The significance of aggression and impulsivity for self-mutilative behavior
The significance of aggression and impulsivity for self-mutilative behavior
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DOI：
10.1055/s-2007-979622
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发表时间：
1995-10-01
影响因子：
4.3
通讯作者：
Sass, H
中科院分区：
文献类型：
--
作者：
Herpertz, S;Steinmeyer, SM;Sass, H
自残行为（SMB）被认为是一种特定形式的内向攻击性，被认为与冲动控制问题有关。有关冲动和冲动攻击的概念问题进行了讨论。在不同形式的失控行为中，SMB具有特殊的启发式意义，因为可以区分患者的冲动行为和有预谋的自我伤害行为。与抑郁症患者和正常先证者相比，自残者的冲动性和攻击性的心理测量和生物测量进行了评估。自残者被分为两个亚组，冲动型（ISMB）和预谋型（PSMB），抑郁症患者也被分为两个亚组，有自杀企图史的和没有自杀企图的。只有ISMB患者（以及有自杀企图史的抑郁症患者）表现出行为和认知模式失控的持久趋势：因此，SMB通常不能被视为高冲动或冲动控制障碍的指标。冲动性和攻击性的措施并没有表现出类似于对方和攻击性或自动攻击行为模式一般不应该被用作冲动性的指数。与正常先证者相比，在所有患者组中均发现对D-芬氟拉明的催乳素反应迟钝，证明了多巴胺能活性的降低。催乳素反应后D-芬氟拉明的挑战，原来是最迟钝的自残者与ISMB和抑郁症与自杀企图的历史。
Self-mutilative behavior (SMB) is presented as a specific form of inwardly directed aggressiveness which is thought to be associated with problems of impulse control. Conceptual problems concerning impulsivity and impulsive aggression are discussed. Among different forms of dyscontrolled behavior, SMB is of special heuristic interest because a distinction can be made between patients committing impulsive and those committing premeditated self-harming actions. Psychometric and biological measures of impulsivity and aggressiveness were assessed in self-mutilators in comparison to depressives and normal probands. Self-mutilators were differentiated into two subgroups, those with an impulsive (ISMB) and those with a premeditated (PSMB) form of SMB, and depressives were also differentiated into two subgroups, those with a history of suicide attempts and those without. Only patients with ISMB (and depressives with a history of suicide attempts) showed an enduring tendency towards dyscontrolled patterns of behavior and cognition: therefore, SMB cannot be generally regarded as an indicator of high impulsivity or an impulse control disorder. Measures of impulsivity and aggressiveness did not behave analogically to each other and aggressive or autoaggressive modes of behavior should not be generally used as an index of impulsivity. A reduction of serotonergic activity, proved by a blunted prolactin response to D-fenfluramine, was found in all patient-groups in comparison to normal probands. Prolactin response after D-fenfluramine challenge turned out to be most blunted among self-mutilators with ISMB and among depressives with a history of suicide attempts.