Characterization of Perpetrators of Domestic Violence

家庭暴力在美国是一个严重的问题。大多数关于家庭暴力病因学的研究都侧重于心理社会因素，而很少强调生物因素。为了探索肇事者表现出的攻击行为与恐惧有关的可能性，我们给一组选定的肇事者注射了致癌剂乳酸钠。这项研究的结果表明，与非暴力对照组相比，犯罪者表现出更多的乳酸诱导的恐惧、恐慌和愤怒。这些结果使我们得出结论，一些家庭暴力肇事者对感知到的威胁有夸大的恐惧相关愤怒反应。我们目前的研究旨在了解肇事者身上可能存在什么异常(S)，这些异常可能导致这些夸大的恐惧相关反应。为此，我们正在进行多项研究。我们对肇事者和控制者进行了详细的精神病学评估。初步结果表明，肇事者患焦虑症的几率高于预期。我们从有(ALC-PERP)和无(PERP)酒精中毒诊断的永久者和健康对照受试者身上获得脑脊液(CSF)。与对照组相比，ALC-PERP组的脑脊液睾酮浓度显著升高，而5-羟基吲哚乙酸(5-HIAA)浓度显著降低。这些发现得出以下结论：1)酗酒和不酗酒的肇事者之间可能存在生物学上的差异；2)低5-羟色胺和高睾丸素都可能在促进肇事者表现出的与恐惧相关的攻击行为中发挥作用。目前正在分析其他脑脊液神经递质。我们对ALC患者、非暴力酗酒者和健康对照受试者进行了FDG PET扫描。初步结果显示，与非暴力性酗酒者和健康对照组相比，ALC-PERP患者右侧下丘脑的葡萄糖代谢水平较低。为了研究肇事者的自主调节，我们进行了一项立位挑战。在对照组中，呼吸性窦性心律失常和心率之间的强烈关联在犯罪者中并不存在。这表明肇事者的自主神经功能可能有障碍。为了研究施暴者的去甲肾上腺素功能，我们给施暴者和对照组注射了α-2-受体拮抗剂育亨宾。我们现在正在对在挑战中获得的血浆进行各种去甲肾上腺素能参数的分析。

Domestic violence is a problem of major proportions in the United States. The majority of studies pertaining to the etiology of domestic violence have focused on psychosocial parameters and given little emphasis to biological factors. In order to explore the possiblity that the aggression displayed by perpetrators is related to fear, we administered the panicogenic agent, sodium lactate, to a select group of perpetrators. Results of this study showed that perpetrators evidenced more lactate-induced fear, panic, and rage than non-violent controls. These results lead us to conclude that some perpetrators of domestic violence have an exaggerated fear-related rage response to perceived threats. Our current research is directed toward understanding what abnormality(s) may be present in perpetrators which could contribute to these exaggerated fear-related responses. To do this, we are conducting a number of research studies. We performed detailed psychiatric evaluations of perpetrators and controls. Preliminary results indicate that perpetrators have a higher incidence of anxiety-related disorders than expected. We obtained cerebral spinal fluid (CSF) from perpetators with (ALC-PERP)and without (PERP) a diagnosis of alcoholism and healthy comparison subjects. Compared to controls, ALC-PERP had significantly higher CSF testosterone concentrations, and PERP had significantly lower CSF concentrations of 5-hydroxyindoleacetic acid (5-HIAA). These findings lead to the following conclusions: 1) there may be biological differences between perpetrators with and without alcoholism; 2) both low serotonin and high testosterone may have a role in facilitating the fear-related aggression displayed by perpetrators. Additional CSF neurotransmitters are currently being assayed.We performed FDG PET scans on ALC-PERP, non-violent alcoholics, and healthy comparison subjects. Preliminary results show that ALC-PERP have lower glucose metabolism in the right hypothalamus compared to non-violent alcoholics and healthy comparison subjects. To study autonomic regulation in perpetrators, we performed an orthostatic challenge. The strong association between respiratory sinus arrhythmia and heart rate present in controls was not present in the perpetrators. This suggests that perpetrators may have a disturbance in their autonomic function. To study noradrenergic function in perpetrators, we administered the alpha-2-antagonist, yohimbine, to perpetrators and controls. We are in now in the process of having the plasma, which was obtained during the challenge, assayed for various noradrenergic parameters.