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Translational Psychiatry Oct 2023The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013, includes an alternative model of personality disorders (AMPD)...
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.
Topics: Humans; Aggression; Anger; Antisocial Personality Disorder; Borderline Personality Disorder; Diagnostic and Statistical Manual of Mental Disorders
PubMed: 37884552
DOI: 10.1038/s41398-023-02612-1 -
Clinical Child and Family Psychology... Dec 2023Understanding and treatment of antisocial behavior have improved through efforts to subtype individuals based on similar risk factors and outcomes. In particular, the...
Understanding and treatment of antisocial behavior have improved through efforts to subtype individuals based on similar risk factors and outcomes. In particular, the presence of psychopathic traits is associated with distinct etiological factors and antisocial behavior that begins early in life, is aggressive, persistent, and less likely to normalize with traditional treatments, relative to individuals low on psychopathy or its childhood precursor, callous-unemotional (CU) traits. However, important distinctions can be made within individuals with CU/psychopathic traits according to the presence of elevated anxiety symptoms and/or adverse childhood experiences, known as secondary psychopathy/CU traits. This paper provides a broad and brief overview of theory and empirical literature supporting the existence of secondary psychopathy/CU variants as a distinct subtype of childhood antisocial behavior. It outlines the Emotionally Sensitive Child-Adverse Parenting Experiences-Allostatic (Over)Load (ESCAPE-AL) model for the developmental psychopathology of secondary psychopathic/CU traits and discusses research and theory supporting this perspective. Future research directions for testing this conceptual model and its implications for assessing and treating high-risk individuals with secondary CU/psychopathic traits are discussed.
Topics: Humans; Parenting; Conduct Disorder; Aggression; Antisocial Personality Disorder; Anxiety; Emotions
PubMed: 37735279
DOI: 10.1007/s10567-023-00455-2 -
Child Abuse & Neglect Jul 2023Adverse Childhood Experiences (ACE) are associated with many deleterious outcomes in young offenders. There is a dearth of studies examining its effects on young...
BACKGROUND
Adverse Childhood Experiences (ACE) are associated with many deleterious outcomes in young offenders. There is a dearth of studies examining its effects on young offenders' antisocial attitudes, disruptive behaviors and aggression, risk factors for delinquency and reoffending.
OBJECTIVE
This study examined ACE patterns and their association with the above factors in young offenders.
PARTICIPANTS AND SETTING
1130 youth offenders (964 males; M = 17.57 years), provided self-reports on ACEs, antisocial attitudes, disruptive behavior ratings and aggression.
METHOD
Latent Class Analysis was performed on 12 self-reported ACEs, followed by Analyses of Covariance on each of the measures.
RESULTS
Four classes - Low ACE, Indirect Victims, Abusive Environment, and Polyvictimized - were identified. Polyvictimized youths had the highest levels of conduct problems (M = 70.35, ps < .05) and proactive aggression (M = 0.45, ps < .05) but did not differ from youths in Abusive Environment in reactive aggression (M = 1.02, p = .69), oppositional problems (M = 65.15, p = .18), and antisocial attitudes (M = 26.95, p = .21). Indirect Victims had lower levels of conduct problems (M = 64.80, p < .05) and antisocial attitudes (M = 24.35, p < .05) than Polyvictimized youths but higher levels of these outcomes than the Low ACE group.
CONCLUSIONS
Our findings showed that ACEs patterns vary in their effects on antisociality and disruptive behaviors. The novel finding was that childhood victimization does not have to be direct, as indirect victimization significantly impacted factors important to delinquency and reoffending.
Topics: Adolescent; Humans; Male; Adverse Childhood Experiences; Aggression; Antisocial Personality Disorder; Criminals; Problem Behavior; Female
PubMed: 37084615
DOI: 10.1016/j.chiabu.2023.106191 -
Psychoradiology 2023Although sex differences in antisocial behavior are well-documented, the extent to which neuroanatomical differences are related to sex differences in antisocial...
BACKGROUND
Although sex differences in antisocial behavior are well-documented, the extent to which neuroanatomical differences are related to sex differences in antisocial behavior is unclear. The inconsistent results from different clinical populations exhibiting antisocial behaviors are mainly due to the heterogeneity in etiologies, comorbidity inequality, and small sample size, especially in females.
OBJECTIVE
The study aimed to find sexual dimorphic brain regions associated with individual differences in antisocial behavior while avoiding the issues of heterogeneity and sample size.
METHODS
We collected structural neuroimaging data from 281 college students (131 males, 150 females) and analyzed the data using voxel-based morphometry.
RESULTS
The gray matter volume in three brain regions correlates with self-reported antisocial behavior in males and females differently: the posterior superior temporal sulcus, middle temporal gyrus, and precuneus. The findings have controlled for the total cortical gray matter volume, age, IQ, and socioeconomic status. Additionally, we found a common neural substrate of antisocial behavior in both males and females, extending from the anterior temporal lobe to the insula.
CONCLUSION
This is the first neuroanatomical evidence from a large non-clinical sample of young adults. The study suggests that differences in males and females in reading social cues, understanding intentions and emotions, and responding to conflicts may contribute to the modulation of brain morphometry concerning antisocial behavior.
PubMed: 38666132
DOI: 10.1093/psyrad/kkad031 -
JAMA Network Open Jan 2024The suicidal risk of psychopathology in adolescence is suggested to differ based on its longitudinal trajectory, but the comorbidity of these symptom trajectories has...
IMPORTANCE
The suicidal risk of psychopathology in adolescence is suggested to differ based on its longitudinal trajectory, but the comorbidity of these symptom trajectories has not been well examined. This study comprehensively clustered trajectories of multiple psychopathological and behavioral symptoms and examined their associations with suicidal thoughts in adolescence.
OBJECTIVE
To determine which categories and trajectories of psychopathological and behavioral symptoms are associated with suicidal thoughts in adolescence, accounting for comorbid symptoms.
DESIGN, SETTING, AND PARTICIPANTS
This population-based cohort study in Japan used data from the Tokyo Teen Cohort (TTC) study, which was established in 2012 and is currently ongoing. Data from 3 waves of surveys conducted at ages 10, 12, and 16 years from October 2012 to September 2021 were used. Of the adolescents in the cohort, participants with at least 2 evaluations of psychopathological and behavioral symptoms were included. Data were analyzed from December 2022 to March 2023.
EXPOSURE
Latent class growth analysis was used to cluster the trajectory of each psychopathological and behavioral symptom.
MAIN OUTCOMES AND MEASURES
The associations between symptom trajectories and suicidal thoughts at age 16 were examined. Suicidal thoughts were assessed using a self-report questionnaire. Psychopathological and behavioral symptoms were assessed using the 8 subscale scores of the caregiver-report Child Behavior Checklist.
RESULTS
This study included 2780 adolescents (1306 female participants [47.0%]). Of the 1920 adolescents with data on suicidal thoughts, 158 (8.2%) had suicidal thoughts. The median (IQR) age was 10.2 (10.0-10.3) years at the first evaluation, 11.9 (11.8-12.1) years at the second evaluation, and 16.3 (16.1-16.5) years at the last evaluation. The clustering pattern of trajectories varied depending on symptom categories. After adjusting for each symptom trajectory and confounders, adolescents with persistent high withdrawn symptoms (odds ratio [OR], 1.88; 95% CI, 1.10-3.21) and those with increasing somatic symptoms (OR, 1.97; 95% CI, 1.16-3.34) had a significantly higher risk of suicidal thoughts than adolescents without these symptoms. There was no interaction between these symptom trajectories and the risk of suicidal thoughts.
CONCLUSIONS AND RELEVANCE
This cohort study found that persistent withdrawn symptoms and increasing somatic symptoms during early to midadolescence were associated with an increased risk of suicidal thoughts in midadolescence, even after accounting for comorbid symptoms and confounders. Attention should be paid to the suicidal risk associated with these symptoms, particularly when they persist or increase in the longitudinal follow-up.
Topics: Child; Adolescent; Humans; Female; Cohort Studies; Medically Unexplained Symptoms; Suicidal Ideation; Behavioral Symptoms; Antisocial Personality Disorder
PubMed: 38270951
DOI: 10.1001/jamanetworkopen.2023.53166 -
Comprehensive Psychiatry Nov 2023Patients in the forensic mental health services (FMHS) with a mental disorder, a co-occurring substance use disorder (SUD), and high risk of aggressive antisocial...
BACKGROUND
Patients in the forensic mental health services (FMHS) with a mental disorder, a co-occurring substance use disorder (SUD), and high risk of aggressive antisocial behavior (AAB) are sometimes referred to as the 'triply troubled'. They suffer poor treatment outcomes, high rates of criminal recidivism, and increased risk of drug related mortality. To improve treatment for this heterogeneous patient group, more insight is needed concerning their co-occurring mental disorders, types of substances used, and the consequent risk of AAB.
METHODS
A three-step latent class analysis (LCA) was used to identify clinically relevant subgroups in a sample of patients (n = 98) from a high-security FMHS clinic in Sweden based on patterns in their history of mental disorders, SUD, types of substances used, and AAB.
RESULTS
A four-class model best fit our data: class 1 (42%) had a high probability of SUD, psychosis, and having used all substances; class 2 (26%) had a high probability of psychosis and cannabis use; class 3 (22%) had a high probability of autism and no substance use; and class 4 (10%) had a high probability of personality disorders and having used all substances. Both polysubstance classes (1 and 4) had a significantly more extensive history of AAB compared to classes 2 and 3. Class 3 and class 4 had extensive histories of self-directed aggression.
CONCLUSIONS
The present study helps disentangle the heterogeneity of the 'triply troubled' patient group in FMHS. The results provide an illustration of a more person-oriented perspective on patient comorbidity and types of substances used which could benefit clinical assessment, treatment planning, and risk-management among patients in forensic psychiatric care.
Topics: Humans; Antisocial Personality Disorder; Sweden; Latent Class Analysis; Mental Disorders; Substance-Related Disorders; Comorbidity; Aggression
PubMed: 37778180
DOI: 10.1016/j.comppsych.2023.152428 -
Psychological Reports Nov 2023A consequence of the proliferation of online communication is the concerning presence of antisocial behavior observed in virtual spaces. Research suggests the cognitive...
A consequence of the proliferation of online communication is the concerning presence of antisocial behavior observed in virtual spaces. Research suggests the cognitive component of empathy is hindered by features of electronic communication which facilitates antisocial behaviors online. Investigations into how features of online communication inhibit cognitive empathy are lacking, and findings on moral disengagement and antisocial behavior have yet to be integrated with studies on cognitive empathy and electronic communication. The current study explores these relationships. One hundred and three undergraduate students completed several measures including the Online Moral Disengagement Scale, Questionnaire of Cognitive and Affective Empathy, and Online Prosocial and Antisocial Behavior Scale. Results showed a positive correlation between compulsive internet use and online moral disengagement, as well as a negative correlation between cognitive empathy and moral disengagement online. It was hypothesized that online moral disengagement would mediate the relation between cognitive empathy and antisocial behavior online but this mediation was not supported. However, a moderated relationship was revealed between cognitive empathy and moral justification, by liberalism. This moderation can be explored further and built upon by future research to deepen our understanding of how political ideology relates to virtual behavior. Furthermore, the findings concerning components of empathy and moral disengagement, and their role within the perpetration of antisocial conduct online, can inform future research as well as interventions focused on fostering prosocial behavior online and curbing cyberaggression.
PubMed: 38032608
DOI: 10.1177/00332941231216415 -
Frontiers in Psychiatry 2023Pathological personality traits have repeatedly been identified as important risk factors for suicidal ideation and behaviors. Moreover, impulsive-aggressive traits,...
INTRODUCTION
Pathological personality traits have repeatedly been identified as important risk factors for suicidal ideation and behaviors. Moreover, impulsive-aggressive traits, have shown a consistent association with suicidal behaviors across the lifespan. Adolescence represents a critical period for the emergence of different personality traits, mood disorders, and suicidal behaviors, but the relationship between these variables remain poorly understood.
METHODS
These variables were examined in a cross-sectional case-control design involving three groups: 30 adolescents with a depressive disorder and past suicide attempt (Mean Age = 16.2, Females = 26), 38 adolescents with a depressive disorder but without past suicide attempt (Mean age = 16.0, Females = 29), and 34 healthy adolescent controls (Mean age = 15.2, Females = 22). Suicidal ideations were indexed using Suicidal Behavior Questionnaire (SBQ-R), psychiatric disorder assessed using a semi-structured questionnaire (K-SADS-PL), depressive symptoms with the Beck Depressive Inventory (BDI), symptoms characteristics of personality disorders with the Scheduled Clinical Interview for the DSM-IV (SCID-II) screening questionnaire, and impulsivity with the Barratt Impulsivesness Scale (BIS).
RESULTS
Findings showed that impulsivity ( = 11.0, < 0.0001) and antisocial symptoms characteristics of personality disorders ( < 0.001, d = 0.70) displayed the most robust association with adolescent suicide attempts. Borderline symptoms characteristics of personality disorders did not discriminate attempters from non-attempters but presented high correlations with suicidal ideation and depression severity. In an item-wise analysis, suicide attempt status was uniquely correlated with symptoms characteristics of an antisocial personality disorder. Suicide attempt status also correlated with non-suicidal self-injury and a chronic feeling of emptiness.
DISCUSSION
The caveats of this cross-sectional study include the stability of symptoms characteristics of personality disorders in adolescence and the limited sample size. In sum, suicidal behaviors were characteristically correlated with increased impulsivity and antisocial symptoms characteristics of personality disorders, but other symptoms characteristics of personality disorders were relevant to adolescent depression and suicidal ideation. Understanding the emergence of symptoms characteristics of personality disorders and suicidal behaviors in a developmental context can ultimately inform not only the neurobiological origin of suicidal behaviors, but also provide new avenues for early detection and intervention.
PubMed: 38146283
DOI: 10.3389/fpsyt.2023.1269744 -
Cureus Oct 2023Our review paper delves into the intricate and multifaceted realm of cannibalism, with a focused exploration of its manifestations in Wendigo psychosis. We aim to... (Review)
Review
Our review paper delves into the intricate and multifaceted realm of cannibalism, with a focused exploration of its manifestations in Wendigo psychosis. We aim to explore the implications of cannibalism within the realms of psychiatry, anthropology, psychology, and sociology by navigating the complexities of cultural beliefs, psychological underpinnings, historical contexts, and contemporary significance surrounding cannibalism. Cannibalism is deeply ingrained in the cultural and mythological heritage of Algonquian-speaking tribes; it is closely associated with the symbolic figure of the Wendigo. The Wendigo serves as a warning about the potential loss of one's humanity in dire circumstances like starvation. Wendigo psychosis, characterized by psychiatric manifestations such as paranoia, anxiety, hallucinations, and cannibalistic urges, often emerges as a result of a fusion of cultural narratives and psychological vulnerabilities. This may provide an outlet for individuals experiencing internal distress. Historical records show that instances of Wendigo psychosis and cannibalism were more prevalent during periods of extreme scarcity and famine among Algonquian tribes, but they can also manifest in non-famine contexts. Cannibalism assumes diverse forms and meanings across various cultures, encompassing ritualistic, sacrificial, or survival cannibalism. Acknowledging these nuances is paramount to avoiding perpetuating harmful stereotypes and to appreciating the significance of these practices within specific cultures. Engaging in discussions about cannibalism necessitates cultural sensitivity and respect for diverse cultural practices and beliefs to foster open dialogue and enhance cross-cultural understanding. Although cannibalism is often associated with psychiatric disorders, it is not exclusively rooted in mental illness. Factors like substance abuse, antisocial traits, and environmental upbringing can also contribute to cannibalistic acts. In some cases, cannibalism may be linked to survival instincts stemming from trauma and abuse. Therefore, it is vital to distinguish between various forms of cannibalism and understand their underlying motivations. Analyzing cannibalistic fantasies from a psychoanalytic perspective involves exploring mechanisms such as melancholia and oral fixation, shedding light on the psychological underpinnings of these thoughts and urges. Moreover, the influence of media portrayals of cannibalism on public perceptions cannot be underestimated. Sensationalism and romanticization in popular culture can distort our understanding of the motivations and mental states of individuals involved in cannibalistic acts. In essence, cannibalism remains an intriguing and multidimensional topic deeply entrenched in cultural narratives and psychological complexities. A comprehensive understanding necessitates a multidisciplinary approach, taking into account how historical context, cultural beliefs, psychological experiences, and societal dimensions shape human behavior and our comprehension of the human condition. To navigate this complex subject with sensitivity and respect, it is essential to recognize the diverse manifestations and motivations behind cannibalistic behavior, whether in the context of Wendigo psychosis or other cultural practices.
PubMed: 38034155
DOI: 10.7759/cureus.47962 -
Psychiatry Research Jan 2024Conduct disorder (CD), a common mental disorder in children and adolescents, is characterized by antisocial behavior. Despite similarities with antisocial personality...
Conduct disorder (CD), a common mental disorder in children and adolescents, is characterized by antisocial behavior. Despite similarities with antisocial personality disorder (ASPD) and possible diagnostic continuity, CD has been shown to precede a range of adult-onset mental disorders. Additionally, little is known about the putative shared genetic liability between CD and adult-onset mental disorders and the underlying gene-environment interplay. Here, we interrogated comorbidity between CD and other mental disorders from the Norwegian Mother, Father and Child Cohort Study (n = 114 500) and investigated how polygenic risk scores (PRS) for mental health traits were associated with CD/CD traits in childhood and adolescence. Gene-environment interplay patterns for CD was explored with data on bullying and parental education. We found CD to be comorbid with several child and adult-onset mental disorders. This phenotypic overlap corresponded with associations between PRS for mental disorders and CD. Additionally, our findings support an additive gene-environment model. Previously conceptualized as a precursor of ASPD, we found that CD was associated with polygenic risk for several child- and adult-onset mental disorders. High comorbidity of CD with other psychiatric disorders reflected on the genetic level should inform research studies, diagnostic assessments and clinical follow-up of this heterogenous group.
Topics: Adult; Female; Adolescent; Humans; Conduct Disorder; Cohort Studies; Antisocial Personality Disorder; Comorbidity; Risk Factors
PubMed: 38029627
DOI: 10.1016/j.psychres.2023.115628