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Alcohol and Violence in Psychopathy and Antisocial Personality Disorder: Neural Mechanisms

N. Kolla,Christine Wang

Published 2019 in Neuroscience of Alcohol

ABSTRACT

Abstract A robust corpus of evidence supports an association between neurochemical dysfunction and violence in individuals with a history of alcohol misuse. Specifically, Type 1 alcoholics have been shown to exhibit higher levels of serotonin and decreased dopamine, whereas Type 2 alcoholics tend to display lower levels of serotonin and increased dopamine levels. Both serotonin and dopamine are neurotransmitters modulated by monoamine oxidase-A, an enzyme important to brain structure and function and which may also underlie pathological aggression. Genetic association studies further highlight certain monoamine oxidase-A polymorphisms that on their own or in combination with early adverse events make individuals more vulnerable to the negative effects of alcohol, including violence. Structural brain changes also present a strong association with aggression and alcohol misuse. MRI analyses have found decreased hippocampal volumes in both Type 1 and Type 2 alcoholics. Different mechanisms may account for divergent findings. For example, the duration of alcohol misuse seems relevant to hippocampal deterioration in Type 1 alcoholics, whereas in Type 2 alcoholics, primary psychopathology may be the main driving force behind hippocampal reduction. These findings suggest that in Type 2 alcoholism, hippocampal alterations may relate more to the effects of antisocial personality disorder than alcohol misuse. Other structural investigations reveal that alcohol misuse and a history of violent behavior present with decreased amygdala volumes compared with nonviolent alcoholics, suggesting a potential role of the mesolimbic reward system in mediating aggressive behavior and alcohol misuse. These findings highlight the conjoint effects of neurotransmitter abnormalities, structural, and functional imaging changes, and effects of specific genes that may alter the nature of alcohol consumption on risk for violent behavior.

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