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Runions KC, Morandini HAE, Rao P, Wong JWY, Kolla NJ, Pace G, Mahfouda S, Hildebrandt CS, Stewart R, Zepf FD. Serotonin and aggressive behaviour in children and adolescents: a systematic review. Acta Psychiatr Scand 2019; 139:117-144. [PMID: 30446991 DOI: 10.1111/acps.12986] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The role of serotonin (5-HT) in human aggression has been the subject of a large number of studies, mostly with adults. Meta-analyses indicate a small but significant inverse relationship between central nervous 5-HT availability and aggression, but genetically informed studies suggest two pathways: one to reactive aggression and the other to proactive aggression. METHOD We conducted a systemic review on central nervous 5-HT function in children and adolescents, with attention to the function of aggression. RESULTS In total, 675 articles were screened for relevance, with 45 reviewed. These included blood assays (e.g. plasma, 5-HIAA; platelet 5-HTR2A ), epigenetic studies, retrospective PET studies and 5-HT challenge paradigms (e.g. tryptophan depletion). Overall, findings were mixed, with support both for negative and for positive associations of central nervous 5-HT function with aggression in children and adolescents. CONCLUSION We propose factors that may be blurring the picture, including problems in the conceptualization and measurement of aggression in young people, the lack of prospective designs and the bias towards clinical samples of boys. Research needs to account for variance in the both motivation for and implementation of aggression, and look to the behavioural economics literature to consider the roles of reward, vengeance and self-control more clearly.
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Affiliation(s)
- K C Runions
- Department of Health, Child and Adolescent Mental Health Services, Bentley, WA, Australia.,Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.,Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, School of Medicine, University of Western Australia, Perth, WA, Australia
| | - H A E Morandini
- Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, School of Medicine, University of Western Australia, Perth, WA, Australia
| | - P Rao
- Department of Health, Child and Adolescent Mental Health Services, Bentley, WA, Australia.,Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, School of Medicine, University of Western Australia, Perth, WA, Australia
| | - J W Y Wong
- Department of Health, Child and Adolescent Mental Health Services, Bentley, WA, Australia.,Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.,Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, School of Medicine, University of Western Australia, Perth, WA, Australia
| | - N J Kolla
- Centre for Addictions and Mental Health, University of Toronto, Toronto, ON, Canada
| | - G Pace
- Department of Health, Child and Adolescent Mental Health Services, Bentley, WA, Australia
| | - S Mahfouda
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.,School of Psychological Sciences, Faculty of Sciences, University of Western Australia, Perth, WA, Australia
| | - C S Hildebrandt
- Jülich Aachen Research Alliance, JARA Translational Brain Medicine, Aachen, Germany.,Child and Adolescent Psychiatry and Psychotherapy, Clinics of the City Cologne GmbH, Cologne, Germany
| | - R Stewart
- Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, School of Medicine, University of Western Australia, Perth, WA, Australia
| | - F D Zepf
- Division of Psychiatry and Clinical Neurosciences and Division of Paediatrics and Child Health, Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, School of Medicine, University of Western Australia, Perth, WA, Australia.,Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Clinics of the Friedrich Schiller University, Jena, Germany
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