It also allowed them to protect themselves from other tribes.
Psychiatric assessment of aggressive patients: a violent attack on a resident.
It was basic for survival. If we look at animal psychology, there is a lot we can learn about the aggression and dominance hierarchy, like how apes interact with each other, or form alliances. As a way of creating alliances, often an alpha ape will groom other males. The violence comes out when the clans come against each other.
Successfully Treating Aggression in Mentally Ill Prison Inmates
When one ape is wandering from its clan, two apes from another clan may attack one single ape viciously. In other circumstances, if a dominant ape is taken away from his clan for a couple of days and brought back into the clan, a couple of other apes may have formed a new alliance against the prior leader and attack him.
As human beings, we are also like this.
Many of our social interactions and group structures have the same kinds of alliances and effects of absence can play out similarly. Of course as humans, we do have higher verbal centers, and philosophy or spirituality, that allows an individual to be less violent and to transcend their base instincts. People with intellectual challenges most often exhibit impulsive violence, particularly those on the autistic spectrum.
The person may have a greater difficulty processing or understanding their own emotions if there are significant intellectual deficits. They may also have elements of not being able to judge a response or to moderate a response. The general pathophysiology of the autistic spectrum disorder suggests that the connections between neurons and the autistic brain is not what it should be, and they are not differentiated so that information processing can be fragmented.
Treating with an antipsychotic medication is helpful and decreases violent episodes. In one study, clozapine helped psychotic aggressive patients with executive dysfunction more, compared to using haldol or olanzapine Krakowski, A predatory-violent individual needs to be contained in prison if there is a demonstrated past of persistent violence.
There is evidence that by enhancing intellectual empathy, psychopaths will be less violent. There is also interesting research that by giving oxytocin, the hormone that increases affiliation and collaboration, may have a moderating effect on some psychopathic individuals.
Some medications, such as clozapine, can affect the underlying issues behind psychotic behavior and thereby reduce it, but there is no direct treatment for psychopathic violence pharmacologically. Cummings discussed the use of Mood stabilizers helping in persons with borderline personality disorder, SSRIs and trazodone helping in dementing illness in the elderly and alpha 2 agonists in people with things like autism or TBI. Alpha 2 agonists clonidine can fool the brain stem into thinking enough norepinephrine has been released, then less norepinephrine is secreted, making the brain stem calm down.
Essentially, in an emotional disorder, if you change the affective limbic tone, you can decrease the likelihood of emotionally reactive aggression, for example, by using mood stabilizers lithium and divalproex. Antipsychotics have been used for people with autism spectrum disorder, and some evidence shows that drugs like risperidone can be helpful to control outburst issues.
If there is evidence of sexual aggression or aggression occurring at women after puberty , using an GnRH agonist—antiandrogen treatment—can sometimes be necessary. There have been a number of anger management therapies that have been used over time.
Therapists can help people be aware of their anger and manage their impulses, or push their anger and aggression toward a more prosocial response. For people with borderline personality disorder, dialectical behavioral therapy, mentalization based therapy or transference therapy are important.
For schizophrenic patients, a good therapeutic alliance is important to create medication compliance. I have touched on how to process anger in my microexpression series and will have future episodes focusing more on the psychotherapy approaches to anger. Overall in therapy, we must assume that our patients will lie to us sometimes because they are afraid, and double check to insure they are following our prescribed protocol. We must also work hard to build trust and a therapeutic alliance.
Bodell, Ph. Samuel R.
Chamberlain, M. Craig Erickson, M. Martha K. Fahlgren, M. Jennifer R. Fanning, Ph. Maurizio Fava, M.
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Aggression: Psychiatric Assessment and Treatment
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