Dimensions of Pathological Aggression: From Neurobiology to Therapy

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Behavioral Neuroscience".

Deadline for manuscript submissions: closed (27 November 2021) | Viewed by 35735

Special Issue Editors


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Guest Editor
Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
Interests: aggression; violence; psychiatric disorders; RDoC; therapy

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Co-Guest Editor
Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, Gelderland, The Netherlands
Interests: abnormal psychology, forensic psychology and cognitive science

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Institute of Neuroscience and Medicine, Forschungszentrum Jülich (FZJ), Jülich, Germany
Interests: neuroscience, endocrinology, clinical psychology, social decision-making

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Co-Guest Editor
Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Omaha, NE, USA
Interests: neuro-cognitive systems, conduct disorder, psychopharmacology, functional imaging

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Co-Guest Editor
Neurodevelopment and Psychosis Section, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
Interests: regional brain function, schizophrenia, affective disorders, stroke, epilepsy, movement disorders, dementia

Special Issue Information

Dear Colleagues,

Considering the devastating consequences of aggressive and violent behavior, a better mechanistic understanding of the phenomenon is of high relevance. As an evolutionarily meaningful preserved behavior, aggression is present in all species; in humans, the extreme and pathological form in many mental disorders poses a major burden, often complicating clinical management. Growing empirical evidence corroborates the influence of (neuro)biological factors and complex interactions between social-environmental and biological, genetic influences in the development of aggressive pathology. Specifically, brain alterations as well as genetic factors can be linked to abnormal aggressive behavior. Being exposed to aggression and violence early in life has severe consequences for mental health. The victim–offender overlap in a biographical life history is impressive. Still, translational findings for diagnostic and especially therapeutic applications are lacking. Methodological, conceptual, and clinical reasons have prevented major achievements here. The transdiagnostic turn in psychiatry and the combination with cognitive constructs may pave the way for new innovative ways to tackle the challenge. Can we define biomarkers and subtypes of aggression with specific underlying neuropsychobiological patterns and characteristics that allow a better transdiagnostic use in terms of a more personalized treatment approach? Parallel applications of non-invasive modulation techniques and developments in psychotherapeutic interventions integrating such new biocognitive fingerprints are needed to break through the vicious cycle of aggression and violence.

Prof. Dr. Ute Habel
Guest Editor

Dr. Inti Brazil
Dr. Lisa Wagels
Dr. James Blair
Prof. Dr. Ruben Gur
Co-Guest Editors

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Keywords

  • Aggression
  • Violence
  • Psychiatric diagnosis
  • Biomarkers
  • Neurobiological therapy

Published Papers (11 papers)

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Editorial

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2 pages, 166 KiB  
Editorial
Dimensions of Pathological Aggression: From Neurobiology to Therapy
by Lisa Wagels and Ute Habel
Brain Sci. 2022, 12(3), 347; https://doi.org/10.3390/brainsci12030347 - 03 Mar 2022
Viewed by 1445
Abstract
This Special Issue brings together recent research on aggression on different scales, starting from animal models in low-aggression, healthy populations to patients with aggression problems [...] Full article
(This article belongs to the Special Issue Dimensions of Pathological Aggression: From Neurobiology to Therapy)

Research

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16 pages, 1349 KiB  
Article
Neurobiological Responses towards Stimuli Depicting Aggressive Interactions in Delinquent Young Adults and Controls: No Relation to Reactive and Proactive Aggression
by Janna F. ter Harmsel, Josanne D. M. van Dongen, Josjan Zijlmans, Thimo M. van der Pol, Reshmi Marhe and Arne Popma
Brain Sci. 2022, 12(2), 124; https://doi.org/10.3390/brainsci12020124 - 18 Jan 2022
Cited by 4 | Viewed by 2217
Abstract
Neurobiological measures underlying aggressive behavior have gained attention due to their potential to inform risk assessment and treatment interventions. Aberrations in responsivity of the autonomic nervous system and electrophysiological responses to arousal-inducing stimuli have been related to emotional dysregulation and aggressive behavior. However, [...] Read more.
Neurobiological measures underlying aggressive behavior have gained attention due to their potential to inform risk assessment and treatment interventions. Aberrations in responsivity of the autonomic nervous system and electrophysiological responses to arousal-inducing stimuli have been related to emotional dysregulation and aggressive behavior. However, studies have often been performed in community samples, using tasks that induce arousal but not specifically depict aggression. In this study, we examined differences in psychophysiological (i.e., heart rate, respiratory sinus arrhythmia, skin conductance level) and electrophysiological responses (i.e., P3, late positive potential, mu suppression) to aggressive versus neutral scenes in a sample of 118 delinquent young adults and 25 controls (all male, aged 18–27). With respect to group differences, we only found significant higher SCL reactivity during the task in the delinquent group compared to controls, but this was irrespective of condition (aggressive and neutral interactions). Within the delinquent group, we also examined associations between the neurobiological measures and reactive and proactive aggression. No significant associations were found. Therefore, although we found some indication of emotional dysregulation in these delinquent young adults, future studies should further elucidate the neurobiological mechanisms underlying emotional dysregulation in relation to different types of aggression. Full article
(This article belongs to the Special Issue Dimensions of Pathological Aggression: From Neurobiology to Therapy)
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22 pages, 1720 KiB  
Article
Virtual Reality for Aggression Assessment: The Development and Preliminary Results of Two Virtual Reality Tasks to Assess Reactive and Proactive Aggression in Males
by Jill Lobbestael and Maaike J. Cima
Brain Sci. 2021, 11(12), 1653; https://doi.org/10.3390/brainsci11121653 - 17 Dec 2021
Cited by 4 | Viewed by 3248
Abstract
Validly measuring aggression is challenging because self-reports are plagued with biased answer tendencies and behavioral measures with ethical concerns and low ecological validity. The current study, therefore, introduces a novel virtual reality (VR) aggression assessment tool, differentially assessing reactive and proactive aggression. Two [...] Read more.
Validly measuring aggression is challenging because self-reports are plagued with biased answer tendencies and behavioral measures with ethical concerns and low ecological validity. The current study, therefore, introduces a novel virtual reality (VR) aggression assessment tool, differentially assessing reactive and proactive aggression. Two VR tasks were developed, one in an alley environment (N = 24, all male, Mage = 23.88, 83.3% students) and an improved second one in a bar (N = 50, all male, Mage = 22.54, 90% students). In this bar VR task, participants were randomly assigned to either the reactive condition where they were triggered by a cheating and insulting dart-player or to the proactive condition where they could earn extra money by aggressing. Participants’ level of self-reported aggression and psychopathy was assessed, after which they engaged in either the reactive or proactive VR task. Changes in affect and blood pressure were also measured. Aggression in the reactive VR task was evidenced to mostly display convergent validity because it positively correlated with self-reported aggression and total and fearless dominance factor scores of psychopathy, and there was a trend relationship with increased systolic blood pressure. The validity of the proactive aggression variant of our VR bar paradigm received less support, and needs more refinement. It can be concluded that VR is a potentially promising tool to experimentally induce and assess (reactive) aggression, which has the potential to provide aggression researchers and clinicians with a realistic and modifiable aggression assessment environment. Full article
(This article belongs to the Special Issue Dimensions of Pathological Aggression: From Neurobiology to Therapy)
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15 pages, 749 KiB  
Article
A Mechanism-Based Approach to Anti-Aggression Psychotherapy in Borderline Personality Disorder: Group Treatment Affects Amygdala Activation and Connectivity
by Corinne Neukel, Katja Bertsch, Marc Wenigmann, Karen Spieß, Marlene Krauch, Sylvia Steinmann and Sabine C. Herpertz
Brain Sci. 2021, 11(12), 1627; https://doi.org/10.3390/brainsci11121627 - 10 Dec 2021
Cited by 9 | Viewed by 4528
Abstract
Aggression is highly prevalent in borderline personality disorder (BPD). Previous studies have identified specific biobehavioral mechanisms underlying aggression in BPD, threat sensitivity being among them. We composited the mechanism-based anti-aggression psychotherapy (MAAP) in order to target these specific mechanisms, and MAAP was found [...] Read more.
Aggression is highly prevalent in borderline personality disorder (BPD). Previous studies have identified specific biobehavioral mechanisms underlying aggression in BPD, threat sensitivity being among them. We composited the mechanism-based anti-aggression psychotherapy (MAAP) in order to target these specific mechanisms, and MAAP was found to be superior to non-specific supportive psychotherapy (NSSP) in reducing aggressive behavior. In the present study, we investigated whether underlying brain mechanisms expected to be involved were affected by MAAP. To this end, n = 33 patients with BPD and overt aggressive behavior (n = 20 in MAAP, n = 13 in NSSP) and n = 25 healthy participants took part in a functional magnetic resonance imaging emotional face-matching task before and after treatment, or at a similar time interval for controls. Overt aggressive behavior was assessed using the overt aggression scale, modified. Results showed a decrease in amygdala activation in response to facial stimuli after MAAP, whereas an increase in amygdala activation was found after NSSP. Furthermore, in the MAAP group, connectivity between amygdala and dorsomedial prefrontal cortex increased from pre- to post-treatment compared to the NSSP group. Hence, the results suggest an impact of MAAP on brain mechanisms underlying the salience circuit in response to threat cues. Full article
(This article belongs to the Special Issue Dimensions of Pathological Aggression: From Neurobiology to Therapy)
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20 pages, 1747 KiB  
Article
A Combined Administration of Testosterone and Arginine Vasopressin Affects Aggressive Behavior in Males
by Dilsa Cemre Akkoc Altinok, Mikhail Votinov, Friederike Henzelmann, HanGue Jo, Albrecht Eisert, Ute Habel and Lisa Wagels
Brain Sci. 2021, 11(12), 1623; https://doi.org/10.3390/brainsci11121623 - 09 Dec 2021
Cited by 4 | Viewed by 2790
Abstract
Aggressive behavior is modulated by many factors, including personality and cognition, as well as endocrine and neural changes. To study the potential effects on the reaction to provocation, which was realized by an ostensible opponent subtracting money from the participant, we administered testosterone [...] Read more.
Aggressive behavior is modulated by many factors, including personality and cognition, as well as endocrine and neural changes. To study the potential effects on the reaction to provocation, which was realized by an ostensible opponent subtracting money from the participant, we administered testosterone (T) and arginine vasopressin (AVP) or a respective placebo (PL). Forty males underwent a functional magnetic resonance imaging session while performing a provocation paradigm. We investigated differential hormone effects and the potential influence of Machiavellian traits on punishment choices (monetary subtractions by the participant) in the paradigm. Participants in the T/AVP group subtracted more money when they were not provoked but showed increased activation in the inferior frontal gyrus and inferior parietal lobule during feedback compared to PL. Higher Machiavellian traits significantly increased punishing behavior independent of provocation only in this group. The pilot study shows that T/AVP affects neural and behavioral responses during a provocation paradigm while personality characteristics, such as Machiavellian trait patterns, specifically interact with hormonal influences (T/AVP) and their effects on behavior. Full article
(This article belongs to the Special Issue Dimensions of Pathological Aggression: From Neurobiology to Therapy)
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21 pages, 1061 KiB  
Article
Testing the Effects of a Virtual Reality Game for Aggressive Impulse Management: A Preliminary Randomized Controlled Trial among Forensic Psychiatric Outpatients
by Danique Smeijers, Erik H. Bulten, Robbert-Jan Verkes and Sander L. Koole
Brain Sci. 2021, 11(11), 1484; https://doi.org/10.3390/brainsci11111484 - 10 Nov 2021
Cited by 5 | Viewed by 2141
Abstract
Prior laboratory experiments among healthy samples found that training avoidance movements to angry faces may lower anger and aggression, especially people high in trait anger. To enrich this training and make it more suitable for clinical applications, the present researchers developed it into [...] Read more.
Prior laboratory experiments among healthy samples found that training avoidance movements to angry faces may lower anger and aggression, especially people high in trait anger. To enrich this training and make it more suitable for clinical applications, the present researchers developed it into a Virtual Reality Game for Aggressive Impulse Management (VR-GAIME). The current study examined the effects of this training in a randomized controlled trial among forensic psychiatric outpatients with aggression regulation problems (N = 30). In addition to the aggression replacement training, patients played either the VR-GAIME or a control game. Aggressive behavior was measured pre-, half-way, and post-treatment via self-report and clinicians ratings. No difference was found between the VR-GAIME and the control game. However, the participants reported gaining more insight into their own behavior and that of others. Future VR intervention tools in clinical settings may capitalize more on their benefits for self-reflection within interpersonal settings. Full article
(This article belongs to the Special Issue Dimensions of Pathological Aggression: From Neurobiology to Therapy)
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26 pages, 1336 KiB  
Article
Reflexive Gaze Shifts and Fear Recognition Deficits in Children with Callous-Unemotional Traits and Impulsivity/Conduct Problems
by Luna C. Muñoz Centifanti, Timothy R. Stickle, Jamila Thomas, Amanda Falcón, Nicholas D. Thomson and Matthias Gamer
Brain Sci. 2021, 11(10), 1342; https://doi.org/10.3390/brainsci11101342 - 13 Oct 2021
Cited by 2 | Viewed by 3045
Abstract
The ability to efficiently recognize the emotions on others’ faces is something that most of us take for granted. Children with callous-unemotional (CU) traits and impulsivity/conduct problems (ICP), such as attention-deficit hyperactivity disorder, have been previously described as being “fear blind”. This is [...] Read more.
The ability to efficiently recognize the emotions on others’ faces is something that most of us take for granted. Children with callous-unemotional (CU) traits and impulsivity/conduct problems (ICP), such as attention-deficit hyperactivity disorder, have been previously described as being “fear blind”. This is also associated with looking less at the eye regions of fearful faces, which are highly diagnostic. Previous attempts to intervene into emotion recognition strategies have not had lasting effects on participants’ fear recognition abilities. Here we present both (a) additional evidence that there is a two-part causal chain, from personality traits to face recognition strategies using the eyes, then from strategies to rates of recognizing fear in others; and (b) a pilot intervention that had persistent effects for weeks after the end of instruction. Further, the intervention led to more change in those with the highest CU traits. This both clarifies the specific mechanisms linking personality to emotion recognition and shows that the process is fundamentally malleable. It is possible that such training could promote empathy and reduce the rates of antisocial behavior in specific populations in the future. Full article
(This article belongs to the Special Issue Dimensions of Pathological Aggression: From Neurobiology to Therapy)
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14 pages, 762 KiB  
Article
Differential Susceptibility or Diathesis-Stress: Testing the Moderating Role of Temperament and Cortisol Levels between Fathers’ Parenting and Children’s Aggressive Behavior
by Eider Pascual-Sagastizabal, Nora del Puerto-Golzarri and Aitziber Azurmendi
Brain Sci. 2021, 11(8), 1088; https://doi.org/10.3390/brainsci11081088 - 19 Aug 2021
Cited by 6 | Viewed by 2759
Abstract
Aggression is a multidimensional behavior that could be caused by different biopsychosocial variables. The aim of this study was to explore whether temperament, cortisol and sex moderate the relation between fathers’ parenting style and aggressive behavior in school-aged children, and whether this corresponds [...] Read more.
Aggression is a multidimensional behavior that could be caused by different biopsychosocial variables. The aim of this study was to explore whether temperament, cortisol and sex moderate the relation between fathers’ parenting style and aggressive behavior in school-aged children, and whether this corresponds to differential susceptibility or diathesis-stress. Participants were 158 children (88 boys and 70 girls) aged 8 years. Aggressive behavior was measured using the Direct and Indirect Aggression Scale and fathers informed about their child’s temperament and their own parenting style through the Children’s Behavior Questionnaire and the Parenting Styles and Dimensions Questionnaire (respectively). Children’s’ baseline saliva cortisol levels were analyzed through an enzyme immunoassay technique. The results revealed that high cortisol levels moderated the relation between fathers’ low levels of authoritative parenting and boys’ aggression. Moreover, high negative emotionality moderated the relation between permissive paternal parenting and girls’ aggressive behavior, with both these relations being consistent with the diathesis-stress theory. Full article
(This article belongs to the Special Issue Dimensions of Pathological Aggression: From Neurobiology to Therapy)
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13 pages, 2376 KiB  
Article
Structural Degradation in Midcingulate Cortex Is Associated with Pathological Aggression in Mice
by Sabrina van Heukelum, Femke E. Geers, Kerli Tulva, Sanne van Dulm, Christian F. Beckmann, Jan K. Buitelaar, Jeffrey C. Glennon, Brent A. Vogt, Martha N. Havenith and Arthur S. C. França
Brain Sci. 2021, 11(7), 868; https://doi.org/10.3390/brainsci11070868 - 29 Jun 2021
Cited by 2 | Viewed by 2373
Abstract
Pathological aggression is a debilitating feature of many neuropsychiatric disorders, and cingulate cortex is one of the brain areas centrally implicated in its control. Here we explore the specific role of midcingulate cortex (MCC) in the development of pathological aggression. To this end, [...] Read more.
Pathological aggression is a debilitating feature of many neuropsychiatric disorders, and cingulate cortex is one of the brain areas centrally implicated in its control. Here we explore the specific role of midcingulate cortex (MCC) in the development of pathological aggression. To this end, we investigated the structural and functional degeneration of MCC in the BALB/cJ strain, a mouse model for pathological aggression. Compared to control animals from the BALB/cByJ strain, BALB/cJ mice expressed consistently heightened levels of aggression, as assessed by the resident-intruder test. At the same time, immunohistochemistry demonstrated stark structural degradation in the MCC of aggressive BALB/cJ mice: Decreased neuron density and widespread neuron death were accompanied by increased microglia and astroglia concentrations and reactive astrogliosis. cFos staining indicated that this degradation had functional consequences: MCC activity did not differ between BALB/cJ and BALB/cByJ mice at baseline, but unlike BALB/cByJ mice, BALB/cJ mice failed to activate MCC during resident-intruder encounters. This suggests that structural and functional impairments of MCC, triggered by neuronal degeneration, may be one of the drivers of pathological aggression in mice, highlighting MCC as a potential key area for pathologies of aggression in humans. Full article
(This article belongs to the Special Issue Dimensions of Pathological Aggression: From Neurobiology to Therapy)
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Review

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22 pages, 1118 KiB  
Review
Modulating Behavioural and Self-Reported Aggression with Non-Invasive Brain Stimulation: A Literature Review
by Ruben Knehans, Teresa Schuhmann, David Roef, Hans Nelen, Joost à Campo and Jill Lobbestael
Brain Sci. 2022, 12(2), 200; https://doi.org/10.3390/brainsci12020200 - 31 Jan 2022
Cited by 9 | Viewed by 5488
Abstract
Aggressive behaviour is at the basis of many harms in society, such as violent crime. The efforts to explain, study, and possibly reduce aggression span various disciplines, including neuroscience. The specific brain networks which are involved in the modulation of aggressive behaviour include [...] Read more.
Aggressive behaviour is at the basis of many harms in society, such as violent crime. The efforts to explain, study, and possibly reduce aggression span various disciplines, including neuroscience. The specific brain networks which are involved in the modulation of aggressive behaviour include cortical asymmetry and brain areas such as the dorsolateral prefrontal cortex (DLPFC), the ventrolateral prefrontal cortex (VLPFC), and the ventromedial prefrontal cortex (VMPFC). Recent non-invasive brain stimulation (NIBS) research suggests that both transcranial direct current stimulation (tDCS) and continuous theta burst stimulation (cTBS) can play a role in the modulation of aggressive behaviour by directly changing brain activity. In this review, we systematically explore and discuss 11 experimental studies that aimed to modulate aggressive behaviour or self-reported aggression using NIBS. Out of these 11 studies, nine significantly up- or downregulated aggression by using tDCS or cTBS targeting the DLPFC, VLPFC or VMPFC. The potential applications of these findings span both the clinical and the forensic psychological domains. However, the results are limited by the methodological heterogeneity in the aggression measures used across the studies, and by their generally small sample sizes. Future research should consider improving the localization and specificity of NIBS by employing neuro-navigational instruments and standardized scoring methods. Full article
(This article belongs to the Special Issue Dimensions of Pathological Aggression: From Neurobiology to Therapy)
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30 pages, 1704 KiB  
Review
Cold-Blooded and on Purpose: A Review of the Biology of Proactive Aggression
by Kimberly D. Belfry and Nathan J. Kolla
Brain Sci. 2021, 11(11), 1412; https://doi.org/10.3390/brainsci11111412 - 26 Oct 2021
Cited by 10 | Viewed by 3483
Abstract
Proactive aggression (PA) is a planned and unprovoked form of aggression that is most often enacted for personal gain or in anticipation of a reward. Frequently described as “cold-blooded” or goal oriented, PA is thought to be associated with low autonomic arousal. With [...] Read more.
Proactive aggression (PA) is a planned and unprovoked form of aggression that is most often enacted for personal gain or in anticipation of a reward. Frequently described as “cold-blooded” or goal oriented, PA is thought to be associated with low autonomic arousal. With this view in mind, we performed a scoping review of the biological correlates of PA and identified 74 relevant articles. Physiological findings indicated a robust association between PA and reduced resting heart rate, and to a lesser extent a relationship between PA and decreased heart rate and skin conductance reactivity, perhaps indicating dampened sympathetic function. The twin literature identified PA as a heritable trait, but little evidence implicates specific genes in the pathogenesis of PA. Neuroimaging studies of PA pinpoint impaired amygdala function in the assessment and conditioning of aversive stimuli, which may influence the establishment of behavioral patterns. Nodes of the default mode network were identified as possible neural correlates of PA, suggesting that altered function of this network may be involved in the genesis of PA. Given the overlap of PA with reactive aggression and the overall behavioral complexity of PA, it is clear that multiple endophenotypes of PA exist. This comprehensive review surveys the most salient neurobiologically informed research on PA. Full article
(This article belongs to the Special Issue Dimensions of Pathological Aggression: From Neurobiology to Therapy)
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