Russo SJ. An emerging role for the lateral habenula in aggressive behavior. Pharmacol Biochem Behav 2017; 162:79-86. [PMID: 28499809 DOI: 10.1016/j.pbb.2017.05.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 03/24/2017] [Accepted: 05/05/2017] [Indexed: 12/19/2022]
Abstract
Inter-male aggression is an essential component of social behavior in organisms from insects to humans. However, when expressed inappropriately, aggression poses significant threats to the mental and physical health of both the aggressor and the target. Inappropriate aggression is a common feature of numerous neuropsychiatric disorders in humans and has been hypothesized to result from the atypical activation of reward circuitry in response to social targets. The lateral habenula (LHb) has recently been identified as a major node of the classical reward circuitry and inhibits the release of dopamine from the midbrain to signal negative valence. Here, we discuss the evidence linking LHb function to aggression and its valence, arguing that strong LHb outputs to the ventral tegmental area (VTA) and the dorsal raphe nucleus (DRN) are likely to play roles in aggression and its rewarding components. Future studies should aim to elucidate how various inputs and outputs of the LHb shape motivation and reward in the context of aggression.
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Affiliation(s)
- Meghan Flanigan
- Fishberg Department of Neuroscience and Graduate School of Biological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Graduate School of Biological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hossein Aleyasin
- Fishberg Department of Neuroscience and Graduate School of Biological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Aki Takahashi
- Fishberg Department of Neuroscience and Graduate School of Biological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA; University of Tsukuba, Tsukuba, Japan
| | - Sam A Golden
- National Institute of Drug Abuse, Baltimore, MD, USA
| | - Scott J Russo
- Fishberg Department of Neuroscience and Graduate School of Biological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Jennings KM, Wildes JE, Coccaro EF. Intermittent explosive disorder and eating disorders: Analysis of national comorbidity and research samples. Compr Psychiatry 2017; 75:62-67. [PMID: 28324677 PMCID: PMC5410643 DOI: 10.1016/j.comppsych.2017.02.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 02/17/2017] [Accepted: 02/28/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Clinical studies suggest comorbidity between eating disorders and aggressive behaviors. This study examined the pattern of comorbidity between intermittent explosive disorder (IED) and eating disorders (ED). METHODS Data were analyzed from both the adult and adolescent samples of the National Comorbidity Survey-Replication (n = 19,430) and a clinical research sample (n = 1,642). RESULTS Lifetime prevalence of Any ED was elevated in IED vs. non-IED for both the community and clinical research samples. Though anorexia nervosa displayed no relationship with IED in either sample, bulimia nervosa was associated with IED in the community sample and binge eating disorder was associated with IED in both the community and clinical research samples. Onset of IED preceded onset of Any ED in at least 70% of comorbid IED/ED cases in both community and clinical research samples. Associations of IED with Any ED and bulimia nervosa in the community sample, and associations of IED with binge eating disorder in the clinical research sample, remained significant after controlling for other psychiatric disorders. CONCLUSIONS Individuals with IED are more likely to report lifetime prevalence of ED, particularly bulimic spectrum disorders. This finding, and the observation that the onset of IED occurs prior to the onset of ED in the majority of individuals, suggests that longitudinal studies are needed to clarify this relationship and determine whether IED is a risk factor for the development of ED. Early identification of individuals with IED or impulsive aggression may provide clinically useful information to determine most effective treatment interventions.
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Affiliation(s)
- Karen M Jennings
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA.
| | - Jennifer E Wildes
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA
| | - Emil F Coccaro
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA
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Coccaro EF, Keedy SK, Gorka SM, King AC, Fanning JR, Lee RJ, Phan KL. Differential fMRI BOLD responses in amygdala in intermittent explosive disorder as a function of past Alcohol Use Disorder. Psychiatry Res Neuroimaging 2016; 257:5-10. [PMID: 27693977 PMCID: PMC6323646 DOI: 10.1016/j.pscychresns.2016.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 09/01/2016] [Accepted: 09/06/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Individuals with intermittent explosive disorder (IED) were previously found to exhibit amygdala (AMYG) hyperactivation to anger faces during functional magnetic resonance imaging (fMRI). However, acute alcohol consumption, and/or life history of alcoholism, may blunt amygdala responses to negative emotional stimuli. Thus, we examined the influence of a past history of DSM-5 Alcohol Use Disorder (AUD) on the fMRI BOLD AMYG response to anger faces in IED. METHOD Forty-two IED participants, 18 with a past history of AUD (IED+AUD) and 24 without Past AUD (IED), and 32 healthy control (HC) participants, underwent fMRI scanning while viewing blocks of angry, fearful, and happy faces. RESULTS Compared to HC and IED+AUD participants, IED subjects exhibited greater AMYG responses to angry, but not to fear or happy, faces in the left AMYG. There were no group differences in responses to anger, fear, or happy, faces in the OFC. CONCLUSION These findings suggest the possibility of a longstanding effect of AUD on AMYG response in IED to anger-related stimuli and highlight the possibility that history of AUD should be considered as an important factor in the interpretation of fMRI studies involving the AMYG response to negative emotional stimuli.
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Affiliation(s)
- Emil F Coccaro
- Department of Psychiatry and Behavioral Neuroscience, the University of Chicago, Chicago, IL, USA.
| | - Sarah K Keedy
- Department of Psychiatry and Behavioral Neuroscience, the University of Chicago, Chicago, IL, USA
| | - Stephanie M Gorka
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Andrea C King
- Department of Psychiatry and Behavioral Neuroscience, the University of Chicago, Chicago, IL, USA
| | - Jennifer R Fanning
- Department of Psychiatry and Behavioral Neuroscience, the University of Chicago, Chicago, IL, USA
| | - Royce J Lee
- Department of Psychiatry and Behavioral Neuroscience, the University of Chicago, Chicago, IL, USA
| | - K Luan Phan
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA; Mental Health Service Line, Jesse Brown VA Medical Center, Chicago, IL, USA
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Abstract
General Strain Theory (GST: Agnew Criminology 30:47-87, 1992) posits that deviant behaviour results from adaptation to strain and the consequent negative emotions. Empirical research on GST has mainly focused on aggressive behaviours, while only few research studies have considered alternative manifestations of deviance, like substance use and gambling. The aim of the present study is to test the ability of GST to explain gambling behaviours and substance use. Also, the role of family in promoting the adoption of gambling and substance use as coping strategies was verified. Data from 266 families with in mean 8 observations for each group were collected. The multilevel nature of the data was verified before appropriate model construction. The clustered nature of gambling data was analysed by a two-level Hierarchical Linear Model while substance use was analysed by Multivariate Linear Model. Results confirmed the effect of strain on gambling and substance use while the positive effect of depressive emotions on these behaviours was not supported. Also, the impact of family on the individual tendency to engage in addictive behaviours was confirmed only for gambling.
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Affiliation(s)
- Romy Greco
- Department of Law, Libera Università SS Maria Assunta (LUMSA), Taranto, Italy.
| | - Antonietta Curci
- Department of Education, Psychology, Communication, University of Bari, Bari, Italy
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