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Individual Biological Interventions for Violence and Aggression. I. Psychopharmacology and Hormonal Treatments

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Abstract

Based on biological models of aggression and violence, there are numerous biological treatments which are reviewed in this and the subsequent chapter. Of these, psychopharmacology is probably the most commonly used and most extensively researched as treatments for aggression and violence. In addition, there are some hormonal treatments for aggression, but there is rather less research available on their effectiveness than for psychopharmacology. The outcomes for psychopharmacology and hormonal treatments of aggression and violence are often very mixed or weak. Biological treatments often raise numerous ethical issues regarding safety, consent, coercion, and avoidable harms due to the availability of alternate potentially effective, safer interventions.

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References

  • Abd Wahab, W., Collinson, K., & Gross, D. W. (2019). Successful management of postictal violence with pindolol in temporal lobe epilepsy. Epilepsy & Behavior Reports, 12, 100346.

    Article  Google Scholar 

  • Ahmed, Z., Fraser, W., Kerr, M. P., Kiernan, C., Emerson, E., Robertson, J., et al. (2000). Reducing antipsychotic medication in people with a learning disability. The British Journal of Psychiatry, 176(1), 42–46.

    Article  PubMed  Google Scholar 

  • Aman, M. G., & Singh, N. N. (1986). Aberrant behavior checklist. Slosson.

    Google Scholar 

  • Benson, T., O’Neill, S., Murphy, S., Ferry, F., & Bunting, B. (2015). Prevalence and predictors of psychotropic medication use: Results from the Northern Ireland Study of Health and Stress. Epidemiology and Psychiatric Sciences, 24(6), 542–552.

    Article  PubMed  Google Scholar 

  • Blader, J. C., Pliszka, S. R., Kafantaris, V., Foley, C. A., Carlson, G. A., Crowell, J. A., ... & Margulies, D. M. (2021). Stepped treatment for attention-deficit/hyperactivity disorder and aggressive behavior: A randomized, controlled trial of adjunctive risperidone, divalproex sodium, or placebo after stimulant medication optimization. Journal of the American Academy of Child & Adolescent Psychiatry, 60(2), 236–251.

    Google Scholar 

  • Booth, A., Scantlebury, A., Hughes-Morley, A., Mitchell, N., Wright, K., Scott, W., & McDaid, C. (2017). Mental health training programmes for non-mental health trained professionals coming into contact with people with mental ill health: A systematic review of effectiveness. BMC Psychiatry, 17(1), 196.

    Article  PubMed  PubMed Central  Google Scholar 

  • Carlson, G. A., Chua, J., Pan, K., Hasan, T., Bied, A., Martin, A., & Klein, D. N. (2020). Behavior modification is associated with reduced psychotropic medication use in children with aggression in inpatient treatment: A retrospective cohort study. Journal of the American Academy of Child & Adolescent Psychiatry, 59(5), 632–641.

    Article  Google Scholar 

  • Carnahan, R. M., Brown, G. D., Letuchy, E. M., Rubenstein, L. M., Gryzlak, B. M., Smith, M., et al. (2017). Impact of programs to reduce antipsychotic and anticholinergic use in nursing homes. Alzheimer’s & Dementia: Translational Research & Clinical Interventions, 3(4), 553–561.

    Google Scholar 

  • Carré, J. M., & Robinson, B. A. (2020). Testosterone administration in human social neuroendocrinology: Past, present, and future. Hormones and Behavior, 122, 104754.

    Article  PubMed  Google Scholar 

  • Carré, J. M., Ruddick, E. L., Moreau, B. J., & Bird, B. M. (2017). Testosterone and human aggression. In P. Sturmey (Ed.), The Wiley handbook of violence and aggression (pp. 1–14). Wiley.

    Google Scholar 

  • Coccaro, E. F. (2012). Intermittent explosive disorder as a disorder of impulsive aggression for DSM-5. American Journal of Psychiatry, 169(6), 577–588.

    Article  PubMed  Google Scholar 

  • Coccaro, E. F., Lee, R. J., & Kavoussi, R. J. (2009). A double-blind, randomized, placebo-controlled trial of fluoxetine in patients with intermittent explosive disorder. The Journal of Clinical Psychiatry, 70(5), 653–662. https://doi.org/10.4088/JCP.08m04150

    Article  PubMed  Google Scholar 

  • Corbett, A., Burns, A., & Ballard, C. (2014). Don’t use antipsychotics routinely to treat agitation and aggression in people with dementia. British Medical Journal, 349, g6420. https://doi.org/10.1136/bmj.g6420

    Article  PubMed  Google Scholar 

  • D’Onise, K., Hazel, S., & Caraguel, C. (2017). Mandatory desexing of dogs: One step in the right direction to reduce the risk of dog bite? A systematic review. Injury Prevention, 23(3), 212–218.

    Article  PubMed  Google Scholar 

  • Donat, D. C. (1998). Impact of a mandatory behavioral consultation on seclusion/restraint utilization in a psychiatric hospital. Journal of Behavior Therapy and Experimental Psychiatry, 29(1), 13–19.

    Article  PubMed  Google Scholar 

  • Donat, D. C. (2003). An analysis of successful efforts to reduce the use of seclusion and restraint at a public psychiatric hospital. Psychiatric Services, 54(8), 1119–1123.

    Article  PubMed  Google Scholar 

  • Donat, D. C. (2005). Special section on seclusion and restraint: Encouraging alternatives to seclusion, restraint, and reliance on PRN drugs in a public psychiatric hospital. Psychiatric Services, 56(9), 1105–1108.

    Article  PubMed  Google Scholar 

  • Douglas, T., Bonte, P., Focquaert, F., et al. (2013). Coercion, incarceration, and chemical castration: An argument from autonomy. Bioethical Inquiry, 10, 393–405. https://doi.org/10.1007/s11673-013-9465-4

    Article  PubMed  Google Scholar 

  • Esbensen, A. J., Greenberg, J. S., Seltzer, M. M., & Aman, M. G. (2009). A longitudinal investigation of psychotropic and non-psychotropic medication use among adolescents and adults with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(9), 1339–1349.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fallah, M. S., Shaikh, M. R., Neupane, B., Rusiecki, D., Bennett, T. A., & Beyene, J. (2019). Atypical antipsychotics for irritability in pediatric autism: A systematic review and network meta-analysis. Journal of Child and Adolescent Psychopharmacology, 29(3), 168–180.

    Article  PubMed  Google Scholar 

  • Fanning, J. R., Coleman, M., Lee, R., & Coccaro, E. F. (2019). Subtypes of aggression in intermittent explosive disorder. Journal of Psychiatric Research, 109, 164–172.

    Article  PubMed  Google Scholar 

  • Faay, M. D., Czobor, P., & Sommer, I. E. (2018). Efficacy of typical and atypical antipsychotic medication on hostility in patients with psychosis-spectrum disorders: a review and meta-analysis. Neuropsychopharmacology, 43(12), 2340–2349.

    Google Scholar 

  • Guastella, A. J., & Hickie, I. B. (2016). Oxytocin treatment, circuitry, and autism: A critical review of the literature placing oxytocin into the autism context. Biological Psychiatry, 79(3), 234–242.

    Article  PubMed  Google Scholar 

  • Guastella, A. J., Einfeld, S. L., Gray, K. M., Rinehart, N. J., Tonge, B. J., Lambert, T. J., et al. (2010). Intranasal oxytocin improves emotion recognition for youth with autism spectrum disorders. Biological Psychiatry, 67, 692–694.

    Article  PubMed  Google Scholar 

  • Gurnani, T., Ivanov, I., & Newcorn, J. H. (2016). Pharmacotherapy of aggression in child and adolescent psychiatric disorders. Journal of Child and Adolescent Psychopharmacology, 26(1), 65–73.

    Article  PubMed  Google Scholar 

  • Hálfdánarson, Ó., Zoëga, H., Aagaard, L., Bernardo, M., Brandt, L., Fusté, A. C., et al. (2017). International trends in antipsychotic use: A study in 16 countries, 2005–2014. European Neuropsychopharmacology, 27(10), 1064–1076.

    Article  PubMed  Google Scholar 

  • Hedlund, P. O. (2000). Side effects of endocrine treatment and their mechanisms: Castration, antiandrogens, and estrogens. The Prostate, 45(S10), 32–37.

    Article  Google Scholar 

  • Institute for Safe Medication. (2016). Chloral hydrate: Is it still being used? Are there safer alternatives? Author. Retrieved December 29, 2021, from https://www.ismp.org/resources/chloral-hydrate-it-still-being-used-are-there-safer-alternatives

    Google Scholar 

  • Jobski, K., Höfer, J., Hoffmann, F., & Bachmann, C. (2017). Use of psychotropic drugs in patients with autism spectrum disorders: A systematic review. Acta Psychiatrica Scandinavica, 135(1), 8–28.

    Article  PubMed  Google Scholar 

  • Knapp, P., Chait, A., Pappadopulos, E., Crystal, S., Jensen, P. S., & T-May Steering Group. (2012). Treatment of maladaptive aggression in youth: CERT guidelines I. Engagement, assessment, and management. Pediatrics, 129(6), e1562–e1576.

    Article  PubMed  Google Scholar 

  • Koch, A. D., Dobrindt, J., & Schützwohl, M. (2021). Prevalence of psychotropic medication and factors associated with antipsychotic treatment in adults with intellectual disabilities: A cross-sectional, epidemiological study in Germany. Journal of Intellectual Disability Research, 65(2), 186–198.

    Article  PubMed  Google Scholar 

  • Lake, J. K., Balogh, R., & Lunsky, Y. (2012). Polypharmacy profiles and predictors among adults with autism spectrum disorders. Research in Autism Spectrum Disorders, 6(3), 1142–1149.

    Article  Google Scholar 

  • Linton, D., Barr, A. M., Honer, W. G., & Procyshyn, R. M. (2013). Antipsychotic and psychostimulant drug combination therapy in attention deficit/hyperactivity and disruptive behavior disorders: A systematic review of efficacy and tolerability. Current Psychiatry Reports, 15(5), 1–11.

    Google Scholar 

  • Lohr, W. D., Creel, L., Feygin, Y., Stevenson, M., Smith, M. J., Myers, J., et al. (2018). Psychotropic polypharmacy among children and youth receiving Medicaid, 2012-2015. Journal of Managed Care & Specialty Pharmacy, 24(8), 736–744.

    Article  Google Scholar 

  • Lösel, F., & Schmucker, M. (2005). The effectiveness of treatment for sexual offenders: A comprehensive meta-analysis. Journal of Experimental Criminology, 1(1), 117–146.

    Article  Google Scholar 

  • Loy, J. H., Merry, S. N., Hetrick, S. E., & Stasiak, K. (2017). Atypical antipsychotics for disruptive behaviour disorders in children and youths. Cochrane Database of Systematic Reviews, 8, CD008559.

    PubMed  Google Scholar 

  • Marsh, L., & Krauss, G. L. (2000). Aggression and violence in patients with epilepsy. Epilepsy & Behavior, 1(3), 160–168.

    Article  Google Scholar 

  • Maturana, W. R., & Maturana, R. R. (2009). Control de la agresividad con olanzapina en pacientes post tec. Ciencia & Trabajo, 11, 22–24.

    Google Scholar 

  • McCloskey, M. S., Noblett, K. L., Deffenbacher, J. L., Gollan, J. K., & Coccaro, E. F. (2008). Cognitive-behavioral therapy for intermittent explosive disorder: A pilot randomized clinical trial. Journal of Consulting and Clinical Psychology, 76(5), 876.

    Article  PubMed  Google Scholar 

  • McNamara, R., Randell, E., Gillespie, D., Wood, F., Felce, D., Romeo, R., et al. (2017). A pilot randomised controlled trial of community-led ANtipsychotic Drug REduction for Adults with Learning Disabilities. Health Technology Assessment, 21(47), 1.

    Article  PubMed  Google Scholar 

  • Muir-Cochrane, E., Oster, C., Gerace, A., Dawson, S., Damarell, R., & Grimmer, K. (2020). The effectiveness of chemical restraint in managing acute agitation and aggression: A systematic review of randomized controlled trials. International Journal of Mental Health Nursing, 29(2), 110–126.

    Article  PubMed  Google Scholar 

  • Ooi, Y. P., Weng, S.-J., Kossowsky, J., Gerger, H., & Sungl, M. (2017). Oxytocin and autism spectrum disorders: A systematic review and meta-analysis of randomized controlled trials. Pharmacopsychiatry, 50, 5–13.

    PubMed  Google Scholar 

  • Orsel, K., Taipale, H., Tolppanen, A. M., Koponen, M., Tanskanen, A., Tiihonen, J., et al. (2018). Psychotropic drugs use and psychotropic polypharmacy among persons with Alzheimer’s disease. European Neuropsychopharmacology, 28(11), 1260–1269.

    Article  PubMed  Google Scholar 

  • Pappadopulos, E., Woolston, S., Chait, A., Perkins, M., Connor, D. F., & Jensen, P. S. (2006). Pharmacotherapy of aggression in children and adolescents: Efficacy and effect size. Journal of the Canadian Academy of Child and Adolescent Psychiatry/Journal de l’Académie Canadienne de Psychiatrie de l’Enfant et de l’Adolescent, 15(1), 27–39.

    PubMed  Google Scholar 

  • Patel, J., Frankel, S., & Tampi, R. R. (2019). Evidence for using PRN pharmacotherapy to treat undifferentiated acute agitation or aggression. Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists, 31(1), 54–69.

    Google Scholar 

  • Paulose-Ram, R., Safran, M. A., Jonas, B. S., Gu, Q., & Orwig, D. (2007). Trends in psychotropic medication use among US adults. Pharmacoepidemiology and Drug Safety, 16(5), 560–570.

    Article  PubMed  Google Scholar 

  • Pillay, J., Boylan, K., Newton, A., Hartling, L., Vandermeer, B., Nuspl, M., et al. (2018). Harms of antipsychotics in children and young adults: A systematic review update. The Canadian Journal of Psychiatry, 63(10), 661–678.

    Article  PubMed  Google Scholar 

  • Piovani, D., Clavenna, A., & Bonati, M. (2019). Prescription prevalence of psychotropic drugs in children and adolescents: An analysis of international data. European Journal of Clinical Pharmacology, 75, 1333–1346. https://doi.org/10.1007/s00228-019-02711-3

    Article  PubMed  Google Scholar 

  • Rosato, N. S., Correll, C. U., Pappadopulos, E., Chait, A., Crystal, S., Jensen, P. S., & Treatment of Maladaptive Aggressive in Youth Steering Committee. (2012). Treatment of maladaptive aggression in youth: CERT guidelines II. Treatments and ongoing management. Pediatrics, 129(6), e1577–e1586.

    Article  Google Scholar 

  • Salzman, C., Jeste, D., Meyer, R. E., Cohen-Mansfield, J., Cummings, J., Grossberg, G., et al. (2008). Elderly patients with dementia-related symptoms of severe agitation and aggression: Consensus statement on treatment options, clinical trials methodology, and policy. The Journal of Clinical Psychiatry, 69(6), 889.

    Article  PubMed  PubMed Central  Google Scholar 

  • van Schalkwyk, G. I., Beyer, C., Johnson, J., Deal, M., & Bloch, M. H. (2018). Antipsychotics for aggression in adults: A meta-analysis. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 81, 452–458.

    Article  Google Scholar 

  • Schmucker, M., & Lösel, F. (2015). The effects of sexual offender treatment on recidivism: An international meta-analysis of sound quality evaluations. Journal of Experimental Criminology, 11(4), 597–630.

    Article  Google Scholar 

  • Schneider, L. S., Dagerman, K. S., & Insel, P. (2005). Risk of death with atypical antipsychotic drug treatment for dementia: Meta-analysis of randomized placebo-controlled trials. Jama, 294(15), 1934–1943.

    Google Scholar 

  • Schneider, L. S., Tariot, P. N., Dagerman, K. S., Davis, S. M., Hsiao, J. K., Ismail, M. S., ... & Lieberman, J. A. (2006). Effectiveness of atypical antipsychotic drugs in patients with Alzheimer’s disease. New England Journal of Medicine, 355(15), 1525–1538.

    Google Scholar 

  • Seifert, J., Engel, R. R., Bernegger, X., Führmann, F., Bleich, S., Stübner, S., et al. (2021). Time trends in pharmacological treatment of major depressive disorder: Results from the AMSP Pharmacovigilance Program from 2001–2017. Journal of Affective Disorders, 281, 547–556.

    Article  PubMed  Google Scholar 

  • Sheehan, R., & Hassiotis, A. (2017). Reduction or discontinuation of antipsychotics for challenging behaviour in adults with intellectual disability: A systematic review. The Lancet Psychiatry, 4(3), 238–256.

    Article  PubMed  Google Scholar 

  • Smeets, C. H., Gerritsen, D. L., Zuidema, S. U., Teerenstra, S., van der Spek, K., Smalbrugge, M., & Koopmans, R. T. (2018). Psychotropic drug prescription for nursing home residents with dementia: Prevalence and associations with non-resident-related factors. Aging & Mental Health, 22(9), 1244–1252.

    Article  Google Scholar 

  • Sturmey, P. (2015). Reducing restraint and restrictive behavior management practices. Springer.

    Google Scholar 

  • Sturmey, P. (Ed.). (2020). Functional analysis in clinical treatment. Academic.

    Google Scholar 

  • Tampi, R. R., Tampi, D. J., Balachandran, S., & Srinivasan, S. (2016). Antipsychotic use in dementia: A systematic review of benefits and risks from meta-analyses. Therapeutic Advances in Chronic Disease, 7(5), 229–245.

    Article  PubMed  PubMed Central  Google Scholar 

  • Téllez-Lapeira, J., López-Torres Hidalgo, J., García-Agua Soler, N., Gálvez-Alcaraz, L., Escobar-Rabadán, F., & García-Ruiz, A. (2016). Prevalence of psychotropic medication use and associated factors in the elderly. The European Journal of Psychiatry, 30(3), 183–194.

    Google Scholar 

  • Tsakanikos, E., Costello, H., Holt, G., Sturmey, P., & Bouras, N. (2007). Behaviour management problems as predictors of psychotropic medication and use of psychiatric services in adults with autism. Journal of Autism and Developmental Disorders, 37(6), 1080–1085.

    Article  PubMed  Google Scholar 

  • Tsiouris, J. A., Kim, S. Y., Brown, W. T., Pettinger, J., & Cohen, I. L. (2013). Prevalence of psychotropic drug use in adults with intellectual disability: Positive and negative findings from a large scale study. Journal of Autism and Developmental Disorders, 43(3), 719–731.

    Article  PubMed  Google Scholar 

  • Vasudev, A., Shariff, S. Z., Liu, K., Burhan, A. M., Herrmann, N., Leonard, S., & Mamdani, M. (2015). Trends in psychotropic dispensing among older adults with dementia living in long-term care facilities: 2004–2013. The American Journal of Geriatric Psychiatry, 23(12), 1259–1269.

    Article  PubMed  Google Scholar 

  • Van der Oord, S., Prins, P. J., Oosterlaan, J., & Emmelkamp, P. M. (2008). Efficacy of methylphenidate, psychosocial treatments and their combination in school-aged children with ADHD: a meta-analysis. Clinical Psychology Review, 28(5), 783–800.

    Google Scholar 

  • Vitiello, B., Hill, J. L., Elia, J., Cunningham, E., McLeer, S. V., & Behar, D. (1991). P.R.N. medications in child psychiatric patients: A pilot placebo-controlled study. The Journal of Clinical Psychiatry, 52(12), 499–501.

    PubMed  Google Scholar 

  • Wang, Y., Wang, M. J., Rong, Y., He, H. Z., & Yang, C. J. (2019). Oxytocin therapy for core symptoms in autism spectrum disorder: An updated meta-analysis of randomized controlled trials. Research in Autism Spectrum Disorders, 64, 63–75.

    Article  Google Scholar 

  • White, C. A. (2015). Physical health problems: A framework and checklist for case formulation. In N. Tarrier & J. Johnson (Eds.), Case formulation in cognitive behaviour therapy: The treatment of challenging and complex cases (pp. 302–321). Routledge.

    Google Scholar 

  • Williamson, D., Frenette, A. J., Burry, L. D., Perreault, M., Charbonney, E., Lamontagne, F., ... & Bernard, F. (2019). Pharmacological interventions for agitated behaviours in patients with traumatic brain injury: A systematic review. BMJ open, 9(7), e029604.

    Google Scholar 

  • Yatawara, C., Einfeld, S., Hickie, I., et al. (2016). The effect of oxytocin nasal spray on social interaction deficits observed in young children with autism: A randomized clinical crossover trial. Molecular Psychiatry, 21, 1225–1231. https://doi.org/10.1038/mp.2015.162

    Article  PubMed  Google Scholar 

  • Zhou, Z., Betts, K. A., Bocharova, I., Kinrich, D., & Spalding, W. M. (2020). Concomitant use of psychotropic medication with stimulants for the treatment of ADHD in children and adolescents: A retrospective insurance claims study in the United States. Journal of Attention Disorders, 24(2), 336–347.

    Article  PubMed  Google Scholar 

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Sturmey, P. (2022). Individual Biological Interventions for Violence and Aggression. I. Psychopharmacology and Hormonal Treatments. In: Violence and Aggression . Advances in Preventing and Treating Violence and Aggression . Springer, Cham. https://doi.org/10.1007/978-3-031-04386-4_11

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