The effects of affective, behavioral, and cognitive components of trait anger on the alcohol-aggression relation

Revisiting the alcohol-aggression link: The impact of alcohol consumption patterns

Laboratory studies have repeatedly reported a link between alcohol and aggression, yet many rely on single-dose administration methods and overlook variations in alcohol consumption patterns. The present study investigates the effects of alcohol on aggressive behavior using a double-blind, placebo-controlled cumulative drinking administration approach that mirrors the natural drinking behaviors often observed in pubs within a laboratory setting. This study also pioneers the examination of how alcohol consumption patterns (light or heavy) moderate the relationship between precise Breath Alcohol Concentration (BrAC) levels and extreme aggressive behavior. Seventy-five individuals who drink alcohol lightly (N=38) and heavily (N=37) were randomly assigned to alcohol (N=33) or placebo (N=42) conditions. Participants drank four drinks successively. Taylor's aggression paradigm was completed twenty minutes after each drink. Multilevel modeling was applied to analyze the effects of precise BrAC and account for within-person variability. Alcohol showed a dose-dependent effect on aggression; as alcohol levels rose, so did aggression (p<.001). Alcohol consumption pattern moderated the effect of cumulative BrAC on aggression, such that the effect was more substantial for as compared with individuals who drink lightly (p=.03). The current study highlights the moderating role of alcohol consumption pattern in the association between precise BrAC levels and extreme aggression, offering insights into individual differences in susceptibility to alcohol-induced aggression, and supporting the I3 meta-theory (Finkel, 2014). The Findings underscore the importance of investigating the interplay between acute and chronic alcohol use on behavior, challenging conventional thresholds for hazardous drinking classification. Implications for future studies, legislators, and policymakers are discussed.

Comparing behavioral measures of aggression in the laboratory: Taylor Aggression Paradigm versus Point-Subtraction Aggression Paradigm

Aggression refers to a wide range of behaviors with lasting individual and societal consequences. Recurrent, unplanned aggressive behavior is the core diagnostic criterion for intermittent explosive disorder (IED). In this study, we compared two behavioral measures of aggression in the laboratory: the Taylor Aggression Paradigm (TAP) and the Point-Subtraction Aggression Paradigm (PSAP). This sample (n = 528) included community participants who met DSM-5 criteria for IED (n = 156), met DSM-5 criteria for a nonaggressive psychiatric disorder (n = 205), or did not meet DSM-5 criteria for any psychiatric disorder (n = 167). All participants completed the TAP, a single-session PSAP, and relevant self-report measures. MANOVA analyses demonstrated differences between IED participants and nonaggressive participants; however, these group differences were no longer significant for the PSAP after including demographic variables. Correlation analyses found that the TAP and PSAP were positively related to one another and the composite variables associated with aggressive behavior (i.e., history of aggression, impulsivity, and propensity to experience anger) and; dependent correlations revealed that past aggression and trait anger were more strongly related to the TAP. Differences in TAP and PSAP outcomes may be partially attributed to operationalizations of aggression and methods of aggression and provocation. Further, as aggressive and nonaggressive participants differed on the PSAP somewhat mirroring the TAP, our results add to growing evidence of the validity of a single-session PSAP; further research is needed to fully establish single-session PSAP as a laboratory aggression task compared to the multi-session PSAP.

Who is killing South African men? A retrospective descriptive study of forensic and police investigations into male homicide

Not much is known about the perpetrators of male homicide in South Africa, which has rates seven times the global average. For the country's first ever male homicide study we describe the epidemiology of perpetrators, their relationship with victims and victim profiles of men killed by male versus female perpetrators. We conducted a retrospective descriptive study of routine data collected through forensic and police investigations, calculating victim and perpetrator homicide rates by age, sex, race, external cause, employment status and setting, stratified by victim-perpetrator relationships. For perpetrators, we reported suspected drug and alcohol use, prior convictions, gang-involvement and homicide by multiple perpetrators. Perpetrators were acquaintances in 63% of 5594 cases in which a main perpetrator was identified. Sharp objects followed by guns were the main external causes of death. The highest rates were recorded in urban informal areas among unemployed men across all victim-perpetrator relationship types. Recreational settings including bars featured prominently. Homicides clustered around festive periods and weekends, both of which are associated with heavy episodic drinking. Perpetrator alcohol use was reported in 41% of homicides by family members and 50% by acquaintances. Other drug use was less common (9% overall). Of 379 men killed by female perpetrators, 60% were killed by intimate partners. Perpetrator alcohol use was reported in approximately half of female-on-male murders. Female firearm use was exclusively against intimate partners. No men were killed by male intimate partners. Violence prevention, which in South Africa has mainly focused on women and children, needs to be integrated into an inclusive approach. Profiling victims and perpetrators of male homicide is an important and necessary first step to challenge prevailing masculine social constructs that men are neither vulnerable to, nor the victims of, trauma and to identify groups at risk of victimisation that could benefit from specific interventions and policies.

The Relationship Between Cannabis Use and Self-Reported Trait Anger in Treatment-Seeking Young People

Objective: Trait anger has been shown to be predictive of emotion-focused coping and alcohol use. Yet, the connection between cannabis use and trait anger remains poorly characterized. The present study sought to investigate the relationship between cannabis use and self-reported trait anger in youth seeking substance use treatment. Methods: A retrospective chart review was conducted on youth (n=168) aged 14-26 presenting for an initial evaluation at an outpatient substance use treatment program. Patients self-reported trait anger score (TAS) and lifetime, recent, and Diagnostic and Statistics Manual-5th Edition diagnostic status of cannabis use were assessed. Clinician-coded psychiatric and substance use patterns were collected, along with urine carboxy delta-9-tetrahydrocannabinol (THC) concentration levels. Additional measures of anxiety, depression, and demographic variables were assessed. Results: Higher self-reported TAS were associated with cannabis use, cannabis use disorder (CUD), and more recent and frequent cannabis use. The presence of a CUD was independently associated with TAS after controlling for the presence of other substance use disorders and co-occurring depression and anxiety disorders. Higher urine THC concentration levels were associated with higher TAS. Conclusions: Findings support an association between heavy, chronic cannabis use and elevated self-reported trait anger at intake. There may be important neurological consequences of heavy, chronic cannabis use that impact anger regulation. It is also plausible that trait anger maybe a predisposing factor for elevated cannabis use. Better controlled prospective research is needed to help determine directionality. Treatment programs should target both cannabis use and anger regulation in youth.

Participants in Court-mandated Intervention Programs for Intimate Partner Violence Perpetrators with Substance Use Problems: A Systematic Review of Specific Risk Factors

Men with alcohol and/or other drug use problems (ADUPs) court-mandated to attend intervention programs for intimate partner violence (IPV) perpetrators have been identified as a high-risk, highly resistant group of IPV perpetrators, as they present lower treatment adherence and higher dropout and recidivism rates. Previous research suggests that IPV perpetrators with ADUPs may require tailored interventions to address their specific risk factors. The present systematic review was conducted using PRISMA guidelines to identify the specific risk factors in men with and without ADUPs on entry to court-mandated perpetrator programs. The following databases were searched from inception to November 2021: Web of Science, PsycINFO, and Scopus. There was a screening of 3,995 records, and 29 quantitative studies were included in the review. Risk factors present in males court-mandated to perpetrator programs were grouped into four categories: sociodemographic risk factors, personality disorders and psychological adjustment, social-relational risk factors, and risk factors related to attitudes towards women. Results indicated that the main risk factors in IPV perpetrators with ADUPs, compared to those without, were higher clinical symptomatology (e.g., anger and impulsivity), personality disorders, poorer executive functions, having experienced more stressful life events, higher exposure to childhood trauma, lower intimate social support, and higher responsibility attributed to the offenders' personal context. These results contribute to a deeper understanding of the complex phenomenon of IPV and ADUPs, and could help to inform key targets for perpetrator programs that may improve the well-being of their (ex)partners and increase the effectiveness of intervention programs for IPV perpetrators.

Alcohol Use Severity, Anger and Drinking Motives among Firefighters

Background: Firefighters represent an understudied population with high rates of hazardous alcohol use and alcohol use disorder. This population is also at an increased risk of mental health disorders and related symptoms such as anger. Anger is a relatively understudied negative mood state with clinical relevance to alcohol use among firefighters. Anger is associated with greater alcohol use and may spur more approach-motivated reasons for drinking compared to other negative emotions. Objectives: This study sought to examine: 1. whether anger significantly contributes to alcohol use severity in firefighters above and beyond general negative mood; 2. which of four validated drinking motives (e.g., coping, social, enhancement and conformity) act as moderators in the relationship between anger and alcohol use severity in this population. The current study is a secondary analysis of data from a larger study examining health and stress behaviors among firefighters (N = 679) at a large urban fire department in the southern United States. Results: Results revealed that anger was positively associated with alcohol use severity, even after controlling for general negative mood. Further, social and enhancement motives for drinking were significant moderators of the relationship between anger and alcohol use severity. Conclusions: These findings identify anger specifically as an important factor to be considered when assessing alcohol use in firefighters, especially those who are drinking to make social experiences more enjoyable or to enhance their mood. These findings can be used to inform more specialized interventions for alcohol use by targeting anger more specifically in firefighters and other male-dominated first-responder populations.

Mental Health Correlates of Probable Posttraumatic Stress Disorder, Probable Alcohol Use Disorder, and Their Co-Occurrence among Firefighters

Firefighters demonstrate high rates of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Research has yet to compare how these diagnoses and their co-occurrence relate to firefighter mental health. This study evaluated trauma load, PTSD, alcohol use, depression, sleep, suicide risk, anger, and occupational stress across four discrete groups of firefighters (N = 660): (1) trauma-exposed only (n = 471), (2) probable PTSD-only (n = 36), (3) probable AUD-only (n = 125), and (4) probable PTSD-AUD (n = 28). Firefighters completed an online survey. Firefighters with probable PTSD-AUD demonstrated higher scores on all criterion variables, except trauma load, compared to firefighters with probable AUD-only or trauma-only. Firefighters with probable PTSD-AUD and probable PTSD-only reported similar levels of all indices, except alcohol use severity and suicide risk, which were higher among the probable PTSD-AUD group. Results provide preliminary empirical evidence of the deleterious impact of PTSD-AUD comorbidity among firefighters.

Alcohol, Trait Anger, and Psychological Flexibility: A Laboratory Investigation of Intimate Partner Violence Perpetration

The I³ Model is a meta-theoretical framework that posits intimate partner violence (IPV) perpetration is the product of three interactive factors: instigators, impellors, and inhibitors. The present study examined the effects of trait anger (an impellor), psychological flexibility (a disimpellor), and alcohol intoxication (a disinhibitor) on IPV perpetration. Participants were 249 heavy drinkers (41% female) who had perpetrated IPV toward their current partner in the past year. Participants completed self-report measures of trait anger and psychological flexibility, were randomly assigned to consume an alcoholic or non-alcoholic beverage, and then engaged in the Taylor Aggression Paradigm (Taylor, 1967) ostensibly against their current partner. Analyses detected a small-to-medium effect for two separate two-way interactions. First, a significant Beverage x Psychological Flexibility interaction was detected. Consistent with the I³ Model, explication analyses revealed that alcohol intoxication predicted higher levels of IPV perpetration in those who reported low, but not high, psychological flexibility (i.e., low disimpellance). Second, although the Beverage x Trait Anger interaction was non-significant, explication analyses revealed that alcohol intoxication predicted higher levels of IPV perpetration among those who reported low, but not high, trait anger (i.e., low impellance). These results have several potential treatment implications among alcohol-consuming clients.

Facial affect recognition moderates the relation between autonomic nervous system reactivity and aggression during dyadic conflict

Researchers examining physiological factors of emotion have identified differential patterns of physiological reactivity among intimate partner violence perpetrators during interpersonal conflict. Although it is unclear what mechanisms are influencing these distinct physiological patterns, research suggests that perpetrators' ability to decode emotions may be involved. The current study examined how the relation between an individual's physiological reactivity and their aggression during conflict with an intimate partner is influenced by the affect they are exposed to and their affect recognition ability. Sixty-seven heterosexual couples completed self-report measures and participated in a conflict discussion while physiological measures were recorded. The sympathetic nervous system (SNS) was indexed by Skin Conductance Level (SCL) and the parasympathetic nervous system (PNS) by Respiratory Sinus Arrhythmia (RSA). Aggressive affect was coded from video. Additionally, men were administered a facial affect recognition task. Results indicated that observed aggression during the conflict discussion was associated with RSA and SCL suppression, but only for men with moderate to high affect recognition ability. Additionally, the interaction effects between physiological reactivity and affect recognition on male aggression was conditional on their partner exhibiting at least moderate levels of aggressive affect. Findings from our study suggest that the relation between autonomic nervous system reactivity during conflict and aggression toward an intimate partner is conditional on men's ability to decode the facial affect of their partner. For individuals who were able to decode aggressive affect from their partner, aggression was associated with decreased parasympathetic and SNS activation.

Concurrent Use of Alcohol and Crack Cocaine is Associated with High Levels of Anger and Liability to Aggression

Objective: To evaluate aggressiveness in individuals receiving treatment for alcohol and crack cocaine use, both alone and in combination with one another, in order to compare them to control subjects with no history of drug problems, using the State-Trait Anger Expression Inventory. Method: The sample consisted of 67 men aged 18-65 years, divided into four groups: alcohol (n = 13); crack cocaine (n = 25); crack cocaine + alcohol (n = 16) and controls (n = 13). Participants completed the following instruments: socioeconomic questionnaire, the Wechsler Abbreviated Scale of Intelligence and the State-Trait Anger Expression Inventory. Results: Individuals with alcohol dependence alone, or comorbid with crack cocaine dependence, showed elevated levels of aggression and anger, though these varied according to the drug of abuse. Concurrent users of alcohol and crack cocaine had the highest levels of aggression, followed by isolated alcohol users, suggesting an association between alcohol consumption and aggression. Conclusion: The present findings suggest that alcohol and aggression levels may be associated with violent behavior. Concurrent use of alcohol and crack cocaine was related to higher levels of aggression, which may be associated with more severe alterations in behavior and impulse control.

Trait anger and anger attacks in relation to depressive and anxiety disorders

BACKGROUND

Patients with various psychiatric disorders may suffer from feelings of anger, sometimes leading to maladaptive (e.g., aggressive) behaviors. We examined to what extent depressive and anxiety disorders, relevant clinical correlates, and sociodemographics determined the level of trait anger and the prevalence of recent anger attacks.

METHODS

In the Netherlands Study of Depression and Anxiety (NESDA), the Spielberger Trait Anger Subscale and the Anger Attacks Questionnaire were analyzed in patients with depressive (n = 204), anxiety (n = 288), comorbid (n = 222), and remitted disorders (n = 1,107), as well as in healthy controls (n = 470) based on DSM-IV criteria.

RESULTS

On average, participants were 46.2 years old (SD = 13.1) and 66.3% were female. Trait anger and anger attacks were most prevalent in the comorbid group (M = 18.5, SD = 5.9, and prevalence 22.1%), followed by anxiety disorder, depressive disorder, remitted disorder, and controls (M = 12.7; SD = 2.9, and prevalence 1.3%). Major depressive disorder, social phobia, panic disorder, and generalized anxiety disorder were most strongly associated to trait anger and anger attacks.

LIMITATIONS

Due to a cross-sectional design, it was not possible to provide evidence for temporal or causal relationships between anger and depressive and anxiety disorders.

CONCLUSIONS

Trait anger and anger attacks are linked to depressive and anxiety disorders, although the strength of the relationship differed among both anger constructs.

Patterns of Substance Abuse in Offenders With Schizophrenia- Illness-Related or Criminal Life-Style?

Objective: The impact of substance abuse on violent behavior in patients suffering from schizophrenia is well-known. However, the association between the pattern of substance abuse and certain aspects of criminal behavior like the severity of offense, the previous history of violence and the age at onset of the criminal career is still unclear. Method: To assess the relationship between substance abuse, schizophrenia and violent behavior we examined healthy non-offenders; healthy offenders; non-offenders suffering from schizophrenia; and offenders suffering from schizophrenia, with respect to different patterns of substance abuse (none, alcohol only, illicit drugs only, and multiple substances). Results: Healthy offenders as well as offenders and non-offenders suffering from schizophrenia are characterized by increased rates of alcohol and illicit drug abuse. Especially multiple substance abuse appears to lower the threshold of aggression and illegal behavior. This effect is more pronounced in subjects suffering from schizophrenia. In both offender groups the abuse of psychoactive substances is associated with an earlier onset of the criminal career, but has no impact on the severity of the offenses. Conclusion: Our results point to the need for a differentiated view on the contribution of substance abuse to the criminality of subjects suffering from schizophrenia.

Hostile interpretation training for individuals with alcohol use disorder and elevated trait anger: A controlled trial of a web-based intervention

High trait anger is associated with more severe alcohol use problems, and alcohol has been found to facilitate aggressive behavior among individuals with high trait anger. Treatments focused on a sample with alcohol use disorder with elevated anger could reduce alcohol use problems, as well as violence and aggression. We sought to examine the efficacy of interpretation bias modification for hostility (IBM-H) in a sample with high trait anger and alcohol use disorder (AUD). Fifty-eight individuals with AUD and elevated trait anger were randomly assigned to eight web-based sessions (two per week) of IBM-H or a healthy video control condition (HVC). Measures of interpretation bias, anger, and alcohol use were administered at pre- and post-treatment and at one-month follow-up. IBM-H led to greater improvements in interpretation bias compared to HVC at post and follow-up. IBM-H also led to greater reductions in trait anger than HVC, though this was an indirect effect mediated by changes in interpretation bias. Further, IBM-H led to lower anger expression than HVC; this was a direct (non-mediated) effect. Lastly, both conditions reported decreases in alcohol use and consequences following treatment, though there were no significant differences between them. These findings provide initial support for the utility of IBM-H as a brief non-confrontational intervention for AUD with elevated trait anger. Limitations and future research directions are discussed.

Violence involvement among nightlife patrons: The relative role of demographics and substance use

The nightlife setting is a risk context for violence involvement that ultimately may cause severe injuries and fatalities. Few studies have examined associations between alcohol and illicit substance use with physical violence involvement among nightlife patrons. The aim of the current study was to investigate the relative role of demographics and substance use characteristics for nightlife violence involvement among Norwegian nightlife patrons. A cross-sectional self-completion survey was conducted outside 12 licensed premises in Oslo (n = 1099, response rate = 76%) and each respondent's BAC level was measured by a breathalyzer and registered on the questionnaire. A total of 103 individuals (10%) reported that they had been involved in physical violence when they were consuming alcohol in the nightlife setting during the last 12 months. Uni-variate results showed that patrons who had been involved in violence were more likely to present a BAC level above 1.00‰ than those who had not been involved. The prevalence of last year illicit substance use was overall high, especially in the violence-involved group. The most important factors associated with violence involvement in multivariate analysis were a high frequency of last year alcohol intoxication and last year illicit substance use. Women and those with high education had a lower risk of violence involvement. The implications for preventive initiatives are that these need to focus on factors additional to alcohol restrictions. Preventive efforts targeted to specific patron groups and measures targeting patrons who are more likely to use illicit substances may hold promise. Aggr. Behav. 43:398-407, 2017. © 2017 Wiley Periodicals, Inc.

Contextual Factors Related to Alcohol Abuse Among Intimate Partner Violence Offenders

BACKGROUND

The association between alcohol consumption and intimate partner violence (IPV) has been reiterated in numerous studies. Some authors have found higher levels of risk factors in intimate partner violence offenders (IPVOs) with alcohol problems than in IPVOs without such problems.

OBJECTIVE

The aim of this study is to analyze the relationship of contextual variables with harmful alcohol use in a sample of IPVOs.

METHOD

This cross-sectional research analyzes data from 231 IPVOs. In addition to demographic data, information was collected on alcohol use, ethnicity, accumulation of stressful life events and perceived social support and rejection. The sample was divided into hazardous and nonhazardous alcohol users, according to the AUDIT test scale.

RESULTS

No differences were found between groups on demographic variables. The results of a hierarchical logistic regression analysis supplemented with ROC curves revealed that Latin American immigrants as opposed to Spanish nationality, accumulating stressful life events, and perceiving low social support significantly increased the likelihood of alcohol abuse, with adequate predictive power.

CONCLUSION

Contextual variables such as ethnicity, accumulation of stressful life events, and lack of social support may explain harmful alcohol consumption. These variables should be taken into account in batterer intervention programs in order to reduce one of the most relevant risk factors of IPV: alcohol abuse.

Examining the Relationship between Heavy Alcohol Use and Assaults: With Adjustment for the Effects of Unmeasured Confounders

BACKGROUND

Experimental studies suggest that alcohol can lead to aggression in laboratory settings; however, it is impossible to test the causal relationship between alcohol use and real-life violence among humans in randomized clinical trials. Objectives. (i) To examine the relationship between heavy alcohol use and assaults in a population based study; (ii) to demonstrate the proxy outcome method, as a means of controlling the effects of unknown/unmeasured confounders in observational studies.

METHODS

This study used data collected from three waves of the National Survey on Drug Use and Health (NSDUH). The effects of heavy alcohol use on assault were measured using multivariable logistic regressions in conjunction with the proxy outcome method.

RESULTS

Application of the proxy outcome method indicated that effect sizes of heavy alcohol use on the risk of assault were overestimated in the standard models. After adjusting for the effects of unknown/unmeasured confounders, the risk of assault remained 43% and 63% higher (P < 0.05) among participants who consumed 5+ drinks/day for 5-8 days/month and 9-30 days/month, respectively.

CONCLUSIONS

Even after adjustment for unknown/unmeasured confounders the association between heavy alcohol use and risk of violence remained significant. These findings support the hypothesis that heavy alcohol use can cause violence.

The ABCs of Trait Anger, Psychological Distress, and Disease Severity in HIV

BACKGROUND

Trait anger consists of affective, behavioral, and cognitive (ABC) dimensions and may increase vulnerability for interpersonal conflict, diminished social support, and greater psychological distress. The concurrent influence of anger and psychosocial dysfunction on Human Immunodeficiency Virus (HIV) disease severity is unknown.

PURPOSE

The purpose of this study was to examine plausible psychosocial avenues (e.g., coping, social support, psychological distress), whereby trait anger may indirectly influence HIV disease status.

METHODS

Three hundred seventy-seven HIV seropositive adults, aged 18-55 years (58% AIDS-defined), completed a battery of psychosocial surveys and provided a fasting blood sample for HIV-1 viral load and T lymphocyte count assay.

RESULTS

A second-order factor model confirmed higher levels of the multidimensional anger trait, which was directly associated with elevated psychological distress and avoidant coping (p<.001) and indirectly associated with greater HIV disease severity (p<.01) (comparative fit index (CFI)=0.90, root-mean-square error of approximation (RMSEA)=0.06, standardized root-mean-square residual (SRMR)=0.06).

CONCLUSION

The model supports a role for the ABC components of anger, which may negatively influence immune function through various psychosocial mechanisms; however, longitudinal study is needed to elucidate these effects.

Cognitive and aggressive reactions of male dating violence perpetrators to anger arousal

In the current study, 20 dating violent and 27 non-violent college males provided verbal articulations and self-report data regarding cognitive biases, change in affect, and aggressive reactions following anger induction through the articulated thoughts in simulated situations paradigm. Violent, relative to non-violent, males articulated more cognitive biases and verbally aggressive statements during provocation. These same relationships did not hold for a retrospective self-report measure. Greater cognitive biases and aggressive articulations reliably distinguished between violent and non-violent males in the current study. Results suggest that assessing cognitive and affective content "in the heat of the moment" may be a more sensitive indicator of dating violence than retrospective self-reports.

Angry affect and violence in the context of a psychotic illness: a systematic review and meta-analysis of the literature

A small but significant relationship between schizophrenia and violence is well established, but not yet fully explained. Research has highlighted anger as an important factor in precipitating actual violence in general and psychiatric populations. However, anger has not been extensively studied as a risk factor for violence in people with schizophrenia and related psychoses. We evaluated published evidence on the relationship between anger and violence in patients with schizophrenia and related psychoses by means of a systematic review of the literature. A search of main online databases from inception till January 2012 was performed and supplemented with correspondence with authors and data available online. 11 studies which measured angry affect in patients with schizophrenia who had been violent were included in the review. 5 studies with a total of 510 individuals had anger data that were suitable to be pooled in a meta-analysis in form of standardised mean difference values comparing the anger scores of the non-violent groups with violent groups. All the studies included showed significantly higher scores for anger in the violent group compared with the non-violent group with the pooled result expressed as standardised mean difference of 0.74 95% CI (0.53, 0.94) and the Z value for overall effect=7.01. The studies not included in the meta-analysis which looked at 610 individuals, were analysed descriptively and all of them reported higher scores for anger for individuals with schizophrenia who acted violently. There is a consistency of significant association between angry affect and violent behaviour in the context of psychotic illness across various study designs, settings and populations. Theoretical support already exists for this relationship and this review lends further support to explore this relationship further.

Trait and state hostile rumination facilitate alcohol-related aggression

OBJECTIVE

This investigation attempted to determine whether trait and state hostile rumination functioned as risk factors for the relation between acute alcohol intoxication and aggression.

METHOD

Participants were 516 social drinkers (252 men and 264 women). Trait hostile rumination was assessed using Caprara's Dissipation-Rumination Scale. Following the consumption of either an alcohol or a placebo beverage, participants were tested on a laboratory task in which electric shocks were received from and administered to a fictitious opponent under the guise of a competitive reaction-time task. Aggression was operationalized as the combined mean responses for shock intensity and duration across all trials. In a subset of the sample (n = 320), state hostile rumination was assessed following the aggression task using a self-report measure.

RESULTS

As expected, both trait and state measures acted as moderators. Specifically, acute alcohol intoxication was more likely to increase aggression in persons with higher trait and state hostile rumination scores compared with their equally intoxicated lower rumination counterparts.

CONCLUSIONS

This was the first investigation to demonstrate that trait or state rumination significantly heighten the risk of intoxicated aggression. We believe that hostile rumination facilitates intoxicated aggression because ruminators have difficulty diverting their attention away from anger-provoking stimuli and related thoughts, thus making violent reactions more likely. Clinical and public health interventions would benefit by developing strategies to distract ruminative attention away from violence-promoting messages, especially when persons are under the influence of alcohol.

Risk factors for sexual aggression in young men: an expansion of the confluence model

There are many explanations for high rates of sexual aggression, with no one theory dominating the field. This study extends past research by evaluating an expanded version of the confluence model with a community sample. One-hour audio computer-assisted self-interviews were completed by 470 young single men. Using structural equation analyses, delinquency, hostile masculinity, impersonal sex, and misperception of women's sexual cues were positively and directly associated with the number of sexually aggressive acts committed. There were also indirect effects of childhood victimization, personality traits associated with subclinical levels of psychopathy, and alcohol consumption. These findings demonstrate the usefulness of the confluence model, as well as the importance of broadening this theory to include additional constructs.

Alcohol, suppressed anger and violence

AIMS

Is alcohol related causally to violence, and if so, is the effect of drinking contingent on suppressed anger such that it is strongest among individuals who are highly inclined to withhold angry feelings? We addressed these questions by analysing panel data using a method that diminishes the effects of confounding factors.

DESIGN

We analysed data on heavy episodic drinking and violent behaviour from the second (1994) and third (1999) waves of the Young in Norway Longitudinal Study (n = 2697; response rate: 67%). The first difference method was applied to estimate the association between these behaviours, implying that changes in the frequency of violence were regressed on changes in the frequency of drinking. Hence, the effects of time-invariant confounders were eliminated. Analyses were conducted for the whole sample, and for groups scoring low, medium and high on a short version of the STAXI anger suppression scale.

FINDINGS

Changes in drinking were related positively and significantly to changes in violent behaviour, but the alcohol effect varied with the level of suppressed anger: it was strongest in the high-anger group (elasticity estimate = 0.053, P = 0.011) and weakest (and insignificant) in the low-anger group (elasticity estimate = 0.004, P = 0.806).

CONCLUSIONS

Alcohol use may be related causally to violence, but the effect of drinking is confined to individuals who are inclined to suppress their angry feelings.

Genetic effects on anger control and their interaction with alcohol intoxication: a self-report study

Individual differences in anger control are important to consider when trying to understand intoxicated aggression (Parrott and Giancola, 2004). We explored, first, genetic and environmental effects on anger control both in self-reported sober and alcohol intoxicated states, and whether the same genetic and environmental effects influence it in both these states, and second, a possible interaction between genetic effects and alcohol in the control of anger. In the population based sample (N=8964) of Finnish twins (18-33 years) and their siblings (18 years or older), genetic effects on anger control were found both for the self-reported sober (27% for men, 34% for women) and alcohol intoxicated states (29% for men, 37% for women), with high genetic correlations (from .77 to .85) between these states. Genetic effects (26% for men, 29% for women) were also found for the difference in anger control between the self-reported sober and alcohol intoxicated states, suggesting the effect of alcohol on anger control depends on the genotype of the individual.

Zolmitriptan and human aggression: interaction with alcohol

RATIONALE

The serotonin 1(B/D) (5-HT1(B/D)) receptor has shown potential as a target for decreasing aggression. The 5-HT1(B/D) agonist zolmitriptan's ability to reduce aggressive behavior in humans and its interaction with the well-known aggression-enhancing drug alcohol were examined.

OBJECTIVES

Our objective was to investigate zolmitriptan's potential to modify human aggression in a laboratory paradigm across a range of alcohol doses. Alcohol has been consistently associated with aggression and violence, thus we hoped to expand current understanding of alcohol's role in aggressive behavior via manipulation of the serotonin (5-HT) system.

METHODS

Eleven social drinkers, seven male, were recruited to participate in a research study lasting 3-4 weeks. Aggression was measured using the point-subtraction aggression paradigm (PSAP), a laboratory model widely used in human aggression studies. Subjects were administered 5-mg zolmitriptan and placebo capsules along with alcohol doses of 0.0, 0.4 and 0.8 g/kg in a within-subject, counterbalanced dosing design. Data were analyzed as the ratio of aggressive/monetary-earning responses, to account for possible changes in overall motor function due to alcohol.

RESULTS

There was a significant alcohol by zolmitriptan interaction on the aggressive/monetary response ratio. Specifically, compared to placebo, zolmitriptan decreased the aggressive/monetary ratio at the 0.4- and 0.8-g/kg alcohol doses.

CONCLUSIONS

A 5-mg dose of zolmitriptan effectively reduced alcohol-related aggression in an acute dosing protocol, demonstrating an interaction of 5-HT and alcohol in human aggressive behavior.

Environmental Strategies for Prevention of Drug Use and Risks in Clubs

Environmental prevention strategies in club settings where music and dance events are featured could provide an important new arena for the prevention of drug use and other risky behaviors (e.g., sexual risk taking, intoxication and drug use, aggression, and driving under the influence). Electronic music dance events (EMDEs) occur in clubs that attract young, emerging adults (18-25 years of age) and attract individuals who engage in various types of drug use. Borrowing from the environmental prevention studies that focus on reducing alcohol use and related problems, a model for drug prevention in the club setting is proposed. Initially, an overview of the relationships between EMDEs and drug use and other risky behaviors are presented. Next, rationales for environmental strategies are provided. Finally, an environmental approach to prevention of drug use and risky behaviors in clubs is described. This comprehensive set of environmental strategies, is designed to be mutually supportive and interactive. Environmental strategies are believed to provide potential for developing an efficacious prevention strategy. The environmental prevention approach presented here is composed of three intervention domains: (1) Mobilization, (2) Strategies for the Exterior Environment, and (3) Strategies for the Interior Environment.

Effects of acute alcohol intoxication and paroxetine on aggression in men

BACKGROUND

The purpose of this study was to examine the role of the serotonin (5-HT) system in alcohol-related aggression.

METHODS

Specifically, we experimentally examined the effects of 5-HT augmentation on alcohol-related aggression in men (n = 56). After consuming either alcohol (mean blood alcohol concentration of 0.10%) or a placebo (no alcohol) drink, and taking either 20 mg of paroxetine (Paxil) or a placebo pill, participants were provided the opportunity to administer electric shock to a (faux) opponent during a task disguised as a reaction-time game. Aggression was defined as the intensity of shock chosen and the frequency with which an extreme (clearly painful) shock was chosen. We predicted that 5-HT augmentation would be associated with lower aggressive behavior overall, and also reduce the aggression facilitating effects of acute alcohol intoxication.

RESULTS

The results indicated that alcohol intoxication increased aggression, particularly under low provocation. Paroxetine decreased aggression, particularly during high provocation. These effects, however, occurred independently of each other.

CONCLUSIONS

The effect of alcohol on extreme aggression was moderated by previous aggression history, with more aggressive individuals showing greater alcohol-related increases in extreme aggression.

Alcohol's role in men's use of coercion to obtain unprotected sex

Past sexual victimization has been identified as a predictor of women's sexual risk-taking. In order to develop effective prevention and treatment programs, research is needed that examines perpetrators' characteristics. Thus, the goal of this study was to examine predictors of men's willingness to use coercive strategies to obtain sex without a condom. Male college students (n = 72) completed a survey that assessed past sexual assault perpetration, hostility, past misperception of women's sexual cues, usual alcohol consumption, and usual condom use. One month later, they participated in an alcohol administration study and watched a video about a couple in a consensual sexual situation. Participants were asked to evaluate how justified they would be in using a variety of coercive strategies to make the woman have unprotected sex. In hierarchical multiple regression analyses, there was a significant main effect of past perpetration such that men who had previously committed sexual assault felt more justified using coercive strategies to obtain unprotected sex than did nonperpetrators. Acute alcohol consumption did not have a main effect; however, it interacted with hostility and misperception. Among participants who consumed alcohol prior to watching the video, the greater their preexisting hostility, the more justified they felt in using coercion. Similarly, the more frequently drinkers had misperceived women's sexual intentions in the past, the more justified they felt in using coercion. Based on these findings, several specific suggestions are made for prevention and treatment programs, including targeted communication skills and normative feedback interventions.

Effects of alcohol intoxication and aggressivity on aggressive verbalizations during anger arousal

We examined the moderating effect of dispositional aggressivity on the relationship between alcohol intoxication and aggressive verbalizations. Using a laboratory anger-induction task that simulated an interpersonal conflict as a method to assess aggressive verbalizations (the articulated thoughts in simulated situations paradigm), 70 participants (33 women, 37 men) consumed either an alcoholic or a placebo beverage, and then imagined a series of audiorecorded interpersonal scenarios. Two blind-to-condition raters assessed the frequency of participants' aggressive verbalizations (insults, aggressive threats, belligerent provocations) articulated during anger arousal. Aggressivity was assessed using a standard measure of dispositional aggression. Results supported the aggressivity moderation hypothesis: intoxicated participants high in aggressivity responded with significantly more aggressive verbalizations relative to low-aggressivity participants regardless of beverage condition, and three times more aggressive verbalizations relative to the high-aggressivity/placebo group. There were no gender effects. These data support the hypothesis that alcohol potentiates aggression primarily among individuals at dispositional risk for engaging in such a behavior. Aggr. Behav. 34:428-436, 2008. (c) 2008 Wiley-Liss, Inc.

Alcohol-aggression expectancies and dispositional rumination moderate the effect of alcohol consumption on alcohol-related aggression and hostility

Alcohol consumption increases aggression, but only in some drinkers. This study extends previous work to show how expectancies for alcohol-induced aggression and dispositional rumination moderate the link between alcohol consumption and alcohol-related aggression and hostility in a sample of 285 men and women. Alcohol-aggression expectancies and quantity of alcohol interacted to predict alcohol-related hostility and aggression. Trait rumination moderated the effect of alcohol consumption on aggressive acts. Finally, women who ruminated were more likely to report alcohol-related aggression than were men who ruminated. These results suggest that alcohol expectancies for aggression and rumination constitute two important cognitive facilitators of alcohol-related aggression and hostility, and that gender plays an important role in these relations.

Effects of alcohol intoxication on anger experience and expression among partner assaultive men

The author investigated the acute effects of alcohol intoxication on anger experience and expression among 46 maritally violent (MV) and 56 maritally nonviolent (NV) men randomly assigned to receive alcohol, placebo, or no alcohol. Participants completed an anger-arousing articulated thoughts in simulated situations (ATSS) paradigm and imagined marital conflict scenarios. Anger experience was operationalized as subjective ratings of anger experienced during ATSS, and anger expression was measured as ATSS anger statements and aggression verbalizations. MV men given alcohol articulated significantly more aggressive verbalizations than all other groups, with high trait anger and increased anger experience predicting more aggressive verbalizations. Thus, alcohol may exert proximal effects on abusive behavior among individuals already prone to respond to conflict with increased anger.

Changes in Outlet Densities Affect Violence Rates

BACKGROUND

Previous assessments of empirical relationships between alcohol outlets and rates of interpersonal violence have been conducted using cross-sectional spatial data, data collected across small geographic units such as Census Tracts and zip codes. These assessments demonstrate that the availability of alcohol, measured by the number and types of alcohol outlets, is related to violence. These analyses have examined many potential confounds of the outlets-violence connection (i.e., population and place characteristics) and statistically corrected for biases that arise in analyses of spatial data. The current study contributes the first observation of longitudinal relationships between alcohol outlets and violence.

METHOD

The study examined longitudinal data from 581 consistently defined zip code areas represented in the California Index Locations Database, a geographic information system that coordinates population and ecological data with spatial attributes for areas across the state. Six years of data were collected on features of local populations (e.g., household size) and places (e.g., retail markets) thought to be related to 1 measure of violence (i.e., hospital discharges related to violent assaults). Assault rates were related to changes in population and place characteristics using random effects models with controls for spatial autocorrelation (n x t = 3,486 observations). Changes in population and place characteristics of bordering (spatial lagged) areas were also considered.

RESULTS

Lower median household income and greater percentages of minorities (African American, Hispanic, and Asian) were related to increased rates of violence. Ten percent increases in numbers of off-premise outlets and bars were related to 1.67 and 2.06% increases in violence rates across local and lagged spatial areas. Every 6 outlets accounted for 1 additional violent assault that resulted in at least 1 overnight stay at hospital. These effects increased with larger male populations, doubling with every 3% increase in percent males.

CONCLUSION

Assault rates were most strongly related to median household incomes and minority populations within zip code areas. Controlling for changes in assault rates related to these measures, greater numbers of licensed alcohol retail establishments, especially bars and off-premise outlets, were related to rates of assault. Failures to regulate the growth in numbers of bars will increase rates of violence, especially in urban areas.

A Further Examination of the Relation Between Trait Anger and Alcohol-Related Aggression: The Role of Anger Control

BACKGROUND

Trait anger has been identified as a risk factor for alcohol-related aggression. However, to develop a more accurate risk profile, it is necessary to examine the interactive relations between trait anger and other key personality variables. The present study examined the influence of anger control on alcohol-related aggression.

METHODS

Participants were 164 social drinking men age 21-35 years old. Trait anger and anger control were assessed with the State-Trait Anger Expression Inventory (Spielberger, 1996). Following consumption of an alcoholic or placebo beverage, participants competed in an aggression paradigm in which electric shocks were received from and administered to a fictitious opponent during a competitive reaction time task. Aggression was operationalized as shock intensities administered to the opponent under conditions of low and high provocation.

RESULTS

Analyses indicated that trait anger significantly predicted aggression, but only among men who were intoxicated and reported low levels of anger control.

CONCLUSIONS

The present findings suggest that anger control may be a crucial risk factor in determining whether one's anger proneness will lead to intoxicated aggression following provocation.

Ecological models of alcohol outlets and violent assaults: crime potentials and geospatial analysis

AIMS

Empirical tests of relationships between alcohol outlets and violence are generally conducted with statistical controls for correlates related to characteristics of people and the places in which they live. Crime potentials theory asserts that certain subpopulations are disposed to participate in criminal activities (population potentials) and certain neighborhoods are more likely to be places where crimes occur (place potentials). The current study assesses the degree to which measures of the different geographic distributions of these potentials contribute to violent crime.

DESIGN

Cross-sectional data on hospital discharges for violent assaults were obtained for residents of 1637 zip code areas in California. Assault rates were related to measures of population and place characteristics using spatial statistical models corrected for spatial autocorrelated error.

FINDINGS

Rates of assault were related to population and place characteristics within zip code areas, and with characteristics of populations living in adjacent zip code areas. Assault rates were greater in densely populated, poor minority urban areas with greater residential instability. Assault rates were also greater in zip code areas adjacent to densely populated urban areas. Assault rates were related significantly to local densities of off-premise alcohol retail establishments, not bars. However, densities of bars moderated substantially effects related to local population characteristics. Bars were related significantly to violence in unstable poor minority areas and in rural middle-income areas of the state.

CONCLUSION

Population and place characteristics are associated with rates of violence across spatial areas. Alcohol outlets directly affect and moderate potentials for violence associated with socio-demographic groups.