Antisocial Personality and Violence

Male inmate profiles and their biological correlates.
Horn, Mathilde, et al.
The Canadian Journal of Psychiatry / La Revue canadienne de psychiatrie, Vol 59(8), Aug, 2014.
Abstract:
Objective: Borderline and antisocial personality disorders (PDs) share common clinical features (impulsivity, aggressiveness, substance use disorders [SUDs], and suicidal behaviours) that are greatly overrepresented in prison populations. These disorders have been associated biologically with testosterone and cortisol levels. However, the associations are ambiguous and the subject of controversy, perhaps because these heterogeneous disorders have been addressed as unitary constructs. A consideration of profiles of people, rather than of exclusive diagnoses, might yield clearer relationships.
Methods: In our study, multiple correspondence analysis and cluster analysis were employed to identify subgroups among 545 newly convicted inmates. The groups were then compared in terms of clinical features and biological markers, including levels of cortisol, testosterone, estradiol, progesterone, and sulfoconjugated dehydroepiandrosterone (DHEA-S).
Results: Four clusters with differing psychiatric, criminal, and biological profiles emerged. Clinically, one group had intermediate scores for each of the tested clinical features. Another group comprised people with little comorbidity. Two others displayed severe impulsivity, PD, and SUD. Biologically, cortisol levels were lowest in the last 2 groups and highest in the group with less comorbidity. In keeping with previous findings reported in the literature, testosterone was higher in a younger population with severe psychiatric symptoms. However, some apparently comparable behavioural outcomes were found to be related to distinct biological profiles. No differences were observed for estradiol, progesterone, or DHEA-S levels. Conclusions: The results not only confirm the importance of biological markers in the study of personality features but also demonstrate the need to consider the role of comorbidities and steroid coregulation.

Associations between dysfunctional personality traits and intimate partner violence in perpetrators and victims.
Sijtsema, Jelle J., et al.
Journal of Interpersonal Violence, Vol 29(13), Sep, 2014. pp. 2418-2438.
Abstract:
In the current study, the role of borderline and antisocial personality traits and psychological and physical forms of intimate partner violence were examined. Using self- and partner-reports, 30 perpetrators (28 males) and 30 victims (29 females) of partner violence, including 23 (former) couples, were interviewed. Results showed that perpetrators (i.e., males) were higher on antisocial personality traits than victims (i.e., females), but the two groups did not differ on borderline traits and self-reported violence. Moreover, borderline traits were associated with partner violence in general, whereas antisocial personality traits were associated with physical, but not psychological, partner violence. Analyses on (former) couples suggest that there is little congruence between perpetrators’ and victims’ reports of partner violence. In conclusion, the findings of the current study not only emphasized the complex nature of intimate partner violence but also showed that dysfunctional personality traits and gender play a significant role in both the display and reporting of partner violence.

Antisocial personality disorder comorbid with borderline pathology and psychopathy is associated with severe violence in a forensic sample.
Howard, Richard C., et al.
Journal of Forensic Psychiatry & Psychology, Vol 25(6), Nov, 2014. pp. 658-672.
Abstract:
Background: Evidence suggests the relationship between personality disorder (PD) and violence in offenders might be clarified by considering sub-groups of PD offenders defined by patterns of PD comorbidity. Aim: to identify patterns of PD comorbidity associated with severe violence, defined by its severity, quantity and age of onset (Violence Index: VI) in a forensic sample of 100 PD offenders.
Methods: Correlations were first computed between VI and a range of personality and criminological variables; next, patients with antisocial/borderline comorbidity were compared with other PD patients; finally, regression analysis was conducted to identify unique predictors of VI.
Results: The antisocial deviance factor of psychopathy and antisocial/borderline comorbidity were each significantly and independently associated with severe violence. Patients showing both a high psychopathy score and antisocial/borderline comorbidity had a significantly greater VI than those without these characteristics. Conclusion: PD patients with high psychopathy co-occurring with borderline and antisocial PDs show a criminal profile characterised by a high degree of serious violence.

Monoamine oxidase A alleles in violent offenders with antisocial personality disorder: High activity associated with proactive aggression.
Kolla, Nathan J., et al.
Criminal Behaviour and Mental Health, Vol 24(5), Dec, 2014. pp. 368-372.
Abstract:
Meta-analysis has confirmed that, among males, carriers of the low-activity variant (L) of the monoamine oxidase A (MAOA) gene who experienced childhood physical abuse (CPA) show elevated rates of aggressive and antisocial behaviour. Studies included examined large population samples, and limited outcome variables to conduct disorder diagnoses and measures of aggression that did not distinguish between its proactive and reactive forms. Two studies examined violent convictions: one reported their association with MAOA-L and the other with the MAOA high-activity variant (H), both among men who had experienced CPA. In another study of offenders, MAOA-L was associated with factor 2 scores on the Psychopathy Checklist: Screening Version. MAOA-H has also been associated with aggression among boys and adult men. We have conducted exploratory analyses among violent offenders (VOs) and non-offenders (NOs) to estimate associations between MAOA genotype, CPA, reactive and proactive aggression, and factor 1 and 2 Psychopathy Checklist-Revised (PCL-R) scores.

‘Bad genes’ & criminal responsibility.
González-Tapia, María Isabel, Obsuth, Ingrid.
International Journal of Law and Psychiatry, Vol 39, Mar, 2015. pp. 60-71.
Abstract:
The genetics of the accused is trying to break into the courts. To date several candidate genes have been put forward and their links to antisocial behavior have been examined and documented with some consistency. In this paper, we focus on the so called ‘warrior gene’, or the low-activity allele of the MAOA gene, which has been most consistently related to human behavior and specifically to violence and antisocial behavior. In preparing this paper we had two objectives. First, to summarize and analyze the current scientific evidence, in order to gain an in depth understanding of the state of the issue and determine whether a dominant line of generally accepted scientific knowledge in this field can be asserted. Second, to derive conclusions and put forward recommendations related to the use of genetic information, specifically the presence of the low-activity genotype of the MAOA gene, in modulation of criminal responsibility in European and US courts.

Examining the role of antisocial personality disorderin intimate partner violence among substance use disordertreatment seekers with clinically significant trauma histories.
Dykstra, Rita E., et al.
Violence Against Women, Vol 21(8), Aug, 2015. pp. 958-974.
Abstract:
This study examined the associations among posttraumatic stress disorder (PTSD) symptom severity, antisocialpersonality disorder (ASPD) diagnosis, and intimate partner violence(IPV) in a sample of 145 substance abuse treatment-seeking men and women with positive trauma histories; sex was examined as a moderator. ASPD diagnosis significantly predicted both verbal and physical aggression; sex moderated the association between ASPD diagnosis and physical violence. PTSD symptom severity significantly predicted engaging in verbal, but not physical, aggression. Overall, these results suggest that an ASPD diagnosis may be an important risk factor for engaging in IPV among women seeking treatment for a substance use disorder.

Effects of the MAOA gene and levels of exposure to violence on antisocial outcomes.
Ouellet-Morin, Isabelle, et al.
The British Journal of Psychiatry, Vol 208(1), Jan, 2016. pp. 42-48.
Abstract:
Background: The monoamine oxidase A (MAOA) gene has been shown to moderate the impact of maltreatment on antisocial behaviour. Replication efforts have, however, yielded inconsistent results. Aims: To investigate whether the interaction between the MAOA gene and violence is present across the full distribution of violence or emerges at higher levels of exposure.
Method: Participants were 327 male members of the Québec Longitudinal Study of Kindergarten Children. Exposure to violence comprised retrospective reports of mother’s and father’s maltreatment, sexual and physical abuse. Conduct disorder and antisocial personality symptoms were assessed in semi-structured interviews and partner violence, property-violent crimes and arrest were self-reported.
Results: Non-linear interactions between the MAOA gene and violence were detected, suggesting that the genetic moderation may come about once a certain level of violence is experienced. Conclusions: Future studies should investigate the mechanisms translating substantial violence exposure, which could, subsequently, trigger the expression of genetically based differences in antisocial behaviour.

Association of ventral striatum monoamine oxidase-a binding and functional connectivity in antisocial personalitydisorder with high impulsivity: A positron emission tomography and functional magnetic resonance imaging study.
Kolla, Nathan J., et al.
European Neuropsychopharmacology, Vol 26(4), Apr, 2016. pp. 777-786.
Abstract:
Impulsivity is a core feature of antisocial personality disorder (ASPD) associated with abnormal brain function and neurochemical alterations. The ventral striatum (VS) is a key region of the neural circuitry mediating impulsive behavior, and low monoamine oxidase-A (MAO-A) level in the VS has shown a specific relationship to the impulsivity of ASPD. Because it is currently unknown whether phenotypic MAO-A markers can influence brain function in ASPD, we investigated VS MAO-A level and the functional connectivity (FC) of two seed regions, superior and inferior VS (VSs, VSi). Nineteen impulsive ASPD males underwent [¹¹C] harmine positron emission tomography scanning to measure VS MAO-A V_T, an index of MAO-A density, and resting-state functional magnetic resonance imaging that assessed the FC of bilateral seed regions in the VSi and VSs. Subjects also completed self-report impulsivity measures. Results revealed functional coupling of the VSs with bilateral dorsomedial prefrontal cortex (DMPFC) that was correlated with VS MAO-A VT (r = 0.47, p = 0.04), and functional coupling of the VSi with right hippocampus that was anti-correlated with VS MAO-A V_T (r = −0.55, p= 0.01). Additionally, VSs-DMPFC FC was negatively correlated with NEO Personality Inventory-Revised impulsivity (r = −0.49, p = 0.03), as was VSi-hippocampus FC with Barratt Impulsiveness Scale-11 motor impulsiveness (r = −0.50, p = 0.03). These preliminary results highlight an association of VS MAO-A level with the FC of striatal regions linked to impulsive behavior in ASPD and suggest that phenotype-based brain markers of ASPD have relevance to understanding brain function.

Antisocial personality disorder and physical partner violence among single and dual substance-abusing couples.
Kelley, Michelle L., Braitman, Abby L..
Journal of Family Violence, Vol 31(4), May, 2016. pp. 423-431.
Abstract:
The current study examined how antisocial personality disorder (APD) and substance use disorder contributed to partners’ reports of physical partner violence among single and dual substance-abusing couples. Participants were 69 heterosexual couples entering treatment in which one or both partners met criteria for substance use disorder. APD diagnosis of the male partner was linked to significantly higher male-to-female and female-to-male perpetration of physical partner violence and victimization. Female partner’s APD diagnosis was associated with women’s reports of victimization by their male partners. Dual substance use diagnosis emerged as a moderator, in which the effect of men’s APD diagnosis on men’s perpetration of physical partner violence and victimization was significantly reduced if both partners had substance use disorder. Findings underscore the importance of both partners’ APD diagnosis and substance use status for understanding physical partner violence among single and dual substance-abusing couples.

Paranoid ideation and violence: Meta-analysis of individual subject data of 7 population surveys.
Coid, Jeremy W., et al.
Schizophrenia Bulletin, Vol 42(4), Jul, 2016. pp. 907-915.
Abstract:
There is controversy whether associations between psychosis and violence are due to coexisting substance misuse and factors increasing risk in nonpsychotic persons. Recent studies in clinical samples have implicated independent effects of paranoid delusions. Research findings suggest that individual psychotic-like-experiences on the psychosis continuum in the general population are associated with violence; it remains unclear whether this association is due to psychiatric comorbidity. We pooled data from 7 UK general population surveys (n = 23 444) and conducted a meta-analysis of individual subject data. Further meta-analyses were performed to identify heterogeneity. Main exposure variables: 5 psychotic-like-experiences and a categorical measure of psychosis. Comorbidity was established through standardized self-report instruments. Information was collected on violence, severity, victims. Paranoid ideation was associated with violence (AOR 2.26, 95% CI 1.75–2.91), severity and frequency, even when controlling for effects of other psychotic-like-experiences. Associations were not explained by comorbid conditions, including substance dependence. Psychotic disorder was associated with violence and injury to the perpetrator but associations were explained by paranoid ideation. Individual associations between hypomania, thought insertion, hallucinations, and violence were nonsignificant after adjustments, and significantly associated only when comorbid with antisocial personalitydisorder. Strange experiences were only associated with intimate partner violence. Paranoid ideation on a psychosis-continuum in the general population was associated with violence. All other associations were explained by comorbidity. Further investigation should determine whether paranoid ideation among persons in the community require preventive interventions, similar to those presenting to mental health services. Nevertheless, risks are considerably increased for psychotic-like-experiences with co-occurring antisocial personality disorder.

Evidence for an agitated-aggressive syndrome in early-onset psychosis correlated with antisocialpersonalitydisorder, forensic history, and substance use disorder.
Huber, Christian G., et al.
Schizophrenia Research, Vol 175(1-3), Aug, 2016. pp. 198-203.
Abstract:
Objective: Agitation, aggression, and violence are increased in psychotic disorders. Additionally, an earlier age at onset may be associated with aggressive behavior. However, the relationship of age at onset, an agitated-aggressive syndrome as measured with the Positive And Negative Syndrome Scale for Schizophrenia—Excited Component (PANSS-EC), and its potential correlates in first-episode psychosis (FEP) has not been studied.
Method: This study assessed the association between age at onset, an agitated-aggressive syndrome, and its potential correlates in a prospective sample of 52 FEP patients with early-onset and adult-onset followed up for 12months.
Results: Twenty-six patients conformed to the criteria of early-onset psychosis. Early age at onset was associated with antisocial personality disorder (p = 0.004; φc = 0.39), a history of legal involvement (p = 0.005; φc= 0.39), and higher rates of lifetime substance use disorder (SUD; p = 0.002; φc = 0.42). Early-onset patients had significantly higher PANSS-EC scores over the course of observation (F(1,44.4) = 5.39; p = 0.025; d = 0.656), but no significant group differences emerged for the remaining PANSS subscores. PANSS-EC scores were correlated positively with antisocial personality disorderand forensic history at 6weeks, 3months, 6months, and 12months, and with lifetime substance use disorder at 3months and 6months. Conclusions: Patients with early onset psychosis may have increased levels of agitation/aggressiveness, and, more likely, antisocial personalitydisorder, forensic history, and lifetime substance use disorder. These variables were linked to suicidality, aggressiveness, and involuntary treatment.

Sensation seeking and impulsive traits as personality endophenotypes for antisocialbehavior: Evidence from twoindependent samples.
Mann, Frank D., et al.
Personality and Individual Differences, Vol 105, Jan 15, 2017. pp. 30-39.
Abstract:
Sensation seeking and impulsivity are personality traits that are correlated with risk for antisocial behavior (ASB). This paper uses two independent samples of twins to (a) test the extent to which sensation seeking and impulsivity statistically mediate genetic influence on ASB, and (b) compare this to genetic influences accounted for by other personality traits. In Sample 1, delinquent behavior, as well as impulsivity, sensation seeking and Big Five personality traits, were measured in adolescent twins from the Texas Twin Project. In Sample 2, adult twins from the Australian Twin Registry responded to questionnaires that assessed individual differences in Eysenck’s and Cloninger’s personality dimensions, and a structured telephone interview that asked participants to retrospectively report DSM-defined symptoms of conduct disorder. Bivariate quantitative genetic models were used to identify genetic overlap between personality traits and ASB. Across both samples, novelty/sensation seeking and impulsive traits accounted for larger portions of genetic variance in ASB than other personality traits. We discuss whether sensation seeking and impulsive personality are causal endophenotypes for ASB, or merely index genetic liability for ASB.

Trait anger, physical aggression, and violent offending in antisocial and borderline personality disorders.
Kolla, Nathan J., et al.
Journal of Forensic Sciences, Vol 62(1), Jan, 2017. pp. 137-141.
Abstract:
Antisocial personality disorder (ASPD) and borderline personality disorder (BPD) are common conditions in forensic settings that present high rates of violence. Personality traits related to the five‐factor model personalitydomains of neuroticism and agreeableness have shown a relationship with physical aggression in nonclinical and general psychiatric samples. The aim of the present investigation was to examine the association of these personality traits with violence and aggression in ASPD and BPD. Results revealed that trait anger/hostility predicted self‐reported physical aggression in 47 ASPD and BPD subjects (β = 0.5, p = 0.03) and number of violent convictions in a subsample of the ASPD participants (β = 0.2, p = 0.009). These preliminary results suggest that high anger and hostility are associated with physical aggression in BPD and ASPD. Application of validated, self‐report personality measures could provide useful and easily accessible information to supplement clinical risk assessment of violence in these conditions.

Offenders with antisocial personality disorder display more impairments in mentalizing.
Newbury-Helps, John, et al.
Journal of Personality Disorders, Vol 31(2), Apr, 2017. pp. 232-255.
Abstract:
This study was designed to test the hypothesis that individuals with antisocial, particularly violent, histories of offending behavior have specific problems in social cognition, notably in relation to accurately envisioning mental states. Eighty-three male offenders on community license, 65% of whom met the threshold for antisocial personality disorder (ASPD), completed a battery of computerized mentalizing tests requiring perspective taking (Perspectives Taking Test), mental state recognition from facial expression (Reading the Mind in the Eyes Test), and identification of mental states in the context of social interaction (Movie for the Assessment of Social Cognition). The results were compared with a partially matched sample of 42 nonoffending controls. The offender group showed impaired mentalizing on all of the tasks when compared with the control group for this study when controlling for demographic and clinical variables, and the offending group performed poorly in comparisons with participants in published studies, suggesting that limited capacity to mentalize may be part of the picture presented by individuals with histories of offending behavior. Offenders with ASPD demonstrated greater difficulty with mentalizing than non-ASPD offenders. Mentalization subscales were able to predict offender status and those with ASPD, indicating that specific impairments in perspective taking, social cognition, and social sensitivity, as well as tendencies toward hypomentalizing and nonmentalizing, are more marked in individuals who meet criteria for a diagnosis of ASPD. Awareness of these deficits may be helpful to professionals working with offenders, and specifically addressing these deficits may be a productive aspect of therapy for this ‘hard to reach’ clinical group.

Sensorimotor gating characteristics of violent men with comorbid psychosis and dissocial personality disorder: Relationship with antisocial traits and psychosocial deprivation.
Sedgwick, Ottilie, et al.
Schizophrenia Research, Jul 6, 2017.
Abstract:
Evidence suggests violence amongst those with psychosis is not aetiologically homogeneous, and that a large proportion of those who engage in violent behaviour have a comorbid antisocial personality disorder. Initial investigations indicate that this subgroup has distinct historical and neuropsychological characteristics, which may indicate diverse treatment needs. This study investigated sensorimotor gating characteristics of violent men with diagnoses of both psychosis and dissocial personality disorder (DPD) (n=21) relative to violent men with psychosis alone (n=12), DPD alone (n=14) and healthy, non-violent male controls (n=27), using the prepulse inhibition (PPI) paradigm. The results indicated that, relative to the psychosis alone and healthy control groups, the comorbid group had lower PPI, especially at 60-ms prepulse-to-pulse interval. The DPD group took an intermediary position and did not differ from any group. Antisocial personality traits (factor two scores of the Psychopathy Checklist – Revised), and greater severity of childhood psychosocial deprivation (including physical and sexual abuse), were significantly correlated with poor PPI across the clinical sample. The findings suggest diverse sensorimotor gating profiles amongst subgroups of violent offenders, with comorbid psychosis and DPD showing most impairment. This is consistent with a ‘double dose’ of deficit explanation amongst those with both diagnoses, explained at least in part by presence of antisocial personality traits and childhood psychosocial deprivation.

Serotonin 1B receptor binding is associated with trait anger and level of psychopathy in violent offenders.
da Cunha-Bang, Sofi, et al.
Biological Psychiatry, Vol 82(4), Aug 15, 2017. pp. 267-274.
Abstract:
Background: The involvement of serotonin in aggression has traditionally been attributed to impaired prefrontal serotonergic inhibitory control of emotional reactions to provocations in antisocial individuals. However, it is unclear which specific serotonergic receptors are involved in the effects. A large body of preclinical research supports a specific role of serotonin 1B receptors (5-HT1BRs) in aggression and impulsivity, but this has never been evaluated in humans.
Methods: Nineteen incarcerated violent offenders and 24 healthy control nonoffenders were included and examined with positron emission tomography, using the radioligand [11C]AZ10419369 for quantification of cerebral 5-HT1BR binding in three regions of interest: the anterior cingulate cortex, orbitofrontal cortex, and striatum.
Results: Group status significantly moderated the association between striatal 5-HT_1BRs and trait anger (difference in slopes, p_corrected = .04). In the violent offender group, striatal 5-HT1BR binding was positively correlated with self-reported trait anger (p = .0004), trait psychopathy (p = .008), and level of psychopathy according to the Psychopathy Checklist-Revised (p = .02). We found no group differences in 5-HT1BR binding. Conclusions: Our data demonstrate for the first time in humans a specific involvement of 5-HT_1BR binding in anger and psychopathy. 5-HT_1BRs putatively represent a molecular target for development of pharmacologic antiaggressive treatments.

Mental Health Factors and Intimate Partner Violence Perpetration and Victimization: A Meta-Analysis.
Spencer, Chelsea, et al.
Psychology of Violence, Nov. 16, 2017
Abstract:
Objectives: This meta-analysis aimed to explore the relationship between mental health disorders and symptoms of mental health disorders (depression, anxiety, posttraumatic stress disorder [PTSD], antisocial personalitydisorder [PD], and borderline PD) and physical intimate partner violence (IPV) perpetration and victimization for males and females.
Method: Data from 207 studies, yielding 511 effect sizes, were analyzed. The overall strength of each correlate for IPV perpetration and victimization was examined. Moderator analyses were used to compare the strength of correlates for IPV victimization versus perpetration, as well as for males versus females.
Results: Depression, anxiety, PTSD, antisocial PD, and borderline PD were all significant correlates for both IPV victimization and perpetration. Anxiety and PTSD were significantly stronger correlates for victimization than for perpetration, and borderline PD and antisocial PD were significantly stronger correlates for perpetration than for victimization. For women, borderline PD was a significantly stronger correlate for IPV perpetration than for victimization, and PTSD was a significantly stronger correlate for IPV victimization than perpetration. Depression was a significantly stronger correlate for IPV victimization for women than for men.
Conclusions: This study provides a comprehensive examination of mental health disorders and their link to IPV perpetration and victimization. The results suggest that clinicians working with individuals or couples in the context of IPV should assess for and treat mental health problems.

Neural mechanisms underlying affective theory of mind in violent antisocial personality disorder and/or schizophrenia.
Schiffer, Boris, et al.
Schizophrenia Bulletin, Vol 43(6), Nov, 2017. pp. 1229-1239.
Abstract:
Among violent offenders with schizophrenia, there are 2 sub-groups, one with and one without, conduct disorder(CD) and antisocial personality disorder (ASPD), who differ as to treatment response and alterations of brain structure. The present study aimed to determine whether the 2 groups also differ in Theory of Mind and neural activations subsuming this task. Five groups of men were compared: 3 groups of violent offenders—schizophrenia plus CD/ASPD, schizophrenia with no history of antisocial behavior prior to illness onset, and CD/ASPD with no severe mental illness—and 2 groups of non-offenders, one with schizophrenia and one without (H). Participants completed diagnostic interviews, the Psychopathy Checklist Screening Version Interview, the Interpersonal Reactivity Index, authorized access to clinical and criminal files, and underwent functional magnetic resonance imaging while completing an adapted version of the Reading-the-Mind-in-the-Eyes Task (RMET). Relative to H, nonviolent and violent men with schizophrenia and not CD/ASPD performed more poorly on the RMET, while violent offenders with CD/ASPD, both those with and without schizophrenia, performed similarly. The 2 groups of violent offenders with CD/ASPD, both those with and without schizophrenia, relative to the other groups, displayed higher levels of activation in a network of prefrontal and temporal-parietal regions and reduced activation in the amygdala. Relative to men without CD/ASPD, both groups of violent offenders with CD/ASPD displayed a distinct pattern of neural responses during emotional/mental state attribution pointing to distinct and comparatively successful processing of social information.

Neuropsychology and emotion processing in violent individuals with antisocial personality disorder or schizophrenia: The same or different? A systematic review and meta-analysis.
Sedgwick, Ottilie, et al.
Australian and New Zealand Journal of Psychiatry, Vol 51(12), Dec, 2017. pp. 1178-1197.
Abstract:
Objectives: To assess whether there are shared or divergent (a) cognitive and (b) emotion processing characteristics among violent individuals with antisocial personality disorderand/or schizophrenia, diagnoses which are commonly encountered at the interface of mental disorder and violence. Cognition and emotion processing are incorporated into models of violence, and thus an understanding of these characteristics within and between disordergroups may help inform future models and therapeutic targets.
Methods: Relevant databases (OVID, Embase, PsycINFO) were searched to identify suitable literature. Meta-analyses comparing cognitive function in violent schizophrenia and antisocial personality disorder to healthy controls were conducted. Neuropsychological studies not comparing these groups to healthy controls, and emotion processing studies, were evaluated qualitatively.
Results: Meta-analyses indicated lower IQ, memory and executive function in both violent schizophrenia and antisocial personality disorder groups compared to healthy controls. The degree of deficit was consistently larger in violent schizophrenia. Both antisocial personality disorder and violent schizophrenia groups had difficulties in aspects of facial affect recognition, although theory of mind results were less conclusive. Psychopathic traits related positively to experiential emotion deficits across the two disorders. Very few studies explored comorbid violent schizophrenia and antisocial personality disorder despite this being common in clinical practice.
Conclusion: There are qualitatively similar, but quantitatively different, neuropsychological and emotion processing deficits in violent individuals with schizophrenia and antisocial personality disorder which could be developed into transdiagnostic treatment targets for violent behaviour. Future research should aim to characterise specific subgroups of violent offenders, including those with comorbid diagnoses.

Antisocial traits, distress tolerance, and alcohol problems as predictors of intimate partner violence in men arrested for domestic violence.
Brem, Meagan J.. et al.
Psychology of Violence, Vol 8(1), Jan, 2018. pp. 132-139.
Abstract:
Objective: Men with antisocial personality disorder (ASPD) traits are at an increased risk for consuming alcohol and perpetrating intimate partner violence (IPV). However, previous research has neglected malleable mechanisms potentially responsible for the link between ASPD traits, alcohol problems, and IPV perpetration. Efforts to improve the efficacy of batterer intervention programs (BIPs) would benefit from exploration of such malleable mechanisms. The present study is the 1st to examine distress tolerance as 1 such mechanism linking men’s ASPD traits to their alcohol problems and IPV perpetration.
Method: Using a cross-sectional sample of 331 men arrested for domestic violence and court-referred to BIPs, the present study used structural equation modeling to examine pathways from men’s ASPD traits to IPV perpetration directly and indirectly through distress tolerance and alcohol problems.
Results: Results supported a 2-chain partial mediational model. ASPD traits were related to psychological aggression perpetration directly and indirectly via distress tolerance and alcohol problems. A 2nd pathway emerged by which ASPD traits related to higher levels of alcohol problems, which related to psychological aggression perpetration. Controlling for psychological aggression perpetration, neither distress tolerance nor alcohol problems explained the relation between ASPD traits and physical assault perpetration.
Conclusion: These results support and extend existing conceptual models of IPV perpetration. Findings suggest intervention efforts for IPV should target both distress tolerance and alcohol problems.

The endocannabinoid system, aggression, and the violence of synthetic cannabinoid use, borderline personalitydisorder, antisocial personality disorder, and other psychiatric disorders.
Kolla, Nathan J., Mishra, Achal.
Frontiers in Behavioral Neuroscience, Vol 12, Mar 27, 2018. ArtID: 41
Abstract:
Endogenous and exogenous cannabinoids bind to central cannabinoid receptors to control a multitude of behavioral functions, including aggression. The first main objective of this review is to dissect components of the endocannabinoid system, including cannabinoid 1 and cannabinoid 2 receptors; the endogenous cannabinoids anandamide and 2-arachidonoylglycerol; and the indirect cannabinoid modulators fatty acid amide hydrolase and monoacylglycerol lipase; that have shown abnormalities in basic research studies investigating mechanisms of aggression. While most human research has concluded that the active ingredient of marijuana, Δ9-tetrahydrocannabinol, tends to dampen rather than provoke aggression in acute doses, recent evidence supports a relationship between the ingestion of synthetic cannabinoids and emergence of violent or aggressive behavior. Thus, another objective is to evaluate the emerging clinical data. This paper also discusses the relationship between prenatal and perinatal exposure to cannabis as well as use of cannabis in adolescence on aggressive outcomes. A final objective of the paper is to discuss endocannabinoid abnormalities in psychotic and affective disorders, as well as clinically aggressive populations, such as borderline  personality disorder and antisocialpersonality disorder. With regard to the former condition, decreased anandamide metabolites have been reported in the cerebrospinal fluid, while some preliminary evidence suggests that fatty acid amide hydrolase genetic polymorphisms are linked to antisocial personality disorder and impulsive-antisocial psychopathic traits. To summarize, this paper will draw upon basic and clinical research to explain how the endocannabinoid system may contribute to the genesis of aggressive behavior.

Self- and other-directed forms of violence and their relationship with lifetime DSM-5 psychiatric disorders: Results from the National Epidemiologic Survey on Alcohol Related Conditions−III (NESARC−III).
Harford, Thomas C., et al.
Psychiatry Research, Vol 262, Apr, 2018. pp. 384-392.
Abstract:
A combined history of violence toward self and others has been reported in clinical and incarcerated populations. Psychiatric disorders have been implicated as risk factors. This study examines the lifetime prevalence of this combined violence in the general population and its associations with DSM-5 psychiatric disorders in comparison with other- and self-directed violence. Data from the National Epidemiologic Survey on Alcohol and Related Conditions–III (NESARC–III) were analyzed, including 36,309 U.S. adults ages 18 and older. Violent behavior was defined by suicide attempts; recurrent suicidal behavior; gestures, threats, or self-mutilating behavior (self-directed); and multiple items of violence toward others (other-directed) in four categories: none, self-directed only, other-directed only, and combined self-/other-directed. Multinomial logistic regression examined these violencecategories in association with sociodemographics and lifetime DSM-5 psychiatric disorders. Results show that approximately 18.1% of adults reported violent behavior, including self-directed only (4.4%), other-directed only (10.9%), and combined self- and other-directed violence (2.8%). DSM-5 psychiatric disorders significantly associated with the violence typology include alcohol, tobacco, cannabis, and other drug use disorders; mood disorders; posttraumatic stress disorder; and schizotypal, antisocial, and borderline personality disorders. Findings extend the clinical literature regarding the co-occurrence of self- and other-directed violent behaviors to the general population.