Understanding Brain Mechanisms of Reactive Aggression Bertsch, Katja; Florange, Julian; Herpertz, Sabine C.
Current psycchiatry reports/Current psychiatry reports,
12/2020, Letnik:
22, Številka:
12
Journal Article
Recenzirano
Odprti dostop
Purpose of Review
To review the current literature on biobehavioral mechanisms involved in reactive aggression in a transdiagnostic approach.
Recent Findings
Aggressive reactions are closely related ...to activations in the brain’s threat circuitry. They occur in response to social threat that is experienced as inescapable, which, in turn, facilitates angry approach rather than fearful avoidance. Provocation-induced aggression is strongly associated with anger and deficits in cognitive control including emotion regulation and inhibitory control. Furthermore, the brain’s reward system plays a particular role in anger-related, tit-for-tat-like retaliatory aggression in response to frustration. More research is needed to further disentangle specific brain responses to social threat, provocation, and frustration.
Summary
A better understanding of the psychological and neurobiological mechanisms involved in reactive aggression may pave the way for specific mechanism-based treatments, involving biological or psychotherapeutic approaches or a combination of the two.
Purpose of Review
Childhood trauma is an important risk factor for the development of personality disorders (PDs), yet most research has been devoted to categorical models of personality pathology. ...Considering the introduction of a dimensional PD model with ICD-11, we review current findings related to various forms of childhood trauma, and PDs, operationalized in the form of personality functioning and maladaptive traits. We focus on the magnitude of associations and examine specific relationships between emotional and physical trauma with areas of personality functioning and single traits.
Recent Findings
Two studies showed a strong association between childhood trauma and personality dysfunction. Seven studies, including clinical and forensic samples, demonstrated heterogeneous associations between various forms of childhood trauma and maladaptive traits. Overall, four studies indicated a slightly stronger association between personality dysfunction, maladaptive trait expression, and higher levels of emotional trauma than for physical or sexual trauma. Regarding specific trait domains and childhood trauma, most studies yielded the strongest associations for either psychoticism or detachment.
Summary
Research on childhood trauma and dimensional PD models (i.e., personality functioning and traits) has the potential to contribute to a better understanding of their complex relationship. However, high intercorrelations among different types of childhood trauma, areas of personality functioning, and trait domains increase the difficulty of disentangling single effects. More research is needed including clinical and non-Western samples, especially considering the upcoming ICD-11 classification.
Interoceptive accuracy (IAc), that is, the ability to accurately perceive one's own bodily signals, is widely assumed to be a trait, although experimental manipulations such as stress may affect IAc. ...We used structural equation modeling to estimate the reliability of IAc, and the proportions of individual differences in IAc, explained by a trait and occasion‐specific effects of situation and person‐situation interactions. We assessed IAc in 59 healthy participants (40 women, MAge = 23.4 years) on three consecutive measurement occasions, approximately 1 week apart, in a rest and poststress condition, using a heartbeat counting and a heartbeat discrimination task. The results showed fair temporal stability (intraclass correlation coefficients ≥ 0.38) and good reliability (Mdn = .63; range .49–.83) for both methods. While around 40% of the variance of a single IAc measurement could be explained by a trait, approximately 27% was accounted for by occasion‐specific effects of situation and person‐situation interaction. These results suggest that IAc measures are relatively consistent and that situations and person‐situation interactions impact IAc as measured at a certain point in time. An aggregation across at least two measurements is recommended when using IAc as a trait variable.
Childhood maltreatment, specifically during sensitive developmental periods, is a major risk factor for poor physical and mental health. Despite its enormous clinical relevance, there is still a lack ...of scales measuring different types, timing, and duration of childhood maltreatment. The current study sought to validate and determine the psychometric properties of the brief German version of the Maltreatment and Abuse Chronology of Exposure (MACE) scale, the KERF-40. The KERF-40 was administered as an interview (i.e., KERF-40-I) to 287 adult participants with and without mental disorders. Based on item response theory, items of the KERF-40-I were assigned to different types of maltreatment, resulting in a scaled version, the KERF-40+. Test-retest reliability was assessed in a small subsample (n = 14). Convergent and relative predictive validity were measured with correlations of the KERF-40+ and the Childhood Trauma Questionnaire (CTQ) as well as self-report measures of general and trauma-related psychopathology. Rasch analysis and fit statistics yielded a 49-item version, encompassing ten different types of maltreatment. The test-retest reliability of the KERF-40+ was shown to be acceptable to excellent for almost all global and subscale scores (.74 less than or equal to rho less than or equal to 1.00), with the exception of the subscale emotional neglect (rho = .55). Convergent validity with the CTQ was confirmed for both KERF-40+ global scores (.72 less than or equal to r less than or equal to .87) and corresponding subscale scores (.56 less than or equal to r less than or equal to .78). Relative predictive validity was reflected by significant small-to-moderate correlations between KERF-40+ global scores and indices of general and trauma-related psychopathology (.24 less than or equal to r less than or equal to .45). Taken together, the KERF-40+ appears to be suited for clinicians and researchers interested in retrospectively assessing different types, timing, and duration of childhood maltreatment experiences during sensitive periods in adults.
Threats can derive from our physical or social surroundings and bias the way we perceive and interpret a given situation. They can be signaled by peers through facial expressions, as expressed anger ...or fear can represent the source of perceived threat. The current study seeks to investigate enhanced attentional state and defensive reflexes associated with contextual threat induced through aversive sounds presented in an emotion recognition paradigm. In a sample of 120 healthy participants, response and gaze behavior revealed differences in perceiving emotional facial expressions between threat and safety conditions: Responses were slower under threat and less accurate. Happy and neutral facial expressions were classified correctly more often in a safety context and misclassified more often as fearful under threat. This unidirectional misclassification suggests that threat applies a negative filter to the perception of neutral and positive information. Eye movements were initiated later under threat, but fixation changes were more frequent and dwell times shorter compared to a safety context. These findings demonstrate that such experimental paradigms are capable of providing insight into how context alters emotion processing at cognitive, physiological, and behavioral levels. Such alterations may derive from evolutionary adaptations necessary for biasing cognitive processing to survive disadvantageous situations. This perspective sets up new testable hypotheses regarding how such levels of explanation may be dysfunctional in patient populations.
Heart rate variability (HRV) is a measure of autonomic influences on heart rate that has frequently been used as a transsituationally consistent biomarker for cardiovascular health and emotional or ...cognitive functions. The psychometric properties of HRV however remain unclear. In the present study, we examined the reliability and temporal stability of parasympathetic HRV measures and estimated the portion of variance explained by transsituationally consistent trait variance and by effects of the situation and person–situation interaction with structural equation modeling. The results show good reliability of indices reflecting central parasympathetic control over heart rate and that about 40% of the variance of a single HRV measurement can be explained by effects of the situation and person–situation interaction. An aggregation across at least two measurements may be recommended when using HRV as a transsituationally consistent biomarker or trait.
•We investigated predictors of interoceptive accuracy in heartbeat counting (IAcHBCT).•IAc in the heartbeat discrimination task was the most stable predictor of IAcHBCT.•Indicators of cardiac signal ...properties were largely unrelated to IAcHBCT.•Time estimation accuracy did not predict IAcHBCT.•These findings may support the convergent and discriminant validity of IAcHBCT scores.
Interoceptive accuracy (IAcc) as assessed with the heartbeat counting task (IAccHBCT) may be affected by a range of factors including (1.) the ability to adequately detect cardiac signals, indicated by IAcc in a heartbeat discrimination task (IAccHBDT), (2.) cardiac signal properties, affected by sympathetic and parasympathetic tone, and (3.) non-interoceptive processes, including time estimation accuracy (TEAcc). In the current study we investigated the contribution of these factors to absolute and Δ IAccHBCT scores, induced by passive head-up and head-down tilt in 49 healthy individuals. A set of hierarchical regression models showed IAccHBDT scores as the strongest and, across different orthostatic (tilt) conditions, most stable (positive) predictor of absolute and Δ IAccHBCT scores. Neither indicators of cardiac signal properties (except for HR in head-down-tilt), nor TEAcc predicted absolute or Δ IAccHBCT scores. These findings support the convergent and discriminant validity of absolute and Δ IAccHBCT scores.
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013, includes an alternative model of personality disorders (AMPD) focusing on a maladaptive ...trait model utilized to diagnose several personality disorders. Borderline personality disorder (BPD) and antisocial personality disorder (ASPD) are two conditions categorized by AMPD that exhibit high rates of violence and aggression. Several of the traits outlined in the AMPD, including hostility, impulsivity, risk-taking, and callousness, have been previously linked to aggression in BPD and ASPD. However, to the best of our knowledge, there has never been a synthesis of neuroimaging studies that have investigated links between these traits and aggression in BPD and ASPD. To overcome this gap, we conducted a systematic review under the PRISMA framework to locate neuroimaging articles published since the release of AMPD linking trait anger/hostility, impulsivity, risk-taking, and callousness to aggression in BPD and ASPD. Key findings included the following: i) anger/hostility, associated with alterations in the interplay between prefrontal and subcortical regions (primarily the amygdala), may be a common factor explaining aggressive reactions to response to interpersonal threat or provocation; ii) alterations of fronto-temporal-limbic regions and serotonergic and endocannabinoid signaling systems may link impulsivity to aggression in BPD and ASPD; iii) weaker cortico-striatal connectivity could relate to greater risk taking and greater proclivity for violence. Insufficient evidence from neuroimaging articles was discerned to describe a relationship between callousness and aggression. Overall, results of this review reveal a relative paucity of neuroimaging studies examining AMPD traits relevant to aggression in BPD and ASPD. In addition to encouraging further investigation of neuroimaging markers of AMPD traits linked to aggression, we recommend multi-methodological designs, including the incorporation of other biomarkers, such as hormones and indices of physiological arousal, to fully expand our understanding of aggression in BPD and ASPD.
Early life maltreatment (ELM) is the major single risk factor for impairments in social functioning and mental health in adulthood. One of the most prevalent and most rapidly increasing forms of ELM ...is emotional neglect. According to bio-behavioral synchrony assumptions, the oxytocin and attachment systems play an important mediating role in the interplay between emotional neglect and social dysfunctioning. Therefore, the aim of the present study was to investigate whether fear and avoidance of social functioning, two important and highly prevalent facets of social dysfunctioning in adulthood, are shaped by emotional neglect, plasma oxytocin levels and attachment representations. We assessed emotional neglect as well as other forms of ELM with the Childhood Trauma Questionnaire, current attachment representations with the Adult Attachment Projective Picture System, and fear and avoidance of social situations with the Liebowitz Social Anxiety Scale in a population-based sample of N = 121 men and women. Furthermore, 4.9 ml blood samples were drawn from each participant to assess peripheral plasma oxytocin levels.
Applying a sequential mediation model, results revealed that emotional neglect was associated with lower plasma oxytocin levels which in turn were associated with insecure attachment representations which were related to elevated fear and avoidance of social situations (a1d21b2: F3,117 = 20.84, P < .001). Plasma oxytocin and current attachment representations hence fully and sequentially mediate the effects of emotional neglect on social fear and avoidance, two important facets of adult social dysfunctioning, confirming bio-behavioral synchrony assumptions.
•Emotional neglect is a frequent form of early life maltreatment with major impact on social functioning in adulthood.•Emotional neglect in childhood influences fear and avoidance of social situations, two important facets of social dysfunctioning, via plasma oxytocin levels and attachment representations even after controlling for other forms of early life maltreatment.•In line with bio-behavioral synchrony assumptions, the findings support the relevance of the oxytocin and attachment system in the interplay between early emotional experiences and later social functioning.
Purpose of Review
This review article aims at giving an update on studies investigating correlates of aggression in personality disorders during the last 5 years.
Recent Findings
Most data refer to ...borderline personality disorder (BPD) and antisocial personality disorder (ASPD). In BPD, emotion dysregulation, hypersensitivity to interpersonal rejection/threat, increased rumination, increased negative urgency, aggression-related knowledge structures, and invalidation were either corroborated or emerged as psychological correlates of aggression, while reduced ambiguity sensitivity, hyposensitivity to interpersonal threat, and reduced mindfulness were associated with aggression in ASPD. Neurobiologically, alterations of the monoaminooxidase-A-, the oxytocinergic-, and the prefrontal-limbic-system as well as increases of the thyroid hormone T3, γ-aminobutyric acid and several inflammatory markers were associated with increased aggression across various personality disorders.
Summary
Our understanding of correlates of aggression in personality disorders has increased over the last 5 years. More efforts in improving the conceptualization of personality disorders and aggression are needed to develop innovative treatments for those affected.
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