PSYCHOLOGICAL/BIOLOGICAL STUDY OF PEOPLE WHO EXHIBIT ABUSIVE BEHAVIOR PATTERNS

涉及儿童和成人的家庭暴力是一个问题 日益增长的国家关注。我们的临床经验和出版的 报告表明，有相当数量的受试者 这些虐待行为可能有恐慌症的潜在诊断。 我们假设“失控”的精神状态，经常 这些人在虐待行为期间所描述的，与 惊恐障碍的病理生理学。来检验这一假设，并 阐明患者独特的心理和生物特征 谁实施了虐待行为，我们将比较那些有恐慌情绪的受试者 症状(如“失控”)，并表现出攻击性：(1) 攻击性强但无恐慌症状的受试者；及 正常的志愿者。这些比较将包括心理社会和 家族病史，药物挑战研究，和决心 脑脊液代谢物，以及仔细分析 与暴力有关的突发事件。 初步结果显示，发起家政行为的个人 暴力的酗酒/滥用的流行率高于预期，并且 惊恐、边缘人格和强迫症人格 精神错乱。乳酸挑战范例的结果，躺/站 去甲肾上腺素立位刺激，脑脊液5-HIAA浓度， 鉴定和正电子发射计算机断层扫描都表明， 暴力与非暴力控制是不同的。

Domestic violence involving both children and adults is a problem of growing national concern. Both our clinical experience and a published report indicate that a significant number of subjects who perpetrate these abusive acts may have an underlying diagnosis of panic disorder. We postulate that the mental state of "being out of control", frequently described by these individuals during the abusive act, is linked to the pathophysiology of panic disorder. To test this hypothesis and to elucidate unique psychological and biological characteristics of patients who perpetrate abusive acts, we will compare subjects who have panic symptoms (e.g., "loss of control") and become aggressive with: (1) subjects who are aggressive but do not have panic symptoms; and (2) normal volunteers. These comparisons will consist of psychosocial and family histories, pharmacological challenge studies, and a determination of cerebral spinal fluid metabolites, as well as a careful analysis of the precipitating events associated with the violence. Preliminary results show that individuals who initiate acts of domestic violence have a higher than expected prevalence of alcoholism/abuse and panic, borderline personality and obsessive compulsive personality disorders. Results from the lactate challenge paradigm, lying/standing norepinephrine orthostatic challenge, CSF 5-HIAA concentration, determination and PET scans all suggest that perpetrators of domestic violence are different from non-violent controls.