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Cognitive and neurobiological mechanisms of alcohol-related aggression

Key Points

  • Alcohol use is implicated in approximately 50% of all violent crimes and sexual assaults in industrialized nations.

  • Both acute and chronic alcohol intake increase the risk for alcohol-associated aggression.

  • Only a subset of individuals who drink alcohol become aggressive, and psychological studies have identified several gender and individual differences that confer risk for alcohol-related aggression.

  • Twin and adoption studies have shown a significant disposition towards violent behaviour only in association with an increased risk to develop alcohol dependence.

  • Animal experiments and a limited number of studies in humans show that alcohol-related aggression is found in a subset of individuals who were exposed to social adversity and carry certain risk genotypes.

  • Genetic and environmental factors are associated with aggressive behaviour: findings point to an important role of the serotonin system and its interactions with GABAergic neurotransmission in determining vulnerability to alcohol-associated aggression.

  • Chronic alcohol intake impairs serotonergic neurotransmission, which (according to studies in healthy controls but not yet in patients who are alcohol dependent) modulates limbic processing of aversive stimuli and prefrontal functions associated with behavioural control.

  • We suggest that acute alcohol intake facilitates aggression in vulnerable individuals because it impairs prefrontal executive functions, disinhibits limbic processing of threatening stimuli and elicits expectancies for alcohol-associated aggression.

Abstract

Alcohol-related violence is a serious and common social problem. Moreover, violent behaviour is much more common in alcohol-dependent individuals. Animal experiments and human studies have provided insights into the acute effect of alcohol on aggressive behaviour and into common factors underlying acute and chronic alcohol intake and aggression. These studies have shown that environmental factors, such as early-life stress, interact with genetic variations in serotonin-related genes that affect serotonergic and GABAergic neurotransmission. This leads to increased amygdala activity and impaired prefrontal function that, together, predispose to both increased alcohol intake and impulsive aggression. In addition, acute and chronic alcohol intake can further impair executive control and thereby facilitate aggressive behaviour.

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Figure 1: A neurobiological model for alcohol-associated aggression.
Figure 2: Functional and structural neural correlates of aggressive behaviour and genetic risk towards violence.

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Acknowledgements

The authors were supported in part by the Deutsche Forschungsgemeinschaft (Excellence Cluster EXC 257 & STE 1430/2-1), the Centre for Integrated Life Sciences (CILS) and the US National Institute on Alcohol Abuse and Alcoholism (F31 AA018918). This work was also supported by the German Federal Ministry of Education and Research (Bundesministerium für Bildung und Forschung; 01QG87164 and NGFN Plus, and 01GS08152).

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Glossary

Alcohol outcome expectancies

Predictions or beliefs about the social, cognitive and affective consequences of alcohol consumption that are shaped by social learning and personal experience with alcohol.

Bandura's social learning theory

A theory that proposes that learning takes place in a social context in which we can learn from observing others, and that this learning can occur without a change in behaviour.

Alcohol schema

The theoretical structure in which information about alcohol (for example, experience and beliefs) is organized and stored in memory.

Go/No-Go task

A task that requires participants to press a key in response to one type of stimulus and not to press a key when another stimulus type occurs. Go/No-Go tasks are typically used to assess cognitive inhibitory control of behaviour.

Reward expectation

Reward expectation describes an anticipatory processing in the face of upcoming positive reinforcement (a reward).

Delay discounting

The reduced ability to choose larger but delayed rewards compared with smaller but earlier rewards (seen as an index of impulsive tendencies).

Fenfluramine

A pharmacological drug that releases serotonin; it reverses reuptake by serotonin transporters and disrupts vesicular storage of serotonin.

'Hot' and 'cold' systems of emotion regulation

Neural systems implicated in emotion regulation; the cold system refers to the rational and logical reasoning usually conducted under low emotion and arousal, whereas the hot system is implicated in decision making under high levels of emotion and arousal that occur in the immediate situation.

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Heinz, A., Beck, A., Meyer-Lindenberg, A. et al. Cognitive and neurobiological mechanisms of alcohol-related aggression. Nat Rev Neurosci 12, 400–413 (2011). https://doi.org/10.1038/nrn3042

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