The interaction of psychosocial adversity and biological risk in childhood aggression

Division of Child and Adolescent Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA.
Psychiatry Research (Impact Factor: 2.47). 07/2007; 151(3):221-30. DOI: 10.1016/j.psychres.2006.07.010
Source: PubMed


Childhood aggression has both biological and environmental underpinnings. However, the manner in which these factors interact to influence various types of aggression remains an important area of study. The current study examined the degree to which biological risk and psychosocial adversity, both alone and in combination, are associated with childhood aggression. Linear regression procedures were used to assess the extent to which biological risk status (low vs. high serotonergic responsivity, as measured by prolactin response to fenfluramine), magnitude of psychosocial risk, and the interaction of these factors predicted parent and teacher ratings of aggression and delinquency. After accounting for the independent contribution of biological and psychosocial risk, the interaction of biological and psychosocial risk was significantly associated with parent-rated aggression and marginally related to parent-rated delinquency. In contrast, no such interaction was observed for teacher-rated aggression. Findings suggest that individuals at biological risk for aggression may be particularly vulnerable to the impact of psychosocial adversity.

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    • "Insufficient serotonergic facilitation of 'top-down' control including the 5-hydroxytryptamine 2A receptors (Coccaro et al., 1997; Krakowski et al., 2006) and 5-HT 2C receptors (Winstanley et al., 2004), catecholaminergic stimulation, the gamma aminobutyric acid (GABA)-glutaminergic system (Lieving et al., 2008) and pathology in neuropeptide systems (Coccaro et al., 1998; Kirsch et al., 2005; Coccaro et al., 2007a,b; Hermans et al., 2008; Ditzen et al., 2009) may contribute to this. Heredity contributes substantially to impulsive aggression (Beitchman et al., 2006; Marks et al., 2007; Mann et al., 2009). In most hypotheses, low cholesterol is related to low serotonin and, in turn, linked to violence, suicidal behaviour and impulsivity (Siever, 2008). "
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    ABSTRACT: Cross-sectional studies have reported an association between lipids and serotonin levels and aggression, but a literature search revealed a paucity of prospective studies. Subjects of the present naturalistic study were 254 of all (489) involuntary and voluntary acutely admitted patients to a psychiatric hospital during 1year. Serum lipids and platelet serotonin at admission were prospectively compared with recorded intra-institutional and 1-year post-discharge violence and self-harm. Total cholesterol had a significant negative relationship to inpatient suicidal behaviour and inpatient violent behaviour and to 3-month post-discharge violent behaviour. Triglycerides were a significant marker of inpatient self-mutilation and of self-mutilation in combination with suicidal behaviour at 3 and 12 months of follow-up. High-density lipoprotein (HDL) had a significant negative relationship to violence at 12-months, and to repeated violence in seven patients with two or more admissions. The post-discharge relationships between total cholesterol and violence and between triglycerides and self-harm remained significant even when controlling for other possible explanatory variables in a multivariate model. Results did not change after controlling for current medication at admission. There was no association between platelet serotonin and violence or self-harm. Future research may examine if lipid measurements add incremental validity to established clinical risk assessment procedures of violent and self-harm behaviour.
    Psychiatry Research 04/2011; 186(2-3):293-9. DOI:10.1016/j.psychres.2010.07.029 · 2.47 Impact Factor
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    ABSTRACT: Acts of violence account for an estimated 1.43 million deaths worldwide annually. While violence can occur in many contexts, individual acts of aggression account for the majority of instances. In some individuals, repetitive acts of aggression are grounded in an underlying neurobiological susceptibility that is just beginning to be understood. The failure of "top-down" control systems in the prefrontal cortex to modulate aggressive acts that are triggered by anger provoking stimuli appears to play an important role. An imbalance between prefrontal regulatory influences and hyper-responsivity of the amygdala and other limbic regions involved in affective evaluation are implicated. Insufficient serotonergic facilitation of "top-down" control, excessive catecholaminergic stimulation, and subcortical imbalances of glutamatergic/gabaminergic systems as well as pathology in neuropeptide systems involved in the regulation of affiliative behavior may contribute to abnormalities in this circuitry. Thus, pharmacological interventions such as mood stabilizers, which dampen limbic irritability, or selective serotonin reuptake inhibitors (SSRIs), which may enhance "top-down" control, as well as psychosocial interventions to develop alternative coping skills and reinforce reflective delays may be therapeutic.
    American Journal of Psychiatry 05/2008; 165(4):429-42. DOI:10.1176/appi.ajp.2008.07111774 · 12.30 Impact Factor
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    ABSTRACT: The prognosis for individuals diagnosed with attention deficit hyperactivity disorder (ADHD) and comorbid aggression is substantially worse than for those with ADHD alone. This study investigates the contribution of key psychosocial factors to both parent and teacher reports of aggressive behaviour in children and adolescents diagnosed with ADHD. It was hypothesized that greater impairment in each would be associated with higher levels of both parent-rated and teacher-rated aggression. Information collected during semi-structured clinical interviews from 676 boys and girls aged 6 to 16 and diagnosed with ADHD was analysed. Measures of potential psychosocial factors including parental psychopathology, family functioning, marital relationship quality and child interpersonal relationship status were administered. Ratings of aggression were obtained from both parents and teachers, and the association of psychosocial measures for each were separately analysed. Correlation and multiple regression analyses revealed significant associations between parent-rated aggression and measures of increased parent psychopathology, decreased family function and deficient child interpersonal relationships. Teacher-rated aggression was only associated with deficient child interpersonal relationships. The findings highlight important differences in the psychosocial factors that contribute to parent and teacher ratings of aggression in the context of ADHD. The implications of these findings for both the clinician and researcher are discussed.
    Australian and New Zealand Journal of Psychiatry 07/2010; 44(7):667-75. DOI:10.3109/00048671003664697 · 3.41 Impact Factor
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