The Connection Between

Mental Illness,

Violence, and

Impulsivity

For years, medical experts have connected mental illness with substance use – in particular, the relationship between substance abuse and harm to oneself or others. However, as researchers continue to study this connection, it appears the role of alcohol and drugs may be more significant than originally hypothesized.

While the amount of violent crimes committed by the mentally ill is low in proportion to the total number, substance use seems to play a weighty role in that portion. A study in the American Journal of Psychiatry found that 58% of the 208 defendants studied had an Axis I or II disorder, with 47% of those individuals diagnosed with substance use.

A different study showed that individuals were 2.7 times more likely to participate in a violent act if their symptoms, and severity of symptoms, fluctuated rapidly, rather than trending back to stability. Substance use – particularly, alcohol – was connected to the inability to control symptoms back to equilibrium or a “set point.”

Psychiatry professor Edward Mulvey says advances in understanding how to identify high-risk groups combined with effectively monitoring changes in risk – in particular, substance use – could be valuable in dealing with potential acts of violence.

Associate professor of psychiatry Kenneth Conner says it is hard to conduct research on suicidality among individuals with alcohol use disorders because it is a challenging group to track. However, he has found in his research that suicide attempts increase up to 6 times with acute alcohol use.

Alan Swann, a professor of psychiatry and behavioral sciences, says violence is closely tied to impulsivity. While substance use is correlated with increased impulsive acts, it is especially dominant in individuals suffering from a psychiatric illness. Being the victim of aggressive behavior, acting out aggressively, and suicidality increase among the mentally ill using substances.

Brain structure is closely linked to the roots of impulsivity. While stress, mania, and even sleep deprivation can wildly affect the complex system of responses in the brain, an acute use of drugs or alcohol can further disturb an already maladapted system, Dr. Swann stresses. For example, alcohol is both a stimulant and a depressant – the brain must go through two independent responses.

The takeaway from this connection between the underlying biology of impulsivity and substance use is that there is potential for future pharmacological treatments, Dr. Swann points out. However, even being aware of the connection allows individuals to recognize their risky behavior and make modifications.

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Resource: http://psychnews.psychiatryonline.org/newsarticle.aspx?articleID=1887008

Summary

Experts are continuing their research linking violence among the mentally ill to substance use. The relationship between impulsivity and acute use of substances, in particular, alcohol, has shown to greatly factor into harming oneself or harming others.