Neuroimaging and Neurocognitive Correlates of Aggression and Violence in Schizophrenia

Abstract

Individuals diagnosed with major mental disorders such as schizophrenia are more likely to have engaged in violent behavior than mentally healthy members of the same communities. Although aggressive acts can have numerous causes, research about the underlying neurobiology of violence and aggression in schizophrenia can lead to a better understanding of the heterogeneous nature of that behavior and can assist in developing new treatment strategies. The purpose of this paper is to review the recent literature and discuss some of the neurobiological correlates of aggression and violence. The focus will be on schizophrenia, and the results of neuroimaging and neuropsychological studies that have directly investigated brain functioning and/or structure in aggressive and violent samples will be discussed as well as other domains that might predispose to aggression and violence such as deficits in responding to the emotional expressions of others, impulsivity, and psychopathological symptoms. Finally gender differences regarding aggression and violence are discussed. In this context several methodological and conceptional issues that limited the comparison of these studies will be addressed.

Clinical and neuropsychological features of violence in schizophrenia: A prospective cohort study

“…This is consistent with evidence that abnormalities in fronto-temporal circuitry are implicated in aggressive behavior among such patients (Weiss, 2012).…”

“…Data exploring the link between executive deficits and risk of violence in schizophrenia are inconsistent (Weiss et al, 2012;Witt et al, 2013). Current psychopathology, social reasoning and functioning have also been reported to be linked to violence (Serper et al, 2008;O'Reilly et al, 2015), though a recent meta-analysis found that only global cognitive impairment and lack of insight predicted violence in schizophrenia (Reinharth et al, 2014).…”

Laughter as a social rejection cue: Gelotophobia and transient cardiac responses to other persons' laughter and insult

“…The link between gelotophobia with anger and aggression proneness may in part be explained by its association with poor emotion regulation capacities. Basic processes contributing to heightened levels of trait anger and aggression in the general population as well as in psychiatric patients (Weiss, 2012;Wilkowski & Robinson, 2010) include the tendency to attribute hostile traits to other persons (see also Dodge, 1993;McNiel, Eisner, & Binder, 2003;Weiss et al, 2006), which may be in line with the disposition of individuals with gelotophobia to assume that laughter in their presence is directed at them and thus hostile, and poor regulation of angry thoughts and feelings (see also Davidson, Putnam, & Larson, 2000). Previous research has demonstrated that, compared to nongelotophobic persons, individuals with gelotophobia felt weak at regulating their emotions, and the approaches they typically use to manage their emotions were considered inefficient by experts (Papousek et al, 2009;Weiss et al, 2012).…”

A randomized study of cognitive remediation for forensic and mental health patients with schizophrenia

“…The majority of patients in forensic settings are offenders who have committed violent crimes such as assaults, armed robberies, rape, manslaughter, or murder. Studies suggest that people with schizophrenia without a life-long history of antisocial behavior but who elicit violent behavior may demonstrate even more profound impairments in executive functions and working memory than people with schizophrenia without a history of violence (Barkataki et al, 2005;Fullam and Dolan, 2008;Reinharth et al, 2014;Soyka, 2011;Weiss, 2012). These impairments may limit the learning capacity of violent offenders and their ability to gain from an intense program of court-ordered competency restoration and psychiatric rehabilitation (Schwalbe and Medalia, 2007).…”