Aggression and violence remain a central clinical issue worldwide. Aggression has many meanings, and the term occurs in a variety of contexts. In this article, violence and aggression will be considered together. Aggression is any behavior, including verbal events, which involves attacking another person, animal, or object with the intent of harming the target. Similarly, violence is intentionally using physical force to hurt, damage, or kill someone or something.
Biological, psychological, and socioeconomic influences must be considered when discussing the etiology of aggression. Biological causes include genetics, medical and psychiatric diseases, neurotransmitters, hormones, abused substances, and medications. Psychological causes include numerous Diagnostic and Statistical Manual of Mental Disorders (DSM–5) diagnoses. These include Bipolar Affective Disorder, Schizophrenia, Major Depression, General Anxiety Disorder, and Antisocial personality[1].Alniak, 2015; Socioeconomic causes include interpersonal, social, group, neighborhood, economic, and cultural conditions that can create the potential for or actual violence. Importantly, these factors often act concomitantly.
Violence is ubiquitous. United States statistics, collected by the Federal Bureau of Investigation and reported in the 2013 Unified Crime Report, noted that there were an estimated 1,163,146 violent crimes that occurred nationwide. Also, information collected regarding types of weapons in violent crime showed that firearms were used in 69% of murders, 40% of robberies, and 21.6% of aggravated assaults. Furthermore, a woman was beaten every 9 seconds. On average, nearly 20 people per minute were physically abused by an intimate partner. During one year, this equates to more than 10 million women and men. Also, one in five women and one in 71 men, in the United States, have been raped in their lifetime. Nearly half of female (46.7%) and male (44.9%) victims of rape knew their attackers. Finally, 1 in 15 children are exposed to intimate partner violence each year, and 90% of these children are eyewitnesses to this violence.
Origins
Although the definition of aggression is simple and straightforward, its origins remain complex and frequently depend upon other, often contradictory, factors. In this exploration, there will be a review of the biological, psychological, and social causes of violence. In exploring the biological basis, there is an analysis of the genetics, brain structures, medical diseases, neurotransmitters, hormones, abused substances, and medications that contribute to aggression. In the psychological assessment, there is an investigation of the DSM–5 diagnoses linked to aggression. Finally, there is an investigation into the social and environmental roots of violence.
Biologic Contributions
Psychological Causes
Although any individual may become aggressive for a variety of reasons, there is a number of specific DSM-5 diagnoses which have violent behavior as one of their features. These include bipolar affective disorder, schizophrenia, the dementia group, post-traumatic stress disorder (PTSD), and acute stress disorder. Also, several of the disorders associated with childhood and adolescence, intellectual deficiencies, some personality disorders, and intermittent explosive disorder are associated with violent behavior. As noted earlier, aggression can result from a combination of several conditions. For example, certain persons with PTSD may become violent after consuming alcohol.
It has known patients with the bipolar affective disorder to become excessively agitated and aggressive, especially during the manic phase. Grandiose delusions often not only dramatically inflate their self-view but also make them demanding of others and combative to those not acknowledging their perceived greatness. Patients with schizophrenia can be aggressive when responding to command hallucinations ordering them to harm others. Patients with a wide range of dementias, such as Alzheimer disease, not only have memory deficiencies but also lose their executive functions. These executive functions provide good judgment and inhibit unacceptable impulses. This can account for some of the violence seen in long-term care facilities and in places where patients with traumatic brain injuries are treated.
An overwhelming stress can make certain individuals aggressive. It is their way of coping. Patients with PTSD struggle with a host of symptoms which can promote potential aggression. These symptoms include hypervigilance, flashbacks, and nightmares, and can lead to aggression. Several childhood diagnoses including conduct disorder and attention-deficit/hyperactivity disorder (ADHD) can result in aggressive behavior, as can disorders along the autism spectrum, because of communication difficulties, impulsiveness, low tolerance, and frustration.[0] ( Saylor, 2016)
Persons with intellectual deficiencies, when confronting difficult tasks and situation, may resort to violence as a coping mechanism. ( Davies, 2016) Certain personality disorders, such as antisocial personality and borderline personality, can cause individuals to exhibit belligerence. Individuals who are antisocial lack an empathic view and have an egocentric center of gravity which can promote aggression. A person with a borderline personality who is overwhelmed and has boundary issues can become aggressive. Finally, aggression is at the core of persons with the intermittent explosive disorder.
Aside from these formal diagnoses, when people are afraid, overwhelmed, feel threatened, or feel out of control, perplexed, disorientated, or frustrated, they often respond aggressively.
Sociocultural Economic Factors
The environment can contribute to aggression on many levels: interpersonal, social, group, neighborhood, economic, and cultural conditions can create the potential for or actual violence.
Interpersonal: Interpersonal aggression occurs in a variety of settings. One of the most noted is domestic violence. [0]( Foshee, 2016) An intimate relationship can promote violence through jealousy, fear of abandonment, domination, and control issues.[0] (Cunha, 2016) This involves spousal or companion abuse. [0]( Lehtonen, 2016) its extreme form, intimate aggression can ultimately result in homicide or suicide.( Murphy, 2016) Other forms of domestic violence include child abuse and senior abuse. Relationships generate intense emotions. Geriatric units and long term care facilities produce intense interpersonal feelings. [0] ( Lanza, 2016) Also violence can erupt on psychiatric in-patient units. [0] (Renwick, 2016) Prisons and jails represent places where violence erupts.[0] (Heynen, 2016) Bullying in any setting is both aggressive in and of itself and can lead to violence. [0] [0] ( Maniglio, 2016; Mudrak, 2015)
Social: In social situations, frustrations can accumulate over time. This is known as an incubation period. In sociology, there is the term "relative deprivation." In this phenomenon, an oppressed group is granted some gains. They have not achieved all they wanted, but there have been some advances. However, instead of the people being grateful, they realize that they have not received all the items of which they have been deprived and act aggressively. For some, they accumulate enough things that annoy them, and they reach a "tipping" point, where the aggression frequently erupts in violence.
Group: Group experiences also can cause aggression. When many people assemble in one place, there can be a growing aggression.
The treatment of aggression and violence must be based on their causes. Diagnosis leads to treatment. If it a mental disorder the responsible contributor then the specific disorder must be addressed. [0] (Gurnani, 2016 )
We are looking for contributors to author, edit, and peer review our vast library of review articles and multiple choice questions. In as little as 2-3 hours you can make a significant contribution to your specialty. In return for a small amount of your time, you will receive free access to all content and you will be published as an author or editor in eBooks, apps, online CME/CE courses, and an online Learning Management System for students, teachers, and program directors that allows access to review materials in over 500 specialties.
This is an academic project designed to provide inexpensive peer-reviewed Apps, eBooks, and very soon an online CME/CE system to help students identify weaknesses and improve knowledge. We would like you to consider being an author or editor. Please click here to learn more. Thank you for you for your interest, the StatPearls Publishing Editorial Team.
Click Your Answer Below
Would you like to access teaching points and more information on this topic?
Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.
Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.
Click Your Answer Below
Would you like to access teaching points and more information on this topic?
Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.
Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.
Click Your Answer Below
Would you like to access teaching points and more information on this topic?
Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.
Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.
Click Your Answer Below
Would you like to access teaching points and more information on this topic?
Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.
Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.
Click Your Answer Below
Would you like to access teaching points and more information on this topic?
Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.
Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.
Click Your Answer Below
Would you like to access teaching points and more information on this topic?
Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.
Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.
Click Your Answer Below
Would you like to access teaching points and more information on this topic?
Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.
Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.
Click Your Answer Below
Would you like to access teaching points and more information on this topic?
Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.
Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.
Click Your Answer Below
Would you like to access teaching points and more information on this topic?
Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.
Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.
Click Your Answer Below
Would you like to access teaching points and more information on this topic?
Improve Content - Become an Author or Editor and get free access to the entire database, free eBooks, as well as free CME/CE as it becomes available. If interested, please click on "Sign Up" to register.
Purchase- Want immediate access to questions, answers, and teaching points? They can be purchased above at Apps and eBooks.
High prevalence of physical and sexual aggression to caregivers in advanced Parkinson's disease. Experience in the Palliative Care Program., Bruno V,Mancini D,Ghoche R,Arshinoff R,Miyasaki JM,, Parkinsonism & related disorders, 2016 Jan 11 [PubMed] |
The role of monoamine oxidase A in aggression: Current translational developments and future challenges., Godar SC,Fite PJ,McFarlin KM,Bortolato M,, Progress in neuro-psychopharmacology & biological psychiatry, 2016 Jan 9 [PubMed] |
Aggressive behavior in humans: Genes and pathways identified through association studies., Fernàndez-Castillo N,Cormand B,, American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics, 2016 Jan 15 [PubMed] |
High trait aggression in men is associated with low 5-HT levels, as indexed by 5-HT4 receptor binding., da Cunha-Bang S,Mc Mahon B,MacDonald Fisher P,Jensen PS,Svarer C,Moos Knudsen G,, Social cognitive and affective neuroscience, 2016 Jan 15 [PubMed] |
Substance use is a risk factor for violent behavior in male patients with bipolar disorder., Alnıak İ,Erkıran M,Mutlu E,, Journal of affective disorders, 2015 Dec 30 [PubMed] |
Ganson KT,Cadet TJ, Exploring Anabolic-Androgenic Steroid Use and Teen Dating Violence Among Adolescent Males. Substance use & misuse. 2018 Dec 21 [PubMed] |
Thiessen MS,Walsh Z,Bird BM,Lafrance A, Psychedelic use and intimate partner violence: The role of emotion regulation. Journal of psychopharmacology (Oxford, England). 2018 Jul [PubMed] |
Kirwan M,Lanni DJ,Warnke A,Pickett SM,Parkhill MR, Emotion Regulation Moderates the Relationship Between Alcohol Consumption and the Perpetration of Sexual Aggression. Violence against women. 2018 Oct 25 [PubMed] |
The intent of StatPearls is to provide practice questions and explanations to assist you in identifying and resolving knowledge deficits. These questions and explanations are not intended to be a source of the knowledge base of all of medicine, nor is it intended to be a board or certification review of Nurse-Professional and Ethics. The authors or editors do not warrant the information is complete or accurate. The reader is encouraged to verify each answer and explanation in several references. All drug indications and dosages should be verified before administration.
StatPearls offers the most comprehensive database of free multiple-choice questions with explanations and short review chapters ever developed. This system helps physicians, medical students, dentists, nurses, pharmacists, and allied health professionals identify education deficits and learn new concepts. StatPearls is not a board or certification review system for Nurse-Professional and Ethics, it is a learning system that you can use to help improve your knowledge base of medicine for life-long learning. StatPearls will help you identify your weaknesses so that when you are ready to study for a board or certification exam in Nurse-Professional and Ethics, you will already be prepared.
Our content is updated continuously through a multi-step peer review process that will help you be prepared and review for a thorough knowledge of Nurse-Professional and Ethics. When it is time for the Nurse-Professional and Ethics board and certification exam, you will already be ready. Besides online study quizzes, we also publish our peer-reviewed content in eBooks and mobile Apps. We also offer inexpensive CME/CE, so our content can be used to attain education credits while you study Nurse-Professional and Ethics.