Mitchell E. Berman

Assessment of life history of aggression: development and psychometric characteristics

The Life History of Aggression (LHA) assessment was administered to up to 252 subjects. In addition to a total LHA score, subscale scores for Aggression, Social Consequences and Antisocial Behavior, and Self-directed Aggression were calculated. Test-retest stability, interrater agreement, and internal consistency reliability were excellent both for the LHA Total score and the LHA Aggression subscore. There were moderately strong correlations between these scores and both self-reports of aggressive tendency (Buss-Durkee Hostility Inventory: n = 214) and recent overt aggression (Overt Aggression Scale-Modified for Out-patients: n = 61). LHA Total scores were highest among subjects with Antisocial or Borderline Personality Disorder. These results support the use of the LHA assessment, and especially the LHA Aggression subscore, as a measure of life history of aggressive behavior.

Intermittent explosive disorder-revised: Development, reliability, and validity of research criteria

The study of human aggression has been hindered by the lack of reliable and valid diagnostic categories that specifically identify individuals with clinically significant displays of impulsive aggressive behavior. DSM intermittent explosive disorder (IED) ostensibly identifies one such group of individuals. In its current form, IED suffers from significant theoretical and psychometric shortcomings that limit its use in clinical or research settings. This study was designed to develop a revised criteria set for IED and present initial evidence supporting its reliability and validity in a well characterized group of personality disordered subjects. Accordingly, research criteria for IED-Revised (IED-R) were developed. Clinical, phenomenologic, and diagnostic data from 188 personality disordered individuals were reviewed. IED-R diagnoses were assigned using a best-estimate process. The reliability and construct validity of IED-R were examined. IED-R diagnoses had high interrater reliability (kappa = .92). Subjects meeting IED-R criteria had higher scores on dimensional measures of aggression and impulsivity, and had lower global functioning scores than non-IED-R subjects, even when related variables were controlled. IED-R criteria were more sensitive than DSM-IV IED criteria in identifying subjects with significant impulsive-aggressive behavior by a factor of four. We conclude that in personality disordered subjects, IED-R criteria can be reliably applied and appear to have sufficient validity to warrant further evaluation in field trials and in phenomenologic, epidemiologic, biologic, and treatment-outcome research.

Effects of Aerobic Exercise on Anxiety Sensitivity

Anxiety sensitivity is a known precursor to panic attacks and panic disorder, and involves the misinterpretation of anxiety-related sensations. Aerobic exercise has been shown to reduce generalized anxiety, and may also reduce anxiety sensitivity through exposure to feared physiological sensations. Accordingly, 54 participants with elevated anxiety sensitivity scores completed six 20-min treadmill exercise sessions at either a high-intensity aerobic ( n = 29 ) or low-intensity ( n = 25 ) level. Self-ratings of anxiety sensitivity, fear of physiological sensations associated with anxiety, and generalized anxiety were obtained at pre-treatment, post-treatment, and one-week follow-up. Results indicated that both high- and low-intensity exercise reduced anxiety sensitivity. However, high-intensity exercise caused more rapid reductions in a global measure of anxiety sensitivity and produced more treatment responders than low-intensity exercise. Only high-intensity exercise reduced fear of anxiety-related bodily sensations. The implications of these findings are discussed.

The serotonin hypothesis of aggression revisited

Many contemporary theorists believe serotonin (5-HT) neurotransmitter functioning plays a role in the regulation of human aggressive behavior. We argue that the evidence supporting this 5-HT hypothesis of human aggression is less compelling than commonly assumed, due to (a) conflicting study results, and (b) significant methodological limitations of existing studies. Recent models that integrate the role of psychological and contextual variables in 5-HT--associated aggression are reviewed. The need to incorporate psychometrically sound measures of aggression in 5-HT studies, to use experimental and longitudinal designs, and to test hypotheses drawn from multifactorial models in future research is advocated.

Serotonin Augmentation Reduces Response to Attack in Aggressive Individuals

We tested the theory that central serotonin (5-hydroxytryptamine, or 5-HT) activity regulates aggression by modulating response to provocation. Eighty men and women (40 with and 40 without a history of aggression) were randomly assigned to receive either 40 mg of paroxetine (to acutely augment serotonergic activity) or a placebo, administered using double-blind procedures. Aggression was assessed during a competitive reaction time game with a fictitious opponent. Shocks were selected by the participant and opponent before each trial, with the loser on each trial receiving the shock set by the other player. Provocation was manipulated by having the opponent select increasingly intense shocks for the participant and eventually an ostensibly severe shock toward the end of the trials. Aggression was measured by the number of severe shocks set by the participant for the opponent. As predicted, aggressive responding after provocation was attenuated by augmentation of serotonin in individuals with a pronounced history of aggression.

The relationship between personality psychopathology and aggressive behavior in research volunteers

Theorists and clinicians have long believed that personality psychopathology is a risk factor for aggressive behavior. Previous investigations in this area, however, have provided mixed results. In this study, the relationship between personality psychopathology and aggressive behavior was examined in 137 research volunteers. The influences of gender and coexisting major mental disorders were statistically controlled. Aggressive behavior was associated with criteria for 7 of the 11 personality disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.). Except for schizoid criteria, all relationships with aggressive behavior were in the positive direction. When all personality disorders were considered simultaneously, paranoid and passive-aggressive criteria were significant predictors of aggressive behavior.

Effects of clorazepate, diazepam, and oxazepam on a laboratory measurement of aggression in men.

The effects of three benzodiazepines on human aggressive behavior were examined in 44 medically healthy men. Volunteers were administered either placebo, 10 mg diazepam, 15 mg chlorazepate, or 50 mg oxazepam orally using double-blind procedures. Approximately 90 min after drug ingestion, participants were given the opportunity to administer electric shocks to an increasingly provocative fictitious opponent during a competitive reaction-time task. Aggression was defined as the level of shock the participant was willing to administer to the opponent. Results support the notion that diazepam (but not all benzodiazepines) can elicit aggressive behavior under controlled, laboratory conditions. Implications regarding the clinical use of various benzodiazepines for the tranquilization of potentially assaultive patients are discussed.

Effects of alcohol on tests of executive functioning in men and women: a dose response examination.

Alcohol has been shown to affect performance on tasks associated with executive functioning. However, studies in this area have generally been limited to a single dose or gender or have used small sample sizes. The purpose of this study was to provide a more nuanced and systematic examination of alcohols effects on commonly used tests of executive functioning at multiple dosages in both men and women. Research volunteers (91 women and 94 men) were randomly assigned to one of four drink conditions (alcohol doses associated with target blood alcohol concentrations of .000%, .050%, .075%, and .100%). Participants then completed three tasks comprising two domains of executive functioning: two set shifting tasks, the Trail Making Test and a computerized version of the Wisconsin Card Sorting Task, and a response inhibition task, the GoStop Impulsivity Paradigm. Impaired performance on set shifting tasks was found at the .100% and .075% dosages, but alcohol intoxication did not impair performance on the GoStop. No gender effects emerged. Thus, alcohol negatively affects set shifting at moderately high levels of intoxication in both men and women, likely attributable to alcohols interference with prefrontal cortex function. Although it is well established that alcohol negatively affects response inhibition as measured by auditory stop-signal tasks, alcohol does not appear to exert a negative effect on response inhibition as measured by the GoStop, a visual stop-signal task.

The Latent Structure of Anxiety Sensitivity—Revisited

Anxiety sensitivity has been implicated as a risk factor for the development and maintenance of panic and other anxiety disorders. Although researchers have generally assumed that anxiety sensitivity is a dimensional, rather than categorical, variable, recent taxometric research has raised questions concerning the accuracy of this assumption. The present study examined the latent structure of anxiety sensitivity by applying four taxometric procedures (MAXEIG, MAXCOV, MAMBAC, and L-Mode) to data collected from two large nonclinical samples (n = 1,025 and n = 744) using two distinct measures of anxiety sensitivity (Anxiety Sensitivity Profile and Anxiety Sensitivity Index—Revised). In contrast to previous taxometric analyses of anxiety sensitivity, results of the present research provided convergent evidence for a latent anxiety sensitivity dimension. Several potential explanations for the discrepancy between these findings and those of previous research are discussed, as well as the implications of these findings for the conceptualization and measurement of anxiety sensitivity.

Unhealthy aggression: Intermittent explosive disorder and adverse physical health outcomes

OBJECTIVE To examine the relationship between Intermittent Explosive Disorder (IED; a psychiatric diagnosis characterized by episodes of affective aggression) and adverse physical health outcomes. DESIGN A large epidemiological sample drawn from the Collaborative Psychiatric Epidemiological Surveys (N = 10,366), was used to compare participants with a lifetime diagnosis of IED (n = 929) to those without any history of IED (n = 9,437) on demographic variables (age, education, gender, race) common risk factors (smoking status, body mass index, substance use disorders, past accident or injury requiring treatment, major depression) and the presence of 12 adverse health outcomes. MAIN OUTCOME MEASURES History of heart attacks, coronary heart disease, hypertension, stroke, lung disease, diabetes, cancer, arthritis, back/neck pain, ulcer, headaches, and other chronic pain. RESULTS Logistic regression analysis controlling for demographic and other risk factors indicated that IED was associated with 9 of the 12 adverse physical health outcomes (coronary heart disease, hypertension, stroke, diabetes, arthritis, back/neck pain, ulcer, headaches, and other chronic pain). Only cancer, heart attacks, and lung disease were not significantly related to IED. CONCLUSION IED may be a risk factor for several significant adverse physical health outcomes.