Clinical Studies Investigating Aggressive Behaviors And Alcoholism

本报告合并了先前报告AA 000094 -14 为了更好地了解酒精和攻击性之间的关系，我们研究了一个有家庭暴力（DV）历史的酗酒者亚群。这样做的理由是，70%至80%的家庭暴力肇事者有酒精问题，其次，大多数肇事者报告说，当他们喝酒时，他们更有可能变得咄咄逼人。 由于5-羟色胺调节情绪和对环境刺激的反应，我们假设氟西汀在降低DV肇事者的攻击和焦虑方面比安慰剂更有效。为了验证这一假设，我们进行了一项门诊研究，比较氟西汀与安慰剂对选定的一组酗酒DV肇事者的易怒和攻击性措施的有效性。结构MRI和功能MRI扫描用于表征大脑形态和功能。 该项目的参与者招募已完成，脑部MRI扫描也已处理。结果显示，氟西汀组的易怒程度比安慰剂组降低得更多。治疗的有效性得到了他们配偶和其他重要人士的报告的支持。这是第一项显示使用药理学药物治疗疗效的DV研究。该手稿已被接受发表在临床精神病学杂志。 MRI研究的结果显示，DV的酗酒者与非暴力酗酒者相比，颅内体积存在差异。 这项研究为我们了解酒精和伴侣暴力之间的相互作用提供了重要信息。目前正在准备行动计划。fMRI数据目前正在分析中。

This report incorporates former report AA000094-14 To better understand the relationship between alcohol and aggression, we studied a subpopulation of alcoholics who had a history of perpetrating acts of domestic violence (DV). The rational for this is based on the fact that 70% to 80% of perpetrators of DV have an alcohol problem and secondly, most perpetrators report that when they consume alcohol they are more likely to become aggressive. Since serotonin modulates mood and responsiveness to environmental stimuli, we hypothesized that fluoxetine would be more effective than placebo in decreasing measures of aggression and anxiety in perpetrators of DV. To test this hypothesis, we conducted an outpatient study comparing the effectiveness of fluoxetine versus placebo on measures of irritability and aggression in a select group of alcoholic perpetrators of DV. Structural MRI and fMRI scans were used to characterize brain morphology and function. Participant accrual has been completed for this project and brain MRI scans have been processed. Results show a greater decrease in irritability with fluoxetine than with placebo. The efficacy of the treatment is supported by the reports from their spouse and significant others. This is the first DV study to show treatment efficacy using a pharmacological agent. The manuscript has been accepted for publication in the Journal of Clinical Psychiatry. Results from the MRI study reveal that alcoholic perpetrators of DV have differences in intracranial volumes compared with non-violent alcoholics. The study adds important information in our attempt to understand the interaction between alcohol and partner violence. Manuscripts are currently in preparation. fMRI data is currently being analyzed.