Aggression and violence Modern versions of biological theories of violence focus on the role of biological and psychosocial factors in the understanding of violence. Many scholars argue that the exposure to environmental contaminants can be linked to neurobehavioral and a higher risk of antisocial behavior. Aggression can take on different meanings, thus separating it into categories like reactive or hostile aggression, and proactive or instrumental aggression. In children, reactive aggression is seen as tantrums. Bullying is a form of Proactive aggression. Early traumas may lead to over reactive, defensive, aggressive responses in the adults. People with PTSD (Widom313-44) feel stressed out even when they are no longer in danger. From a criminological viewpoint, one might ponder over whether violence can exist in conjunction with PTSD.
Violence is probably one of the most central public health problems worldwide. The use of excessive violence was reported to be majorly related to the offender–victim relationship, offender age, and substance abuse, but not related to having developmental issues, crime history or mental illness. Violence can take several forms and can different in intensity and type. It can be hidden too in the form of Domestic violence. Alcohol, substance abuse, and biological factors too act as independent risk factors that can amplify the violence. The issue of personality disorders is very complex and often related to delinquency. Recent research in a maximum security psychiatric facility exposed that 68% of inmates had a psychotic disorder, and 30% met criteria for psychopathy. Psychopathy impression has the bent to slip from a medical domain towards a psycho-legal concept. Psychopathic inferiority and disorders can lead to early behavioral disorders, lack of empathy, promiscuous sexual behavior, lower behavioral control, short term marital relationships, criminal versatility, etc. (Petris and Podea 77).
Personality disorders (PD) carry a significant clinical risk for violence, and the different personality dimensions are impulse control, regulation, paranoid cognitive personality and threatened egotism. Two of these dimensions, the regulation and impulse control effect are known to link to violence. Paranoid cognitive personality and threatened egotism too have been linked to violence. The clinical and legal criminal significance of personality disorders (PD) in serious and violent behaviors is undisputable. These are important aspects in the assessment of the risk of violence. There is a very high occurrence of PDs in the forensic and reformatory populations. However, the numbers vary considerably in the different studies. In 1983, the concept of Dangerous People with Severe Personality Disorder (DSPD), was introduced to apply to patients having a high probability of committing a serious offense (Esbec and Echeburúa 249-261).
The terms violence and hostility overlap each other and are frequently used to denote different levels of agitation and aggression in humans (Látalová and Prasko239-51). A study was done based on PUBMED data base was, searching for borderline personality disorder and violence.Borderline personality disorder is categorized by the instability and dysfunction in behavioral and interpersonal domains. Extreme instability can lead to impulsive and self-destructive behaviors. Although these episodes are brief, they involve intense and extremely angry and depressed states. Different therapies are used on these patients to control and manage the impulsive and aggressive behaviors, but more studies need to be done (Látalová and Prasko239-51).
Borderline personality disorder (BPD) Recent studies show that medications may reduce impulsivity, irritability, and aggressive behavior. Patients with borderline personality disorder often exhibit self-mutilation, impulsive aggression, and self-damaging behavior. Some examples are reckless spending, substance abuse, promiscuous sex, etc. Aggression against others or self is one of the essential components of the borderline personality disorder (BPD). These forms of aggression influence the patient’s environment, clinical care, and legal involvement. A longitudinal study of the subjects displayed that more than 58% have been involved in physical fights as adults, and about 25% have used weapons against others (Látalová and Prasko239-51). The scales denoting the levels of aggressive behavior in BPD, however, cannot be linked to these aggressive incidents.
BPD is looked upon as a disorder of dysregulation of behavior, cognition, and interpersonal relationships. As a consequence of these dysregulations, one finds suicidal aggressive behavior characteristic of many individuals with BPD. The psychopathology not only affects the probability of violence but also its intensity. The murders are found to have a higher borderline personality scores as compared to the nonviolent offenders. Borderline traits are linked with instability and unstable as well as intense relationships.
Personality disorders are often linked with criminality and borderline personalities that are looked upon as strong predictors of violence. Borderline patients show more of emotional violence while antisocial patients exhibit instrumental violence. When medical records of patients with antisocial personality disorder and borderline personality disorder were studied, it was found that there are differences relating to the engagement in violence according to the personality disorder. The antisocial patients engaged in crimes against property while the borderline patients showed a tendency to get involved in episodes of physical violence (de Barros 19-22). Thus, a distinct personality can lead to a different pattern of crimes and violence. Criminals with antisocial disorders are found to be more aggressive than criminals without personality disorders.
Managing violence in patients with Personality Disorders
The dysregulation and impulsive aggression are magnitudes that need particular attention in these patients with BPD as they are risk factors for self-injury, suicidal behavior, and the interpersonal aggressiveness. Under the pharmacological approach, medications are typically used as treating options. Although the antipsychotics and mood stabilizers show promising results (Látalová and Prasko239-51), there is still lack of adequate evidence in the published trials and studies. Psychotherapy on a group of outpatients showed decreases of severity of global symptoms, self-harm, and violent behavior.
Socioeconomic factors are quite weak for predicting and prevention of violence. Child abuse or witnessing domestic violence can relate to the exhibition of violent behaviors among these children (Fountoulakis 84-92). A major problem is that all the prognostic factors depend a lot on the detection of a violent act and thus prevent early detection and diagnosis.
The findings of a recent study on antisocial and borderline personality disorder patients confirm that while the antisocial patients exhibit instrumental style in violence, the borderline patients show an emotional style. The relationship between personality and violence leads to different patients to committing various acts of violence. It can be concluded that behavioral differences between borderline personality disorder and antisocial patients lead them to a distinct pattern of misdemeanors.
Recent surveys studying the relationship between personality disorders and violent behavior suggest that personality disorders, especially antisocial and borderline, are linked strongly to the manifestation of violent acts. Biological factors too play a role in being a risk factor for violent behavior. Many patients show marked cognitive deficits although intelligence does not seem to be connected to violence. Substance abuse is another aspect that could play a role. Several determinants such as age, gender, and race are strong predictors of violence (Fountoulakis 84-92). Another line of research could be a connection among disorders that usually take root during childhood and manifest during adulthood.
The above studies show that mental patients are often a victim of their own defenselessness. The destructive behaviors are not the produce of the insanity, but a result of the marginalization and wickedness. Studies on the likely association between mental diseases in violent behavior are controversial. Many of the factors that are linked with violent behavior such as anti-social behavior, psychopathy, drug abuse, anger are predictors (Esbec and Echeburúa 249-261) of substantial violence among subjects without mental disorders. Thus, the independent impact of the mental disease and violence is not clear. Antisocial personality is looked upon as a distinct disorder from psychopathy.
The available studies indicate that medications may prove to be mildly effective for controlling aggressive and violent behavior in the patients with personality disorders. The emergency psychiatry settings to treat patients with personality disorders offer extraordinarily difficult challenges. There are risks that individuals with BPD carry a higher risk of getting involved in interpersonal violence. Research on mental illnesses and violence has shown that there is a small subgroup that shows violent behavior repeatedly. Studies also show that majority of these patients with BPD do not engage in self-harm but inflict harm upon others (Newhill 541-54). These individuals also show anti-social behavior and higher levels of psychopathy. And, because of their violence, such individuals are not able to receive adequate treatment and psychiatric care, and often get involved with criminal justice system.
There are complex socio economic disorders that play their role such as poverty, single- or no-parent families, substance abuse, lack of education, unemployment. The less personal space in high-density areas too can lead to increased violence.
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de Barros, Daniel Martins, and Antonio de Pádua Serafim. "Association between Personality Disorder and Violent Behavior Pattern." Forensic Science International 179.1 (2008): 19-22. Print.Esbec, E., and E. Echeburúa. "Violence and Personality Disorders: Clinical and Forensic Implication." Medical Specialist in Legal and Forensic Medicine and in Psychiatry (2010): :249-261. Print.
Fountoulakis, Konstantinos N., Stefan Leucht, and George S. Kaprinis. "Personality Disorders and Violence." Current opinion in psychiatry 21.1 (2008): 84-92. Print.
Látalová, K., and J. Prasko. "Aggression in Borderline Personality Disorder." The Psychiatric quarterly 81.3 (2010): 239-51. Print.
Newhill, Christina E., Shaun M. Eack, and Edward P. Mulvey. "Violent Behavior in Borderline Personality."Journal of personality disorders 23.6 (2009): 541-54. Print.
WIDOM, CATHY SPATZ. "Varieties of Violent Behavior."Criminology 52.3 (2014): 313-44. Print.