The contribution of brain volume to explain autonomous imbalance during recovery from acute stress in batterers.

AIM: Many authors have suggested that intimate partner violence (IPV) perpetrators present an imbalance between both branches of the autonomous nervous system when coping with acute stress. Concretely, there is a predominance of the sympathetic branches over the parasympathetic ones when recovering from stress. This imbalance can be explained by their tendency toward anger rumination, and more concretely, by their focus on thoughts of revenge during this period. Unfortunately, there is a gap in the scientific literature in terms of using magnetic resonance imaging (MRI) techniques to assess which brain structures would explain this tendency of IPV perpetrators when coping with acute stress. METHOD: The main objective of this study was to assess whether the gray matter volume (GMV) of relevant brain structures, signaled in previous scientific literature, moderates the association between thoughts of revenge and sympathetic activation during the recovery period, based on skin conductance levels (SCL) after being exposed to stress, in a group of IPV perpetrators (n = 58) and non-violent men (n = 61). RESULTS: This study highlighted that the GMV of the left nucleus accumbens, right lobules of the cerebellum, and inferior temporal gyrus in IPV perpetrators moderated the association between thoughts of revenge and SCL during the recovery period. Accordingly, the higher the thoughts of revenge, the higher the sympathetic predominance (or higher SCL levels), especially among IPV perpetrators with the lowest GMV of these brain structures. Nonetheless, those variables were unrelated in the control group. CONCLUSIONS: Our study highlights the involvement of certain brain structures and how they explain the tendency of some IPV perpetrators to ruminate anger or, more precisely, to focus on thoughts of revenge when they recover from acute stress. These results reinforce the need to incorporate neuroimaging techniques during screening processes to properly understand how IPV perpetrators deal with stress, which in turn helps target their needs and design concrete intervention modules.

Weakened sympathetic response and lower parasympathetic activity in intimate partner violence perpetrators when empathizing: Influence of autonomous activation in affective approach and prosocial behavior.

The autonomic nervous system (ANS) functioning has been proposed as a relevant method to characterize the therapeutic needs of intimate partner violence (IPV) perpetrators. Nevertheless, research has neglected the influence of the ANS on socio-affective functions in this population. The aim of the present study was to analyze the psychophysiological activity of IPV perpetrators (n = 52) compared to controls (n = 46) following an empathic induction task, performed through negative emotion-eliciting videos. We employed two general ANS markers (heart rate [HR] and respiratory rate [RR]), two sympathetic-related indexes (pre-ejection period [PEP] and skin conductance level [SCL]) and a parasympathetic biomarker (respiratory sinus arrhythmia [RSA]). Additionally, we explored the impact of psychophysiological activity on prosocial behavior using Hare's donation procedure. Compared to controls, IPV perpetrators reported lower HR and SCL following the task, as well as longer PEP, suggesting an attenuated sympathetic response to others' distress. No differences in the RSA response pattern were found, however, IPV perpetrators displayed lower overall RSA levels throughout the protocol, indicative of reduced parasympathetic activity. Besides, while no differences in prosocial performance were observed, greater sympathetic responses and overall parasympathetic activity predicted increased donations across the sample. Thus, a high sympathetic and parasympathetic activity might influence the occurrence of prosocial behavior. The present study provides further evidence supporting that IPV perpetrators cope differently with others' negative emotions. In line with this biopsychosocial perspective, insights are gained on the emotional processing of IPV perpetrators which, in turn, could contribute to improve IPV psychotherapeutic programs.

The role of intimate partner violence perpetrators' resting state functional connectivity in treatment compliance and recidivism.

To expand the scientific literature on how resting state functional connectivity (rsFC) magnetic resonance imaging (MRI) (or the measurement of the strength of the coactivation of two brain regions over a sustained period of time) can be used to explain treatment compliance and recidivism among intimate partner violence (IPV) perpetrators. Therefore, our first aim was to assess whether men convicted of IPV (n = 53) presented different rsFC patterns from a control group of non-violent (n = 47) men. We also analyzed if the rsFC of IPV perpetrators before staring the intervention program could explain treatment compliance and recidivism one year after the intervention ended. The rsFC was measured by applying a whole brain analysis during a resting period, which lasted 45 min. IPV perpetrators showed higher rsFC in the occipital brain areas compared to controls. Furthermore, there was a positive association between the occipital pole (OP) and temporal lobes (ITG) and a negative association between the occipital (e.g., occipital fusiform gyrus, visual network) and both the parietal lobe regions (e.g., supramarginal gyrus, parietal operculum cortex, lingual gyrus) and the putamen in IPV perpetrators. This pattern was the opposite in the control group. The positive association between many of these occipital regions and the parietal, frontal, and temporal regions explained treatment compliance. Conversely, treatment compliance was also explained by a reduced rsFC between the rostral prefrontal cortex and the frontal gyrus and both the occipital and temporal gyrus, and between the temporal and the occipital and cerebellum areas and the sensorimotor superior networks. Last, the enhanced rsFC between the occipital regions and both the cerebellum and temporal gyrus predicted recidivism. Our results highlight that there are specific rsFC patterns that can distinguish IPV perpetrators from controls. These rsFC patterns could be useful to explain treatment compliance and recidivism among IPV perpetrators.

A Meta-analysis of Cognitive Functioning in Intimate Partner Violence Perpetrators.

Numerous psychologists have shown interest in applying neuropsychological tests to study intimate partner violence (IPV) perpetrators and gain a further understanding of the underlying nature of this type of violence. However, up until now, no meta-analysis has drawn on all the available scientific literature to calculate whether consistent differences exist between the neuropsychological performance of IPV perpetrators and other samples of men (non-violent men, IPV perpetrators with drug misuse, and other men with criminal history). The aim of this study was to carry out this calculation and also measure whether neuropsychological performance explained IPV perpetration. We conducted a meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. After initially identifying 7243 sources, we eventually included a total of 25 publications. The number of studies included for effect size calculation in each cognitive domain ranged from two to nine. Taking solely into account studies comparing IPV perpetrators with non-violent men, our findings indicate that both IPV perpetrators who misuse drugs and those who do not exhibit worse neuropsychological functioning compared to non-violent men. These differences range from moderate to large for working memory, switching attention, cognitive flexibility, planning abilities, and phonemic fluency. However, while low functioning in response IQ was only observed in IPV perpetrators without drug misuse, continuous attention performance only differed in IPV perpetrators with drug misuse. It should be noted that most conclusions were consistent. In addition, the comparison between IPV perpetrator subsamples and other types of criminal convictions only revealed differences in switching attention, with IPV perpetrators presenting worse abilities than the rest of the subsamples. Finally, we also found some support for significant associations between neuropsychological performance and both physical and psychological IPV perpetration. This meta-analysis is a significant contribution that will help inform future clinical strategies for the early detection of cognitive needs. It will also guide the implementation of new or complementary intervention programs.

Neuropsychological Performance, Substance Misuse, and Recidivism in Intimate Partner Violence Perpetrators.

Previous research has pointed out the importance of neuropsychological impairments in intimate partner violence (IPV) perpetrators for reoffending/recidivism once treatment ends. However, less is known about whether substance misuse is associated with impairments or deficits, which facilitate recidivism. In this study, we first aimed to assess whether IPV perpetrators with (n = 104) and without (n = 120) substance misuse showed differences in specific neuropsychological variables in comparison with non-violent men (n = 82). Second, we examined whether there were differences in IPV perpetrators' recidivism and whether these differences were explained by neuropsychological performance. Our results revealed that IPV perpetrators with substance misuse showed worse cognitive performance than controls. Furthermore, we also found differences between IPV perpetrators without substance misuse and controls, but only in terms of executive functioning. There were no differences in neuropsychological performance between the two groups of IPV perpetrators, although those with substance misuse presented higher recidivism rates than those without substance misuse. Finally, cognitive flexibility, verbal fluency, and worse attention functioning were related to high recidivism in both groups of IPV perpetrators. This study underlies the importance of performing neuropsychological assessments during the initial stages of intervention programs for IPV perpetrators in order to design coadjutant neuropsychological/cognitive training to address not only the psychological needs (including substance misuse) of IPV perpetrators, but also their neuropsychological needs.

La investigación previa ha puesto de manifiesto la importancia de los déficits neuropsicológicos para la reincidencia en los hombres penados por violencia contra la mujer en las relaciones de pareja (o maltratadores) una vez que han finalizado el tratamiento. Sin embargo, disponemos de un menor conocimiento sobre si el abuso de sustancias se relacionaría con los déficits neuropsicológicos, lo que, a su vez, facilitaría la reincidencia por parte de los maltratadores. Por lo tanto, el primer objetivo de este estudio fue el de analizar si existían diferencias entre un grupo de maltratadores con abuso de sustancias (n = 104) y otro sin consumo de sustancias (n = 120) en comparación con un grupo de hombres no violentos (n = 82). En segundo lugar, examinamos si existían diferencias en la reincidencia entre los grupos de maltratadores y si estas diferencias se explicaban por su funcionamiento neuropsicológico. Nuestros resultados pusieron de manifiesto que los maltratadores con abuso de sustancias mostraron un peor rendimiento cognitivo que los controles. Además, también encontramos diferencias entre el grupo de maltratadores sin abuso de sustancias y los controles, pero solo en las funciones ejecutivas. Del mismo modo, no hubo diferencias en el rendimiento neuropsicológico entre los dos grupos de maltratadores, aunque aquellos con abuso de sustancias presentaron tasas de reincidencia más altas que aquellos sin consumo de sustancias. Finalmente, la flexibilidad cognitiva, la fluidez verbal y el peor funcionamiento de la atención se relacionaron con una alta reincidencia en ambos grupos de maltratadores. Este estudio subraya la importancia de realizar evaluaciones neuropsicológicas durante las etapas iniciales de los programas de intervención para los maltratadores con el fin de diseñar programas neuropsicológicos o de entrenamiento cognitivo para abordar no solo las necesidades psicológicas (incluido el abuso de sustancias) de los maltratadores, sino también sus necesidades neuropsicológicas.

Neuropsychological Performance, Substance Misuse, and Recidivism in Intimate Partner Violence Perpetrators / [Rendimiento neuropsicológico, abuso de sustancias y reincidencia en hombres penados por violencia contra la mujer en las relaciones de pareja]

Previous research has pointed out the importance of neuropsychological impairments in intimate partner violence (IPV) perpetrators for reoffending/recidivism once treatment ends. However, less is known about whether substance misuse is associated with impairments or deficits, which facilitate recidivism. In this study, we first aimed to assess whether IPV perpetrators with (n = 104) and without (n = 120) substance misuse showed differences in specific neuropsychological variables in comparison with non-violent men (n = 82). Second, we examined whether there were differences in IPV perpetrators’ recidivism and whether these differences were explained by neuropsychological performance. Our results revealed that IPV perpetrators with substance misuse showed worse cognitive performance than controls. Furthermore, we also found differences between IPV perpetrators without substance misuse and controls, but only in terms of executive functioning. There were no differences in neuropsychological performance between the two groups of IPV perpetrators, although those with substance misuse presented higher recidivism rates than those without substance misuse. Finally, cognitive flexibility, verbal fluency, and worse attention functioning were related to high recidivism in both groups of IPV perpetrators. This study underlies the importance of performing neuropsychological assessments during the initial stages of intervention programs for IPV perpetrators in order to design coadjutant neuropsychological/cognitive training to address not only the psychological needs (including substance misuse) of IPV perpetrators, but also their neuropsychological needs.(AU)

La investigación previa ha puesto de manifiesto la importancia de los déficits neuropsicológicos para la reincidencia en los hombres penados por violencia contra la mujer en las relaciones de pareja (o maltratadores) una vez que han finalizado el tratamiento. Sin embargo, disponemos de un menor conocimiento sobre si el abuso de sustancias se relacionaría con los déficits neuropsicológicos, lo que, a su vez, facilitaría la reincidencia por parte de los maltratadores. Por lo tanto, el primer objetivo de este estudio fue el de analizar si existían diferencias entre un grupo de maltratadores con abuso de sustancias (n = 104) y otro sin consumo de sustancias (n = 120) en comparación con un grupo de hombres no violentos (n = 82). En segundo lugar, examinamos si existían diferencias en la reincidencia entre los grupos de maltratadores y si estas diferencias se explicaban por su funcionamiento neuropsicológico. Nuestros resultados pusieron de manifiesto que los maltratadores con abuso de sustancias mostraron un peor rendimiento cognitivo que los controles. Además, también encontramos diferencias entre el grupo de maltratadores sin abuso de sustancias y los controles, pero solo en las funciones ejecutivas. Del mismo modo, no hubo diferencias en el rendimiento neuropsicológico entre los dos grupos de maltratadores, aunque aquellos con abuso de sustancias presentaron tasas de reincidencia más altas que aquellos sin consumo de sustancias. Finalmente, la flexibilidad cognitiva, la fluidez verbal y el peor funcionamiento de la atención se relacionaron con una alta reincidencia en ambos grupos de maltratadores. Este estudio subraya la importancia de realizar evaluaciones neuropsicológicas durante las etapas iniciales de los programas de intervención para los maltratadores con el fin de diseñar programas neuropsicológicos o de entrenamiento cognitivo para abordar no solo las necesidades psicológicas (incluido el abuso de sustancias) de los maltratadores...(AU)

The Interaction between Attention Deficit Hyperactivity Disorder and Neuropsychological Deficits for Explaining Dropout and Recidivism of Intimate Partner Violence Perpetrators / La interacción entre el trastorno por déficit de atención e hiperactividad y los déficits neuropsicológicos para explicar el abandono prematuro de la intervención y la reincidencia de los maltratadores

Objective: Even though previous research has identified the negative impact of the attention deficit hyperactivity disorder (ADHD) in intimate partner violence (IPV) perpetration, less is known regarding the moderator factors that explain this association. In this study, we first aimed to assess whether there would be differences in terms of specific neuropsychological variables (e.g., IQ, working memory, executive functioning, and emotion decoding) between different groups of IPV perpetrators, affected or not by ADHD, and also compared with non-violent men (without ADHD). Second, we evaluated differences in dropout and recidivism among the subgroups of IPV perpetrators. Third, we assessed whether ADHD interacts with neuropsychological functioning to explain treatment compliance (dropout) and official recidivism among IPV perpetrators. Method: We administered a set of neuropsychological tests and self-reports to a group of IPV perpetrators with ADHD (n = 161), without ADHD (n = 163), and non-violent men (n = 103). Data on IPV perpetrators’ treatment compliance and official recidivism were collected after treatment. Results: Our results indicated that all the groups of IPV perpetrators presented worse performance in all cognitive domains than controls. Furthermore, ADHD IPV perpetrators also showed worse performance in all cognitive domains than IPV perpetrators without ADHD, except for emotion decoding abilities. Most importantly, the combined subtype of ADHD IPV perpetrators presented the highest rate of dropout and official recidivism. Lastly, ADHD diagnosis and neuropsychological impairments separately offered a considerable explanation of treatment compliance and recidivism but their combination did not increase the amount of explained variance. Conclusions: Our study highlights the need to implement good screening processes for correctly diagnosing IPV perpetrators and, consequently, designing more effective intervention programs. (AU)

Objetivo: Existen múltiples investigaciones que han identificado el impacto negativo del trastorno por déficit de atención e hiperactividad (TDAH) en la perpetración de la violencia contra la mujer en las relaciones de pareja. Sin embargo, existen menos evidencias sobre los factores moderadores que explicarían la asociación entre dichas variables. Por lo tanto, el primer objetivo de este estudio ha sido valorar si existen diferencias en variables neuropsicológicas específicas (p. ej., cociente intelectual, memoria de trabajo, funcionamiento ejecutivo y decodificación de las emociones) entre diferentes grupos de hombres que ejercen violencia contra la mujer en las relaciones de pareja (o maltratadores), afectados o no por el TDAH, y también en comparación con hombres no violentos (sin TDAH). En segundo lugar, evaluamos las diferencias en el abandono prematuro de la intervención y la reincidencia entre los subgrupos de maltratadores. En tercer lugar, calculamos si el TDAH interactuaba con el funcionamiento neuropsicológico para explicar el abandono prematuro de la intervención y la reincidencia oficial en maltratadores. Método: Administramos un conjunto de pruebas neuropsicológicas y autoinformes a un grupo de maltratadores con TDAH (n = 161), sin TDAH (n = 163) y hombres no violentos (n = 103). Tras finalizar el tratamiento se recopilaron datos sobre el cumplimiento del tratamiento de los maltratadores y la reincidencia oficial. (AU)

Dropout and recidivism are partly explained by emotional decoding and perspective taking deficits of intimate partner violence perpetrators.

Professionals and researchers have dedicated important efforts to understanding the underlying factors that explain the failure to complete interventions (dropout) and the recidivism of men convicted of intimate partner violence (IPV) against their female partners. There is a growing interest in measuring emotional decoding and empathic deficits in IPV perpetrators to better understand dropout and recidivism proneness, due to their direct impact on behavioral regulation. In the current study, we first aimed to examine whether the emotional decoding abilities of facial expressions and empathic abilities (cognitive and emotional), as well as their interrelationships in IPV perpetrators (n = 561), would explain dropout, treatment attendance, and recidivism (risk and official) once treatment ended. Our results allowed us to conclude that emotional decoding abilities and perspective taking (cognitive empathy) were significantly and negatively associated with dropout and recidivism. Two moderation models were significant. On the one hand, participants with low emotional decoding abilities presented lower intervention doses the lower their perspective taking. Furthermore, the percentage of participants that reoffended was higher among individuals with low and moderate perspective taking who dropped out. Therefore, our study highlights the importance of conducting emotional decoding and empathic assessments during the initial stages of intervention programs to clearly outline the therapeutic needs of IPV perpetrators. This would allow designing coadjuvant and complementary training programs that can support the main interventions by increasing treatment adherence and, in turn, reducing the risk of recidivism.

Hormonal Profile in Response to an Empathic Induction Task in Perpetrators of Intimate Partner Violence: Oxytocin/Testosterone Ratio and Social Cognition.

Empathy deficits have been proposed to be an important factor for intimate partner violence (IPV). IPV perpetrators have shown a differential change in salivary oxytocin (sOXT), testosterone (sT), and cortisol (sC), following empathic and stress tasks, compared to non-violent men. However, the influence of empathic deficits in those hormones after an emotion-induction task in IPV perpetrators remains unclear. We analyzed the effects of an empathic induction task on endogenous sOXT, sT and sC levels, as well as their hormonal ratios, in IPV perpetrators (n = 12), and compared them to controls (n = 12). Additionally, we explored the predictive capacity of empathy-related functions (measured with the interpersonal reactivity index) in the hormonal responses to the task. IPV perpetrators presented lower sOXT changes and higher total sT levels than controls after the task, lower sOXT/T change and total sOXT/T levels, as well as higher total sT/C levels. Notably, for all participants, the lower the perspective taking score, the lower the total sOXT levels and sOXT changes and the higher the sT changes were. Low perspective taking also predicted smaller sOXT/T and sOXT/C changes in the empathic induction task, and higher total sT/C levels for all participants. Therefore, our results could contribute to furthering our ability to focus on new therapeutic targets, increasing the effectiveness of intervention programs and helping to reduce IPV recidivism in the medium term.

Reactive vs proactive aggression: A differential psychobiological profile? Conclusions derived from a systematic review.

INTRODUCTION: Scholars have established subcategories of aggressive behavior in order to better understand this construct. Specifically, a classification based on motivational underpinnings makes it possible to differentiate between reactive and proactive aggression. Whereas reactive aggression is characterized by emotional lability, which means it is prone to impulsive reactions after provocation, proactive aggression is driven by low emotionality and high levels of instrumentality to obtain benefits. Some authors have conceived these two types as having a dichotomous nature, but others argue against this conceptualization, considering a complementary model more suitable. Hence, neuroscientific research might help to clarify discussions about their nature because biological markers do not present the same biases as psychological instruments. AIM: The main objective of this study was to carry out a systematic review of studies that assess underlying biological markers (e.g., genes, brain, psychophysiological, and hormonal) of reactive and proactive aggression. METHODS: To carry out this review, we followed PRISMA quality criteria for reviews, using five digital databases complemented by hand-searching. RESULTS: The reading of 3993 abstracts led to the final inclusion of 157 papers that met all the inclusion criteria. The studies included allow us to conclude that heritability accounted for approximately 45% of the explained variance in both types of aggression, with 60% shared by both, especially, for overt and physical expression forms, and 10% specific to each type. Regarding allelic risk factors, whereas low functioning variants affecting serotonin transport and monoaminoxidase increased the risk of reactive aggression, high functioning variants were associated with proactive aggression. Furthermore, brain analysis revealed an overlap between the two types of aggression and alterations in the volume of the amygdala and temporal cortex. Moreover, high activation of the medial prefrontal cortex (PFC) facilitated proneness to both types of aggression equally. Whereas stimulation of the right ventrolateral (VLPFC) and dorsolateral (DLPFC) reduced proneness to aggression, inhibition of the left DLPFC increased it. Finally, psychophysiological and hormonal correlates in general did not clearly differentiate between the two types because they were equally related to each type (e.g., low basal cortisol and vagal variability in response to acute stress) CONCLUSIONS: This study reinforces the complementary model of both types of aggression instead of a dichotomous model. Additionally, this review also offers background about several treatments (i.e., pharmacological, non-invasive brain techniques…) to reduce aggression proneness.

¿Existe una relación entre la esquizofrenia y la violencia y los homicidios? / Is there a relationship between schizophrenia and violence and homicides?

La cultura popular ha empleado la esquizofrenia y otras enfermedades mentales como un recurso narrativo útil. Sin embargo, esto puede llegar a estigmatizar a las personas que las padecen, creando una imagen errónea. Por ejemplo, la película Joker (2019) puede malinterpretarse y concluir que las personas con esquizofrenia son potenciales homicidas. Es por ello por lo que debemos prestar atención a las conclusiones de la comunidad científica respecto a la relación de la esquizofrenia con la violencia y los homicidios. En este sentido, las evidencias científicas con las que contamos hasta el momento no nos permiten asumir que la esquizofrenia sea la causa principal de la violencia y, mucho menos, del homicidio. De hecho, son necesarias más variables, no directamente relacionas con la enfermedad, como el consumo de drogas, la psicopatía o el maltrato durante la infancia para que exista una relación entre este enfermedad y la violencia o el homicidio.

Pop culture has used schizophrenia and other mental illnesses as a helpful narrative resource. However, this can stigmatize people who suffer from these illnesses, creating a distorted image. For example, the movie Joker (2019) can be misinterpreted and conclude that people with schizophrenia are potential murderers. Thus, We must pay attention to the findings of the scientific community about schizophrenia's relationship with violence and homicides. In this regard, we cannot conclude that schizophrenia is the leading cause of violence and much less homicide. Other variables are necessary that are not directly related to the disease, such as drug use, psycho-pathy, or childhood abuse, for there to be a relationship between schizophrenia and violence or homicide.

A Systematic Review of the Role of Oxytocin, Cortisol, and Testosterone in Facial Emotional Processing.

A topic of interest is the way decoding and interpreting facial emotional expressions can lead to mutual understanding. Facial emotional expression is a basic source of information that guarantees the functioning of other higher cognitive processes (e.g., empathy, cooperativity, prosociality, or decision-making, among others). In this regard, hormones such as oxytocin, cortisol, and/or testosterone have been found to be important in modifying facial emotion processing. In fact, brain structures that participate in facial emotion processing have been shown to be rich in receptors for these hormones. Nonetheless, much of this research has been based on correlational designs. In recent years, a growing number of researchers have tried to carry out controlled laboratory manipulation of these hormones by administering synthetic forms of these hormones. The main objective of this study was to carry out a systematic review of studies that assess whether manipulation of these three hormones effectively promotes significant alterations in facial emotional processing. To carry out this review, PRISMA quality criteria for reviews were followed, using the following digital databases: PsycINFO, PubMed, Dialnet, Psicodoc, Web of Knowledge, and the Cochrane Library, and focusing on manuscripts with a robust research design (e.g., randomized, single- or double-blind, and/or placebo-controlled) to increase the value of this systematic review. An initial identification of 6340 abstracts and retrieval of 910 full texts led to the final inclusion of 101 papers that met all the inclusion criteria. Only about 18% of the manuscripts included reported a direct effect of hormone manipulation. In fact, emotional accuracy seemed to be enhanced after oxytocin increases, but it diminished when cortisol and/or testosterone increased. Nonetheless, when emotional valence and participants' gender were included, hormonal manipulation reached significance (in around 53% of the articles). In fact, these studies offered a heterogeneous pattern in the way these hormones altered speed processing, attention, and memory. This study reinforces the idea that these hormones are important, but not the main modulators of facial emotion processing. As our comprehension of hormonal effects on emotional processing improves, the potential to design good treatments to improve this ability will be greater.

Hormonal Differences in Intimate Partner Violence Perpetrators When They Cope with Acute Stress: A Pilot Study.

BACKGROUND: Only a few studies have paid attention to the ability of perpetrators of intimate partner violence (IPVAW) against women to cope with acute stress, including hormonal parameters. In fact, previous studies assessed how salivary testosterone (Tsal) and cortisol (Csal) changed after coping with an acute emotional stressor (directly related to IPVAW), and they concluded that an imbalance between the two hormones might be characteristic of these men. Nevertheless, they neglected to examine the role of other hormones, such as salivary oxytocin (OXsal), which also seemed to play an important role in behavioral regulation, and whether this response could be generalized to other types of stress not directly related to IPVAW. METHODS: This study aims to assess whether IPVAW perpetrators (n = 19) present differential hormonal (Tsal, Csal, OXsal and their ratios) and psychological state (anxiety, anger, and general affect) responses when coping with an acute cognitive laboratory stressor (a set of neuropsychological tests performed in front of an expert committee) in comparison with non-violent men (n = 16). This quasi-experimental study also assessed whether the psychological state variables drive this different hormonal response. RESULTS: Our results revealed that IPVAW perpetrators had lower Csal and higher Tsal/Csal ratio levels during the post-task period, as well as higher total levels (average) of OXsal than controls. We also found that, only in IPVAW perpetrators, high levels of baseline anxiety and negative affect were related to high rises in Csal during the stress task. CONCLUSIONS: These data present a background showing that IPVAW perpetrators and non-violent men cope differently with stress. These findings might help to identify idiosyncratic profiles of IPVAW perpetrators that can then be employed to establish their therapeutic needs. Moreover, we reinforced the importance of combining biological markers with self-reports, thus increasing the reliability of these forensic assessments.

Eficacia de la rehabilitación cognitiva en un paciente con esclerosis múltiple progresiva primaria / Efficacy of cognitive rehabilitation in a patient with primary progressive multiple sclerosis

La esclerosis múltiple (EM) es una enfermedad inflamatoria crónica que cursa con la desmielinización y la neurodegeneración a nivel del sistema nervioso central. Existen tres tipos de EM en función de la progresión de la enfermedad, pero la mayor parte de los pacientes tienden a presentar déficits cognitivos. Por lo tanto, resulta imprescindible el desarrollo de programas de entrenamiento cognitivos dirigidos a la mejora de estos déficits y, en definitiva, a la mejora de la calidad de vida de estos pacientes. En este sentido, el objetivo principal de este estudio fue la puesta en marcha de un programa de entrenamiento cognitivo dirigido a un paciente con esclerosis múltiple progresiva primaria (EMPP) a lo largo de un año. Los resultados pusieron de manifiesto que algunos de los déficits cognitivos que presentó inicialmente el paciente mejoraron tras varios meses de intervención. En este sentido, el paciente presentó notables mejoras en el control inhibitorio y la flexibilidad cognitiva. No obstante, los déficits en la velocidad de procesamiento se mantuvieron constantes a lo largo de toda la intervención. Asimismo, aparecieron otros déficits a lo largo de la intervención que remitieron tras la adecuación de los objetivos de intervención. Por todo ello, nuestro estudio reforzó la importancia de la puesta en marcha de los programas de rehabilitación cognitiva dirigidos a pacientes con enfermedades desmielinizantes para paliar las secuelas cognitivas derivadas de las mismas. Además, es importante que estos programas de entrenamiento cognitivo sean revisados periódicamente para adecuar los objetivos del tratamiento.

Multiple sclerosis (MS) is a chronic inflammatory disease that involves demyelination and neurodegeneration at the level of the central nervous system. Despite the different characteristics of each of the three types of MS, most patients with this disease present significant cognitive deficits. Therefore, it is essential to develop cognitive training programs to improve these deficits and, ultimately, increase the quality of life of these patients. Thus, the main objective of this study was to implement a one-year cognitive training program with a patient with progressive primary multiple sclerosis (PPMS). The results showed that some of the cognitive deficits the patient initially presented improved after several months of intervention. In this regard, the patient presented noteworthy improvements in inhibitory control and cognitive flexibility. However, deficits in processing speed remained constant throughout the intervention. Likewise, other deficits appeared during the intervention that remitted after adapting the intervention objectives to the patient's needs. Therefore, our study reinforces the importance of implementing cognitive rehabilitation programs for patients with demyelinating diseases to alleviate the cognitive sequelae they produce. In addition, it is important to evaluate these cognitive training programs periodically in order to adapt the objectives and improve the patient's functionality.

Alexithymia as a Predictor of Arousal and Affect Dysregulations when Batterers with Attention Deficit Hyperactivity Disorder Cope with Acute Stress.

Empirical research has stated that Attention Deficit Hyperactivity Disorder (ADHD) might underlie intimate partner violence against women (IPVAW) perpetration. Even though there is a clear relationship between these two variables, it is still unknown how ADHD facilitates violence proneness. In this regard, psychophysiological variables such as skin conductance levels (SCL) might offer information about emotional regulation when individuals cope with stress. Furthermore, alexithymia traits might be a strong candidate in explaining the above-mentioned emotional dysregulations. Hence, we compared the SCL response to acute cognitive stress in IPVAW perpetrators with and without ADHD symptoms to that of controls (non-violent and unaffected), and we also assessed the presence of alexithymia traits and their role in emotional regulation. Our data point out that ADHD IPVAW perpetrators presented higher SCL and negative affect than controls, particularly during the recovery period. Moreover, ADHD IPVAW perpetrators showed higher self-reported alexithymia, and this variable was a good predictor of autonomic and psychological state dysregulations, even after controlling for the effects of alcohol and drug misuse. Therefore, our study reinforces the need to consider psychophysiological measurements when screening the therapeutic needs of IPVAW perpetrators, due to their relatively low cost and the significant contents of their results. Finally, we also highlight the key role of alexithymia in this violent population, which should be considered when designing cognitive intervention training coadjutant to current psychotherapies for IPVAW perpetrators.

A Systematic Review of the Effectiveness of Non-Invasive Brain Stimulation Techniques to Reduce Violence Proneness by Interfering in Anger and Irritability.

The field of neurocriminology has proposed several treatments (e.g., pharmacological, brain surgery, androgen-deprivation therapy, neurofeedback) to reduce violence proneness, but unfortunately, their effectiveness has been limited due to their side-effects. Therefore, it is necessary to explore alternative techniques to improve patients' behavioural regulation with minimal undesirable effects. In this regard, non-invasive brain stimulation techniques, which are based on applying changing magnetic fields or electric currents to interfere with cortical excitability, have revealed their usefulness in alleviating the symptomatology of several mental disorders. However, to our knowledge, there are no reviews that assess whether these techniques are useful for reducing violence proneness. Therefore, we conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria using the following databases: PsycINFO, PubMed, Dialnet, Psicodoc, Web of Knowledge, and the Cochrane Library. We initially identified 3746 entries, and eventually included 56 publications. Most of the studies were unanimous in concluding that the application of these techniques over the prefrontal cortex (PFC) was not sufficient to promote anger and irritability reductions in euthymic individuals of both genders. Nevertheless, the application of non-invasive brain stimulation techniques, especially transcranial direct current stimulation, over the right PFC seemed to reduce violent reactions in these individuals by interfering with the interpretation of the unfavourable situations (e.g., threating signals) or inner states that evoked anger. In antisocial and pathological populations, the conclusions were provided by a few pilot studies with important methodological weaknesses. The main conclusion of these studies was that bilateral stimulation of the PFC satisfactorily reduced anger and irritability only in inmates, patients with autism spectrum disorders (ASD), people who suffered a closed-head injury, and agitated patients with Alzheimer's disease. Moreover, combining these techniques with risperidone considerably reduced aggressiveness in these patients. Therefore, it is necessary to be cautious about the benefits of these techniques to control anger, due the methodological weaknesses of these studies. Nonetheless, they offer valuable opportunities to prevent violence by designing new treatments combining brain stimulation with current strategies, such as psychotherapy and psychopharmacology, in order to promote lasting changes.

Influence of substance use and cognitive impairment on adherence to antiretroviral therapy in HIV+ patients. / Perfil cognitivo de los alcohólicos abstinentes durante un periodo de tiempo prolongado en comparación con un grupo de hombres que no consumen alcohol.

Scarce studies have focused on the cognitive profile of chronic alcoholic men after long-term abstinence. Thus, we examined neuropsychological differences between long-term abstinent alcoholics for an average of 3.2 years (n = 40, LTAA; age = 45.55 ± 8.99) and matched for socio-demographic variables with non-alcoholic controls (n = 39; age = 42.05 ± 11.33). To this aim, we employed a neuropsychological assessment battery covered relevant cognitive domains: IQ, memory, attention, executive functions and empathy. LTAA presented deficits in abstract reasoning, speed processing, sustained attention, working and long-term memory (verbal and visuospatial), cognitive flexibility, inhibition and planning. Although our results must be interpreted with caution because of the cross-sectional nature of our study, it may offer a broader knowledge and understanding of alcohol-related socio-cognitive deficits after long-term abstinence. These deficits might entail risk factors for relapse in alcohol consumption, as they may interfere with recording therapeutic advice and internalizing the verbal material presented in rehabilitation programs. In turn, these impair the global efficacy of alcohol-relapse prevention programs. Hence, this knowledge could be applicable in guiding the development of early coadjutant treatments.

Solo pocos estudios han analizado el perfil cognitivo de los hombres con un trastorno por consumo de alcohol tras un periodo de abstinencia prolongado. Por tanto, este estudio tiene como principal objetivo analizar las diferencias neuropsicológicas entre un grupo de hombres con trastorno por consumo de alcohol pero abstinentes de forma ininterrumpida durante 3,2 años (n = 40, edad = 45,55 ± 8,99) en comparación con un grupo de hombres sin trastorno por consumo de alcohol pero con unas características socio-demográficas similares a las del grupo experimental (n = 39; edad = 42,05 ± 11,33) para establecer diferentes perfiles neuropsicológicos. Empleamos una batería neuropsicológica exhaustiva que evaluó los siguientes dominios cognitivos: CI, memoria, atención, funciones ejecutivas y empatía. El grupo de hombres alcohólicos abstinentes presentaron déficits en razonamiento abstracto, velocidad de procesamiento, atención sostenida, memoria de trabajo y a largo plazo (para información verbal y visuoespacial), flexibilidad cognitiva, y en las capacidades de inhibición y planificación. A pesar de que nuestros resultados deben interpretarse con cautela dado el carácter transversal de nuestro estudio, ofrece información relevante sobre el estado cognitivo de los hombres con un trastorno por consumo de alcohol tras una abstinencia prolongada. Estos déficits podrían estar implicados en las frecuentes recaídas en esta población. Del mismo modo, interferirían en la asimilación de contenidos teóricos de intervenciones psicoterapéuticas, lo que, a su vez, disminuiría la eficacia de las mismas. Por ello, estos resultados deberían ser empleados para el desarrollo de programas de rehabilitación cognitivos coadyuvantes a la psicoterapia.

Perfil cognitivo de los alcohólicos abstinentes durante un periodo de tiempo prolongado en comparación con un grupo de hombres que no consumen alcohol / Cognitive profile of long-term abstinent alcoholics in comparison with non-alcoholics

Solo pocos estudios han analizado el perfil cognitivo de los hombres con un trastorno por consumo de alcohol tras un periodo de abstinencia prolongado. Por tanto, este estudio tiene como principal objetivo analizar las diferencias neuropsicológicas entre un grupo de hombres con trastorno por consumo de alcohol pero abstinentes de forma ininterrumpida durante 3,2 años (n = 40, edad = 45,55 ± 8,99) en comparación con un grupo de hombres sin trastorno por consumo de alcohol pero con unas características socio-demográficas similares a las del grupo experimental (n = 39; edad = 42,05 ± 11,33) para establecer diferentes perfiles neuropsicológicos. Empleamos una batería neuropsicológica exhaustiva que evaluó los siguientes dominios cognitivos: CI, memoria, atención, funciones ejecutivas y empatía. El grupo de hombres alcohólicos abstinentes presentaron déficits en razonamiento abstracto, velocidad de procesamiento, atención sostenida, memoria de trabajo y a largo plazo (para información verbal y visuoespacial), flexibilidad cognitiva, y en las capacidades de inhibición y planificación. A pesar de que nuestros resultados deben interpretarse con cautela dado el carácter transversal de nuestro estudio, ofrece información relevante sobre el estado cognitivo de los hombres con un trastorno por consumo de alcohol tras una abstinencia prolongada. Estos déficits podrían estar implicados en las frecuentes recaídas en esta población. Del mismo modo, interferirían en la asimilación de contenidos teóricos de intervenciones psicoterapéuticas, lo que, a su vez, disminuiría la eficacia de las mismas. Por ello, estos resultados deberían ser empleados para el desarrollo de programas de rehabilitación cognitivos coadyuvantes a la psicoterapia

Scarce studies have focused on the cognitive profile of chronic alcoholic men after long-term abstinence. Thus, we examined neuropsychological differences between long-term abstinent alcoholics for an average of 3.2 years (n = 40, LTAA; age = 45.55 ± 8.99) and matched for socio-demographic variables with non-alcoholic controls (n = 39; age = 42.05 ± 11.33). To this aim, we employed a neuropsychological assessment battery covered relevant cognitive domains: IQ, memory, attention, executive functions and empathy. LTAA presented deficits in abstract reasoning, speed processing, sustained attention, working and long-term memory (verbal and visuospatial), cognitive flexibility, inhibition and planning. Although our results must be interpreted with caution because of the crosssectional nature of our study, it may offer a broader knowledge and understanding of alcohol-related socio-cognitive deficits after longterm abstinence. These deficits might entail risk factors for relapse in alcohol consumption, as they may interfere with recording therapeutic advice and internalizing the verbal material presented in rehabilitation programs. In turn, these impair the global efficacy of alcohol-relapse prevention programs. Hence, this knowledge could be applicable in guiding the development of early coadjutant treatments

Hormonal Alterations in Victimized Women Explained by Their Hostile Reactions in Coping with Couple Violence.

Recent studies have highlighted the dysregulation of hypothalamic-pituitary-adrenal (HPA) axis activity and its end products, cortisol and dehydroepiandrosterone (DHEA), in women with a history of intimate partner violence (IPV) victimization. These studies analyzed several coping styles, but they neglected to examine the use of violent strategies to confront IPV and the way these strategies affect HPA functioning. This latter proposal would be based on the gender symmetry model of IPV, which sustains that IPV is generally symmetrical, but that women's violence tends to be a reaction to male violence. Hence, the main objective of the present study was to examine whether women's violent reactions to IPV would significantly predict salivary cortisol and DHEA levels, as well as the cortisol/DHEA ratio (assessed through two saliva samples per day on four consecutive work days), controlling for the women's prior IPV abuse, psychopathology, and demographic variables. Our data demonstrated that, specifically, psychological confrontation strategies predicted vespertine cortisol levels (adj R2 = .18, ß = .447, p < .01) and the cortisol/DHEA ratio (adj R2 = .08, ß = .322, p < .05), even after controlling several confounding variables, whereas physical and total confrontation in response to IPV did not predict these hormonal parameters.

The Importance of Considering Alexithymia during Initial Stages of Intimate Partner Violence Interventions to Design Adjuvant Treatments.

Empirical evidence supports that individuals with alexithymia might be prone to certain types of violence, such as intimate partner violence against women (IPVAW). Moreover, considering that alexithymia is directly involved in behavior regulation, problems due to identifying and regulating emotional states might be postulated as responsible, at least in part, for the success of psychotherapeutic treatments designed for decreasing the future risk of reoffending. Therefore, we assessed whether alexithymia was a good predictor of the discontinuation of treatment (dropout) and the risk of recidivism during the initial stages of intervention in a sample of men convicted of IPVAW perpetration (n = 118), while controlling for potential confounding variables (i.e., socio-demographic characteristics, impulsivity, and drug misuse). Our data demonstrate that high alexithymic traits lead to dropout and a high risk of recidivism during the initial stages of treatment, remaining significant even after including potential confounding variables. Even though impulsivity and drug misuse increase the amount of explained variance, none of them moderates the association of alexithymia with dropout and/or reoffending. It should be noted that this study identified alexithymia as a direct modulator of violence due to its effects on discontinuing IPVAW treatment during initial stages. Therefore, as we gain knowledge analyzing the relationships between previously mentioned factors, it could be applied to develop valid screening methods along with strengthening current rehabilitation programs and designing adjuvant treatments to increase their effectiveness.