Cortisol and Oxytocin Could Predict Covert Aggression in Some Psychotic Patients.

Background: The covert or indirect type of aggression has a risk of converting in violent acts and, considering that, it is very important to identify it in order to apply effective preventive measures. In cases of psychotic patients, the risk of becoming violent is harder to predict, as even neuter stimuli may be perceived as threat and trigger aggression. Treating all the psychiatric patients as potential aggressive subjects is not the best preventive measure as only a few of them are aggressive and this measure may further enhance the stigma on mentally ill patients. There is a current need for better understanding of covert aggression and to find objective measures, such as biological markers, that could be indicative of potential violent behavior. In this work, we try to investigate the role of cortisol and oxytocin as potential biomarkers of aggression in patients with psychosis. Material and Methods: We analyzed the level of peripheral oxytocin (pg/mL) and cortisol level (ng/mL) in 28 psychotic patients (they were not on psychotropic treatment at the moment of admission and those with substance abuse or personality disorder were excluded from the study) and correlated it with the intensity of aggression reported by the patient (overt and covert type) using the Overt Covert Aggression Inventory and the level of observed aggression of the patient in the past 7 days (rated by the health care provider) using the Modified Overt Aggression Scale. Results: We found that psychotic patients with a higher level of covert aggression had a lower level of cortisol (61.05 ± 8.04 ng/mL vs. 216.33 ± 12.6.9 ng/mL, p ˂ 0.01) and a higher level of oxytocin (102.87 ± 39.26 vs. 70.01 ± 25.07, p = 0.01) when compared with patients with a lower level of covert aggression. Furthermore, we observed significant negative correlation between cortisol and covert aggression (r = -0.676, p < 0.001) and between oxytocin and covert type of aggression (r = 0.382, p = 0.04). Moreover, we found that a lower level of cortisol together with a higher level of oxytocin are significant predictors of a style of internalized manifestation of aggression, with the predictive model explaining 55% of the variant of the internalized manifestation of aggression (F (2.25) = 17.6, p < 0.001, ß = 0.35, R2 = 55.2). We did not find significant correlations between cortisol and overt aggression, and neither between oxytocin and overt aggression. Positive correlations were also found between the overt type of self-reported aggression and overt aggression reported by the rater (r = 0.459, p = 0.01). Conclusions: The importance of a predictive model in understanding covert aggression is imperative and the results of our study show that oxytocin and cortisol warrant to be further investigated in establishing a definitive predictive model for covert aggression.

The Factors That Influence and Protect Against Power Imbalance in Covert Bullying Among Preadolescent Children at School: A Thematic Analysis.

In this article, the perceptions of preadolescent children (ages 9-11) regarding factors that influence and protect against power imbalance associated with covert aggression and bullying are explored. In aggression research, the term covert has been typically used to describe relational, indirect, and social acts of aggression that are hidden. These behaviors contrast with overt physical and verbal aggression. Children have previously conveyed their belief that covert aggression is harmful because adults do not see it even though children, themselves, are aware. We used focus groups to explore children's understanding of covert aggression and to identify children's experience and perception of adult support in relation to bullying. Thematic analysis supported the definition of covert aggression as that which is intentionally hidden from adults. Friendship, social exclusion, and secret from teacher were identified as factors that influence power imbalance, while support from friends and adult support protected against power imbalance.

Conductas socialmente indeseables asociadas a agresores y resilientes. Un estudio de casos y controles en Medellín, Colombia. 2003 - 2005 / Deviant behaviors associated with aggressors and resilient subjects. A case-control study in Medellin, Colombia. 2003-2005

Con base en un estudio de casos y controles realizado en Medellín, Colombia, entre 2003 y 2005 con el fin de estimar los factores asociados a formas severas de agresión y delincuencia, así como los factores de resiliencia frente a ellas, se estimaron las conductas socialmente indeseables o anómicas vinculadas a cada uno de los grupos estudiados. Metodología: Se estudiaron cinco grupos: agresores severos (n=62), agresores principalmente de riñas graves (n=81), miembros de las Autodefensas Unidas de Colombia (AUC) no reinsertados, comúnmente denominados paramilitares (n=72), resilientes (n=59) y controles comunitarios (n=103). A todos se les hizo una encuesta, respondida personalmente en las comunidades donde residen, para ello se los identificó y contactó por medio de entidades y personas de las comunidades que les merecieran respeto y confianza. Resultados: La magnitud de la prevalencia y el número de las conductas de agresión abierta, de agresión encubierta, de oposición y el consumo de sicoactivos es mayor entre los miembros de las AUC, los agresores severos y los agresores de riñas que entre los controles y resilientes. Los resilientes presentan menor número de conductas socialmente anómalas que los controles comunitarios y con una proporción de prevalencia menor. El grupo de AUC no se diferencia de los agresores más severos en cuanto a las conductas que están frecuentemente asociadas a cada uno de estos grupos.

Concurrent risky or deviant behaviors of serious offenders, resilient men and community controls were estimated through a case-control study carried out in Medellin, Colombia between 2003 and 2005. Methodology: Cases: serious offenders (n=62), men involved in violent quarrels or brawls (n=81), and members of Autodefensas Unidas de Colombia -Colombian paramilitary army- (AUC), also known as paramilitaries (n=72) were compared to resilient men (n=59) and community controls (n=103). All were interviewed face to face in their communities. Cases were interviewed at the site, day and hour agreed with the group leader. Controls and resilient men were referred by respected and trusted persons of the community and interviewed in their own communities in a place chosen by them. Results: Antecedents of overt and covert aggression, deviant behaviors and oppositional behaviors, and substance abuse was higher among AUC members (paramilitaries), serious offenders and men involved in quarrels than among community controls and resilient men. Resilient men report a smaller number of concurrent deviant and risky behaviors compared to community controls. AUC members (paramilitaries) are not different from serious offenders in their reports of concurrent risky and deviant behaviors.