Sex, aggression and impulse control: an integrative account

The longitudinal relationship between executive dysfunction and reactive and proactive aggression in adolescents: impulsivity as a mediator and sex differences

Background

Adolescent aggression poses a significant threat to mental health and social functioning. This study investigated the underlying mechanisms of reactive and proactive aggression in Chinese adolescents, focusing on the roles of executive dysfunction, impulsivity, and sex. We hypothesized that executive dysfunction would predict both reactive and proactive aggression, with impulsivity mediating these relationships. Furthermore, we explored the moderating role of sex in the association between impulsivity and both types of aggression.

Method

A longitudinal design with a 1-year follow-up was employed. The sample comprised 617 middle school students (mean age = 15.26 years at Time 2; 59% male). Participants completed self-report questionnaires at two time points (T1: April 2023; T2: April 2024): the Reactive-Proactive Aggression Questionnaire (RPQ), the Teenage Executive Functioning Inventory (TEXI), and the Barratt Impulsiveness Scale (BIS).

Results

Executive dysfunction at T1 significantly predicted both proactive and reactive aggression at T2. Impulsivity at T2 partially mediated the relationship between executive dysfunction at T1 and both proactive and reactive aggression at T2. Sex moderated the relationship between impulsivity and aggression. Specifically, impulsivity at T2 significantly predicted proactive aggression at T2 only in male adolescents. Impulsivity at T2 significantly predicted reactive aggression at T2 in both male and female adolescents, with a stronger effect observed in males.

Conclusion

Our findings suggest that executive dysfunction contributes to adolescent aggression both directly and indirectly through increased impulsivity. Sex plays a moderating role, with male adolescents demonstrating greater vulnerability to the influence of impulsivity on aggression. These results underscore the importance of considering executive function, impulsivity, and sex in the development of interventions to prevent and reduce adolescent aggression.

Internet gaming disorder and the alternative five factor personality model: a study in a Spanish community sample

BACKGROUND

This study was designed to examine the prevalence and relationships between the Internet gaming disorder (IGD) behaviors, suggested by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and personality traits.

PARTICIPANTS AND PROCEDURE

A sample community of 1,548 subjects, 707 men and 841 women, with a mean age of 40.90 and 38.89 years, respectively, was evaluated.

RESULTS

The results showed that only 7 subjects (0.5%) exceeded the cut-off point of 75 points to be classed as "disordered gamers" proposed by Fuster et al. (2016) in Spain. This study demonstrates the unidimensionality of the IGD-20, so it can be used as an ordinal dimensional measure to study the relationship between IGD symptoms and other related variables such as personality in community samples. A multiple linear regression analysis revealed that up to 8% of the variance of the Internet Gaming Disorder-20 scale (IGD-20), as a dimensional scale, can be explained by low activity, high aggressiveness, introversion, non-planning impulsivity, sensation seeking, neuroticism and impulsiveness (attention impulsivity) using the Alternative Five Factor Model (AFFM) of personality and the Barratt Impulsivity Scale (BIS-11).

CONCLUSIONS

This study shows that the prevalence of IGD in the Spanish population is similar to that of other Western countries. The unidimensionality of the IGD-20 allows its use in correlational studies to examine the relationship between Internet gambling behaviors and personality variables. The implications of these personality profiles are discussed in relation to the psychological and clinical mechanisms involved in Internet gaming disorder.

Emotion dysregulation and depressive symptoms mediate the association between inhibitory control difficulties and aggressive behaviour in children with ADHD

Background/objectives

Impulsive aggressive behaviour, although not a core symptom, is often part of the clinical presentation of attention-deficit/hyperactivity disorder (ADHD). Recently, impulsive aggression has been attributed to emotion dysregulation, which is currently conceptualised as a transdiagnostic factor and seems to contribute to the co-occurrence of other problems in ADHD. Thus, this study investigated the presence of impulsive aggressive behaviour and explored whether emotion dysregulation mediates the relationship between inhibitory control difficulties and aggressive behaviour in children with ADHD. Because ADHD may act as a risk factor for the development of other conditions, such as internalising problems, we aimed to understand whether depressive symptoms contribute to this relationship.

Methods

Seventy-two children were recruited from a hospital and the community, 38 of whom had ADHD and 34 were typically developing (TD). Parents completed the Child Behaviour Checklist, the Behaviour Rating Inventory of Executive Function, and the Emotion Regulation Checklist. Simple mediation and serial mediation models were performed to test our hypotheses.

Results

Aggressive behaviour was significantly higher in ADHD children compared to TD children. Emotion dysregulation fully mediated the relationship between inhibitory control difficulties and aggressive behaviour in ADHD children. Adding depressive symptoms to the model increased the explained variance in aggressive behaviour.

Conclusion

The main result of our study supports the role of emotion dysregulation and depressive symptoms in mediating the relationship between inhibitory control difficulties and impulsive aggressive behaviour in children with ADHD. This highlights that aggressive behaviour is, in part, a result of the inability of the child to appropriately regulate their emotions. Future interventions may be tailored to improve emotion regulation skills to address aggressive behaviour.

Smaller amygdala subnuclei volume in schizophrenia patients with violent behaviors

To investigate the association between the volume of amygdala subnuclei and violent behaviors in patients with schizophrenia (SCZ). In the present study, we recruited 40 SCZ patients with violent behaviors (VS), 26 SCZ patients without violent behaviors (NVS), and 28 matched healthy controls (HC) who completed T1-weighted magnetic resonance imaging. Both the total amygdala and amygdala subnuclei volumes were estimated with FreeSurfer. When comparing the SCZ patients with HC, SCZ patients had a smaller volume of the left basal nucleus (P < 0.05, uncorrected). Further, the VS patients had a smaller volume of the left amygdala central nucleus than the NVS group (P < 0.05, Bonferroni corrected). Our study suggests that a smaller volume of the left amygdala basal nucleus may be a biomarker for SCZ and that a smaller volume of the left central nucleus may be relevant to violence risk in patients with schizophrenia.

Effect of subjective sleep quality on aggression: A two-year longitudinal and fMRI pilot study

BACKGROUND/OBJECTIVE

To examine the causal relationship between sleep quality and aggression and their reliable cognitive neural mechanisms.

METHOD

We conducted two follow-up measures on subjective sleep quality, aggression, and resting-state functional magnetic resonance imaging (rs-fMRI) of 455 college students, with a two-year interval between the two follow-up measures. We used cross-lag model on the questionnaire and amplitude of low-frequency fluctuation (ALFF) on rs-fMRI for data analysis.

RESULTS

1) The cross-lag model showed that sleep quality at the first time could predict aggression at the second time. 2) ALFF showed poor sleep quality decreased spontaneous activity in prefrontal regions, but increased activity in limbic system regions, which may be the possible neural basis linking poor sleep quality with increased aggressive behavior.

CONCLUSIONS

There is a causal relationship between subjective sleep quality and aggressive behavior. Our finding proposes a new view of how sleep quality affects aggressive behavior.

The moderating role of sex in the relationship between executive functions and academic procrastination in undergraduate students

The objective of the study was to determine if sex plays a moderating role in the relationship between executive functions and academic procrastination in 106 university students of both genders (28.3% male and 71.7% female) between the ages of 18 and 30 years (M = 19.7; SD = 2.7). The Academic Procrastination Scale and the Neuropsychological Battery of Executive Functions and Frontal Lobes (BANFE-2) were used to measure the variables. The results of the study showed that the degree of prediction of the tasks linked to the orbitomedial cortex (involves the orbitofrontal cortex [OFC] and the medial prefrontal cortex [mPFC]) on academic procrastination is significantly moderated by the sex of the university students (β₃ = 0.53; p < 0.01). For men, the estimated effect of the tasks linked to the orbitomedial cortex on the degree of academic procrastination is −0.81. For women, the estimated effect of the tasks linked to the orbitomedial cortex on the degree of academic procrastination is −0.28. In addition, it was shown that sex does not play a moderating role in the relationship between the tasks linked to the dorsolateral prefrontal cortex (dlPFC) and academic procrastination (β₃ = 0.12; p > 0.05). It was also determined that sex does not play a moderating role in the relationship between the tasks linked to the anterior prefrontal cortex (aPFC) and academic procrastination (β₃ = 0.05; p > 0.05). It is concluded that only the executive functions associated with the orbitomedial cortex are moderated by the sex of the university students, where the impact of the tasks linked to the orbitomedial cortex on academic procrastination in men is significantly greater than in women.

Neural Correlates of Decisions in Quasi-Realistic, Affective Social Interactions in Individuals With Violence-Related Socialization

Appropriate social behavior in aggressive-provocative interactions is a prerequisite for a peaceful life. In previous research, the dysfunctions of the control of aggression were suggested to be modulated by enhanced bottom-up (sub-cortically driven) and reduced top-down (iso-cortical frontal) processing capability. In the present study, two groups of individuals with enhanced (EG) and normal (NG) experiences of violent acts during their socialization made binary behavioral decisions in quasi-realistic social interactions. These interactions were presented in short video clips taken from a first-person perspective. The video clips showed social interaction scenarios oriented on realistic everyday life situations. The behavioral data supported the distinct affective qualities of three categories of social interactions. These categories were labeled as aggressive–provocative, social–positive, and neutral–social interactions. Functional neuroimaging data showed extended activation patterns and higher signal intensity for the NG compared to the EG in the lateral inferior frontal brain regions for the aggressive provocative interactions. Furthermore, the peri-aqueductal gray (PAG) produced enhanced activations for the affective interaction scenarios (i.e., aggressive-provocative and social-positive) in both groups and as a trend with the medium effect size for the neutral interactions in the EG. As the individuals in the EG did not show open aggression during the functional MRIA (fMRI) investigation, we concluded that they applied individual self-control strategies to regulate their aggressive impulses immediately. These strategies appeared to be top-down regulated through the dorsal frontal brain areas. The predominant recruitment of the heteromodal cortices during the neural processing of complex social interactions pointed to the important role of the learning history of individuals and their socialization with differing levels of violent experiences as crucial modulators in convicts. Our data suggest that building or strengthening the association between prototypical social contexts (e.g., aggressive-provocative interactions) and appropriate behaviors as a response to it provides a promising approach to successfully re-socialize people with a delinquent history.

Impulsivity in cocaine users compared to matched controls: Effects of sex and preferred route of cocaine use

BACKGROUND

Impulsivity has been identified as playing a role in cocaine use. The purpose of this study was to explore self-report measures of impulsivity in large groups of male and female cocaine users and matched controls and to determine if differences in impulsivity measures within a group of cocaine users related to self-reported money spent on cocaine and route of cocaine use.

METHODS

Eight self-report impulsivity measures yielding 34 subscales were obtained in 230 cocaine users (180 M, 50 F) and a matched group of 119 healthy controls (89 M, 30 F). Correlational analysis of the questionnaires revealed 2 factors: Impulsive Action (Factor 1) consisting of many traditional impulsivity measures and Thrill-seeking (Factor 2) consisting of delay discounting, sensation and thrill seeking.

RESULTS

Sex influenced within group comparisons. Impulsive Action scores did not vary as a function of sex within either group. But, male controls and male cocaine users had greater Thrill-seeking scores than females within the same group. Sex also influenced between group comparisons. Male cocaine users had greater Impulsive Action scores while female cocaine users had greater Thrill-seeking scores than their sex-matched controls. Among cocaine users, individuals who preferred insufflating ("snorting") cocaine had greater Thrill-seeking scores and lower Impulsive Action scores than individuals who preferred smoking cocaine. Individuals who insufflate cocaine also spent less money on cocaine.

CONCLUSIONS

Greater Impulsive Action scores in males and Thrill-seeking scores in females were associated with cocaine use relative to controls.

Suicide and Associations with Air Pollution and Ambient Temperature: A Systematic Review and Meta-Analysis

Given health threats of climate change, a comprehensive review of the impacts of ambient temperature and ar pollution on suicide is needed. We performed systematic literature review and meta-analysis of suicide risks associated with short-term exposure to ambient temperature and air pollution. Pubmed, Scopus, and Web of Science were searched for English-language publications using relevant keywords. Observational studies assessing risks of daily suicide and suicide attempts associated with temperature, particulate matter with aerodynamic diameter ≤10 μm (PM₁₀) and ≤2.5 mm (PM_2.5), ozone (O₃), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), and carbon monoxide (CO) were included. Data extraction was independently performed in duplicate. Random-effect meta-analysis was applied to pool risk ratios (RRs) for increases in daily suicide per interquartile range (IQR) increase in exposure. Meta-regression analysis was applied to examine effect modification by income level based on gross national income (GNI) per capita, national suicide rates, and average level of exposure factors. In total 2274 articles were screened, with 18 studies meeting inclusion criteria for air pollution and 32 studies for temperature. RRs of suicide per 7.1 °C temperature was 1.09 (95% CI: 1.06, 1.13). RRs of suicide per IQR increase in PM_2.5, PM₁₀, and NO₂ were 1.02 (95% CI: 1.00, 1.05), 1.01 (95% CI: 1.00, 1.03), and 1.03 (95% CI: 1.00, 1.07). O₃, SO₂, and CO were not associated with suicide. RR of suicide was significantly higher in higher-income than lower-income countries (1.09, 95% CI: 1.07, 1.11 and 1.20, 95% CI: 1.14, 1.26 per 7.1 °C increased temperature, respectively). Suicide risks associated with air pollution did not significantly differ by income level, national suicide rates, or average exposure levels. Research gaps were found for interactions between air pollution and temperature on suicide risks.

Sex, Education and Procrastination: An Epidemiological Study of Procrastinators’ Characteristics from A Global Sample

Procrastination is a common form of self–regulatory failure with substantive connections to lower levels of health, wealth and well–being. Conducting an epidemiological study, we determined the characteristics of prototypical procrastinators from a global sample based on several relevant self–reported demographic variables. Using an internet sampling strategy, we surveyed 16 413 English–speaking adults (58.3% women; 41.7% men: M age = 38.3 years, SD = 14), specifically on the variables of sex, age, marital status, family size, education, community location, and national origin. Almost all the results were statistically significant because of our large sample size. However, procrastination tendencies were most prominently associated with sex, age, marital status, education and nationality. Procrastinators tended to be young, single men with less education, residing in countries with lower levels of self–discipline. Notably, procrastination mediated the relationship between sex and education, providing further support that men are lagging behind women academically because of lower self–regulatory skills. Given procrastination's connection with a variety of societal ailments (e.g. excessive debt, delayed medical treatment), identifying risk factors and at risk populations should be helpful for directing preventative public policy. Copyright © 2012 John Wiley & Sons, Ltd.

Neuroanatomical Differences Among Sexual Offenders: A Targeted Review with Limitations and Implications for Future Directions

As sexual assault and child sexual abuse continue to be worldwide public health concerns, research has continued to explore factors associated with sexual offending. Structural and functional neuroanatomical brain differences have been examined in an effort to differentiate sexual offenders and their behavior. This targeted review searched PubMed and Google Scholar for empirical studies using brain imaging techniques to examine possible structural or functional differences among control groups compared with at least one group of sexual offenders with contact offenses. This targeted review summarizes the structural and functional findings of 15 brain imaging studies (i.e., computed tomography, diffusion tensor imaging, magnetic resonance imaging, positron emission tomography, and functional magnetic resonance imaging), which suggest possible differences in brain size and gray matter volume, cortical thickness, white matter connectivity, and specific structural and functional differences among brain regions (fronto-temporal region, amygdala, prefrontal cortex, etc.). The methodological limitations of brain imaging studies and the associated findings with regard to sexual offenders are highlighted, as research indicates that many of the proposed differences in brain structure and function are not unique to this population. We further highlight several limitations to using neuroimaging studies to examine this population of interest, including publication bias, small sample size, underpowered studies, and all-male samples. As these results are mixed and findings are not seemingly unique to sexual offenders, we suggest future sexual offender research may benefit from focusing on more financially feasible options, such as neuropsychological assessment approaches, to assess for and attend to offenders' criminogenic and rehabilitative/therapeutic needs in alignment with the risk-need-responsivity model.

Sex differences in the neural correlates of aggression

Although sex differences in aggression have been investigated for decades, little is known about the underlying neurobiology of this phenomenon. To address this gap, the present study implemented a social reactive aggression paradigm in 20 women and 22 men, employing a modified Taylor Aggression Task (mTAT) to provoke aggressive behavior in an fMRI setting. Subjects were provoked by money subtraction from a fake opponent and given the opportunity to retaliate likewise. In the absence of behavioral differences, male and female subjects showed differential brain activation patterns in response to provocation. Men had higher left amygdala activation during high provocation. This amygdala activation correlated with trait anger scores in men, but not in women. Also, men showed a positive association between orbitofrontal cortex, rectal gyrus and anterior cingulate cortex (ACC) activity in the provocation contrast and their tendency to respond aggressively, whereas women displayed a negative association. As the rectal gyrus and OFC have been attributed a crucial role in automatic emotion regulation, this finding points toward the assumption that highly aggressive men use automatic emotion regulation to a greater extent in response to provocation compared to highly aggressive women.

Impulsive aggression and response inhibition in attention-deficit/hyperactivity disorder and disruptive behavioral disorders: Findings from a systematic review

BACKGROUND

Although impulsive aggression (IA) and dysfunctional response inhibition (RI) are hallmarks of attention-deficit/hyperactivity disorder (ADHD) and disrupted behavioral disorders (DBDs), little is known about their shared and distinct deviant neural mechanisms.

AIMS AND METHODS

Here, we selectively reviewed s/fMRI ADHD and DBD studies to identify disorder-specific and shared IA and RI aberrant neural mechanisms.

RESULTS

In ADHD, deviant prefrontal and cingulate functional activity was associated with increased IA. Structural alterations were most pronounced in the cingulate cortex. Subjects with DBDs showed marked cortico-subcortical dysfunctions. ADHD and DBDs share similar cortico-limbic structural and functional alterations. RI deficits in ADHD highlighted hypoactivity in the dorso/ventro-lateral PFC, insula, and striatum, while the paralimbic system was primarily dysfunctional in DBDs. Across disorders, extensively altered cortico-limbic dysfunctions underlie IA, while RI was mostly associated with aberrant prefrontal activity.

CONCLUSION

Control network deficits were evidenced across clinical phenotypes in IA and RI. Dysfunctions at any level within these cortico-subcortical projections lead to deficient cognitive-affective control by ascribing emotional salience to otherwise irrelevant stimuli. The clinical implications of these findings are discussed.

Aggression-related brain function assessed with the Point Subtraction Aggression Paradigm in fMRI

The Point Subtraction Aggression Paradigm (PSAP) measures aggressive behavior in response to provocations. The aim of the study was to implement the PSAP in a functional neuroimaging environment (fMRI) and evaluate aggression-related brain reactivity including response to provocations and associations with aggression within the paradigm. Twenty healthy participants completed two 12-min PSAP sessions within the scanner. We evaluated brain responses to aggressive behavior (removing points from an opponent), provocations (point subtractions by the opponent), and winning points. Our results showed significant ventral and dorsal striatal reactivity when participants won a point and removed one from the opponent. Provocations significantly activated the amygdala, dorsal striatum, insula, and prefrontal areas. Task-related aggressive behavior was positively correlated with neural reactivity to provocations in the insula, the dorsal striatum, and prefrontal areas. Our findings suggest the PSAP within an fMRI environment may be a useful tool for probing aggression-related neural pathways. Activity in the amygdala, dorsal striatum, insula, and prefrontal areas during provocations is consistent with the involvement of these brain regions in emotional and impulsive behavior. Striatal reactivity may suggest an involvement of reward during winning and stealing points.

Psychometric validation of the Persian nine-item Internet Gaming Disorder Scale - Short Form: Does gender and hours spent online gaming affect the interpretations of item descriptions?

Background and aims The nine-item Internet Gaming Disorder Scale - Short Form (IGDS-SF9) is brief and effective to evaluate Internet Gaming Disorder (IGD) severity. Although its scores show promising psychometric properties, less is known about whether different groups of gamers interpret the items similarly. This study aimed to verify the construct validity of the Persian IGDS-SF9 and examine the scores in relation to gender and hours spent online gaming among 2,363 Iranian adolescents. Methods Confirmatory factor analysis (CFA) and Rasch analysis were used to examine the construct validity of the IGDS-SF9. The effects of gender and time spent online gaming per week were investigated by multigroup CFA and Rasch differential item functioning (DIF). Results The unidimensionality of the IGDS-SF9 was supported in both CFA and Rasch. However, Item 4 (fail to control or cease gaming activities) displayed DIF (DIF contrast = 0.55) slightly over the recommended cutoff in Rasch but was invariant in multigroup CFA across gender. Items 4 (DIF contrast = -0.67) and 9 (jeopardize or lose an important thing because of gaming activity; DIF contrast = 0.61) displayed DIF in Rasch and were non-invariant in multigroup CFA across time spent online gaming. Conclusions Given the Persian IGDS-SF9 was unidimensional, it is concluded that the instrument can be used to assess IGD severity. However, users of the instrument are cautioned concerning the comparisons of the sum scores of the IGDS-SF9 across gender and across adolescents spending different amounts of time online gaming.

Monogamy and Nonmonogamy: Evolutionary Considerations and Treatment Challenges

INTRODUCTION

Few topics generate such controversy and emotional reactivity as the nature of human mating behavior. Unfortunately, and potentially to the detriment of good patient care, sexual medicine practitioners have largely avoided this matter. An understanding of the scientific literature can empower practitioners to more effectively confront the inevitable monogamy and nonmonogamy challenges present in research and clinical practice.

AIM

To review and summarize relevant scientific literature as a context to evaluate the more common myths and misunderstanding relating to the practice of monogamy and nonmonogamy in humans. This review also is intended to promote a discussion of the ways human mating strategies may impact sexual function and dysfunction for the individual and couple.

METHODS

A review of English written peer-reviewed evolutionary, anthropological, neuropsychiatric, zoological research, and other scholarly texts was conducted. Work published between 2000 and 2016 concentrating on evolutionary theory, long- and short-term mating strategies in primates and most specifically in humans, and consensual nonmonogamy was highlighted.

MAIN OUTCOME MEASURES

Main outcomes included a brief explanation of evolutionary theory and a review of relevant literature regarding long- and short-term mating behaviors and consensual nonmonogamy.

RESULTS

Serial sexual and social monogamy is the norm for humans. Across time and cultures, humans have adapted both long- and short-term mating strategies that are used flexibly, and sometimes simultaneously, based on unique personal, social, and environmental circumstances.

CONCLUSION

Human mating behavior is individualistic, the result of numerous biopsychosocial influences. The clinician cannot assume that an individual presenting as a patient maintains a monogamy-valued view of his or her intimate relationship. Patients may experience conflict between the cultural monogamous ideal and their actual sexual behaviors. This conflict may be critical in understanding a patient's sexual concerns and in treatment planning. Awareness of these issues will aid the practitioner in sexual medicine.

Psychometric properties of the Greek TCI-R and its clinical correlates: schizotypy and the self-regulation of affective and cognitive functioning

Background. The revised Temperament and Character Inventory (TCI-R) measures Cloninger’s psychobiological model of personality. The average effects of individual temperament and character traits have been associated with schizotypy and with impaired regulation of affect and cognition. We extended prior research by testing predictions about the association of specific multidimensional configurations of temperament and character traits on schizotypy, affect balance, and self-perceived cognitive functioning.

Method. A well-educated sample of native Greeks (N = 483), completed a new Greek translation of the TCI-R, as well as the Schizotypal Personality Questionnaire (SPQ), the Positive/Negative Affect Schedule (PANAS) and the Cognitive Failures Questionnaire (CFQ). The factor structure of the TCI-R was examined with exploratory and confirmatory tests. Associations between reported measures were examined with correlational and regression analyses.

Results. The TCI-R had good psychometric properties as expected from studies in other countries. As predicted, specific configurations of temperament and character were associated with schizotypy, negative affect balance, and cognitive lapses. The “Borderline/Explosive temperament” (high Novelty Seeking, high Harm Avoidance, low Reward Dependence), “Schizotypal/Disorganized character” (low Self-directedness, low Cooperativeness, high Self-transcendence), and “Low Ego Strength/Fragile” profile (high Harm Avoidance, low Persistence, low Self-Directedness) were each strongly associated with higher stereotypy, negative affect balance (low positive affect and high negative affect), and subjective cognitive lapses compared to their contrast groups.

Discussion. Multidimensional TCI profiles are strongly related to individual differences in schizotypy and self-reported regulation of affect and cognition. The Greek translation of the TCI-R is psychometrically sound and useful for clinical assessment and research.

A quantitative and qualitative review of the effects of testosterone on the function and structure of the human social-emotional brain

Social and affective research in humans is increasingly using functional and structural neuroimaging techniques to aid the understanding of how hormones, such as testosterone, modulate a wide range of psychological processes. We conducted a meta-analysis of functional magnetic resonance imaging (fMRI) studies of testosterone administration, and of fMRI studies that measured endogenous levels of the hormone, in relation to social and affective stimuli. Furthermore, we conducted a review of structural MRI i.e. voxel based morphometry (VBM) studies which considered brain volume in relation to testosterone levels in adults and in children. In the included testosterone administration fMRI studies, which consisted of female samples only, bilateral amygdala/parahippocampal regions as well as the right caudate were significantly activated by social-affective stimuli in the testosterone condition. In the studies considering endogenous levels of testosterone, stimuli-invoked activations relating to testosterone levels were noted in the bilateral amygdala/parahippocampal regions and the brainstem. When the endogenous testosterone studies were split by sex, the significant activation of the brain stem was seen in the female samples only. Significant stimuli-invoked deactivations relating to endogenous testosterone levels were also seen in the right and left amygdala/parahippocampal regions studies. The findings of the VBM studies were less consistent. In adults larger volumes in the limbic and temporal regions were associated with higher endogenous testosterone. In children, boys showed a positive correlation between testosterone and brain volume in many regions, including the amygdala, as well as global grey matter volume, while girls showed a neutral or negative association between testosterone levels and many brain volumes. In conclusion, amygdalar and parahippocampal regions appear to be key target regions for the acute actions of testosterone in response to social and affective stimuli, while neurodevelopmentally the volumes of a broader network of brain structures are associated with testosterone levels in a sexually dimorphic manner.

Analysis of the impact of mortality due to suicides in Mexico, 2000-2012

The objective of this study was to analyze the burden of disease due to suicide in Mexico using years of life lost (YLL) between 2000 and 2012 by sex, age group (for those under 85 years of age) and jurisdiction. Vital statistics on mortality and population estimates were used to calculate standardized mortality rates and years of life lost due to suicide. Between 2000 and 2012 a sustained increase in the suicide mortality rate was observed in Mexico. The age group with the highest rate was 85 years of age or older for men, and 15-19 years of age for women. The highest impact in life expectancy due to suicide occurred at 20 to 24 years of age in men and 15 to 19 years of age in women. The states with the highest mortality due to suicide were located in the Yucatan Peninsula (Yucatan, Quintana Roo and Campeche). Mortality due to suicide in Mexico has increased continually. As suicides are preventable, the implementation of health public policies through timely identification, integral prevention strategies and the detailed study of associated risk factors is imperative.

Neural mediator of the schizotypy-antisocial behavior relationship

Prior studies have established that schizotypal personality traits (schizotypy) were associated with antisocial behavior (crime), but it is unclear what neural factors mediate this relationship. This study assessed the mediating effect that sub-regional prefrontal gray, specifically the orbitofrontal gray matter volume, has on the schizotypy-antisocial behavior relationship. Five prefrontal sub-regional (superior, middle, inferior, orbitofrontal and rectal gyral) gray matter volumes were assessed using structural magnetic resonance imaging in 90 adults from the community, together with schizotypy and antisocial behavior. Among all five prefrontal sub-regions, the orbitofrontal cortex (OFC) was the major region-of-interest in the present study. Mediation analyses showed that orbitofrontal gray fully mediated the association between schizotypy and antisocial behavior. After having controlled the sex, age, socio-economic statuses, whole brain volumes and substance abuse/dependence of test subjects, the orbitofrontal gray still significantly mediated the effect of schizotypy on antisocial behavior by 53.5%. These findings are the first that document a neural mediator of the schizotypy-antisocial behavior relationship. Findings also suggest that functions subserved by the OFC, including impulse control and inhibition, emotion processing and decision-making, may contribute to the above comorbidity.

The interactive effects of emotion regulation and alcohol intoxication on lab-based intimate partner aggression

This study draws on Finkel and Eckhardt's (2013) I³ framework to examine the interactive effects of 2 emotion regulation strategies-anger rumination (an impellance factor) and reappraisal (an inhibition factor), and alcohol intoxication (a disinhibition factor)-on intimate partner aggression (IPA) perpetration as measured with an analogue aggression task. Participants were 69 couples recruited from a large Midwestern university (total N = 138). Participants' trait rumination and reappraisal were measured by self-report. Participants were randomized individually to an alcohol or placebo condition, then recalled an anger event while using 1 of 3 randomly assigned emotion regulation conditions (rumination, reappraisal, or uninstructed). Following this, participants completed an analogue aggression task involving ostensibly assigning white noise blasts to their partner. Participants in the alcohol condition displayed greater IPA than participants in the placebo condition for provoked IPA, but not unprovoked IPA. Results also revealed interactions such that for those in the alcohol and rumination group, higher trait reappraisal was related to lower unprovoked IPA. For provoked IPA, higher trait rumination was related to greater IPA among those in the alcohol and rumination condition and those in the placebo and uninstructed condition. In general, results were consistent with I³ theory, suggesting that alcohol disinhibits, rumination impels, and trait reappraisal inhibits IPA. The theoretical and clinical implications of these findings are discussed in the context of current knowledge about the influence of alcohol intoxication and emotion regulation strategies on IPA perpetration.

The relation between emotional intelligence and criminal behavior: A study among convicted criminals

BACKGROUND

Lack of emotional intelligence (EI) may lead to maladjustment and inability to achieve desired goals. A relationship between low levels of EI and crime has been proposed.

AIM

The aim was to assess the relationship between EI and criminal behavior.

MATERIALS AND METHODS

Study sample consisted of 202 subjects, in whom 101 subjects were convicted offenders, and 101 were matched normal controls. Offender group comprised of individuals convicted for different crimes such as murder, rape, and robbery, selected from Birsa Munda Central Jail, Hotwar, Ranchi, Jharkhand, India based on purposive sampling. Sample of the normal control group was taken from Ranchi and nearby areas. All subjects gave informed consent for participating in the study. Both the groups were matched on age, gender, education, occupation, and marital status. All participants were assessed on General Health Questionnaire-12 and Mangal Emotional Intelligence Inventory (MEII). The results were analyzed using statistical package SPSS-version 20.

RESULTS

The group of convicted offenders obtained significantly lower scores on all the domains of MEII such as intrapersonal awareness (own emotions), interpersonal awareness (others emotions), intrapersonal management (own emotions) and interpersonal management (others emotions), and aggregate emotional quotient in comparison to their normal counterparts.

CONCLUSION

The convicted offenders group had significantly lower EI compared to normal subjects. Starting EI enhancement program in prison can help the inmates better understand their feelings and emotions.

Gender differences in aggression of borderline personality disorder

Aggression is a core feature of borderline personality disorder (BPD). Well-replicated results from the general population indicate that men engage in aggression more frequently than women. This article addresses the question of whether gender also influences aggression in BPD, and whether the neurobiological mechanisms underlying aggressive behavior differ between male and female BPD patients. Data show that most self-reports, interviews and behavioral tasks investigating samples of BPD patients do not find enhanced aggressiveness in male patients, suggesting that BPD attenuates rather than aggravates gender differences usually present in the general population. Neurobiological studies comparing BPD patients with gender-matched healthy controls, however, reveal a number of interesting gender differences: On the one hand, there are well-replicated findings of reduced amygdala and hippocampal gray matter volumes in female BPD patients, while these findings are not shared by male patients with BPD. On the other hand, only male BPD patients exhibit reduced gray matter volume of the anterior cingulate cortex, increased gray matter volume of the putamen, reduced striatal activity during an aggression task, and a more pronounced deficit in central serotonergic responsivity. These neurobiological findings point to a particular importance of impulsivity for the aggression of male BPD patients. Limitations include the need to control for confounding influences of comorbidities, particularly as male BPD patients have been consistently found to show higher percentages of aggression-predisposing comorbid disorders, such as antisocial personality disorder, than female BPD patients. In the future, studies which include systematic comparisons between females and males are warranted in order to disentangle gender differences in aggression of BPD patients with the aim of establishing gender-sensitive treatments where needed.

Losing control: assaultive behavior as a predictor of impulse control disorders in young adults

OBJECTIVE

Assaultive behaviors are common among young people and have been associated with a range of other unhealthy, impulsive behaviors such as substance use and problem gambling. This study sought to determine the predictive ability of single assaultive incidents for impulse control disorders, an association that has yet to be examined, especially in young adults.

METHODS

The authors conducted a university-wide email survey in the spring of 2011 on 6000 university students. The survey examined assaultive behavior and associated mental health variables (using a clinically validated screening instrument, the Minnesota Impulsive Disorders Interview), stress and mood states, and psychosocial functioning.

RESULTS

The rate of response was 35.1% (n=2108). 109 (5.9%) participants reported that they had assaulted another person or destroyed property at some time in their lives. Compared with respondents without lifetime assaultive behavior, those with a history of assaultive or destructive behavior reported more depressive symptoms, more stress, and higher rates of a range of impulse control disorders (intermittent explosive disorder, compulsive sexual behavior, compulsive buying, and skin picking disorder).

CONCLUSIONS

Assaultive behavior appears fairly common among college students and is associated with symptoms of depression and impulse control disorders. Significant distress and diminished behavioral control suggest that assaultive behaviors may often be associated with significant morbidity. Additional research is needed to develop specific prevention and treatment strategies for young adults attending college who report problems with assaultive behaviors.

Sex-related and non-sex-related comorbidity subtypes of tic disorders: a latent class approach

BACKGROUND AND PURPOSE

Recent evidence suggests that there may be more than one Gilles de la Tourette syndrome (GTS)/tic disorder phenotype. However, little is known about the common patterns of these GTS/tic disorder-related comorbidities. In addition, sex-specific phenomenological data of GTS/tic disorder-affected adults are rare. Therefore, this community-based study used latent class analyses (LCA) to investigate sex-related and non-sex-related subtypes of GTS/tic disorders and their most common comorbidities.

METHODS

The data were drawn from the PsyCoLaus study (n = 3691), a population-based survey conducted in Lausanne, Switzerland. LCA were performed on the data of 80 subjects manifesting motor/vocal tics during their childhood/adolescence. Comorbid attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder, depressive, phobia and panic symptoms/syndromes comprised the selected indicators. The resultant classes were characterized by psychosocial correlates.

RESULTS

In LCA, four latent classes provided the best fit to the data. We identified two male-related classes. The first class exhibited both ADHD and depression. The second class comprised males with only depression. Class three was a female-related class depicting obsessive thoughts/compulsive acts, phobias and panic attacks. This class manifested high psychosocial impairment. Class four had a balanced sex proportion and comorbid symptoms/syndromes such as phobias and panic attacks. The complementary occurrence of comorbid obsessive thoughts/compulsive acts and ADHD impulsivity was remarkable.

CONCLUSIONS

To the best of our knowledge, this is the first study applying LCA to community data of GTS symptoms/tic disorder-affected persons. Our findings support the utility of differentiating GTS/tic disorder subphenotypes on the basis of comorbid syndromes.

Effects of individual glucose levels on the neuronal correlates of emotions

This study aimed to directly assess the effect of changes in blood glucose levels on the psychological processing of emotionally charged material. We used functional magnetic resonance imaging (fMRI) to evaluate the effect of blood glucose levels on three categories of visually presented emotional stimuli. Seventeen healthy young subjects participated in this study (eight females; nine males; body weight, 69.3 ± 14.9 kg; BMI, 22 ± 2.7; age, 24 ± 3 years), consisting of two functional MRI sessions: (1) after an overnight fast under resting conditions (before glucose administration); (2) after reaching the hyperglycemic state (after glucose administration). During each session, subjects were presented with visual stimuli featuring funny, neutral, and sad content. Single-subject ratings of the stimuli were used to verify the selection of stimuli for each category and were covariates for the fMRI analysis. Analysis of the interaction effect of the two sessions (eu- and hyperglycemia), and the emotional categories accounting for the single-subject glucose differences, revealed a single activation cluster in the hypothalamus. Analysis of the activation profile of the left amygdala corresponded to the three emotional conditions, and this profile was obtained for both sessions regardless of glucose level. Our results indicate that, in a hyperglycemic state, the hypothalamus can no longer respond to emotions. This study offers novel insight for the understanding of disease-related behavior associated with dysregulation of glucose and glucose availability, potentially offering improved diagnostic and novel therapeutic strategies in the future.

Criminal thinking styles and emotional intelligence in Egyptian offenders

BACKGROUND

The Psychological Inventory of Criminal Thinking Styles (PICTS) has been applied extensively to the study of criminal behaviour and cognition. Increasingly growing evidence indicates that criminal thinking styles vary considerably among individuals, and these individual variations appear to be crucial for a full understanding of criminal behaviour.

AIMS

This study aimed to examine individual differences in criminal thinking as a function of emotional intelligence.

METHODS

A group of 56 Egyptian male prisoners completed the PICTS and Bar-On Emotional Quotient Inventory (EQ-i). The correlations between these assessments were examined using a series of Pearson correlations coefficients, with Bonferroni correction.

RESULTS

General criminal thinking, reactive criminal thinking and five criminal thinking styles (mollification, cutoff, power orientation, cognitive indolence and discontinuity) negatively correlated with emotional intelligence. On the other hand, proactive criminal thinking and three criminal thinking styles (entitlement, superoptimism and sentimentality) did not associate with emotional intelligence.

CONCLUSIONS

Emotional intelligence is an important correlate of individual differences in criminal thinking, especially its reactive aspects. Practical implications of this suggestion were discussed.

Impulsivity in the general population: a national study

OBJECTIVE

The construct of impulsivity is an important determinant of personality differences, psychiatric disorders, and associated risk-taking behaviors. Most existing knowledge about impulsivity comes from clinical samples. To date, no study has estimated the prevalence of impulsivity and examined its correlates in the general population.

METHOD

We analyzed data from a large national sample of the United States population. Face-to-face surveys of 34 653 adults aged 18 years and older residing in households were conducted during the 2004-2005 period. Diagnoses of mood, anxiety, and drug disorders as well as personality disorders were based on the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version.

RESULTS

Impulsivity was common (17% of the sample), particularly among males and younger individuals, and associated with a broad range of axis I and II disorders, particularly drug dependence, cluster B, dependent and schizotypal personality disorders, bipolar disorder and ADHD. It was associated with behavioral disinhibition, attention deficits, and lack of planning. Individuals with impulsivity were more likely to engage in behaviors that could be dangerous to themselves or others, including driving recklessly, starting fights, shoplifting, perpetrating domestic violence and trying to hurt or kill themselves. They were exposed to higher risk of lifetime trauma and to substantial physical and psychosocial impairment.

CONCLUSION

Given the association of impulsivity with psychiatric disorders and multiple adverse events, there is a need to target impulsivity in prevention and treatment efforts.

Delay discounting and frontostriatal fiber tracts: a combined DTI and MTR study on impulsive choices in healthy young adults

Delay discounting, a measure of impulsive choice, has been associated with decreased control of the prefrontal cortex over striatum responses. The anatomical connectivity between both brain regions in delaying gratification remains unknown. Here, we investigate whether the quality of frontostriatal (FS) white matter tracts can predict individual differences in delay-discounting behavior. We use tract-based diffusion tensor imaging and magnetization transfer imaging to measure the microstructural properties of FS fiber tracts in 40 healthy young adults (from 18 to 25 years). We additionally explored whether internal sex hormone levels affect the integrity of FS tracts, based on the hypothesis that sex hormones modulate axonal density within prefrontal dopaminergic circuits. We calculated fractional anisotropy (FA), mean diffusivity (MD), longitudinal diffusivity, radial diffusivity (RD), and magnetization transfer ratio (MTR), a putative measure of myelination, for the FS tract. Results showed that lower integrity within the FS tract (higher MD and RD and lower FA), predicts faster discounting in both sexes. MTR was unrelated to delay-discounting performance. In addition, testosterone levels in males were associated with a lower integrity (higher RD) within the FS tract. Our study provides support for the hypothesis that enhanced structural integrity of white matter fiber bundles between prefrontal and striatal brain areas is associated with better impulse control.

The gender paradox in suicidal behavior and its impact on the suicidal process

BACKGROUND

An important gender difference has been reported regarding suicidal behavior with an overrepresentation of females in nonfatal suicidal behavior and a preponderance of males in completed suicide, also known as the 'gender paradox of suicidal behavior'. The concept of a 'suicidal process' classifies suicidal behavior chronologically; this process starts with suicidal ideation and then implies a progression of suicidality ranging from suicidal ideation over plans to suicide attempts and finally fatal suicide.

AIMS/METHODS

The current paper aims to deepen the knowledge on the gender paradox by collecting and discussing the recent literature on this topic: the most relevant, impacting gender-related factors will be discussed within the suicidal process concept.

RESULTS

Several factors had a gender-dependent impact on suicidal behavior: psychosocial life stressors such as stressful life events but also sociodemographical or socio-economical factors, and sexual abuse. The gender differences in psychiatric (co)morbidity and in response to or attitude towards antidepressant treatment also appear to have an impact. Furthermore, not only suicide methods but also the gender-dependent variation in reporting suicide has an influence. Finally, the gender differences in help seeking behavior as well as region-dependent cultural beliefs and societal attitudes are discussed.

CONCLUSIONS

Especially life-events seem to exert an important influence at the beginning of a suicidal process, whereas the other factors occur at a further stage in the process, however without a fixed chronology. Also, the duration of the suicidal process is much shorter in male than in females. Finally, some implications with regard to clinical practice and suicide prevention are suggested.

Sex differences in anterior cingulate cortex activation during impulse inhibition and behavioral correlates

Poor impulse inhibition is associated with behavioral problems including aggression and violence as well as clinical diagnoses such as attention deficit hyperactivity disorder (ADHD) and substance abuse, all of which are more prevalent in men than in women. Studies have found that fronto-parietal and fronto-striatal-thalamic networks are critical for successful impulse inhibition. However, few studies have investigated neural differences in these networks between men and women. In this study, we use a well established behavioral task, the parametric Go/noGo task, to explore the relationships between brain regional activity during impulse control and impulsivity trait measures, as well as sex differences in these relationships. We found that males showed heightened activation of the rostral anterior cingulate, which correlated with ratings related to impulsivity. We also found that the activation/deactivation in males and females correlates with personality ratings in a sex-specific manner.

Love is more than just a kiss: a neurobiological perspective on love and affection

Love, attachment, and truth of human monogamy have become important research themes in neuroscience. After the introduction of functional Magnetic Resonance Imaging (fMRI) and Positron Emission Tomography (PET), neuroscientists have demonstrated increased interest in the neurobiology and neurochemistry of emotions, including love and affection. Neurobiologists have studied pair-bonding mechanisms in animal models of mate choice to elucidate neurochemical mechanisms underlying attachment and showed possible roles for oxytocin, vasopressin, and dopamine and their receptors in pair-bonding and monogamy. Unresolved is whether these substances are also critically involved in human attachment. The limited number of available imaging studies on love and affection is hampered by selection bias on gender, duration of a love affair, and cultural differences. Brain activity patterns associated with romantic love, shown with fMRI, overlapped with regions expressing oxytocin receptors in the animal models, but definite proof for a role of oxytocin in human attachment is still lacking. There is also evidence for a role of serotonin, cortisol, nerve growth factor, and testosterone in love and attachment. Changes in brain activity related to the various stages of a love affair, gender, and cultural differences are unresolved and will probably become important research themes in this field in the near future. In this review we give a resume of the current knowledge of the neurobiology of love and attachment and we discuss in brief the truth of human monogamy.

Sex differences in same-sex direct aggression and sociosexuality: the role of risky impulsivity

Sex differences in same-sex direct aggression and sociosexuality are among the most robust in the literature. The present article evaluated the hypothesis that both can be explained by a sex difference in the willingness to take impulsive risks. Self-report data were gathered from 3,775 respondents (1,514 female) on same-sex aggression, sociosexuality, and risky impulsivity. Risky impulsivity was higher for men than for women (d = .34) and path analysis showed it to be a common cause of same-sex aggression and sociosexuality for both sexes. However, it did not completely mediate the sex differences in same-sex aggression and sociosexuality. The results suggest that same-sex aggression and sociosexual behavior share a common psychological mechanism, but that fully explaining sex differences in aggression requires a more sensitive assay of impulsive risk and a consideration of dyadic processes.

Neural mechanisms of the testosterone-aggression relation: the role of orbitofrontal cortex

Testosterone plays a role in aggressive behavior, but the mechanisms remain unclear. The present study tested the hypothesis that testosterone influences aggression through the OFC, a region implicated in self-regulation and impulse control. In a decision-making paradigm in which people chose between aggression and monetary reward (the ultimatum game), testosterone was associated with increased aggression following social provocation (rejecting unfair offers). The effect of testosterone on aggression was explained by reduced activity in the medial OFC. The findings suggest that testosterone increases the propensity toward aggression because of reduced activation of the neural circuitry of impulse control and self-regulation.

The diagnosis of a personality disorder increases the likelihood for seropositivity to Toxoplasma gondii in psychiatric patients

Individuals serologically positive for the chronic infection with the parasite Toxoplasma gondii (TG) display certain personality traits differently from uninfected individuals. Experimental data in mice demonstrate that TG infection modulates behaviour. However, psychiatric patients with a personality disorder have not yet been investigated systematically. In our sample containing 896 psychiatric inpatients with the primary diagnoses of schizophrenia, major depression, schizoaffective or bipolar disorder and 214 psychiatrically unaffected controls (same geographic region, sampled during same time period) we analysed for effects of the additional diagnosis of a personality disorder in the patients. Psychiatrically, a patient can meet the criteria of a personality disorder additionally to any of the mentioned primary diagnoses. We applied logistic regression and cross-table statistics, separated groups by the presence/absence of a personality disorder (ICD-10) and adjusted for age between groups. We found that among all patients the additional diagnosis of a personality disorder was significantly associated with TG infection. Furthermore, only in the patients with an additional personality disorder medium titre responses (1:16-1:64) were associated with chronic course and high C-reactive protein (CRP) levels whereas high titre response (>1:64) was associated with a more acute recurrent clinical course. In the older individuals only there was a preponderance of medium titre responses (1:16-1:64) among the patients with personality disorder compared to those without and controls. We conclude that TG infection and the host's response to it make a difference for the diagnosis of a personality disorder. Our data support that TG infection can modulate human behaviour and personality traits.

Exogenous cortisol enhances aggressive behavior in females, but not in males

The hypothalamic-pituitary-adrenal (HPA) axis plays a major role in the development, elicitation, and enhancement of aggressive behavior in animals. Increasing evidence suggests that this is also true for humans. Here, we report on a study of the role of basal and acute HPA axis activity in a sample of 48 healthy male and female adults. We pharmacologically enhanced cortisol levels and used the Taylor Aggression Paradigm (TAP) to induce and measure aggression (divided into three blocks). Participants either received an oral dose of 20 mg hydrocortisone (cortisol group) or a placebo (placebo group). Half of each group received high or low levels of provocation with the TAP, respectively. Before, we assessed the cortisol awakening response as a trait measure of basal HPA axis activity. Participants in the cortisol group reacted more aggressively in the third block of the TAP compared to the placebo group. Furthermore, gender interacted with treatment: only females, but not males showed enhanced aggressive behavior after cortisol administration. There was no significant difference in males between the placebo and cortisol group. Basal HPA axis activity was negatively related to aggressive behavior, but again only in females and most strongly within the placebo group. This study provides the first evidence for a causal involvement of acute HPA axis activation in aggressive behavior in humans.

The relationship between basal and acute HPA axis activity and aggressive behavior in adults

The hypothalamic-pituitary-adrenal (HPA) axis seems to play a major role in the development, elicitation, and enhancement of aggressive behavior in animals. Increasing evidence suggests that this is also true for humans. However, most human research on the role of the HPA axis in aggression has been focusing on highly aggressive children and adolescent clinical samples. Here, we report on a study of the role of basal and acute HPA axis activity in a sample of 20 healthy male and female adults. We used the Taylor Aggression Paradigm to induce and measure aggression. We assessed the cortisol awakening response as a trait measure of basal HPA axis activity. Salivary free cortisol measures for the cortisol awakening response were obtained on three consecutive weekdays immediately following awakening and 30, 45, and 60 min after. Half of the subjects were provoked with the Taylor Aggression Paradigm to behave aggressively; the other half was not provoked. Acute HPA axis activity was measured four times, once before and three times after the induction of aggression. Basal cortisol levels were significantly and negatively related to aggressive behavior in the provoked group and explained 67% of the behavioral variance. Cortisol levels following the induction of aggression were significantly higher in the provoked group when baseline levels were taken into account. The data implicate that the HPA axis is not only relevant to the expression of aggressive behavior in clinical groups, but also to a large extent in healthy ones.

[Neurobiological aspects of reactive and proactive violence in antisocial personality disorder and "psychopathy"]

Impulsive-reactive violent offenders show increased autonomic activity in response to negative emotional and threatening stimuli. A volume reduction and/or activity decrease of frontal brain structures associated with impulse control and the regulation of fear and anger are likewise found in combination with a fear-related hyperactivity of the amygdala. In addition, impulsive aggression is facilitated by variants of gene polymorphisms influencing the serotonergic system. Conversely, proactive-instrumental violent offender with psychopathy, who are characterized by a lack of empathy and remorse, demonstrate an autonomic hypo-responsivity as well as dysfunctions of the amygdala and of cortical regions related to empathic and social behavior. Developmentally, aggressive children exhibit temperamental differences from early childhood on that are characteristic of a developmental pathway towards either reactive or proactive violence later in life. Exposure to negative environmental factors like ineffective parenting or childhood maltreatment has been related to a heightened risk for developing reactive violence. A developmental trajectory of proactive violence, however, has been related to a mostly genetically determined callous unemotional temperament of the child that disrupts the parental socialization efforts during childhood.