Violência física, sexual e psicológica segundo a análise conceitual evolucionista de rodgers / Physical, sexual and psychological violence according to rodgers' evolutionary conceptual analysis / Violencia física, sexual y psicológica según el análisis conceptual evolutivo de rodgers

RESUMO Objetivo: esclarecer os conceitos de violência física, psicológica e sexual e, a partir dos resultados obtidos, comparar similaridades e diferenças entre conceitos, suas características, condições para acontecimentos e possíveis desfechos. Métodos: utilizou-se a análise de conceito evolutivo de Rodgers. Os antecedentes, atributos e consequentes foram extraídos de 91 documentos publicados em 2018, em português, inglês, francês ou espanhol, por busca utilizando os descritores "violência física", "violência psicológica" e "violência sexual". Resultados: para "violência física" foram extraídos 17 atributos, um antecedente e sete consequentes; para "violência sexual" 31 atributos, 10 antecedentes e dois consequentes; e para "violência psicológica" 33 atributos, quatro antecedentes e seis consequentes. Considerações finais: distintas tipologias de violência apresentam diferentes atos que as caracterizam, e que quando (re)conhecidos pelo enfermeiro, oportunizam um planejamento da assistência otimizado e de qualidade.

ABSTRACT Objective: to clarify the concepts of physical, psychological, and sexual violence and, from the results obtained, to compare similarities and differences among concepts, their characteristics, conditions for events, and possible outcomes. Methods: Rodgers' evolving concept analysis was used. The antecedents, attributes and consequents were extracted from 91 documents published in 2018, in Portuguese, English, French or Spanish, by search using the descriptors "physical violence", "psychological violence" and "sexual violence". Results: for "physical violence" 17 attributes, one antecedent and seven consequents were extracted; for "sexual violence" 31 attributes, 10 antecedents and two consequents; and for "psychological violence" 33 attributes, four antecedents and six consequents. Final considerations: different types of violence have different acts that characterize them, and that when (re)known by the nurse, allow for an optimized and quality care planning.

RESUMEN Objetivo: aclarar los conceptos de violencia física, psicológica y sexual y, a partir de los resultados obtenidos, comparar las similitudes y diferencias entre los conceptos, sus características, las condiciones de los acontecimientos y los posibles resultados. Métodos: Se utilizó el análisis conceptual evolutivo de Rodgers. Los antecedentes, atributos y consecuentes se extrajeron de 91 documentos publicados en 2018, en portugués, inglés, francés o español, mediante la búsqueda con los descriptores "violencia física", "violencia psicológica" y "violencia sexual". Resultados: para la "violencia física" se extrajeron 17 atributos, un antecedente y siete consecuentes; para la "violencia sexual" 31 atributos, 10 antecedentes y dos consecuentes; y para la "violencia psicológica" 33 atributos, cuatro antecedentes y seis consecuentes. Consideraciones finales: los diferentes tipos de violencia presentan diferentes actos que los caracterizan, y que al ser (re)conocidos por la enfermera, permiten una planificación de cuidados optimizada y de calidad.

Evidence for the taxonic latent structure for DSM-5 intermittent explosive disorder in adults.

BACKGROUND: Identification of individuals with clinically significant aggressive behavior is critical for the prevention and management of human aggressive behavior. A previous population-based taxometric study reported that the Diagnostic and Statistical Manual of Mental Disorders-4th Edition (DSM-IV) intermittent explosive disorder (IED) belongs to its own discrete class (taxon) rather than existing along a continuum. METHODS: This study sought to extend previous population-based findings in a clinical research sample of adults with DSM-5 IED (n = 346), adults with non-aggressive DSM-5 disorders (n = 293), and adults without any DSM-5 disorder (n = 174), using standardized assessments of DSM-5 diagnoses, aggression, and other related measures not available in past studies. RESULTS: Analyses revealed a taxonic latent structure that overlapped with the DSM-5 diagnosis of IED. Within the sample, taxon group members had higher scores on a variety of measures of psychopathology than did the complement members of the sample. Comorbidity of other diagnoses with IED did not affect these results. CONCLUSION: These findings support the proposition that DSM-5 IED represents a distinct behavioral disorder rather than the severe end of an aggressive behavior continuum.

Profile of violence against older individuals registered at the dial 100 in the period 2011-2015 in Brazil / Perfil da violência contra a pessoa idosa registrada no Disque 100 de 2011 a 2015, Brasi

OBJETIVO: Analisar o perfil das denúncias de violência contra os idosos registradas no Disque 100, entre os anos de 2011 e 2015. METODOLOGIA: Estudo descritivo-retrospectivo, baseado em amostra composta de 130.164 denúncias. Para coleta de dados, elaborou-se um roteiro contendo as seguintes variáveis: cidade, sexo, faixa etária, raça/cor, local onde ocorre a agressão, tipo da violência e relação da vítima com o suspeito. RESULTADOS: Ao analisarmos os dados por região brasileira, nota-se que o maior número de registros ocorreu na Região Sudeste (42,27%) e o menor na Região Norte (6,79%). Quando analisamos as denúncias por 100.000 habitantes, encontramos como estados líderes no ranking de denúncia de violência contra o idoso Amazonas, Distrito Federal e Rio Grande do Norte. O perfil das possíveis vítimas denunciadas foi: idade entre 76 e 80 anos, com predominância feminina e de cor branca. Observa-se que os filhos são os principais suspeitos de cometer agressão e os netos elencam a segunda posição no ranking de suspeitos. Em relação ao local da ocorrência do ato violento, os dados indicam que o maior percentual de violência ocorre na casa da vítima, seguido pela casa do suspeito. No que se refere aos tipos de violência, a negligência (36,72%) foi a mais recorrente, seguida da violência psicológica (28,46%) e do abuso financeiro (20,45%). CONCLUSÃO: O Disque 100 é uma das ferramentas mais eficazes para romper o silêncio e a invisibilidade da violência contra os idosos, fornecendo um panorama de denúncias em nosso país.

OBJECTIVE: To analyze the profile of the reports of violence and abuse against older people registered in the Dial 100 helpline from 2011 to 2015. METHODS: This was a descriptive, retrospective study, based on a sample of 130 164 denunciation reports of the Dial 100. The data collection considered the following variables: city, sex, age, race, place of abuse, type of abuse, and the victim's relationship with the suspect. RESULTS: The greatest number of reports was registered in the Southeast (42.27%), and the lowest in the North (6.79%). When we analyze the complaints per 100 000 inhabitants, we found as leading states in the ranking of complaints of violence against older people: Amazonas, Federal District, and Rio Grande do Norte. The main profile of possible victims was age from 76 to 80 years, predominantly women, and white. The main abusers were the victim's children and grandchildren. The most frequent type of abuse was negligence (36.72%), followed by psychological abuse (28.46%), and financial abuse (20.45%). CONCLUSION: The Dial 100 helpline is one of the most effective tools for breaking the silence and invisibility of abuse and violence against older adults, offering a panorama of abuse denunciation in our country.

Perpetration of Alcohol-Related Aggression by Male and Female College Students: An Examination of Overt and Relational Aggression.

Existing literature exemplifies the relationship between alcohol and overt aggression, especially for adult males. Less clear is the relationship between alcohol and aggression among male and female college students, in particular, the nature of this aggression and the co-occurrence of drinking and aggression on the same day (temporal proximity). This study examines the chronic and temporal nature of males' and females' alcohol-related aggression among college students. Two hundred fourteen students completed a web-based 7-day event-level survey measuring alcohol consumption and perpetration of physical aggression, verbal aggression, anger, and relational aggression over 4 weeks, resulting in 4,256 observations (days). The global analysis revealed students who are heavy drinkers are more likely to perpetrate all four forms of aggression, whereas the event-level analysis revealed that specific forms of aggression are associated with drinking at the time, while other forms were not linked to drinking occasions. Cross-tabulation revealed males and females were more likely to use verbal and physical aggression when drinking. For females, drinking was also associated with relational aggression and anger. Despite often being overlooked in research on aggression during emerging adulthood, relational aggression was prevalent. Discrepancies between the global and temporal analysis revealed factors other than alcohol might explain the relationship between chronic alcohol consumption and specific forms of aggression. This is one of the first event-level studies to show the temporal relationship between alcohol and relational aggression. The distinctions in the current study, exemplifying the diversity of alcohol-related aggression, are critical for understanding aggressive behavior, potential gender differences, and for developing interventions. The temporal relationship between alcohol and aggression suggests health interventions should target drinking and aggression simultaneously.

Cross-sectional study on patient-physician aggression in Belgium: physician characteristics and aggression types.

OBJECTIVES: The aim of this Belgian research study was to describe the characteristics of physicians who are at increased risk for patient-physician aggression. Second, aggression subtypes were described and data were provided on the prevalence of patient-physician aggression in Belgium. DESIGN: Cross-sectional survey. SETTING: Primary and secondary care inside and outside hospitals. PARTICIPANTS: Any physician who had worked in Belgium for the preceding 12 months was eligible to participate (n=34 648). MAIN OUTCOME MEASURES: An online, original questionnaire was used to obtain physician characteristics (eg, age, sex, native language), department, working conditions and contact with aggressive patients during their career and during the preceding 12 months. RESULTS: The questionnaire was completed by 4930 participants and 3726 (76%) were valid to take into account for statistics. During the preceding 12 months, 37% had been victims of aggression: 33% experienced verbal aggression, 30% psychological, 14% physical and 10% sexual. Multiple answers were allowed. Women and younger physicians were more likely to experience aggression. Psychiatric departments and emergency departments were the settings most commonly associated with aggression. Physicians who provided primarily outpatient care were more subject to aggression. CONCLUSION: Belgian physicians experience several forms of aggression. Those most at-risk of aggression are young and female physicians who work in outpatient, emergency or psychiatric settings.

Maladaptive Aggression: With a Focus on Impulsive Aggression in Children and Adolescents.

Objective: Aggressive behavior is among the most common reasons for referral to psychiatric clinics and confers significant burden on individuals. Aggression remains poorly defined; there is currently no consensus on the best ways to recognize, diagnose, and treat aggression in clinical settings. In this review, we synthesize the available literature on aggression in children and adolescents and propose the concept of impulsive aggression (IA) as an important construct associated with diverse and enduring psychopathology. Methods: Articles were identified and screened from online repositories, including PubMed, PsychInfo, the Cochrane Database, EMBase, and relevant book chapters, using combinations of search terms such as "aggression," "aggressive behavio(u)r," "maladaptive aggression," "juvenile," and "developmental trajectory." These were evaluated for quality of research before being incorporated into the article. The final report references 142 sources, published from 1987 to 2019. Results: Aggression can be either adaptive or maladaptive in nature, and the latter may require psychosocial and biomedical interventions when it occurs in the context of central nervous system psychopathology. Aggression can be categorized into various subtypes, including reactive/proactive, overt/covert, relational, and IA. IA in psychiatric or neurological disorders is reviewed along with current treatments, and an algorithm for systematic evaluation of aggression in the clinical setting is proposed. Conclusions: IA is a treatable form of maladaptive aggression that is distinct from other aggression subtypes. It occurs across diverse psychiatric and neurological diagnoses and affects a substantial subpopulation. IA can serve as an important construct in clinical practice and has considerable potential to advance research.

An exploratory study on microaggressions in medical school: What are they and why should we care?

INTRODUCTION: Microaggressions and their impact have been documented in minority college students; however, little is known about the experience of medical students. This study reports the prevalence and understanding of microaggressions among medical students at the University of Florida College of Medicine (UFCOM), while gaining insights into experiences of medical students dealing with microaggressions. METHOD: A nine-question survey was sent out to all medical students at the UFCOM in the spring of 2017 to understand their experiences with microaggressions. The authors used simple statistics and chi-test to analyze the demographic data and an inductive thematic qualitative analysis was performed on the open-ended responses to study medical students' understanding of the term, experiences, and impact of microaggressions. RESULTS: The response rate was 64% (n = 351/545). Fifty-four percent reported experiencing microaggressions, of those the majority were female students (73% compared with 51% among male students, p = 0.0003); for female students from minority backgrounds this was 68% and for white female students 76% (p = 0.2606). Microaggressions are more common in the second year of medical school (30%), followed by the third year (23%). Most students were able to recognize and identify microaggressions, but some denied the concept existed, attributing concerns about microaggressions to a culture promoting oversensitivity and political correctness. Students described microaggressions related to sexism; religion; skin colour; and ethnicity. Students described indifference, emotional reactions and denial of the event as coping mechanisms. CONCLUSION: Microaggressions are prevalent on a day-to-day basis among medical students with female students from a minority background as well as white female students experiencing more microaggressions. Further research is needed to explore interventions to counter microaggressions in order to ensure a healthy learning environment.

Subtypes of aggression in intermittent explosive disorder.

Research in aggression has distinguished two major subtypes of aggressive behavior: hostile and instrumental. Previous research has examined these subtypes in healthy individuals and forensic samples but not in intermittent explosive disorder (IED), a disorder characterized by recurrent and severe aggressive behavior. We examined aggression subtypes in individuals with IED, healthy subjects, and psychiatric control subjects. We also considered the relationship between aggression subtypes and measures of trait anger and impulsivity to evaluate whether the hostile/instrumental dichotomy adequately captures the heterogeneity of aggressive behavior in this sample. Finally, we consider the implications of these results for research on aggression, including neuroscience research on aggression.

Development of Aggression Subtypes from Childhood to Adolescence: a Group-Based Multi-Trajectory Modelling Perspective.

The persistence of elevated subtypes of aggression beginning in childhood have been associated with long-term maladaptive outcomes. Yet it remains unclear to what extent there are clusters of individuals following similar developmental trajectories across forms (i.e., physical and indirect) and functions (i.e., proactive and reactive) of aggression. We aimed to identify groups of children with distinct profiles of the joint development of forms and functions of aggression and to identify risk factors for group membership. A sample of 787 children was followed from birth to adolescence. Parent and teacher reports, and standardised assessments were used to measure two forms and two functions of aggressive behaviour, between six and 13 years of age along with preceding child, maternal, and family-level risk-factors. Analyses were conducted using a group-based multi-trajectory modelling approach. Five trajectory groups emerged: non-aggressors, low-stable, moderate-engagers, high-desisting, and high-chronic. Coercive parenting increased membership risk in the moderate-engagers and high-chronic groups. Lower maternal IQ increased membership risk in both high-desisting and high-chronic groups, whereas maternal depression increased membership risk in the high-desisting group only. Never being breastfed increased membership risk in the moderate-engagers group. Boys were at greater risk for belonging to groups displaying elevated aggression. Individuals with chronic aggression problems use all subtypes of aggression. Risk factors suggest that prevention programs should start early in life and target mothers with lower IQ. Strategies to deal with maternal depression and enhance positive parenting while replacing coercive parenting tactics should be highlighted in programming efforts.

Predictors of childhood trajectories of overt and indirect aggression: An interdisciplinary approach.

The aim of this study was to advance our understanding of the development of aggression in boys and girls by testing a model combining insights from both evolutionary theory and developmental psychology. A sample of 744 children (348 girls) between six and 13 years old was recruited in schools with high deprivation indices. Half of the sample (N = 372; 40.1% girls) had received special educational services for behavioral and/or socio-emotional problems. Two trajectories for overt aggression and two trajectories for indirect aggression were identified and binomial logistic regressions were used to identify environmental predictors and sex-specific patterns of these trajectories. Results indicated that peer rejection predicted overt aggression and indirect aggression and that extraversion and male sex predicted overt aggression. The results also showed that interaction between parental practices and some child temperament traits predicted overt aggression (coercion and lack of supervision associated with extraversion or low effortful control) or indirect aggression (coercion and neglect associated with negative affect or low effortful control), and the absence of a father figure predicted high indirect aggression in girls.

Specific Contributions of Age of Onset, Callous-Unemotional Traits and Impulsivity to Reactive and Proactive Aggression in Youths with Conduct Disorders.

Youths with conduct disorders (CD) are particularly studied for their violent and aggressive behaviors. Many researchers considered aggressive behaviors as being either reactive or proactive. Moreover, factors such as age of CD onset, impulsivity, and callous-unemotional traits, separately, have been related to these different types of aggressive behaviors. However, very few studies addressed the combined contribution of these three factors on proactive and reactive aggression. This question was tested in a sample composed of 43 male adolescents with CD. A single regression analysis including all predictors and outcomes, using Bayesian statistics, was computed. Results indicated that impulsivity was related to reactive aggression, while CU traits were related to proactive aggression. These results suggest first, an important heterogeneity among youth with CD, probably leading to different trajectories and, second, that youths with callous-unemotional traits should receive special attention and care as they are more at risk for proactive aggression.

Focus on aggressive behaviour in mental illness.

Background: Aggression is a behaviour with evolutionary origins, but in today's society it is often both destructive and maladaptive. Increase of aggressive behaviour has been observed in a number of serious mental illnesses, and it represents a clinical challenge for mental healthcare provider. These phenomena can lead to harmful behaviours, including violence, thus representing a serious public health concern. Aggression is often a reason for psychiatric hospitalization, and it often leads to prolonged hospital stays, suffering by patients and their victims, and increased stigmatization. Moreover, it has an effect on healthcare use and costs in terms of longer length of stay, more readmissions and higher drug use. Materials and methods: In this review, based on a selective search of 2010-2016 pertinent literature on PubMed, we analyze and summarize information from original articles, reviews, and book chapters about aggression and psychiatric disorders, discussing neurobiological basis and therapy of aggressive behaviour. Results: A great challenge has been revealed regarding the neurobiology of aggression, and an integration of this body of knowledge will ultimately improve clinical diagnostics and therapeutic interventions. The great heterogeneity of aggressive behaviour still hampers our understanding of its causal mechanisms. Still, over the past years, the identification of specific subtypes of aggression has released possibilities for new and individualized treatment approaches. Conclusions: Neuroimaging studies may help to further elucidate the interrelationship between neurocognitive functioning, personality traits, and antisocial and violent behaviour. Recent studies point toward manipulable neurobehavioral targets and suggest that cognitive, pharmacological, neuromodulatory, and neurofeedback treatment approaches can be developed to ameliorate urgency and aggression in schizophrenia. These combined approaches could improve treatment efficacy. As current pharmacological and therapeutic interventions are effective but imperfect, new insights into the neurobiology of aggression will reveal novel avenues for treatment of this destructive and costly behaviour.

Subtypes of suicide attempters based on longitudinal childhood profiles of co-occurring depressive, anxious and aggressive behavior symptoms.

Because suicide attempts are multi-determined events, multiple pathways to suicidal behaviors exist. However, as a low-frequency behavior, within group differences in trajectories to attempts may not emerge when examined in samples including non-attempters. We used longitudinal latent profile analysis to identify subtypes specific for suicide attempters based on longitudinal trajectories of childhood clinical symptoms (i.e., depression, anxiety, and aggression measured in 2nd, 4th-7th grades) for 161 young adults (35.6% male; 58.6% African American) who attempted suicide between ages 13-30 from a large, urban community-based, longitudinal prevention trial (n = 2311). Differences in psychiatric diagnoses, suicide attempt characteristics, criminal history and traumatic stress history were studied. Three subtypes emerged: those with all low (n = 32%), all high (n = 16%), and high depressive/anxious, but low aggressive (n = 52%) symptoms. Those with the highest levels of all symptoms were significantly more likely to report a younger age of suicide attempt, and demonstrate more substance abuse disorders and violent criminal histories. Prior studies have found that childhood symptoms of depression, anxiety and aggression are malleable targets; interventions directed at each reduce future risk for suicidal behaviors. Our findings highlight the link of childhood aggression with future suicidal behaviors extending this research by examining childhood symptoms of aggression in the context of depression and anxiety.

Effect of personality traits, age and sex on aggressive driving: Psychometric adaptation of the Driver Aggression Indicators Scale in China.

This study aimed to assess the reliability and validity of the Chinese version of the Driver Aggression Indicators Scale (DAIS), which measures aggressive driving behaviors. Besides, demographic variables (sex and age) and the big five personality traits were examined as potential impact factors of aggressive driving. A total of 422 participants completed the DAIS, Big Five Personality Inventory (BFPI), and the socio-demographic scale. First, psychometric results confirmed that the DAIS had a stable two-factor structure and acceptable internal consistency. Then, agreeableness and conscientiousness were negatively correlated with hostile aggression and revenge committed by the drivers themselves, while neuroticism was positively correlated with aggressive driving committed by the drivers themselves. Meanwhile, more agreeable drivers may perceive less hostile aggression and revenge. More neurotic drivers may perceive more aggressive warning. Finally, the effects of age and sex on aggressive driving were not same as most studies. We found that older age group perceived and committed more hostile acts of aggression and revenge than younger age groups. Female drivers of 49-60 years perceived more aggressive warnings committed by other drivers.

Are Proactive and Reactive Aggression Meaningful Distinctions in Adolescents? A Variable- and Person-Based Approach.

This study was designed to examine whether proactive and reactive aggression are meaningful distinctions at the variable- and person-based level, and to determine their associated behavioral profiles. Data from 587 adolescents (mean age 15.6; 71.6 % male) from clinical samples of four different sites with differing levels of aggression problems were analyzed. A multi-level Latent Class Analysis (LCA) was conducted to identify classes of individuals (person-based) with similar aggression profiles based on factor scores (variable-based) of the Reactive Proactive Questionnaire (RPQ) scored by self-report. Associations were examined between aggression factors and classes, and externalizing and internalizing problem behavior scales by parent report (CBCL) and self-report (YSR). Factor-analyses yielded a three factor solution: 1) proactive aggression, 2) reactive aggression due to internal frustration, and 3) reactive aggression due to external provocation. All three factors showed moderate to high correlations. Four classes were detected that mainly differed quantitatively (no 'proactive-only' class present), yet also qualitatively when age was taken into account, with reactive aggression becoming more severe with age in the highest affected class yet diminishing with age in the other classes. Findings were robust across the four samples. Multiple regression analyses showed that 'reactive aggression due to internal frustration' was the strongest predictor of YSR and CBCL internalizing problems. However, results showed moderate to high overlap between all three factors. Aggressive behavior can be distinguished psychometrically into three factors in a clinical sample, with some differential associations. However, the clinical relevance of these findings is challenged by the person-based analysis showing proactive and reactive aggression are mainly driven by aggression severity.

Examining the reactive proactive questionnaire in adults in forensic and non-forensic settings: A variable- and person-based approach.

The Reactive Proactive Questionnaire (RPQ) was originally developed to assess reactive and proactive aggressive behavior in children. Nevertheless, some studies have used the RPQ in adults. This study examines the reliability of the RPQ within an adult sample by investigating whether reactive and proactive aggression can be distinguished at a variable- and person-based level. Male adults from forensic samples (N = 237) and from the general population (N = 278) completed the RPQ questionnaire. Variable-based approaches, including factor analyses, were conducted to verify the two-factor model of the RPQ and to examine alternative factor solutions of the 23 items. Subsequently, a person-based approach, i.e., Latent Class Analysis (LCA), was executed to identify homogeneous classes of subjects with similar profiles of aggression in the observed data. The RPQ proved to have sufficient internal consistency. Multiple-factor models were examined, but the original two-factor model was statistically and theoretically considered as most solid and in line with previous research. The multi-level LCA identified three different classes of aggression severity (class 1 showed low aggressive behavior; class 2 subjects displayed modest aggression levels; and class 3 exhibited the highest level of aggressive behavior). In addition, class 1 and 2 showed more reactive than proactive aggression, whereas class 3 displayed comparable levels of reactive/proactive aggression. The RPQ appears to have clinical relevance for adult populations in the way that it can distinguish severity levels of aggression. Before the RPQ is implemented in adult populations, norm scores need to be developed. Aggr. Behav. 43:155-162, 2017. © 2016 Wiley Periodicals, Inc.

Criminal victimization in childhood and adolescence according to official records: the Pelotas (Brazil) birth cohort study. / Vitimização por crime na infância e adolescência segundo registros oficiais: coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil.

This article describes different types of officially recorded victimization among 5,249 children in the 1993 birth cohort in the city of Pelotas, Rio Grande do Sul State, Brazil. Official data were obtained from the Secretariat for Public Security and the Special Court for Children and Youth. Victimization was registered for in 1,150 cohort members, with 1,396 incidents recorded as of December 31, 2012. The total incidence of victimization was 15.7 ocorrences per 1,000 person-years, with the majority involving violent victimization (12.7 per 1,000 person-years). Victimization increased gradually in childhood and rapidly throughout adolescence. The highest incidence rates were among females (p < 0.05), the poor (p < 0.05), children of adolescent mothers (p < 0.001), and children of single mothers (p < 0.05). The most common violent victimization types were physical injuries, robbery, and crimes against personal freedom; non-violent victimization mainly involved theft. Studies like this help identify lifetime risk and protective factors for victimization, highlighting the importance of surveillance and control measures against violence.

Discovery of biochemical biomarkers for aggression: A role for metabolomics in psychiatry.

Human aggression encompasses a wide range of behaviors and is related to many psychiatric disorders. We introduce the different classification systems of aggression and related disorders as a basis for discussing biochemical biomarkers and then present an overview of studies in humans (published between 1990 and 2015) that reported statistically significant associations of biochemical biomarkers with aggression, DSM-IV disorders involving aggression, and their subtypes. The markers are of different types, including inflammation markers, neurotransmitters, lipoproteins, and hormones from various classes. Most studies focused on only a limited portfolio of biomarkers, frequently a specific class only. When integrating the data, it is clear that compounds from several biological pathways have been found to be associated with aggressive behavior, indicating complexity and the need for a broad approach. In the second part of the paper, using examples from the aggression literature and psychiatric metabolomics studies, we argue that a better understanding of aggression would benefit from a more holistic approach such as provided by metabolomics. © 2016 Wiley Periodicals, Inc.

The clinical usefulness of the new LPE specifier for subtyping adolescents with conduct disorder in the DSM 5.

In DSM 5, conduct disorder (CD) has been expanded with a new specifier 'with Limited Prosocial Emotions' (LPE) in addition to the age-of-onset (AoO) subtyping, and is thought to identify a severe antisocial subgroup of CD. However, research in clinical practice has been scarce. Therefore, the current study will examine differences in clinical symptoms between subtypes of CD, based on both subtyping schemes. Subsequently, it will investigate whether the LPE specifier explains unique variance in aggression, added to the AoO subtyping. A sample of 145 adolescents with CD (51 % male, mean age 15.0) from a closed treatment institution participated in this study. CD diagnoses and AoO subtype were assessed using a structured diagnostic interview. The LPE specifier was assessed using the callous-unemotional dimension of the Youth Psychopathy Traits Inventory (YPI). Self-reported proactive and reactive aggression, rule-breaking behavior and internalizing problems within the subtypes were compared. Youth with childhood-onset CD and LPE showed significantly more aggression than adolescent-onset CD without LPE (proactive aggression: F = 3.1, p < 0.05, reactive aggression: F = 3.7, p < 0.05). Hierarchical regression revealed that the LPE specifier uniquely explained 7 % of the variance in reactive aggression, additionally to the AoO subtyping. For proactive aggression, the interaction between AoO and the LPE added 4.5 % to the explained variance. Although the LPE specifier may help to identify a more aggressive subtype of CD in adolescents, the incremental utility seems to be limited. Therefore, clinical relevance of the LPE specifier in high-risk adolescent samples still needs to be investigated thoroughly.

Parsing the heterogeneity of psychopathy and aggression: Differential associations across dimensions and gender.

Psychopathy is a multidimensional construct that is broadly associated with both reactive (RA) and proactive (PA) aggression. Nevertheless, a consistent pattern of associations between psychopathy and these 2 aggression subtypes has yet to emerge because of methodological differences across studies. Moreover, research has yet to examine gender differences in the relation between dimensions of psychopathy and RA/PA. Accordingly, we examined the associations between psychopathy dimensions, as operationalized by 2 self-report instruments, and subtypes of aggression within a diverse sample of undergraduates (N = 1,158). Results confirmed that psychopathy is broadly associated with PA, as well as RA, with dimensions of psychopathy evidencing common and distinct associations with both raw and residual RA and PA scores. In both models of psychopathy, PA was significantly and positively associated with all dimensions, whereas RA was significantly negatively associated with interpersonal and affective dimensions, and significantly positively associated with dimensions related to an antisocial and impulsive lifestyle. Gender significantly moderated associations among dimensions of psychopathy and RA/PA, such that the antisocial/behavioral dimension of psychopathy was positively associated with PA for males, whereas the antisocial/behavioral dimension was positively associated with RA for females. Results suggest both generality and specificity of psychopathy dimensions as related to subtypes of aggression, as well as possible differential pathways from psychopathy to different subtypes of aggression in men and women.