Relationship between 5-HT function and impulsivity and aggression in male offenders with personality disorders

The ability to inhibit impulses is related to social behavior in long-tailed macaques

Performance in cognitive tasks has been linked to differences in species' social organization, yet to understand its function its relationship to within-species variation in behavior should also be explored. One important cognitive capacity, the ability to inhibit impulses, is typically better in egalitarian than despotic primate species and in primate species with strong fission-fusion dynamics. A different line of research indicates that a high ability to inhibit impulses is related to less aggressive behavior and more socio-positive behavior. However, within species the relationship between performance on cognitive inhibition tasks and variation in social behavior remains to be explored. Here we investigate how performance in a typical inhibition task in cognitive research is related to aggressive and socio-positive behavior in despotic long-tailed macaques. Twenty individuals living in two naturalistic mixed-sex groups were tested with the Plexiglass Hole Task. Aggressive behavior and three types of socio-positive behavior (neutral/friendly approaches, socio-positive signaling, and grooming others) among group members were measured. Individuals differed in their ability to inhibit impulses. Individuals that were not good at inhibiting impulses showed higher rates of aggressive behavior, but also more socio-positive signals, whereas inhibition was not related to neutral/friendly approaches and grooming. These results confirm the positive link between impulsiveness and aggression. In addition, the results indicate that some social-positive behavior may be enhanced when inhibition is limited. In this species, benefits potentially derived from aggression and socio-positive signals match a low ability to inhibit impulses, suggesting that a low ability to inhibit impulses may actually be advantageous. To understand differences between species in cognitive skills, understanding the benefits of variation in a cognitive capacity within a species is crucial.

Frustration-aggression hypothesis reconsidered: The role of significance quest

One of the oldest scientific theories of human aggression is the frustration-aggression hypothesis, advanced in 1939. Although this theory has received considerable empirical support and is alive and well today, its underlying mechanisms have not been adequately explored. In this article, we examine major findings and concepts from extant psychological research on hostile aggression and offer an integrative conception: aggression is a primordial means for establishing one's sense of significance and mattering, thus addressing a fundamental social-psychological need. Our functional portrayal of aggression as a means to significance yields four testable hypotheses: (1) frustration will elicit hostile aggression proportionately to the extent that the frustrated goal serves the individual's need for significance, (2) the impulse to aggress in response to significance loss will be enhanced in conditions that limit the individual's ability to reflect and engage in extensive information processing (that may bring up alternative, socially condoned means to significance), (3) significance-reducing frustration will elicit hostile aggression unless the impulse to aggress is substituted by a nonaggressive means of significance restoration, (4) apart from significance loss, an opportunity for significance gain can increase the impulse to aggress. These hypotheses are supported by extant data as well as novel research findings in real-world contexts. They have important implications for understanding human aggression and the conditions under which it is likely to be manifested and reduced.

The Role of Alexithymia and Impulsivity in Male Victims and Perpetrators of Intimate Partner Violence

(1) Background: Alexithymia and impulsivity appear to represent risk factors for violence perpetration, while mixed results are present with respect to victimization experience. In light of this, the purpose of this study was to compare the roles of both alexithymia and impulsivity among three different samples of men: men who experienced partner victimization (IPVV); male intimate partner violence perpetrators (IPVP); and men from the general population (CG). (2) Methods: Participants were recruited from specialized centers in Italy. A profile analysis was conducted. (3) Results: The results showed that IPVV presented alexithymia and impulsivity comparable to the CG. Furthermore, differences were found between victims and perpetrators in terms of impulsivity and alexithymia. The IPVP group had higher levels of both impulsivity and alexithymia in comparison to IPVV. Moreover, the perpetrators exhibited significantly higher levels of alexithymia compared to the CG. However, despite the medium Cohen's d (d = 0.441) resulting from the analyses, IPVP's level of impulsivity was not statistically different from the CG. (4) Conclusion: Alexithymia and impulsivity appear to play a key role in violent behaviors and should be the focus of psychological interventions with perpetrators.

Bidirectional association between sleep quality or duration and aggressive behaviour in early adolescents: A cross-lagged longitudinal study

BACKGROUND

Several cross-sectional studies have suggested a strongly positive link between sleep and aggressive behaviour; however, longitudinal studies reporting the relationship between sleep and aggressive behaviour are lacking. This study aimed to examine whether a bidirectional relationship exists between sleep quality or duration and aggressive behaviour in early adolescents.

METHODS

A total of 1579 early adolescents (60.9 % boys) from the Chinese Early Adolescents Cohort study were included in this study. Data on sleep quality, sleep duration and aggressive behaviour collected at two time points (September 2019 and September 2021) were used, and the bidirectional relationship between sleep quality or duration and aggressive behaviour was examined using a cross-lagged model.

RESULTS

The results revealed a bidirectional relationship between low sleep quality and highly aggressive behaviour. A shorter sleep duration did not predict highly aggressive behaviour, whereas only highly aggressive behaviour predicted a shorter sleep duration.

CONCLUSIONS

Sleep quality and aggressive behaviour were interrelated over time among adolescents. However, sleep duration did not predict aggressive behaviour, suggesting that sleep quality, instead of sleep duration, should be the primary target for managing aggressive behaviour.

Fibroblast growth factor 21 associating with serotonin and dopamine in the cerebrospinal fluid predicts impulsivity in healthy subjects

Background

Impulsivity is more commonly reported in subjects with mental disorders compared to healthy subjects, suggesting a potential application of impulsivity in predicting impulsivity-related mental disorders. However, no biomarker of impulsivity available so far. This study explored the association between cerebrospinal fluid (CSF) fibroblast growth factor 21 (FGF21), a key hormonal mediator of the stress response, and impulsivity in healthy subjects.

Methods

A total of 126 healthy persons subjected to surgery of anterior cruciate ligament were recruited in the present study. The impulsiveness of the subjects was evaluated by the Chinese version of the Barratt Impulsiveness Scale (BIS)-11 before surgery. CSF and blood samples of the subjects were collected before spinal anesthesia for surgery. The levels of FGF21, serotonin and dopamine in CSF and the level of FGF21 in blood of the subjects were measured by ELISA using commercial kits.

Results

Negative correlations were found between BIS-11 total score and either FGF21, serotonin or dopamine in CSF. However, BIS-11 total score was not correlated with FGF21 in blood. In addition, FGF21 was positively correlated with serotonin and dopamine in CSF, respectively. Multivariable linear regression models indicated that the decrease of FGF21 level associating with the decrease of serotonin and dopamine level in CSF contributed to the higher impulsivity. Furthermore, receiver operating characteristic curve (ROC) analysis indicated an important role of CSF FGF21 predicting high impulsivity.

Conclusions

FGF21, serotonin and dopamine in CSF associate with impulsivity in opposite directions. The decrease of CSF FGF21 is related to higher impulsivity, and indicate that CSF FGF21 may predict impulsivity in healthy subjects.

Detection of Minor and Major Depression through Voice as a Biomarker Using Machine Learning

Both minor and major depression have high prevalence and are important causes of social burden worldwide; however, there is still no objective indicator to detect minor depression. This study aimed to examine if voice could be used as a biomarker to detect minor and major depression. Ninety-three subjects were classified into three groups: the not depressed group (n = 33), the minor depressive episode group (n = 26), and the major depressive episode group (n = 34), based on current depressive status as a dimension. Twenty-one voice features were extracted from semi-structured interview recordings. A three-group comparison was performed through analysis of variance. Seven voice indicators showed differences between the three groups, even after adjusting for age, BMI, and drugs taken for non-psychiatric disorders. Among the machine learning methods, the best performance was obtained using the multi-layer processing method, and an AUC of 65.9%, sensitivity of 65.6%, and specificity of 66.2% were shown. This study further revealed voice differences in depressive episodes and confirmed that not depressed groups and participants with minor and major depression could be accurately distinguished through machine learning. Although this study is limited by a small sample size, it is the first study on voice change in minor depression and suggests the possibility of detecting minor depression through voice.

Toxoplasma gondii, Suicidal Behavior, and Intermediate Phenotypes for Suicidal Behavior

Within the general literature on infections and suicidal behavior, studies on Toxoplasma gondii (T. gondii) occupy a central position. This is related to the parasite's neurotropism, high prevalence of chronic infection, as well as specific and non-specific behavioral alterations in rodents that lead to increased risk taking, which are recapitulated in humans by T. gondii's associations with suicidal behavior, as well as trait impulsivity and aggression, mental illness and traffic accidents. This paper is a detailed review of the associations between T. gondii serology and suicidal behavior, a field of study that started 15 years ago with our publication of associations between T. gondii IgG serology and suicidal behavior in persons with mood disorders. This "legacy" article presents, chronologically, our primary studies in individuals with mood disorders and schizophrenia in Germany, recent attempters in Sweden, and in a large cohort of mothers in Denmark. Then, it reviews findings from all three meta-analyses published to date, confirming our reported associations and overall consistent in effect size [ranging between 39 and 57% elevation of odds of suicide attempt in T. gondii immunoglobulin (IgG) positives]. Finally, the article introduces certain links between T. gondii and biomarkers previously associated with suicidal behavior (kynurenines, phenylalanine/tyrosine), intermediate phenotypes of suicidal behavior (impulsivity, aggression) and state-dependent suicide risk factors (hopelessness/dysphoria, sleep impairment). In sum, an abundance of evidence supports a positive link between suicide attempts (but not suicidal ideation) and T. gondii IgG (but not IgM) seropositivity and serointensity. Trait impulsivity and aggression, endophenotypes of suicidal behavior have also been positively associated with T. gondii seropositivity in both the psychiatrically healthy as well as in patients with Intermittent Explosive Disorder. Yet, causality has not been demonstrated. Thus, randomized interventional studies are necessary to advance causal inferences and, if causality is confirmed, to provide hope that an etiological treatment for a distinct subgroup of individuals at an increased risk for suicide could emerge.

Reconsidering the role of sex hormones in psychopathy development: Estrogen and psychopathy among male justice-involved youth

Prominent theory suggests that factor one psychopathic traits may develop from increased input from hormones in the hypothalamic pituitary gonadal axis (HPG; i.e., testosterone) and decreased input from the hypothalamic pituitary adrenal axis (HPA; i.e., cortisol). Although there are extensive findings connecting low cortisol to psychopathy, less support has emerged for high levels of testosterone. This study examined whether incorporating the HPG hormone, estradiol, into this model would reveal relationships in line with theory: high levels of estradiol and testosterone in combination with low levels of cortisol would inform psychopathic traits. Baseline and reactive hormone levels were measured and compared to Psychopathy Checklist-Youth Version (PCL-YV) interviews among 66 male justice-involved youth (M age = 15.73) in a Southeastern juvenile detention center. The primary findings of this study were relationships between interacting HPA and HPG axis hormones with facet one and facet two psychopathic traits. Specifically, psychopathy total scores, interpersonal traits, and affective traits related to estradiol and testosterone reactivity, in that psychopathy scores were more likely with decreases in hormone reactivity (i.e., change in hormone level) following a stressor. Moreover, affective traits related to reactivity in all three hormones. These findings support inclusion of estradiol in neurobiological models of psychopathy and consideration of the individual components of psychopathy. This study adds to the growing body of research supporting interactions between variations in functioning of the HPA and HPG axes in relation to psychopathy.

In-Vitro Assessment of Hapten-Induced Immune Regulation in Children with Asthenoneurotic Syndrome

The study employed in vitro assay to examine the peculiarities of immune status in children with functional disorders of the autonomic nervous system diagnosticated as asthenoneurotic syndrome. In contrast to control children without asthenoneurotic syndrome, the examined group was characterized by significantly (p<0.05) elevated hapten-specific immunological sensitization (indicated by anti-Al IgG), induction of inflammatory reactions (IL-1), activation of apoptosis (CD3⁺CD95⁺ and р53) observed against the background inhibition of adaptive immune response (CD3⁺, CD3⁺CD4⁺, CD3⁺CD8⁺, CD16⁺56⁺, and CD19⁺), as well as hyperexpression of glutamic acid, NO, and VEGF combined with deficiency of serotonin. In cultured immunocompetent cells derived from children with hapten-modified immune status, the combined application of cytokine stimulator IL-1 with hapten sensitizer aluminum or with endocrine stimulator cortisol significantly (p<0.05) up-regulated expression of IL-8 and IL-10, but down-regulated production of IL-17 in a dose-dependent manner.

Serotonin transporter gene linked polymorphism (5-HTTLPR) determines progredience of alcohol dependence in Belarusian young males

PURPOSE

Allelic duality and functional impact of degenerate repeat at 5'- flanking promoter region in SLC6A4 gene of the serotonin transporter (5-HTTLPR), have been in the focus of investigations over the years. Various outcomes regarding an association of its polymorphism with risks of alcohol dependence syndrome (ADS) were presented. Such studies have not been conducted in the Eastern European population e.g. Belarus. We therefore checked: the association of 5-HTTLPR polymorphism with ADS, and functional impact of the polymorphism on progredience of ADS in Belarusian population.

MATERIAL AND METHODS

The study involved 499 Belarusian males: 377 subjects with ADS (AG), and a control group (CG) with 122 subjects without alcohol-related problems. The ADS group was further divided into two groups of individuals with rapid (AG (R)) and delayed (AG (D)) progression of ADS. Clinical diagnosis was carried-out using ICD-10 criteria, Belarusian Addiction Severity Index, "B-ASI" and Alcohol-Use-Disorders-Identification-Test (AUDIT). PCR-RFLP analysis was performed.

RESULTS

There were no significant differences in the distribution of frequencies of either the 5-HTTLPR genotype or the short and long allele among AG and CG. However, the ADS 5-HTTLPR genotype and allele distribution frequencies differ significantly by the variation in progression of ADS.

CONCLUSIONS

There is no significant association between polymorphism of serotonin transporter gene and risk of ADS. However, the polymorphism significantly determines progredience of ASD in subjects with pathological patterns of alcohol consumption. Findings from this study carry preliminary significance as a facility to effective alcohol addiction treatment, rehabilitation and preventive services in the Eastern Europe.

Moderation of the relationship between Toxoplasma gondii seropositivity and trait impulsivity in younger men by the phenylalanine-tyrosine ratio

Previously, we reported that Toxoplasma gondii (T. gondii)-seropositivity is associated with higher impulsive sensation seeking in younger men. As dopaminergic and serotonergic signaling regulate impulsivity, and as T. gondii directly and indirectly affects dopaminergic signaling and induces activation of the kynurenine pathway leading to the diversion of tryptophan from serotonin production, we investigated if dopamine and serotonin precursors or the tryptophan metabolite kynurenine interact with the T. gondii-impulsivity association. In 950 psychiatrically healthy participants, trait impulsivity scores were related to T. gondii IgG seropositivity. Interactions were also identified between categorized levels of phenylalanine (Phe), tyrosine (Tyr), Phe:Tyr ratio, kynurenine (Kyn), tryptophan (Trp) and Kyn:Trp ratio, and age and gender. Only younger T. gondii-positive men with a high Phe:Tyr ratio, were found to have significantly higher impulsivity scores. There were no significant associations in other demographic groups, including women and older men. No significant effects or interactions were identified for Phe, Tyr, Kyn, Trp, or Kyn:Trp ratio. Phe:Tyr ratio, therefore, may play a moderating role in the association between T. gondii seropositivity and impulsivity in younger men. These results could potentially lead to individualized approaches to reduce impulsivity, based on combined demographic, biochemical and serological factors.

The Role of the Lateral Hypothalamus in Violent Intraspecific Aggression-The Glucocorticoid Deficit Hypothesis

This review argues for a central role of the lateral hypothalamus in those deviant forms of aggression, which result from chronic glucocorticoid deficiency. Currently, this nucleus is considered a key region of the mechanisms that control predatory aggression. However, recent findings demonstrate that it is strongly activated by aggression in subjects with a chronically downregulated hypothalamus-pituitary-adrenocortical (HPA) axis; moreover, this activation is causally involved in the emergence of violent aggression. The review has two parts. In the first part, we review human findings demonstrating that under certain conditions, strong stressors downregulate the HPA-axis on the long run, and that the resulting glucocorticoid deficiency is associated with violent aggression including aggressive delinquency and aggression-related psychopathologies. The second part addresses neural mechanisms in animals. We show that the experimental downregulation of HPA-axis function elicits violent aggression in rodents, and the activation of the brain circuitry that originally subserves predatory aggression accompanies this change. The lateral hypothalamus is not only an integral part of this circuitry, but can elicit deviant and violent forms of aggression. Finally, we formulate a hypothesis on the pathway that connects unfavorable social conditions to violent aggression via the neural circuitry that includes the lateral hypothalamus.

Antisocial personality disorder: new directions

Antisocial personality disorder is a complex condition carrying high rates of comorbidity and mortality for individuals as well as harmful consequences for their families and society. Despite the publication of National Institute for Health and Care Excellence (NICE) guidelines for the disorder, the evidence base and provision of effective treatments remain inadequate, and the belief that the condition is untreatable remains widespread among psychiatrists and other professionals. This article highlights current diagnostic controversies and summarises the evidence for conceptualising antisocial personality disorder as a disorder of attachment. Informed by this developmental perspective, we provide a framework for the management and treatment of adults with antisocial personality disorder, highlighting the importance of creating a safe setting and recommending adaptations of therapeutic technique to facilitate the engagement of this ‘treatment-rejecting’ patient population. We conclude with an outline of the current government policy on the treatment of high-risk offenders with personality disorder.

LEARNING OBJECTIVES

The role of central and medial amygdala in normal and abnormal aggression: A review of classical approaches

The involvement of the amygdala in aggression is supported by overwhelming evidence. Frequently, however, the amygdala is studied as a whole, despite its complex internal organization. To reveal the role of various subdivisions, here we review the involvement of the central and medial amygdala in male rivalry aggression, maternal aggression, predatory aggression, and models of abnormal aggression where violent behavior is associated with increased or decreased arousal. We conclude that: (1) rivalry aggression is controlled by the medial amygdala; (2) predatory aggression is controlled by the central amygdala; (3) hypoarousal-associated violent aggression recruits both nuclei, (4) a specific upregulation of the medial amygdala was observed in hyperarousal-driven aggression. These patterns of amygdala activation were used to build four alternative models of the aggression circuitry, each being specific to particular forms of aggression. The separate study of the roles of amygdala subdivisions may not only improve our understanding of aggressive behavior, but also the differential control of aggression and violent behaviors of various types, including those associated with various psychopathologies.

Effects of maternal stress and perinatal fluoxetine exposure on behavioral outcomes of adult male offspring

Women of child-bearing age are the population group at highest risk for depression. In pregnant women, fluoxetine (Flx) is the most widely prescribed selective serotonin reuptake inhibitor (SSRI) used for the treatment of depression. While maternal stress, depression, and Flx exposure have been shown to effect neurodevelopment of the offspring, separately, combined effects of maternal stress and Flx exposure have not been extensively examined. The present study investigated the effects of prenatal maternal stress and perinatal exposure to the SSRI Flx on the behavior of male mice as adults.

METHODS

C57BL/6 dams exposed to chronic unpredictable stress from embryonic (E) day 4 to E18 and non-stressed dams were administered Flx (25 mg/kg/d) in the drinking water from E15 to postnatal day 12. A separate control group consisted of animals that were not exposed to stress or Flx. At 12 days of age, brain levels of serotonin were assessed in the male offspring. At two months of age, the male offspring of mothers exposed to prenatal stress (PS), perinatal Flx, PS and Flx, or neither PS or Flx, went through a comprehensive behavioral test battery. At the end of testing brain-derived neurotropic factor (BDNF) levels were assessed in the frontal cortex of the offspring.

RESULTS

Maternal behavior was not altered by either stress or Flx treatment. Treatment of the mother with Flx led to detectible Flx and NorFlx levels and lead to a decrease in serotonin levels in pup brains. In the adult male offspring, while perinatal exposure to Flx increased aggressive behavior, prenatal maternal stress decreased aggressive behavior. Interestingly, the combined effects of stress and Flx normalized aggressive behavior. Furthermore, perinatal Flx treatment led to a decrease in anxiety-like behavior in male offspring. PS led to hyperactivity and a decrease in BDNF levels in the frontal cortex regardless of Flx exposure. Neither maternal stress or Flx altered offspring performance in tests of cognitive abilities, memory, sensorimotor information processing, or risk assessment behaviors. These results demonstrate that maternal exposure to stress and Flx have a number of sustained effects on the male offspring.

Testosterone Modulates Altered Prefrontal Control of Emotional Actions in Psychopathic Offenders(1,2,3)

Psychopathic individuals are notorious for their controlled goal-directed aggressive behavior. Yet, during social challenges, they often show uncontrolled emotional behavior. Healthy individuals can control their social emotional behavior through anterior prefrontal cortex (aPFC) downregulation of neural activity in the amygdala, with testosterone modulating aPFC-amygdala coupling. This study tests whether individual differences in this neuroendocrine system relate to the paradoxical lack of emotional control observed in human psychopathic offenders. Emotional control was operationalized with an fMRI-adapted approach-avoidance task requiring rule-driven control over rapid emotional responses. Fifteen psychopathic offenders and 19 matched healthy control subjects made approaching and avoiding movements in response to emotional faces. Control of social emotional behavior was required during affect-incongruent trials, when participants had to override affect-congruent, automatic action tendencies and select the opposite response. Psychopathic offenders showed less control-related aPFC activity and aPFC-amygdala coupling during trials requiring control of emotional actions, when compared with healthy control subjects. This pattern was particularly pronounced in psychopathic individuals with high endogenous testosterone levels. These findings suggest that reduced prefrontal coordination underlies reduced behavioral control in psychopathic offenders during emotionally provoking situations. Even though the modest sample size warrants replication, the modulatory role of endogenous testosterone on the aPFC-amygdala circuit suggests a neurobiological substrate of individual differences that is relevant for the advancement of treatment and the reduction of recidivism.

Aggression and aspects of impulsivity in wild-type rats

Aggression is closely related to impulsive behavior both in humans and in animals. To avoid potential negative consequences, aggressive behavior is kept in control by strong inhibitory mechanisms. Failure of these inhibitory mechanisms results in violent behavior. In the present experiments, we investigated whether aggressive behavior is related to impulsive behavior. Furthermore, we investigated if violent behavior can be distinguished from "normal" aggressive behavior in terms of impulsivity levels. We used rats of the wild-type Groningen strain, rats of this strain differ widely in their level of offensive aggression expressed toward an unfamiliar intruder male, ranging from no aggression at all to very high levels of intense and sometimes violent behavior. Violent behavior was displayed by some of the animals that were given repeated winning experience. We used behavioral performance in an unpredictable operant conditioning paradigm for food reinforcement (variable interval 15) and performance in a differential-reinforcement of low rate (DRL-60s) responding as determinants for impulsivity. We predicted that offensive aggression is correlated with behavioral flexibility measured by the VI-15 procedure and that aggressive behavior is characterized by low behavioral inhibition on the DRL task. In addition we expected that violent animals would be characterized by extremely low levels of behavioral inhibition on the DRL task. We showed that the level of offensive aggression indeed positively correlated with VI-15 performance. In addition, we showed that behavioral performance on the DRL procedure is similar in low and high aggressive rats. However, violent animals can be dissociated by a lower efficiency of lever pressing on a DRL-60s schedule of reinforcement.

The Endurance of Uncertainty: Antisociality and Ontological Anarchy in British Psychiatry, 1950–2010

Research into the biological markers of pathology has long been a feature of British psychiatry. Such somatic indicators and associated features of mental disorder often intertwine with discourse on psychological and behavioral correlates and causes of mental ill-health. Disorders of sociality – particularly psychopathy and antisocial personality disorder – are important instances where the search for markers of pathology has a long history; research in this area has played an important role in shaping how mental health professionals understand the conditions. Here, I characterize the multiplicity of psychiatric praxis that has sought to define the mark of antisociality as a form of “ontological anarchy.” I regard this as an essential feature of the search for biological and other markers of an unstable referent, positing that uncertainties endure – in part – precisely because of attempts to build consensus regarding the ontology of antisociality through biomedical means. Such an account is suggestive of the co-production of biomarkers, mental disorder, and psychiatric institutions.

The glucocorticoid/aggression relationship in animals and humans: an analysis sensitive to behavioral characteristics, glucocorticoid secretion patterns, and neural mechanisms

Glucocorticoids control a wide array of biological processes from glucose homeostasis to neuronal function. The mechanisms mediating their effects are similarly varied and include rapid and transient nongenomic effects on calcium trafficking, various neurotransmitter receptors, and other membrane/cytoplasmic proteins, as well as slowly developing but durable genomic effects that are mediated by a large number of glucocorticoid-sensitive genes that are affected after variable lag-times. Given this complexity, we suggest that the aggression/glucocorticoid relationship cannot be reduced to the simple "stimulation/inhibition" question. Here, we review the effects of glucocorticoids on aggression by taking into account the complexities of glucocorticoid actions. Acute and chronic effects were differentiated because these are mediated by different mechanisms. The effects of chronic increases and decreases in glucocorticoid production were discussed separately, because the activation of mechanisms that are not normally activated and the loss of normal functions should not be confounded. Findings in healthy/normal subjects and those obtained in subjects that show abnormal forms of behavior or psychopathologies were also differentiated, because the effects of glucocorticoids are indirect, and largely depend on the properties of neurons they act upon, which are altered in subjects with psychopathologies. In addition, the conditions of glucocorticoid measurements were also thoroughly evaluated. Although the role of glucocorticoids in aggression is perceived as controversial by many investigators, a detailed analysis that is sensitive to glucocorticoid and behavioral measure as well as to the mediating mechanism suggests that this role is rather clear-cut; moreover, there is a marked similarity between animal and human findings.

The role of serotonin, vasopressin, and serotonin/vasopressin interactions in aggressive behavior

Aggression control has been investigated across species and is centrally mediated within various brain regions by several neural systems that interact at different levels. The debate over the degree to which any one system or region affects aggressive responding, or any behavior for that matter, in some senses is arbitrary considering the plastic and adaptive properties of the central nervous system. Nevertheless, from the reductionist point of view, the compartmentalization of evolutionarily maladaptive behaviors to specific regions and systems of the brain is necessary for the advancement of clinical treatments (e.g., pharmaceutical) and novel therapeutic methods (e.g., deep brain stimulation). The general purpose of this chapter is to examine the confluence of two such systems, and how their functional interaction affects aggressive behavior. Specifically, the influence of the serotonin (5HT) and arginine vasopressin (AVP) neural systems on the control of aggressive behavior will be examined individually and together to provide a context by which the understanding of aggression modulation can be expanded from seemingly parallel neuromodulatory mechanisms, to a single and highly interactive system of aggression control.

Revisiting the serotonin-aggression relation in humans: a meta-analysis

The inverse relation between serotonin and human aggression is often portrayed as "reliable," "strong," and "well established" despite decades of conflicting reports and widely recognized methodological limitations. In this systematic review and meta-analysis, we evaluate the evidence for and against the serotonin deficiency hypothesis of human aggression across 4 methods of assessing serotonin: (a) cerebrospinal fluid levels of 5-hydroxyindoleacetic acid (CSF 5-HIAA), (b) acute tryptophan depletion, (c) pharmacological challenge, and (d) endocrine challenge. Results across 175 independent samples and over 6,500 total participants were heterogeneous, but, in aggregate, revealed a small, inverse correlation between serotonin functioning and aggression, anger, and hostility (r = -.12). Pharmacological challenge studies had the largest mean weighted effect size (r = -.21), and CSF 5-HIAA studies had the smallest (r = -.06). Potential methodological and demographic moderators largely failed to account for variability in study outcomes. Notable exceptions included year of publication (effect sizes tended to diminish with time) and self- versus other-reported aggression (other-reported aggression was positively correlated to serotonin functioning). We discuss 4 possible explanations for the pattern of findings: unreliable measures, ambient correlational noise, an unidentified higher order interaction, and a selective serotonergic effect. Finally, we provide 4 recommendations for bringing much needed clarity to this important area of research: acknowledge contradictory findings and avoid selective reporting practices; focus on improving the reliability and validity of serotonin and aggression measures; test for interactions involving personality and/or environmental moderators; and revise the serotonin deficiency hypothesis to account for serotonin's functional complexity.

Excessive aggression as model of violence: a critical evaluation of current preclinical methods

RATIONALE

Preclinical experimental models of pathological aggressive behavior are a sorely understudied and difficult research area.

OBJECTIVES

How valid, reliable, productive, and informative are the most frequently used animal models of excessive aggressive behavior?

METHODS

The rationale, key methodological features, supporting data, and arguments as well as their disadvantages and limitations of the most frequently used animal models for excessive aggressive behavior are summarized and their validity and reliability are evaluated.

RESULTS

Excessive aggressive behavior is validly and reliably seen in (1) a proportion of feral-derived rats and selectively bred mice; (2) rats with compromised adrenal function resulting in a hypoglucocorticoid state; (3) a significant minority of mice, rats, and monkeys after consumption of a moderate dose of alcohol; and (4) resident animals of various species after social instigation. Limitations of these procedures include restrictive animal research regulations, the requirement of expertise in surgical, pharmacological, and behavioral techniques, and the behaviorally impoverished mouse strains that are used in molecular genetics research. Promising recent initiatives for novel experimental models include aggressive behaviors that are evoked by optogenetic stimulation and induced by the manipulation of early social experiences such as isolation rearing or social stress.

CONCLUSIONS

One of the most significant challenges for animal models of excessive, potentially abnormal aggressive behavior is the characterization of distinctive neurobiological mechanisms that differ from those governing species-typical aggressive behavior. Identifying novel targets for effective intervention requires increased understanding of the distinctive molecular, cellular, and circuit mechanisms for each type of abnormal aggressive behavior.

A review on the relationship between testosterone and life-course persistent antisocial behavior

Life-course persistent antisocial behavior is 10 to 14 times more prevalent in males and it has been suggested that testosterone levels could account for this gender bias. Preliminary studies with measures of fetal testosterone find inconsistent associations with antisocial behavior, especially studies that use the 2D:4D ratio as a proxy for fetal testosterone. However, circulating testosterone consistently shows positive associations with antisocial behaviors throughout childhood, adolescence, and adulthood, particularly in males. It is suggested that high fetal/circulating testosterone interactively influence the maturation and functionality of mesolimbic dopaminergic circuitry, right orbitofrontal cortex, and cortico-subcortical connectivity, resulting in a strong reward motivation, low social sensitivity, and dampened regulation of strong motivational/emotional processes. The link between these testosterone induced endophenotypes and actual display of antisocial behavior is strongly modulated by different social (e.g., social rejection, low SES) and genetic (e.g., MAOA, 5HTT) risk factors that can disturb socio-, psycho-, and biological development and interact with testosterone in shaping behavior. When these additional risk factors are present, the testosterone induced endophenotypes may increase the risk for a chronic antisocial lifestyle. However, behavioral endophenotypes induced by testosterone can also predispose towards socially adaptive traits such as a strong achievement motivation, leadership, fair bargaining behaviors, and social assertiveness. These adaptive traits are more likely to emerge when the high testosterone individual has positive social experiences that promote prosocial behaviors such as strong and secure attachments with his caregivers, affiliation with prosocial peers, and sufficient socioeconomic resources. A theoretical model is presented, various hypotheses are examined, and future venues for research are discussed.

Pre- and postsynaptic serotonergic differences in males with extreme levels of impulsive aggression without callous unemotional traits: a positron emission tomography study using (11)C-DASB and (11)C-MDL100907

BACKGROUND

Impulsive aggression (IA) in adults is associated with brain serotonin (5-HT) system abnormalities and is more common following childhood adversity. Within aggressive behavior, IA and callous unemotional (CU) traits are core components of differentiable factors with opposing 5-HT abnormalities. We aimed to investigate 5-HT abnormalities in IA and potential correlations with severity of childhood adversity while controlling for confounding 5-HT effects of high CU traits and mental disorders.

METHODS

Healthy male subjects (mean age 34 ± 9 years) without high CU traits were recruited with IA ratings in the high (n = 14) and low (n = 13) population extremes. Serotonin transporter (SERT) and 5-HT(2A) receptor availability was measured in multiple brain regions using positron emission tomography with (11)C-DASB and (11)C-MDL100907, respectively, and compared between high-IA and low-IA groups. Correlations were measured between SERT and 5-HT(2A) receptor availability, impulsivity and aggression, and childhood adversity.

RESULTS

Compared with the low-IA group, SERT were significantly higher in brainstem regions in the high-IA group (by 29.0% ± 11.4%) and modestly lower across cortical regions (by 11.1% ± 6.0%), whereas 5-HT(2A) receptors were also modestly lower (by 8.6% ± 4.0%). Across all subjects, brainstem SERT were significantly positively correlated with impulsivity, aggression, and childhood trauma ratings. Within the high-IA group, higher brainstem SERT was most strongly predicted by severity of childhood trauma (r = .76 in midbrain).

CONCLUSIONS

Pre-and postsynaptic 5-HT differences are present in men with high levels of IA and are strongly suggestive of a persisting effect of childhood adversity on serotonergic neurodevelopment and emotional-behavioral control.

The neuropsychology of prefrontal function in antisocial personality disordered offenders with varying degrees of psychopathy

BACKGROUND

Despite methodological differences between studies, it has been suggested that psychopathy may be associated with a ventromedial prefrontal cortex (VMPFC) deficit and antisocial personality disorder (ASPD), as classified in the DSM-IV, with a broader range of deficits in dorsolateral prefrontal cortex (DLPFC) and VMPFC function.

METHOD

Ninety-six male offenders with ASPD who were assessed using the psychopathy checklist: screening version (PCL:SV) and 49 male right-handed healthy controls (HCs), matched for age and IQ, completed a neuropsychological test battery.

RESULTS

Offenders with ASPD displayed subtle impairments on executive function tasks of planning ability and set shifting and behavioural inhibition compared to HCs. However, among the offenders with ASPD there was no significant association between executive function impairment and scores on the measure of psychopathy.

CONCLUSIONS

Psychopathic traits in offenders with ASPD are not associated with greater executive function impairment.

A review on the relationship between testosterone and the interpersonal/affective facet of psychopathy

Testosterone (T) has received increasing interest in the recent years as a probable biological determinant in the etiology of male-biased clinical conditions such as psychopathy (i.e. psychopathy is more prevalent in men and leads to an earlier onset and more severe expression of antisocial and aggressive behavior in men compared to women). In this review, the authors evaluated the potential relationship between T and different constructs closely related to the core characteristics of psychopathy (affective empathy, fear-reactivity, and instrumental aggression). After a thorough examination of the literature, it is concluded that high T exposure in utero and high circulating T levels throughout important life phases (most notably adolescence) or in response to social challenges (e.g. social stress, competition) could be an important etiological risk factor in the emergence of psychopathic behavior. Nevertheless, studies consistently indicate that high T is not related to a significantly reduced fear-reactivity and is only indirectly associated with the increased levels of instrumental aggression observed in psychopathic individuals. Therefore, psychopathy is likely to arise from an interaction between high T levels and other biological and socio-psychological risk factors, such as a constitutionally based dampened fear-reactivity, insecure/disordered attachment processes in childhood, and social discrimination/rejection in adolescence and/or adulthood.

Poor sleep as a potential causal factor in aggression and violence

Clinical observations suggest that sleep problems may be a causal factor in the development of reactive aggression and violence. In this review we give an overview of existing literature on the relation between poor sleep and aggression, irritability, and hostility. Correlational studies are supporting such a relationship. Although limited in number, some studies suggest that treatment of sleep disturbances reduces aggressiveness and problematic behavior. In line with this is the finding that sleep deprivation actually increases aggressive behavior in animals and angriness, short-temperedness, and the outward expression of aggressive impulses in humans. In most people poor sleep will not evoke actual physical aggression, but certain individuals, such as forensic psychiatric patients, may be particularly vulnerable to the emotional dysregulating effects of sleep disturbances. The relation between sleep problems and aggression may be mediated by the negative effect of sleep loss on prefrontal cortical functioning. This most likely contributes to loss of control over emotions, including loss of the regulation of aggressive impulses to context-appropriate behavior. Other potential contributing mechanisms connecting sleep problems to aggression and violence are most likely found within the central serotonergic and the hypothalamic-pituitary-adrenal-axis. Individual variation within these neurobiological systems may be responsible for amplified aggressive responses induced by sleep loss in certain individuals. It is of great importance to identify the individuals at risk, since recognition and adequate treatment of their sleep problems may reduce aggressive and violent incidents.

The effects of acute tryptophan depletion on costly information sampling: impulsivity or aversive processing?

RATIONALE

The neurotransmitter serotonin (5-HT) has been implicated in both aversive processing and impulsivity. Reconciling these accounts, recent studies have demonstrated that 5-HT is important for punishment-induced behavioural inhibition. These studies focused on situations where actions lead directly to punishments. However, decision-making often involves making tradeoffs between small 'local' costs and larger 'global' losses.

OBJECTIVE

We aimed to distinguish whether 5-HT promotes avoidance of local losses, global losses, or both, in contrast to an overall effect on reflection impulsivity. We further examined the influence of individual differences in sub-clinical depression, anxiety and impulsivity on global and local loss avoidance.

METHODS

Healthy volunteers (N = 21) underwent an acute tryptophan depletion procedure in a double-blind, placebo-controlled crossover design. We measured global and local loss avoidance in a decision-making task where subjects could sample information at a small cost to avoid making incorrect decisions, which resulted in large losses.

RESULTS

Tryptophan depletion removed the suppressive effects of small local costs on information sampling behaviour. Sub-clinical depressive symptoms produced effects on information sampling similar to (but independent from) those of tryptophan depletion. Dispositional anxiety was related to global loss avoidance. However, trait impulsivity was unrelated to information sampling.

CONCLUSIONS

The current findings are consistent with recent theoretical work that characterises 5-HT as pruning a tree of potential decisions, eliminating options expected to lead to aversive outcomes. Our results extend this account by proposing that 5-HT promotes reflexive avoidance of relatively immediate aversive outcomes, potentially at the expense of more globally construed future losses.

Effects of acute tryptophan depletion on prefrontal-amygdala connectivity while viewing facial signals of aggression

BACKGROUND

Reduced levels of serotonin (5-HT) within prefrontal cortex (PFC)-amygdala circuits have long been implicated in impulsive aggression. However, whether lowering 5-HT alters the dynamic interplay between the PFC and the amygdala has not been directly tested in humans. It is known that manipulating 5-HT via acute tryptophan depletion (ATD) causes variable effects on brain responses to a variety of emotional stimuli, but it remains unclear whether ATD affects functional connectivity in neural networks involved in processing social signals of aggression (e.g., angry faces).

METHODS

Thirty healthy individuals were enrolled in a randomized, double-blind, placebo-controlled ATD study. On each treatment, brain responses to angry, sad, and neutral faces were measured with functional magnetic resonance imaging. Two methods (psycho-physiological-interaction in a general linear model and dynamic causal modeling) were used to assess the impact of ATD on the functional connectivity between PFC and amygdala.

RESULTS

Data from 19 subjects were available for the final analyses. A whole-brain psycho-physiological-interaction in a general linear model showed that ATD significantly modulated the connectivity between the amygdala and two PFC regions (ventral anterior cingulate cortex and ventrolateral PFC) when processing angry vs. neutral and angry vs. sad but not sad vs. neutral faces. Dynamic causal modeling corroborated and extended these findings by showing that 5-HT depletion reduced the influence of processing angry vs. neutral faces on circuits within PFC and on PFC-amygdala pathways.

CONCLUSIONS

We provide strong support for neurobiological accounts positing that 5-HT significantly influences PFC-amygdala circuits implicated in aggression and other affective behaviors.

Genetic determinants of aggression and impulsivity in humans

Human aggression/impulsivity-related traits have a complex background that is greatly influenced by genetic and non-genetic factors. The relationship between aggression and anxiety is regulated by highly conserved brain regions including amygdala, which controls neural circuits triggering defensive, aggressive, or avoidant behavioral models. The dysfunction of neural circuits responsible for emotional control was shown to represent an etiological factor of violent behavior. In addition to the amygdala, these circuits also involve the anterior cingulated cortex and regions of the prefrontal cortex. Excessive reactivity in the amygdala coupled with inadequate prefrontal regulation serves to increase the likelihood of aggressive behavior. Developmental alterations in prefrontal-subcortical circuitry as well as neuromodulatory and hormonal abnormality appear to play a role. Imbalance in testosterone/serotonin and testosterone/cortisol ratios (e.g., increased testosterone levels and reduced cortisol levels) increases the propensity toward aggression because of reduced activation of the neural circuitry of impulse control and self-regulation. Serotonin facilitates prefrontal inhibition, and thus insufficient serotonergic activity can enhance aggression. Genetic predisposition to aggression appears to be deeply affected by the polymorphic genetic variants of the serotoninergic system that influences serotonin levels in the central and peripheral nervous system, biological effects of this hormone, and rate of serotonin production, synaptic release and degradation. Among these variants, functional polymorphisms in the monoamine oxidase A (MAOA) and serotonin transporter (5-HTT) may be of particular importance due to the relationship between these polymorphic variants and anatomical changes in the limbic system of aggressive people. Furthermore, functional variants of MAOA and 5-HTT are capable of mediating the influence of environmental factors on aggression-related traits. In this review, we consider genetic determinants of human aggression, with special emphasis on genes involved in serotonin and dopamine metabolism and function.

Eating psychopathology and personality in eating disorders

Summary

Objective - The question of how many psychopathologic factors are involved in Anorexia Nervosa (AN) and Bulimia Nervosa (BN) has no definite answer. The combination of psychopathology and personality research may shed a light upon the determinants of eating pathology. Methods - The study consists inthe administration of the Temperament and Character Inventory (TCI) and the Eating Disorder Inventory 2 (EDI-2) to 95 outpatient anorectic women (50 restrictive and 45 binge-purging) and to 92 bulimic outpatientwomen (78 with and 14 without purging behaviours). The respective scores of each DCA subgroup are compared. Results - Restricter anorectics are characterised by lower novelty seeking on respect to all the other groups and by a higher self-directedness on respect to bingeing-purging anorectics and purging bulimics. Alsopsychopathologic differences between restricter anorectics and the other groups are extensive. Bingeing-purging anorexia shares many traits with bulimia. Conclusions - In their complex, data suggest and in-deep study aimed to a possible re-classification of EDs which would take impulsiveness in greater consideration. The differences in temperament and character traits may partially be responsible of the repression or discontrol of impulsive eating behaviours in different ED subtypes.

Declaration of Interest

Authors received grants and research support from Regione Piemonte (Project no. 19701/27001).

Genital self mutilation in alcohol withdrawal state complicated with delirium

Genital self mutilation is a rare and a severe form of self-injurious behavior usually described in psychotic disorders, with delusions and hallucinations. It has been ascribed to sexual conflicts, Body image distortions, Internalized aggression, and suicidal intent. This phenomenon has been described in schizophrenia, affective psychosis, alcohol intoxication, and personality disorders. The present case genital self mutilation in a case of alcohol withdrawal state complicated by delirium is reported.

Support for religio-political aggression among teenaged boys in Gaza: part II: neuroendocrinological findings

Hormones seem to play important roles in the regulation of human aggression. Multiple studies have confirmed that testosterone (T) levels exhibit complex relationships with aggression, dominance, and/or risk-taking behavior. Some evidence suggests that cortisol (CORT) interacts with T and may also be associated with aspects of mood and aggression. However, almost no research to date has investigated the possibility that these neuroendocrine factors are associated with variations in political attitudes or with political aggression. During the second intifada, we tested the hypothesis that morning salivary T and/or salivary CORT levels might be associated with self-rated aggression or with support for religio-political aggression (RPA) among 14-year-old Palestinian boys living in Gaza. We obtained and averaged weekly 09:00 hr salivary measures of T and CORT for more than 1 month. Averaged morning T levels did not correlate with self-rated aggression, but were positively associated with agreement with the statement "religious ends justify any means," (r = .355, P = .014) and marginally associated with a composite measure of support for RPA (r = .247, P = .094). Average CORT levels were inversely correlated with self-rated aggression (r = -.328, P = .037) and with anger (r = -.373, P = .016), but CORT levels were not associated with support for RPA or with the statement "religious ends justify any means." Acknowledging that a modest sample size and methodological issues necessarily limit confidence in our conclusions, these results may represent the first findings regarding neurobiological correlates of support for political aggression.

Cortisol responses to ipsapirone challenge correlate with aggression, while basal cortisol levels correlate with impulsivity, in personality disorder and healthy volunteer subjects

BACKGROUND

This study was performed to test the hypothesis that 5-HT-1a receptors, as assessed by the cortisol (post-synaptic) and temperature (pre-synaptic) responses to the 5-HT-1a agonist, Ipsapirone (IPSAP), play a role in the regulation of impulsive aggressive behavior in human subjects.

METHODS

Fifty-two healthy subjects (28 with Personality Disorder: PD; 24 Healthy Volunteers: HV) underwent acute challenge with the selective 5-HT-1a agonist, ipsaprione (IPSAP: .3 mg/kg po). Residual Peak Delta Cortisol (ΔCORT[IPSAP]-R; after removal of Basal CORT and IPSAP plasma levels) was used as the primary 5-HT-1a post-synaptic receptor variable. Residual Nadir Delta Temperature (ΔTEMP[IPSAP]-R; after removal of Basal TEMP) was used as the primary 5-HT-1a somatodendritic (pre-synaptic) receptor variable. Measures of trait aggression included the Aggression scales of the Buss-Durkee Hostility Inventory (BDHI) and the Life History of Aggression (LHA); trait impulsivity was assessed with the Impulsivity scale of the Eysenck Personality Questionnaire (EPQ-II).

RESULTS

Correlations between ΔCORT[IPSAP]-R responses and BDHI Aggression scores varied by group. Specifically, BDHI Aggression correlated inversely with ΔCORT[IPSAP]-R values in PD subjects but directly in HV subjects. While EPQ-II Impulsivity did not correlate with ΔCORT[IPSAP]-R responses, this measure of impulsivity correlated directly with Basal CORT levels in all subjects. ΔTEMP[IPSAP]-R responses did not correlate with measures of trait aggression or trait impulsivity.

CONCLUSION

Physiologic responses of 5-HT-1a post-synaptic receptors may be reduced as a function of trait aggression, but not impulsivity, in PD subjects. In contrast, pre-synaptic 5-HT-1a receptors may not play a role in the regulation of aggression or impulsivity in human subjects.

Psychopathic personality traits and cortisol response to stress: the role of sex, type of stressor, and menstrual phase

Previous research indicates that psychopathic personality traits are associated with lower cortisol secretion in response to stress in men but not in women. The current study explored whether prior null results for women were related to the latency of the cortisol stress response to two different types of stressors. Additionally, accuracy of self-reported menstrual phase was explored via salivary progesterone levels. A mixed-sex sample of 145 participants characterized by high (36 men, 37 women) and low (34 men, 38 women) scores on a screening measure of psychopathic personality traits were randomly assigned to either a performance-based stressor task or a social rejection stressor task. Salivary hormone samples were taken just prior to task onset (baseline) and at 0, 20, 40, and 60 min post-stressor. Results indicated that both men and women characterized by psychopathic personality traits exhibited lower stress-induced cortisol levels to the performance-based task in comparison with controls at 20 min post-stressor. The social rejection task produced a cortisol response 20 min post-stressor in the male controls only. Removal of women with low progesterone from the analyses strengthened the psychopathy group differences. Results could suggest that deficient cortisol production in response to stress might be another important neurobiological feature associated with psychopathic traits, and that biological verification of menstrual phase is an important aspect to obtaining accurate cortisol results in women.

What imaging tells us about violence in anti-social men

This paper provides an overview of imaging studies in samples of men with personality disorder (PD) who have been violent. Mention is also made of the work of two groups that have looked at the neural correlates of violence across diagnostic categories, including schizophrenia and anti-social PD given their relevance in the field. The paper focuses on the notion that aggressive behaviour can be conceptualised in terms of at least two types, reactive and pro-active, and that few studies separate them. The neuro-anatomical basis of aggression and associated neurobehavioural theories are discussed in relation to clinical disorders (mainly anti-social personality pathology) associated with these different types of aggressive behaviour. Structural (computed tomography, magnetic resonance imaging) and functional (positron emission tomography, fMRI, single-photon emission tomography) studies with violent people variously characterised as anti-social or having psychopathy will be critically reviewed.

Risk-taking behavior in a gambling task associated with variations in the tryptophan hydroxylase 2 gene: relevance to psychiatric disorders

Decision making, choosing the best option from the possible outcomes, is impaired in many psychiatric conditions including affective disorders. We tested the hypothesis that variations in serotonergic genes (TPH2, TPH1, SLC6A4, HTR1A), which influence serotonin availability, affect choice behavior in a probabilistic gambling task. A population cohort (N=1035) completed a paper-and-pencil gambling task, filled out personality and symptom questionnaires and gave consent for the use of their DNA in a genetic association study. A subgroup of subjects (N=69) also completed a computer version of the task. The gambling task was designed to estimate an individual's tendency to take a risk when choosing between a smaller but more certain 'win' and a larger, less probable one. We genotyped seven haplotype tagging SNPs in the TPH2 gene, and previously reported functional polymorphisms from the other genes (rs1800532, 5HTTLPR, and rs6295). Carriers of the more prevalent TPH2 haplotype, which was previously associated with less active enzyme variant, showed reduced risk taking on both tasks compared with subjects not carrying the common haplotype. The effect of TPH2 haplotypes on risk-taking was independent of current depression and anxiety symptoms, neuroticism and impulsiveness scores. We did not find an association between functional polymorphisms in the TPH1, SLC6A4, HTR1A genes and risk-taking behavior. In conclusion, our study demonstrates the role of the TPH2 gene and the serotonin system in risk taking and suggests that TPH2 gene may contribute to the expression of psychiatric phenotypes through altered decision making.

Is desire for social relationships mediated by the serotonergic system in the prefrontal cortex? An [(18)F]setoperone PET study

Social behavior and desire for social relationships have been independently linked to the serotonergic system, the prefrontal cortex, especially the orbitofrontal cortex (OFC), and the anterior cingulate cortex (ACC). The goal of this study was to explore the role of serotonin 5HT(2A) receptors in these brain regions in forming and maintaining close interpersonal relationships. Twenty-four healthy subjects completed the Temperament and Character Inventory (TCI) prior to undergoing [(18)F]setoperone brain positron emission tomography (PET) to measure serotonin 5HT(2A) receptor availability within the OFC (BA 11 and 47) and ACC (BA 32). We explored the relationship between desire for social relationships, as measured by the TCI reward dependence (RD) scale, and 5HT(2A) receptor non-displaceable binding potential (BP(nd)) in these regions. Scores of RD were negatively correlated with 5HT(2A) BP(nd) in the ACC (BA 32, r = -.528, p = .012) and OFC (BA 11, r = -.489, p = .021; BA 47, r = -.501, p = .017). These correlations were corroborated by a voxel-wise analysis. These results suggest that the serotonergic system may have a regulatory effect on the OFC and ACC for establishing and maintaining social relationships.

Neuronal correlates and serotonergic modulation of behavioural inhibition and reward in healthy and antisocial individuals

Individuals with antisocial personality disorder (ASPD) are impulsive and show impairment in reinforcement processing. There is increasing evidence for a neurobiological basis of psychopathy, which shares some of the characteristics of ASPD, but research on the neuronal correlates of neuropsychological processes in ASPD remains limited. Furthermore, no research has examined the effects of serotonergic manipulation on brain activations in antisocial groups. In this study, 25 male participants with ASPD (mean age 42.1) and 32 male control participants (mean age 30.5; 25 participants providing usable scans) were randomly allocated to receive the 5-HT(2C)-agonist mCPP or placebo. Participants were scanned using functional magnetic resonance imaging (fMRI) during a behavioural inhibition (Go/NoGo) and a reward task. In comparison to healthy controls the ASPD group showed reduced task related activations in the dorsolateral prefrontal cortex (DLPFC) but increased signal in the pre/subgenual anterior cingulate cortex (ACC) in the Go/No-Go task and increased activation in OFC in the reward task. mCPP modulated brain responses in both tasks in the whole group. Interactions between group and drug occured in bilateral OFC, caudate and ventral pallidum during the reward task but no significant interactions were found in the Go/No-Go task. This suggests that ASPD involves altered serotonin modulation of reward, but not motor inhibition pathways. These findings suggest that ASPD involves altered DLPFC, ACC and OFC function. Altered serotonergic modulation of reward pathways seen in the ASPD group raises the possibility that targeting serotonin systems may be therapeutic.

Platelet poor plasma serotonin level in delinquent adolescents diagnosed with conduct disorder

OBJECTIVE

Accumulating data indicate the involvement of the serotonergic system in adolescent aggression. The aim of this study was to examine the platelet-poor plasma (PPP) serotonin (5-HT) levels among delinquent adolescent boys with conduct disorder (CD) in comparison with normal controls.

METHOD

PPP 5-HT levels were measured in 16 male delinquent CD adolescents from a correctional facility and in 14 normal male adolescent controls. Severity of aggressive behavior was assessed by the Child Behavior Checklist (CBCL) and the Overt Aggression Scale (OAS).

RESULTS

Delinquent CD adolescents had higher PPP 5-HT levels (about 3-fold) than the normal controls (27.68+/-32.29 vs. 7.76+/-4.23 ng/ml, respectively, p=0.027). In the delinquent CD adolescents a significant correlation was found between the PPP 5-HT levels and the CBCL and OAS aggressive scores (r=0.68, p=0.0034 and r=0.59, p=0.016, respectively).

CONCLUSIONS

Juvenile delinquency is associated with high PPP 5-HT levels. Modulation of 5-HT neurotransmission may have a role in the symptomatology and treatment of severe adolescent CD.

Dysfunctional, but not functional, impulsivity is associated with a history of seriously violent behaviour and reduced orbitofrontal and hippocampal volumes in schizophrenia

Aggression and violent acts have been linked with impulsive responding. We investigated whether impulsive personality trait, especially suggestive of dysfunctional impulsivity (i.e. fast and inaccurate responding where this is non-optimal), is associated with a history of seriously violent behaviour and specific brain deficits in schizophrenia. Twenty-four male participants with schizophrenia, of whom 10 had a history of serious physical violence, and 14 healthy male participants were assessed on impulsiveness (dysfunctional impulsivity), venturesomeness (functional impulsivity), and empathy. All participants underwent magnetic resonance imaging. The results revealed that participants with schizophrenia and a history of violence showed elevated impulsiveness but had comparable scores on venturesomeness and empathy dimensions. Impulsiveness scores correlated negatively with reduced orbitofrontal grey matter volume in both the patient and healthy control groups, and with hippocampal volume in the patient group. Our findings suggest that dysfunctional, but not functional, impulsivity is elevated in patients with schizophrenia with a propensity for repetitive violence, and this in turn appears to be associated with reduce volumes of both the orbitofrontal cortex grey matter and the hippocampus. Violence risk prediction and management strategies in schizophrenia may benefit from including specific measures of dysfunctional impulsive traits.