BIOLOGICAL BASES OF PSICHIATRY 

Minerva Psichiatrica 2011 December;52(4):187-203

Copyright © 2012 EDIZIONI MINERVA MEDICA

language: English

Neurobiological and clinical aspects of violent offenders

Schiltz K. ¹, Witzel J. G. ², Bogerts B. ¹

¹ Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany 2 Central Forensic State Hospital, Uchtspringe, Germany

Violent offending is a major public health issue. Nevertheless, little is known yet about putative therapeutic interventions that might prevent a substantial fraction of violent offences. A first step towards such a causative approach to violence prevention is a sound understanding of factors that lead to violent offending, be it in the social, medical or neurobiological domain. In this review, the knowledge on neurobiological underpinnings of aggression and violent behaviour is addressed, as has been explored in animals and extended to humans by pharmacological, genetic and imaging studies. Here, specific impact is attributable to serotonergic and dopaminergic neurotransmission which has been implicated in certain forms violent behaviour, i.e. reactive aggression/defensive rage or premeditated, predatory violence in cold blood, in animals as well as humans. The role of nitric oxide and of testosterone is also addressed. Variations of the neurotransmitter systems do not only relate to violent offending itself but rather seem to interact with early social developmental influences predisposing to consecutive violent offending as has been specifically exemplified for a polymorphism of the Monoaminoxidase A, a catecholamine degrading enzyme. Furthermore, particular mental diseases, such as schizophrenia, attention deficit hyperactivity disorder, posttraumatic stress disorder, borderline and antisocial personality disorder, psychopathy as well as traumatic brain injury display an increased prevalence in violent offenders. Specific features of these disorders predispose to different forms of aggressive behaviour. Hyperreactive amygdalar responses in borderline personality disorder patients e.g. are the basis for their impulsive violence while the autonomous hyporeactivity in response to emotional situations in conjunction with a lack of empathy predisposes psychopathic individuals to predatory violence.