Theories & Implications of aggression in Psychiatry

1. AGGRESION
THEORIES & IMPLICATION FOR PSYCHIATRY
DR. SUBRATA NASKAR
PGT, DEPARTMENT OF PSYCHIATRY
SILCHAR MEDICAL COLLEGE & HOSPITAL

2. PLAN OF PRESENTATION
 INTRODUCTION
 NEUROANATOMY OF AGGRESSION
 TYPES OF AGGRESSION
 ETIOLOGY OF AGGRESSION
 THEORIES OF AGGRESSION
 FORMS OF AGGRESSION IN SOCIETY
 CONTROLLING AGGRESSION
 BIBLIOGRAPHY

3. INTRODUCTION
 AGGRESSION IS DEFINED AS ANY FORM OF BEHAVIOUR DIRECTED TOWARDS THE GOAL OF HARMING OR
INJURING ANOTHER LIVING BEING WHO IS MOTIVATED TO AVOID SUCH TREATMENTS. (BARON,1997)
 ONE INFLUENTIAL IDEA ABOUT HUMAN AGGRESSION IS THAT IT IS PART OF “NATURE OF THE BEAST”. (FREUD,
1920/1953; LORENZ 1966)
 AGGRESSION CAN BE EITHER ‘HOSTILE’ WHICH HAS ITS GOALS IN HARMING ANOTHER PERSON OR
‘INSTRUMENTAL ‘ WHICH IS USED TO SATISFY SOME OTHER NEEDS.
 AGGRESSION IS AN ADAPTIVE BEHAVIOUR HAVING ITS ORIGINS IN GENETICALLY CODED NEURAL MECHANISMS
THAT ARE ACTED UPON BY HORMONAL AND PSYCHOSOCIAL FACTORS . IT HAS MULTIPLE DETERMINATES
WHOSE MANIFESTATIONS AND EFFECTS VARY WITH AGE, SEX AND CULTURE.
 AGGRESSIVE BEHAVIOUR PROMOTES THE SURVIVAL OF INDIVIDUAL AS WELL AS SOCIAL GROUPS. HOWEVER IN
THE CONTEXT OF RAPID SOCIAL AND CULTURAL CHANGES, THE SURVIVAL VALUE OF AGGRESSION BECOMES
SUSPECT.AS IS GENERALLY BELIEVED, APPROPRIATE AGGRESSION MAY NOT BE HARMFUL AND ATTEMPTS TO
EXTINGUISH ALL FORM OF IT MAY PROVE MALADAPTIVE.

4. NEUROANATOMY
 HYPOTHALAMALIC ATTACK AREA : Ventral portion of the ventromedial and lateral
nuclei of hypothalamus is called Hypothalamic Attack Area (HAA).
DORSAL RAPHE
MEDIAL AMYGDALA
HAA
CENTRAL GREY
MEDIAL NUCLEUS
OF THALAMUS
SEPTUM
PREFRONTAL
CORTEX

5. ACTIVATES MUSCLES INVOLVED
IN AGGRESSIVE BEHAVIOR
VISCERAL/AUTONOMIC
RESPONSE
AMYGDALA
MOTOR CORTEX
HYPOTHALAMUS

6. CORTICOBASOLATERAL AMYGDALA
CONDITIONED FEAR RESPONSE TO THREATENED
STIMULI
ANOTHER MODEL
THALAMUS
THALAMUS AMYGDALA
STIMULI LIKE
APPROACHING
FIST
RAPID SIGNALS
SEMIAUTOMATIC
RESPONSE
ASSESS
FIGHT/FLIGHT
SITUATION
CENTROMEDIAL
AMYGDALA

7. ANTERIOR CINGULATE GYRUS
• ACTS AS A CONFLICT DETECTOR
• RECIEVES INPUT FROM LIMBIC SYSTEM & PREFRONTAL CORTEX
DORSOLATERAL PRE-FRONTAL CORTEX
CALCULATION OF RELATIVE RISK

8. FRONTAL LOBE
INTEGRATES
SENSORY LIMBIC INPUT + MEMORY OF IMMEDIATE PAST
PLANS, SEQUENCE, ANTICIPATE CONSEQUENCES OF ACTION
ADJUST THE MOTOR PROGRAMS IN RESPONSE TO ENVIORNMENTAL CHANGES

9. DORSOLATERAL PREFRONTAL CORTEX (DLPFC)
INTENTIONAL BEHAVIOR INVOLVING THE CONSCIOUS WILL TO EXECUTE PLAN
HEMISPHERES:
EMOTIONALLY THREATENED STIMULI
RIGHT BRAINLEFT BRAIN
AGGRESSIVE
RESPONSE
PROCESSED BY
RESTRAINS
INJURY

10. THALAMUS
SENSORY INFORMATION
SENSORY
CORTEX
AMYGDALA
HYPOTHALAMUS
VMPFC DLPFC
PREMOTOR
SUPPLEMENTAL
MOTOR AREA
MOTOR AREA
VISCERAL, AUTONOMIC
RESPONSES
DORSAL
RAPHE
AGGRESSION

11. TYPES OF AGGRESSION
• PHYSICAL-ACTIVE-DIRECT (physical attack, nonverbal, vulgar gestures directed at the target)
• PHYSICALLY-ACTIVE-INDIRECT (theft, destruction of property, unnecessary consumption of resources needed by the
target)
• PHYSICALLY-PASSIVE-DIRECT (reducing target's ability to contribute, i.e. scheduling them to present at the end of
the day where fewer people will be attending)
• PHYSICALLY- PASSIVE INDIRECT (causing others to create a delay for the target)
• VERBAL-ACTIVE-DIRECT (insulting, acting condescendingly, yelling)
• VERBAL-ACTIVE-INDIRECT (spreading false rumors belittling ideas or work)
• VERBAL-PASSIVE-DIRECT ("silent treatment", failure to return communication, i.e. phone calls, e-mails)
• VERBAL-PASSIVE-INDIRECT (failure to deny false rumors about target, failure to provide information needed by
target)

12.  TYPES OF AGGRESSION
AFFECTIVE OR IMPULSIVE: Includes intramale, irritable, territorial and maternal aggression.
Evokes intense activation of sympathetic nervous system.
PREMEDITATED OR PREDATORY: It is accomplished more silently and cautiously by
silently stalking the prey and quickly dispatching it in the interest of providing food.
DEFENSIVE AGGRESSION: characterized by fear, is accompanied by high level of serum
cortisol.
OFFENSIVE AGGRESSION: characterized by low serotonergic brain activity, high serum
testosterone levels and low serum cortisol levels
• 1. Sanctioned And Nonsanctioned Aggression.
• 2. Hypo arousal versus hyper arousal related aggression
• 3. Proactive Versus Reactive Aggression
OTHER CLASSIFICATIONS

13. ETIOLOGY:
 GENDER:
• Males of human species like males of most other species are more
aggressive .
• Their play is rougher and the crimes they commit as adults are more
numerous and violent .
• The greater aggressiveness is also reflected in the patriarchal styles of
most human species.

14. NEUROCHEMISTRY
• Androgens are the one of the main hormones implicated for
aggression.
• Higher levels of testosterone produced by male fetuses shape the
anatomical and physiological characteristics of male brain.
• Testosterone regulates aggression through various neurotransmitters
like serotonin, GABA etc.

15. • Men using anabolic androgenic steroids for the purpose of body
building often exhibit aggressive and violent behavior. This action is
mediated by down regulation of 5HT1b receptors in parts of
hippocampus.
• Corticosteroids: Chronically low cortisol levels are associated with
aggressive and disruptive behavior in boys.
• Oxytocin is considered essentially a socializing, antiaggresive
hormone. Decrease Oxytocin in the paraventricular nucleus of rodents
increase maternal aggression.

16. NEUROTRANSMITTERS:
SEROTONIN:
• Low levels of 5-HIAA have been consistently associated with higher level of
aggression and suicide.
• 5 HT1A receptor agonists like buspirone has been found to have antiaggressive
effect.
• 5HT2A Antagonists also have antiaggressive effect [RISPERIDONE]
• A laboratory study of the behaviors of men depleted of tryptophan have
shown that they become more aggressive than those who are not deprived.

17. NOREPINEPHRINE AND EPINEPHRINE
• In the periphery it brings about adaptive changes in the cardiovascular
system and mobilization of energy sources required for the aggressive
act.
• In the CNS its effects are mediated by its effects on the release of CRH.
• Other neurotransmitters like dopamine and GABA also have a role in
regulating aggression.

18. DOPAMINE STIMULATION OF REWARD CENTERS
MOTIVATION FOR AGGRESSION
PUZZLING THING ABOUT DOPAMINE:
D1 AGONISTS AS WELL AS ANTAGONISTS BINDS TO D1, D2, D3 RECEPTORS.
AGGRESSION (SO DOPAMINE ITSELF DON’T INITIATE AGGRESSION)

19. GENETIC ASPECT OF AGGRESSION
• It has long been recognized that criminality runs in families and there are many
studies supporting this view.
• Greater the number of convicted family members, the more likely was the boy to
be convicted of crime.
• Of special note, having a father or a brother who had been convicted significantly
increased the likelihood of a boy’s conviction.
• Having a older criminal sibling is more closely associated with a child’s criminality
than having a younger criminal sibling.

20. • Early studies of adopted children of criminal biological fathers and noncriminal
biological fathers revealed that the children of criminal fathers are more likely to
become antisocial.
• However, those children with both criminal biological fathers and criminal
adoptive fathers were at greater risk of becoming antisocial, suggesting that
both intrinsic and environmental factors contribute to antisocial behavior.
CONTINUED…..

21. AGGRESSION IS FOUND TO BE MORE CLOSELY ASSOCIATED WITH
VARIANTS OF :
• MAO-A and COMT gene
• Polymorphism of SERT gene.
• Promoter of serotonin transporter.
• MAO (X chromosome) low and high functioning variant –
• low functioning variant associated with more aggression.
• Tryptophan hydroxylase - L allele & U allele - U allele have higher scores on aggression.

22. ENVIRONMENTAL STRESSORS:
Whatever the innate assets and liabilities the way humans are treated in utero, at birth, during
infancy, childhood, adolescence and beyond are the most important influences on social
adaptation.
I) INTRAUTERINE AND PERINATAL INFLUENCES:
 Maternal cocaine addiction
 Maternal alcoholism
 Psychological stressors and anxiety
 Postnatal toxicities. (Lead, polystyrene)
 Marital discord, single parenthood, domestic violence, neglect.

23. II) NURTURING:
 EARLY NURTURANCE HAS SUBSEQUENT ADAPTATION IN ANIMALS AND HUMANS. E.G. ANIMALS
BRED FOR GENTLENESS IF CROSS FOSTERED BY AGGRESSIVE FEMALES OF A VIOLENT STRAIN , WILL
BECOME AGGRESSIVE.
 STUDIES HAVE SHOWN RELATIONSHIP BETWEEN DISORGANIZED MOTHER INFANT ATTACHMENT
AND SUBSEQUENT CHILDHOOD AGGRESSIVENESS.
 DISORGANIZED ATTACHMENT HAVE BEEN SHOWN TO BE ASSOCIATED WITH LAGS IN COGNITIVE
DEVELOPMENT IRRESPECTIVE OF MATERNAL IQ AND AGGRESSIVE BEHAVIORS.
 GOOD NURTURANCE LEADS TO DENDRITIC AND AXONAL ARBORIZATION AND MYELINATION. THE
LACK OF EMPATHY SHOWN BY SOME ANTISOCIAL ADOLESCENTS AND ADULTS MAY BE A
REFLECTION IN PART, OF THEIR FAILURE TO HAVE CREATED DENDRITIC CIRCUITS ASSOCIATED WITH
HEALTHY ATTACHMENT.

24. III) BRAIN INJURY AND VIOLENCE:
 THE PART OF THE BRAIN THOUGHT TO BE INVOLVED IN SEXUAL AND AGGRESSIVE DRIVES LIES DEEP IN
THE AREAS OFTEN REFERRED TO AS THE LIMBIC SYSTEM.
 AREAS OF THIS REGION MOST CLOSELY ASSOCIATED WITH AGGRESSION ARE THE HYPOTHALAMUS,
SEPTAL AREA AND THE AMYGDALA.
 FEAR IS PROCESSED IN AMYGDALA, STIMULATION OF WHICH ELICITS DEFENSIVE AND AGGRESSIVE
RESPONSE.
 THE PREFRONTAL CORTEX ALLOWS SOME CONTROL OVER THIS DEFENSIVE AND AGGRESSIVE RESPONSES,
BY ASSESSING THE THREAT INTELLECTUALLY AND CHOOSE TO ACT OR NOT TO ACT IN RESPONSE TO THE
STIMULI.
 THUS LESION TO ANY OF THESE AREAS CAN PRODUCE AGGRESSIVE AND VIOLENT BEHAVIOUR.

25.  AGGRESSIVE BEHAVIOUR CHANGE HAS BEEN REPORTED IN INDIVIDUALS WITH DAMAGE TO
MEDIAL TEMPORAL LOBE AND BRAIN TUMORS IN THE LIMBIC SYSTEM.
 LONGITUDINAL STUDIES HAVE SHOWN THAT CHILDREN WHO SUSTAIN INJURY TO THE
PREFRONTAL CORTEX, AS ADULTS BECAME VERBALLY AND PHYSICALLY AGGRESSIVE WITH
DEFICITS IN MORAL REASONING.
 PET STUDIES HAVE SHOWN HYPOACTIVATION IN LATERAL AND MEDIAL ZONES OF
PREFRONTAL CORTEX IN INDIVIDUALS GIVEN TO IMPULSIVE AGGRESSIVE ACTS.

26. IV) CHILDHOOD ABUSE AND VIOLENCE:
 PROBABLY THE MOST IMPORTANT CONTRIBUTOR TO THE GENESIS OF VIOLENT BEHAVIOURS
IS EARLY, ONGOING PHYSICAL EMOTIONAL AND SEXUAL ABUSE.
 EARLY REPEATED SEXUAL ABUSE , ESPECIALLY OF BOYS, SEEMS TO HAVE DEVASTATING
CONSEQUENCES .
 STRESSORS SUCH AS ONGOING MALTREATMENT, ACTIVATE THE AMYGDALA AND THE HPA
AXIS CAUSING RELEASE OF CATECHOLAMINES AND CORTISOL.
 EXCESSIVE EXPOSURE TO GLUCOCORTICOIDS RESULTS IN LOSS OF HIPPOCAMPAL NEURONS
AND DAMAGE TO CEREBELLAR VERMIS AN AREA IMPORTANT FOR MODULATING LIMBIC
ACTIVITY.

27. V. SOCIAL FACTORS AND AGGRESSION:
DIFFERENT RATES OF VIOLENT CRIME IN DIFFERENT SOCIETIES ATTEST TO THE IMPORTANCE OF
SOCIAL FACTORS IN THE GENESIS OF VIOLENCE.
IT IS SUGGESTED THAT VIOLENCE IN A SOCIETY IS INVERSELY PROPORTIONAL TO THE
PERCENTAGE OF MEN IN INTACT FAMILIES OF ORIGIN OR PROCREATION.
DAVID COURTWRIGHT CONCLUDED THAT IN SOCIETIES IN WHICH STABLE, INTACT FAMILIES
AND ADEQUATE PARENTAL GUIDANCE ARE LACKING, VIOLENCE WILL FLOURISH.
IT WAS EARLIER BELIEVED THAT POVERTY HAS A STRONG CO RELATION WITH VIOLENCE BUT IT
IS NOT POVERTY PER SE THAT BREEDS VIOLENCE, BUT RATHER SOCIAL DISORGANIZATION,
CHARACTERIZED BY A LOSS OF SOCIAL SUPPORTS, POOR NURTURING, POOR NUTRITION AND
SAFETY AND FAILURE TO ESTABLISH SECURE CHILDHOOD ATTACHMENTS.

28. PEER PRESSURE: PEER PRESSURE PROMOTES AGGRESSION VIA 2 VISCIOUS
LOOP.
AGGRESSION AGGRESSION
PEER REJECTION GROUP FORMATION
REINFORCEMENT
Fig. 1 Fig .2

29. MEDIA
MANY STUDIES REPORT AN ASSOCIATION BETWEEN EXPOSURE TO VIOLENT MOVIES,
TELEVISION PROGRAMS AND VIDEO GAMES AND THE DEVELOPMENT OF VIOLENT
BEHAVIOURS ESPECIALLY IN THE CASE OF VERY VULNERABLE CHILDREN.
 TELEVISION VIOLENCE IS THOUGHT TO CONTRIBUTE TO VIOLENCE IN CHILDREN AND
ADULTS IN THE FOLLOWING WAYS:
 IT HAS A SHORT TERM STIMULATING EFFECT ON AGGRESSIVE BEHAVIOUR IN ALL AGES.
 IT PORTRAYS THE WORLD AS A MORE HOSTILE PLACE THAN IT IS.
 IT JUSTIFIES VIOLENCE(E.G. 40% OF VIOLENT TV ACTS ARE PERFORMED BY CHARACTER
POTRAYED AS HEROES)
 IT STIMULATES AGGRESSIVE IDEAS.

30. GANGS :
 Youth gangs exist throughout the world and consist
primarily of young men.
 Gangs flourish in prisons and tend to exist in
socioeconomically disadvantaged sectors of society.
 They tend to be made of school drop outs whose limited
education and lack of work skills restrict their economic
opportunities.
 Youngsters who join gangs become more aggressive than
they were on their own because in gangs individuality is
submerged.

31. VI. MENTAL ILLNESS AND AGGRESSION:
 IT IS TRUE THAT MOST INDIVIDUALS WITH MENTAL ILLNESS ARE NOT VIOLENT. HOWEVER
MOST STUDIES FROM AROUND THE WORLD INDICATE THAT VIOLENCE IS MORE COMMON
AMONG SERIOUSLY MENTALLY ILL INDIVIDUALS THAN AMONG MENTALLY HEALTHY
INDIVIDUALS.
 STUDIES HAVE FOUND THAT THE PREVALENCE OF VIOLENCE IS FIVE TIMES HIGHER IN
INDIVIDUALS WHO MEET THE DSM IV CRITERION FOR AXIS 1 DIAGNOSIS THAN IN PEOPLE
NOT MEETING CRITERION FOR SERIOUS MENTAL ILLNESS.
 THE PREVALENCE OF VIOLENCE IN INDIVIDUALS WHO HAVE SCHIZOPHRENIA , MAJOR
DEPRESSION, OR MANIA/BIPOLAR DISORDERS WAS SIMILAR ( I.E. 11-13%).
 HIGHER PERCENTAGE OF INDIVIDUALS WITH ALCOHOLISM OR OTHER SUBSTANCE ABUSE
WERE VIOLENT (E.G. 25% AND 35% RESPECTIVELY)

32.  OF NOTE ALMOST ALL THE DIFFERENCE IN PREVALENCE OF VIOLENCE BETWEEN PATIENTS
AND NON PATIENTS SEEM TO BE ACCOUNTED FOR BY THE PRESENCE OF ACTIVE PSYCHOTIC
SYMPTOMS. WHEN THEY WERE NOT ACTIVELY PSYCHOTIC THEY WERE NO MORE VIOLENT
THAN OTHERS.
 SEVERAL CLINICAL RESEARCHERS HAVE REPORTED THAT PSYCHOTIC FEATURE MOST CLOSELY
ASSOCIATED WITH VIOLENCE IS PARANOIA.
 OTHER PSYCHIATRIC DISORDERS ASSOCIATED WITH EPISODIC VIOLENCE ARE PTSD AND
DISSOCIATIVE PERSONALITY DISORDERS.

33. PREDICTIVE MARKERS OF AGGRESSION:
1. DISORGANIZED ATTACHMENT.
2. HIGHLY OPPOSITIONAL AND DEFIANT IN KINDERGARTEN
3. HOSTILE ATTRIBUTION BIAS
4. LOWER THAN AGE APPROPRIATE SOLVING SKILLS
5. PROLACTIN RESPONSE TO FENFLURAMINE.

34. THEORIES OF AGGRESSION
THEORIES OF AGGRESSION FALL INTO ONE OF THE TWO CATEGORIES, BIOLOGICAL THEORY
AND SOCIAL THEORY.
• ACCORDING TO BIOLOGICAL THEORY WE ARE BORN WITH A TENDENCY TO BEHAVE
AGGRESSIVELY.
• IN CONTRAST, THE SOCIAL PERSPECTIVE ARGUES THAT AGGRESSION IS A SOCIAL
BEHAVIOUR THAT WE LEARN FROM THOSE AROUND US.

35. BIOLOGICAL THEORIES ARGUE THAT WE ARE GENETICALLY PREDETERMINED TO BE AGGRESSIVE.
HERE WE WILL DISCUSS TWO PERSPECTIVE THAT PROPOSE THAT AGGRESSION IS INNATE:
PSYCHODYNAMIC
THEORY
EVOLUTIONARY
APPROACH
BIOLOGICAL THEORIES OF AGGRESSION

36. I. PSYCHODYNAMIC THEORY:
THE PSYCHODYNAMIC PERSPECTIVE WAS DOMINANT AT THE START OF THE 20TH CENTURY
PROPOSED THAT PEOPLE HOLD TWO INNATE, BUT OPPOSING, INSTINCTS:
• AN INSTINCT FOR LIFE OR ‘EROS’ , AND
• AN INSTINCT FOR DEATH OR ‘THANATOS’
LIFE INSTINCT SOMETIMES REFERRED TO AS SEXUAL INSTINCTS, THE LIFE INSTINCTS ARE THOSE
THAT DEAL WITH BASIC SURVIVAL, PLEASURE, AND REPRODUCTION. THESE INSTINCTS ARE
IMPORTANT FOR SUSTAINING THE LIFE OF THE INDIVIDUAL AS WELL AS THE CONTINUATION OF
THE SPECIES.
FREUD (1930) PROPOSED THAT ALTHOUGH DEATH INSTINCT INITIALLY LEAD TO SELF DESTRUCTIVE
BEHAVIOUR, IT LATER BECAME REDIRECTED FROM THE SELF TOWARDS OTHERS AS AGGRESSIVE
BEHAVIOUR.

37. II) EVOLUTIONARY APPROACH:
• EVOLUTIONARY SOCIAL PSYCHOLOGISTS CLAIM THAT SOCIAL BEHAVIOUR HAS EVOLVED
OVER TIME, PASSED DOWN FROM GENERATION TO GENERATION ( SIMPSON AND
KENRICK, 1997).
• PROPONENTS OF THIS APPROACH ARGUE THAT SOCIAL BEHAVIOUR EXIST TO ENSURE
THAT AN INDIVIDUAL’S GENES SURVIVE FOR LONG ENOUGH TO BE PASSED ONTO THEIR
OFFSPRINGS.

38. SOCIAL THEORY:
ACCORDING TO SOCIAL PSYCHOLOGIST, THE SOCIAL CONTEXT IN WHICH WE EXIST CAN ALSO
EXPLAIN AGGRESSIVE BEHAVIOUR.
I) FRUSTRATION-AGGRESSION HYPOTHESIS:
DOLLARD AND COLLEAGUES (1939) ARGUED THAT AGGRESSION RESULTED FROM FRUSTRATION
AT A PARTICULAR PERSON OR EVENT, IF CANT DIRECTLY BE TARGETED AT THE CAUSE OF
FRUSTRATION BECAUSE THEY ARE TOO PHYSICALLY OR SOCIALLY POWERFUL OR THE CAUSE IS A
SITUATION RATHER THAN A PERSON, IT MAY BE REDIRECTED AT A MORE REALISTIC TARGET. THIS
HIGHLY INFLUENTIAL IDEA BECAME KNOWN AS THE FRUSTRATION-AGGRESSION HYPOTHESIS.

39. HOVARD AND SEARS (1940) SUGGESTED THAT FRUSTRATION
CAUSED BY ECONOMIC DOWNTURN (A SITUATIONAL CAUSE)
WOULD PRODUCE AGGRESSIVE IMPULSES THAT WOULD BE
DIRECTED AT VULNERABLE TARGETS SUCH AS MINORITY
GROUPS EVEN WHEN THOSE GROUPS BEAR NO RESPONSIBILITY
FOR ECONOMIC DECLINE. ACCORDINGLY, THEY FOUND A
STRONG RELATIONSHIP BETWEEN LYNCHING OF BLACKS IN
AMERICAN SOUTH AND ECONOMIC DOWNTURNS, ASSESSED BY
LOOKING AT COTTON PRICES AND ECONOMIC GROWTH FROM
1882 AND 1930.

40. CRITICISM TO FRUSTRATION-AGGRESSION THEORY:
1. GREEN, GASLER AND RICH (1998) REANALYZED THE DATA USED BY HOVLAND AND SEARS
AS WELL AS LOOKING AT NEW DATA FROM NEW YORK. THEY FOUND A VERY LIMITED
EVIDENCE FOR A LINK BETWEEN THE ECONOMY AND HATE CRIMES.
2. SECONDLY, WHERE A LINK BETWEEN FRUSTRATION AND AGGRESSION DOES EXIST, IT IS
UNLIKELY TO BE SPONTANEOUS OR DIRECT, INSTEAD, RACIST GROUPS MAY EXACERBATE
PEOPLE’S EXISTING FRUSTRATIONS BY ATTRIBUTING BLAME AND ENCOURAGING PUBLIC
RESENTMENT TOWARDS MINORITIES IN TIMES OF ECONOMIC DECLINE.

41. 3. FRUSTRATION DOES NOT ALWAYS LEAD TO AGGRESSION . PEOPLE MAY REACT TO FRUSTRATION
BY WITHDRAWING FROM THE SITUATION, BY GIVING UP, BY USING ALCOHOL OR OTHER DRUGS,
OR ON A MORE POSITIVE NOTE INCREASING THEIR EFFORTS TO OVERCOME THEIR FRUSTRATION.
4. WHETHER FRUSTRATION LEADS TO AGGRESSION DEPENDS ON 2 FACTORS, FIRST THE
FRUSTRATION MUST BE INTENSE, AND THE FRUSTRATION MUST BE PERCEIVED AS UNJUSTIFIED.
AGGRESSION, IT MAY NOT OCCUR AT ALL IF THWARTING OF MOTIVES IS VIEWED AS JUSTIFIED BY
THE FRUSTRATED INDIVIDUAL. (ZILLMANN & CANTOR, 1976)

42. II. CATHARTIC HYPOTHESIS:
(Catharsis (from the Greek katharsis meaning "purification" or "cleansing") is the purification and purgation of
emotions)
IT IS CLOSELY RELATED TO THE CONCEPT OF FRUSTRATION- AGGRESSION, WHEN FACED WITH A
FRUSTRATING OR IRRITATING SITUATION, WE EXPERIENCE A BUILD UP OF NEGATIVE EMOTIONS
IN ORDER TO RID OURSELVES OF THIS EMOTION WE NEED TO ACT THEM OUT. ONLY THEN WILL
WE BE ABLE TO RETURN TO OUR NORMAL, BALANCED STATE.
III. COGNITIVE NEOASSOCIATIONALIST MODEL:
THIS MODEL WAS PROPOSED BY BERKOWITZ (1969,1989). APART FROM FRUSTRATION IT ALSO
TAKES INTO ACCOUNT ENVIRONMENTAL ‘CUES’ THAT INCREASE THE PROBABILITY OF AN
AGGRESSIVE RESPONSE, ANY OBJECT OR PERSON CAN PROVIDE A CUE FOR AGGRESSION IF IT
HAS BEEN LINKED REPEATEDLY WITH ANGER AND AGGRESSION IN THE PAST.

43. 6
5
4
3
2
1
0
CONTROL SITUATIONAL CUES
FIG 1. THE EFFECT OF SITUATIONAL CUES ON AGGRESSION. DATA FROM BERKOWITZAND LEPAGE (1967)

44. IV. EXCITATION- TRANSFER MODEL (ZILLMAN, 1984):
 ACCORDING TO THIS MODEL, AROUSAL IN ONE SITUATION CAN CARRY OVER INTO A
COMPLETELY NEW SITUATION .
 THIS RESIDUAL AROUSAL FROM ONE SITUATION CAN INCREASE THE LIKELIHOOD THAT
WE WILL BEHAVE AGGRESSIVELY IN ANOTHER SITUATION.

45. V. LEARNING THEORIES OF AGGRESSION:
HERE WE DESCRIBE TWO WAYS IN WHICH WE MAY LEARN TO BEHAVE AGGRESSIVELY.
OPERANT REINFORCEMENT:
SKINNER PROPOSED THAT CHANGES IN BEHAVIOUR RESULT FROM THE RESPONSE TO STIMULI
IN A PERSON’S ENVIRONMENT, A PROCESS HE CALLED ‘OPERANT CONDITIONING’
WHEN A PARTICULAR STIMULUS-RESPONSE PATTERN IS POSITIVELY REINFORCED, BY REWARDING
IT RATHER THAN PUNISHING IT, THE LINK BETWEEN THE STIMULUS AND THE RESPONSE IS
STRENGTHENED.

46. SOCIAL LEARNING THEORY:
BANDURA (1977) ALSO BELIEVED THAT PEOPLE ARE NOT BORN WITH A READY TO USE
REPERTOIRE OF BEHAVIOUR.
IN CONTRAST TO SKINNER, HOWEVER HE PROPOSED THAT BEHAVIOUR COULD ALSO BE
LEARNT INDIRECTLY, BY OBSERVING THE BEHAVIOUR OF OTHERS. BANDURA CALLED THIS
PROCESS OR
HE ARGUED THAT WHETHER A PERSON IS AGGRESSIVE IN A PARTICULAR SITUATION
DEPENDS ON A PERSON’S DIRECT OR INDIRECT EXPERIENCES OF THAT AGGRESSIVE
BEHAVIOUR.
DID THE OBSERVED BEHAVIOUR REACH ITS GOALS?
WAS IT REWARDED OR PUNISHED?

47. PERSON CENTERED DETERMINANTS OF AGGRESSION:
I. GENDER:
MALES OF ALMOST ALL SPECIES ARE MORE AGGRESSIVE THAN THEIR FEMALE COUNTERPARTS .
THERE MAY BE A HORMONAL EXPLANATION FOR THIS GENDER DIFFERENCE.
• MEN TYPICALLY HAVE HIGHER LEVELS OF TESTOSTERONE THAN WOMEN, WHICH MIGHT ACCOUNT
FOR THIS GREATER AGGRESSION.
• ANOTHER REASON FOR THIS GREATER AGGRESSION IS GENDER SOCIALIZATION.
• WHILE BOYS TEND TO SHOW HIGHER LEVELS OF PHYSICAL AGGRESSION THAN GIRLS, THERE WERE
NO GENDER DIFFERENCE IN VERBAL AGGRESSION. INTERESTINGLY, GIRLS SHOW HIGHER LEVELS OF
INDIRECT AGGRESSION THAN BOYS.

48. II. PERSONALITY:
• CAPRARA AND COLLEAGUES (1994,1996) FOUND IRRITABILITY, RUMINATION,
EMOTIONAL SUSCEPTIBILITY TO BE CONSISTENT TRAITS ASSOCIATED WITH AGGRESSION.
• PEOPLE WHO HAVE TYPE A PERSONALITY MAY ALSO BE PARTICULARLY SUSCEPTIBLE TO
AGGRESSION (CARVER AND GLASS, 1978).
• PEOPLE WITH HIGH SELF ESTEEM WOULD BE PARTICULARLY LIKELY TO ENGAGE IN
AGGRESSIVE BEHAVIOUR WHEN THEIR EGO IS THREATENED. (BAUMEISTER , 1996)

49. III. ALCOHOL:
ALCOHOL IS CONSIDERED A PERSON CENTERED DETERMINANT BECAUSE DIFFERENT DEGREES OF
CONSUMPTION CAN CAUSE INDIVIDUAL DIFFERENCES IN PEOPLE’S AGGRESSIVE BEHAVIOUR .
A NUMBER OF STUDIES HAVE SHOWN THAT PEOPLE UNDER THE INFLUENCE OF ALCOHOL ARE MORE
AGGRESSIVE THAN THOSE WHO ARE NOT. ALSO PEOPLE UNDER THE INFLUENCE OF ALCOHOL ARE LIKELY TO
EXHIBIT AGGRESSIVE BEHAVIOUR WHEN THE BLOOD LEVEL OF ALCOHOL IS RISING. (GIANCOLA AND
ZEICHNER,1997)
ALCOHOL LEADS TO AGGRESSION BY:
FIRST, THE INCREASE IN PHYSIOLOGICAL AROUSAL DURING THE RISE OF ALCOHOL IN THE SYSTEM MAY
LEAD TO GREATER AGGRESSION.
SECOND THE IMPAIRMENT OF NEUROPHYSIOLOGICAL FUNCTION MAY RESULT INTO AGGRESSIVE
BEHAVIOUR.
THIRDLY, AN ALTERNATIVE EXPLANATION IS THE ALCOHOL EXPECTANCY THEORY.

50. SITUATION CENTERED DETERMINANTS OF AGGRESSION:
1. PHYSICAL ENVIRONMENT
I) TEMPERATURE:
HIGHER THE TEMPERATURE MORE LIKELY IT IS THAT PEOPLE WILL BEHAVE AGGRESSIVELY. BUT
AT VERY HIGH TEMPARATURES THE RATE OF ASSAULTS COME DOWN BECAUSE OF DRAINING
OUT OF ENERGY. HOWEVER THE LINK BETWEEN TEMPERATURE AND AGGRESSION IS STRONGER
FOR AFFECTIVE AGGRESSION THAN FOR INSTRUMENTAL AGGRESSION.

51. II. CROWDING:
• A HIGH DENSITY OF PEOPLE CAN RESULT IN AGGRESSION, LIKE IS SEEN IN BEHAVIOUR
OF CROWDS OF FOOTBALL FANS AND DRUNKEN REVELLERS IN BUSY BARS AND
NIGHTCLUBS.
• CROWDING CAUSES AGGRESSION BY LEADING TO PHYSIOLOGICAL AROUSAL, FEELINGS
OF STRESS, IRRITATION AND FRUSTRATION SUCH THAT THE THRESHOLD FOR
AGGRESSIVE OUTBURSTS IS LOWERED, ALSO BY THE PROCESS OF DEINDIVIDUALIZATION.
III. NOISE :
• THE PRESENCE OF UNWANTED SOUND PARTICULARLY WHEN IT IS TOO LOUD OR
UNPREDICTABLE, CAN LEAD TO AN INCREASE IN AGGRESSION .

52. 2. SOCIAL DISADVANTAGE:
IF AN INDIVIDUAL OR GROUP FEELS THAT THEY ARE BEING UNJUSTLY DISADVANTAGED
WHEN COMPARED TO OTHER INDIVIDUALS OR GROUPS, AND BELIEVE THAT THEY ARE
UNABLE TO IMPROVE THEIR PRESENT SITUATION BY LEGITIMATE MEANS, THEY MAY INSTEAD
BEHAVE AGGRESSIVELY. THIS MAY INVOLVE VANDALISM OR ASSAULT OR COLLECTIVE ACTS
OF AGGRESSION SUCH AS RIOTS THAT OCCURRED IN THE NORTH OF ENGLAND IN 2001.
[The Bradford Riots]

53. 3. CULTURAL INFLUENCES:
ALTHOUGH ACTS OF VIOLENCE AND AGGRESSION OCCUR ALL OVER THE WORLD, THE
LEVEL OF AGGRESSION DIFFER FROM CULTURE TO CULTURE. SOME CULTURES HAVE THEIR
OWN CULTURE OF HONOUR THAT PERMITS THEM MORALLY TO ACT AND BEHAVE MORE
AGGRESSIVELY(NISBETT AND COHEN).
Eg: THE CRUSADES BY THE CHRISTIANS, JIHADS OF THE MUSLIMS.
EVEN WITHIN CULTURES THERE FORM MINORITY GROUPS WHICH ARE MORE AGGRESSIVE. GROUPS SUCH AS
THESE WITH THEIR OWN SUBCULTURE VIOLENCE MAY PERCEIVE AGGRESSION TO BE LEGITIMATE. E.G. SILICAN
MAFIA IN ITALY OR WAHHABISM AMONG SUNNI MUSLIMS.

54. DISINHIBITION:
DISINHIBITION IS A WEAKENING OF NORMATIVE CONSTRAINTS WHICH
USUALLY LEAD TO AVOIDANCE OF AGGRESSIVE BEHAVIOUR. WE WILL DISCUSS
WHY PEOPLE BECOME DISINHIBITED.
DEINDIVIDUALIZATION DEHUMANIZATION

55. DEINDIVIDUALIZATION:
WHEN AN INDIVIDUAL IS PART OF A CROWD OR ACTING AS A MEMBER OF A LARGE SOCIAL
GROUP, THEY ARE LESS LIKELY TO SEE THEMSELVES AS AN IDIOSYNCRATIC INDIVIDUAL AND
MORE LIKELY TO SEE THEMSELVES AS A RELATIVELY ANONYMOUS GROUP MEMBER.THIS
PROCESS OF DEINDIVIDUALIZATION LEADS INDIVIDUALS TO SEE THEMSELVES AS LESS
IDENTIFIABLE AND ACCOUNTABLE FOR THEIR BEHAVIOUR THAN NORMAL .
SOME SOCIAL PSYCHOLOGIST OPPOSE THIS VIEW OF DEINDIVIDUALIZATION IN GROUP
VIOLENCE. THEY INSTEAD STRESS ON THE IDEA OF EMERGENT NORM THEORY.
ACCORDING TO THIS THEORY PEOPLE BEHAVE AGGRESSIVELY IN A GROUP NOT BECAUSE THEY
IGNORE THE SOCIETAL NORMS OF NON VIOLENCE BUT BECAUSE THEY ADHERE TO A
DIFFERENT GROUP NORM OF AGGRESSION THAT MAY ARISE IN A PARTICULAR SITUATION .
WHEN SOME MEMBERS OF A GROUP START TO BEHAVE AGGRESSIVELY, OTHER MEMBERS ARE
LIKELY TO ADHERE TO THIS BEHAVIOUR IF THEY PERCEIVE IT TO BE NORMATIVE.

56. The Ku Klux Klan demonstrates characterizes
the perfect situation for deindividuation.
Members wear white robes and hoods that
completely unify their appearance and
mask their identity.
Fearing violence from other members, any
potential dissenters would probably squash
their views out of self-preservation.
It is therefore unsurprising that the Klan
committed many lynchings and other
violent attacks

57. DEHUMANIZATION:
DEHUMANIZATION OCCURS WHEN PEOPLE FAIL TO SEE OTHERS AS UNIQUE HUMAN BEINGS.
BY CONSIDERING SOMEONE ELSE TO BE IN SOME WAY LESS THAN A HUMAN, A PERPETRATOR
IS LESS LIKELY TO APPRECIATE THE SUFFERING EXPERIENCED BY THE TARGET OF THEIR
AGGRESSION. THIS ENABLES THEM TO LEGITIMIZE THEIR ACTION AND REDUCE ANY FEELINGS
OF SHAME OR GUILT. IT CAN HAVE CATASTROPHIC CONSEQUENCES AND ARE MAJOR CAUSES
OF GENOCIDE.
EG: THE HOLOCAUST, MASS MURDER OF JEWS PERFORMED BY THE NAZIS IN 1939-1945 IN
VARIOUS CONCENTRATION CAMPS ACROSS EUROPE LIKE AUSCHWITZ BIRKENAU, SOBIBOR,
TREBLINKA

58. ADOLF
EICHMANN
RUDOLF
HÖSS

59. FORMS OF AGGRESSION IN SOCIETY:
1. DOMESTIC VIOLENCE:
IT IS DEFINED AS PHYSICAL OR VERBAL AGGRESSION TOWARDS ANY MEMBER OF
ONE’S FAMILY. SHOCKINGLY, PEOPLE ARE MORE LIKELY TO BE KILLED OR PHYSICALLY
ASSAULTED BY MEMBERS OF THEIR OWN FAMILY THAN BY ANYBODY ELSE (GELLES,
1997). THE REASONS BEHIND THIS ACCORDING TO GELLES AND STRAUS ARE
 PEOPLE SPEND MORE TIME WITH THEIR FAMILY MEMBERS.
 ENGAGE IN A BROADER RANGE OF ACTIVITIES WITH THEM.
 FAMILY MEMBERS ARE HIGHLY DEPENDENT ON EACH OTHER
 HAVE AN INTIMATE KNOWLEDGE ABOUT EACH OTHER’S STRENGTHS AND
WEAKNESSES.
 PHYSICAL PROXIMITY

60. WHEN THINGS ARE GOING WELL, THESE CHARACTERISTICS ARE GOOD THINGS, BUT
WHEN THERE IS STRESS OR THINGS GO WRONG, THEY MAY BE USED AS A MEANS OF
HARMING OTHER FAMILY MEMBERS.
PEOPLE WHO THEMSELVES HAVE PREVIOUSLY BEEN VICTIMS OF DOMESTIC VIOLENCE ARE
MORE LIKELY TO AGGRESS AGAINST FAMILY MEMBERS, RESULTING IN A CYCLE OF ABUSE
THAT PASSES DOWN FROM GENERATION TO GENERATION.

61. 2. SEXUAL AGGRESSION:
THE BRITISH CRIME SURVEY (2002) ESTIMATED THAT DURING 2001, THERE WERE 190,000
INCIDENCES OF SERIOUS SEXUAL ASSAULTS AND 47,000 FEMALE VICTIMS OF RAPE OR
ATTEMPTED RAPE.
ACCORDING TO THE NATIONAL CRIME RECORDS BUREAU,
24,206 RAPE CASES WERE REGISTERED IN INDIA IN 2011,
ALTHOUGH EXPERTS AGREE THAT THE UNREPORTED CASES
OF SEXUAL ASSAULT IS MUCH HIGHER.
A NEW CASE IS REPORTED EVERY 20 MINUTES.HOWEVER THE
LATEST ESTIMATE SUGGEST A NEW CASE EVERY 22 MINUTES.

62. ONE FACTOR THAT MAY CONTRIBUTE TOWARDS SEXUAL AGGRESSION IS THE AVAILABILITY OF
PORNOGRAPHIC MATERIAL. STUDIES HAVE SHOWN THAT EXPOSURE TO PORNOGRAPHIC
MATERIAL MAY INCREASE TOLERANCE FOR SEXUAL AGGRESSION AND ACTUAL AGGRESSION
TOWARDS OTHERS.
PORNOGRAPHIC MATERIAL ALSO PERPETUATES THE RAPE MYTH, A BELIEF THAT WOMEN
SECRETLY ENJOY BEING SEXUALLY ASSAULTED. ANOTHER FORM OF RAPE CALLED
AQUAINTANCE RAPE WHERE THE VICTIM KNOWS THE PERPETRATOR OR IS EVEN DATING HIM.
THE MAJOR REASON BEHIND SUCH KIND OF RAPES ACCORDING TO RESEARCHERS IS TOKEN
RESISTANCE SHOWED BY FEMALES.(MUELENHARD & HOLLABAUGH)

63. 3. TERRORISM:
SINCE THE START OF THIS MILLENNIUM, WE HAVE WITNESSED A NUMBER OF CATASTROPHIC
ACTS OF INTERNATIONAL TERRORISM . BE IT THE 11/9 TWIN TOWER ATTACK, THE 26/11
MUMBAI ATTACK ALL HAVE WITNESSED GHASTLY CRIME AGAINST HUMANITY AND HAS LEAD
PEOPLE TO THINK HOW SUCH INDIVIDUAL OR GROUP COULD CARRY OUT SUCH HEINOUS
CRIMES AGAINST MANKIND.

64. MOGHADDAM (2005) PROPOSED THE STAIRCASE TO
TERRORISM, A PSYCHOLOGICAL MODEL WHICH MAY HELP
TO EXPLAIN HOW AND WHY SUCH INDIVIDUALS COME TO
COMMIT SUCH ATROCITIES. THE STAIRCASE HAD THE
FOLLOWING CHARACTERISTICS:
• HE USED THE METAPHOR OF A NARROWING
STAIRCASE LEADING TO THE TERRORIST ACT AT THE
TOP OF THE BUILDING.
• POTENTIAL TERRORIST GO THROUGH SEVERAL
STAGES, AS THEY PROCEED UPTO EACH FLOOR OF
THE BUILDING, BEFORE A TERRORIST ACT WILL BE
COMMITTED.
• AT EACH FLOOR THE NUMBER THE OF OPTIONS THAT
AN INDIVIDUAL CAN PURSUE REDUCES UNTIL THERE
IS NO OPTION APART FROM DESTRUCTION OF
OTHERS.
MAHMOOD AMIRY-MOGHADDAM

65. THE TERRORIST ACT
CATEGORICAL THINKING AND
PERCEIVED LEGITIMACY
ADOPTION OF AN ALTERNATIVE
MORAL CODE
DISPLACEMENT OF AGGRESSION
PERCEPTION OF PROCEDURAL
JUSTICE
PERCEPTIONS OF RELATIVE
DEPRIVATION

66. • MOGHADDAM (1998) NOTED THAT ALTHOUGH SOME PEOPLE ARE
PROBABLY MORE LIKELY TO BECOME TERRORIST THAN OTHERS.
• IT IS THE CONDITIONS ON THE GROUND FLOOR WHICH ULTIMATELY LEAD
TO TERRORISM.
• HE ARGUED THAT ONLY BY CHANGING THE CONDITIONS ON THE
GROUND FLOOR CAN TERRORISM BE EFFECTIVELY STOPPED.

67. LIFE COURSE OF AGGRESSION:
1A) EARLY-CHILDHOOD-ONSET, LIMITED DURATION
1B) ADOLESCENT-ONSET, LIMITED DURATION
2A) EARLY-CHILDHOOD-ONSET, LIFE-COURSE PERSISTENT
2B) ADOLESCENT-ONSET , LIFE-COURSE PERSISTENT
3) ADULT ONSET AGGRESSION

68. CONTROLLING HUMAN AGGRESSION:
1. PUNISHMENT:
PUNISHMENT THAT FOLLOWS AGGRESSIVE BEHAVIOUR MIGHT HELP TO REDUCE IT.
HOWEVER IT WORKS BEST WHEN IT IS:
 STRONG
 THE AGGRESSOR IS RELATIVELY SURE OF RECEIVING IT.
 WHEN IT IMMEDIATELY FOLLOWS AGGRESSIVE BEHAVIOUR
 WHEN THE PERSON PERCEIVES THE PUNISHMENT AS BEING LEGITIMATE
AND APPROPRIATE .

69. 2. CATHARSIS: RESEARCH RESULTS INDICATE THAT WE CAN GET CATHARTIC RELIEF FROM OUR
ANGER AND AGGRESSIVE FEELINGS TOWARDS OTHERS BY ACTUALLY VENTING OUR ANGER ON
THAT PERSON.(KONECNI & EBBESEN, 1976)
3. MODELS: LIKE AGGRESSIVE MODELS INDUCE AGGRESSIVE FEELINGS NON AGGRESSIVE MODELS
LESSEN THEM.(BARON AND KEPNER, 1970)
4. THE THOUGHTS OR COGNITIONS, WE HAVE ABOUT THE REASON FOR ANOTHER PERSON’S
AGGRESSION PLAY A ROLE IN HELPING US CONTROL OUR AGGRESSION.(ZILLMANN & CANTOR,
1976)

70. 5. CERTAIN FEELINGS AND EMOTIONS ARE INCOMPATIBLE WITH ANGER AND AGGRESSION
(BARON, 1977,1983). THUS ANGER MAY DISAPPEAR WHEN A PERSON IS INDUCED TO SMILE,
FEELS CONCERN ABOUT THE OBJECT OF HIS ATTACK (EMPATHY), OR PERHAPS IS MILDLY
SEXUALLY AROUSED.
6. INSIGHT ORIENTED PSYCHOTHERAPY.
7. COGNITIVE BEHAVIOURAL THERAPY.

71. 8. PHARMACOLOGICAL INTERVENTIONS:
• ANTIPSYCHOTICS : TYPICAL AND ATYPICAL
• LITHIUM
• ANTIEPILEPTIC DRUGS
• ANTIDEPRESSANTS
• ß BLOCKERS
• α2 AGONISTS
• ANTIANDROGENIC THERAPY

72.  AGGRESSION IN MR & DEVELOPMENTAL DISABILITIES
 LITHIUM CARBONATE (IN SEVERAL STUDIES)
 RISPERIDONE (BEST SUPPORTED SINGLE CHOICE)
 AGGRESSION IN AUTISM
 RISPERIDONE (BEST SUPPORTED CHOICE)
 DIVALPROEX SODIUM
 ARIPIPRAZOLE ( UNDER INVESTIGATION )
 AGGRESSION IN ADHD
 METHYLPHENIDATE
 RISPERIDONE
 ALPHA AGONISTS LIKE CLONIDINE
 CONDUCT DISORDER
 RISPERIDONE (BEST )
 OLANZAPINE ( IMPULSIVENESS IN ADOLESCENTS)
 LITHIUM
 DIVALPROEX SODIUM
 CARBAMAZEPINE

73.  SCHIZOPHRENIA & SCHIZO-AFFECTIVE DISORDERS
 LITHIUM
 SODIUM VALPROATE
 PHENYTOIN SODIUM
 BORDERLINE PERSONALITY DISORDER
 DIVALPROEX SODIUM
 LAMOTRIGINE (IN WOMEN)
 TOPIRAMATE (IN MEN)
 ALZHEIMERS & RELATIVE DEMENTIA
 RISPERIDONE
 OLANZAPINE
 MEMANTINE HAS FOUND TO DECREASE AGGRESSION IN PATIENTS TREATED WITH DONEPEZIL
 TRAUMATIC BRAIN INJURY
 BETA BLOCKERS (Propranolol, Pindolol)
 INTIMATE PARTNER VIOLENCE
 SSRI ( NOT CONVINCINGLY PROVEN)

74. BIBLIOGRAPHY:
1. COMPREHENSIVE TEXTBOOK OF PSYCHIATRY, VOL 2, KAPLAN AND
SADOCK.
2. ESSENTIAL SOCIAL PSYCHOLOGY , RICHARD J. CRISP AND RHIANNON N.
TURNER.
3. INTRODUCTION TO PSYCHOLOGY, MORGAN AND KING
4. INTERNET SOURCES.

75. “When we can lay down our fear and anger and choose
responses other than aggression, we create condition for
bringing out the best in us humans”
- MARGARET WHEATLEY

76. Thank