Depression as a risk marker for aggression

By Donald G. Dutton

INTRODUCTION

Resemblance between depression and aggression

Depression connotes lethargy -making a person aggressive

Major depressive episode:

1. Feeling of sadness

2. Diminished interest in activities

3. In decisiveness -Not able to take decisions

4. Recurrent thoughts of death

Depression and general aggression

• Broadband relation between Externalizing and internalizing

• Aggression causes peer rejection causes internalizing problems

• “causal role of depression and aggression”

Depression and spousal aggression• Studies Assessed “ depressive

symptomology increased the mild wife assault by 30%and severe wife assault by 70%.

• Suggestion by clinical literature ‘males who are depressed, display aggression and violence but don't report the depressed affect.’

• Sexuality and physical violence had higher scores on depression.

Depression and spousal homicide

• A triggering separation by the women deepens depression, then murder/suicide

• Risk factors of homicide were alcohol abuse and jealousy.

• Major cause of spousal homicide was being unemployed and problem alcohol use.

Depression and child abuse

• Parent-child interactions of depressed mothers and abusive mothers were similar.

• Research showed that moderate depression was associated with an increase in probability of aggression to a child.

Depression and aggression to the self

• Suicide is the aggression towards self (Frued)

• Suicide-escape from aversive self awareness.( short of self standards)

PROCESSES LINKING DEPRESSION TO AGGRESSION

Depression aggression

• Individuals with high rates of depression showed alcohol dependency

• Alcohol dependency was estimated in depressed individuals at 32.3% while it was 9.5%for persons without depression.

• Evidence showed that AUD increases the risk of MD rather than vice versa.

Depression and isolation

• Depressed individuals receive less social support either actual or perceived.

• Non depressed subjects expressed a general lack of interest for further contact with depressed individuals.

Depression and rumination

• Inability to remove negative thoughts from working memory.

Sadness rumination-negative events to the self

Anger rumination-external entity

• Catathymic crises : fluctuation between self blame and other blame

Depression and impulsivity

• Depression has negative implications for self regulation affecting behavior.

• “Impulsivity is neurophysiologically based inability to conform behavior to its results.”

• Impulsive individuals are sensitive to rewards.

Depression and Internalized anger

• Internalized anger refers to suppressed(or unexpressed anger at others)

• There is a correlation between high levels of hostility and depression in patients with internalized and externalized anger.

Depression and emotional flooding

• Depression can serve as “flooding function that generates anger and hence, increases the likelihood of aggression.

• Authors concluded that both aggressive and depressive responses may be displayed in reaction to the same situation

COMMON CAUSES OF DEPRESSION AND AGGRESSION

Genetics

• Approach has been suggested by studies indicating that a genetic variation in a serotonin transporter gene is indicated in depression.

Attachment style

• Insecure attachment style has been linked to both depression and use of aggression especially intimate partner aggression.

• Attachment insecurity consistently relate to more frequent and severe depression.

Conclusion

• Depression should constitute a routine aspect of mental health assessment and where present , should be viewed as a risk factor for aggression.