Aggression, autoaggression and stress in people with a heart attack

Prevalence and incidence of depressive and anxious symptoms in couples undergoing assisted reproductive treatment in an Italian infertility department

Emotional Dysregulation and Aggression in People with Borderline Personality Disorder

Hostility, anger, and aggression are conceptually related but unique constructs found to occur more often among veterans with posttraumatic stress disorder (PTSD) than among civilians or veterans without PTSD. However, the pathways between PTSD, depression, hostility, anger, and aggression have not been comprehensively characterized. Therefore, drawing on a sample of returning Operation Enduring Freedom/Operation Iraqi Freedom combat veterans ( N = 175; 95% male; mean age 30 years), this study sought to examine the direct and indirect relationships among PTSD, depression, hostility, anger, and four types of aggression: verbal, and physical toward self, others, and objects. Functional modeling of direct effects was done using multiple least-squares regression and bootstrapped mediation analyses were carried out to test indirect effects. Results indicate that PTSD is not the overall direct contributor to different forms of aggression, supporting the mediating role of depression and trait anger. Depression symptoms explain part of the relationships between PTSD and verbal aggression, physical aggression toward objects, and physical aggression toward self and trait anger explains part of the relationships between PTSD and verbal aggression, physical aggression toward objects, and physical aggression toward others. Our findings support the importance of assessing for anger, depression, and different types of aggression among veterans presenting for PTSD treatment to develop individualized treatment plans that may benefit from early incorporation of interventions.

A new study has identified modifiable context and care worker factors associated with aggressive behavior of nursing home residents toward staff. According to Karin Stutte, MScN, of Solothurn’s Hospital AG, Switzerland, and fellow researchers, aggressive behavior from nursing home residents against care workers is a distressing and often unacknowledged experience. “Previous studies have linked differences in prevalence not only to the individual histories of the residents, or the details of their injuries, psychological states, or dementia, but also to a range of context factors (i.e., factors related either to the nursing home setting or to individual care workers),” Stutte and colleagues wrote (Geriatr Nurs 2017;38:398–405).“Identifying context and care worker factors’ relationships with aggressive behavior would support recommendations for interventions to reduce residents’ aggression.” Their study detailed the prevalence of three types of aggressive behavior by residents toward care workers in Swiss nursing homes, and examined the relationship of context and care worker factors with the aggressive behaviors. The researchers defined aggressive behavior as any nonaccidental overt act involving the delivery of noxious stimuli toward an object, oneself, or another person. The types of aggression could be verbal, physical, or sexual. The researchers performed a secondary data analysis of the Swiss Nursing Homes Human Resources Project, a representative multicenter study with a cross-sectional design. They collected data from May 2012 to April 2013 and surveyed care workers by use of a self-report questionnaire. The analysis included 155 nursing homes that housed 402 units and employed 3,919 care workers. The mean age of the residents was 85 years, with 62% displaying symptoms or having a diagnosis of dementia. The mean care worker was 43 years old, and 92% were female. During the 4 weeks preceding the survey, the researchers found that 66% of care workers had been verbally assaulted, 42% had been physically assaulted, and 15% had been the focus of sexual aggression. For the care workers who were exposed to aggression, most experienced it less than once a week. The care workers reported a lower likelihood of experiencing verbal, sexual, or physical aggression if they were older or they worked in non–special care units versus special care units, or if they perceived their facility to be well staffed, with adequate resources. Sexual aggression was less likely to be experienced by male workers or by staff who characterized their working style as autonomous. Verbal aggression was more likely to be experienced by workers who perceived they had good or very good collaboration among team members. Both verbal and physical aggression were more likely to be experienced by staff who were emotionally exhausted. Compared with tertiary-level care workers, certified nursing assistants and nurse aides had an increased likelihood of reporting physical aggression. “Intervention studies should assess whether strategies that modify context factors (e.g., campaigns to tackle the roots of low perceptions of staffing and resource adequacy, or to increase work autonomy) should also facilitate aggression reduction,” the researchers wrote. “Since our study points to the higher exposure of care workers on [special care units] to aggressive behavior, it is vital to choose care workers whose personal characteristics best match the needs of specialized units, and to adequately train and supervise them in aggression management.” Brian Ellis is a freelance writer and editor based in NJ.

The study of the phenomenon of verbal aggression is devoted to a large number of foreign and domestic intelligence, processed in different schools and areas. One such research center is the School of Communication Studies at Kent State University (UK). Its brilliant representative, the world-famous Professor Dominic A. Infante, together with his colleagues and students, has developed a programmatic line of research and theory of argumentativeness and verbal aggressiveness inspiring many young communication scholars in the field. The object of the article is verbal aggression as a component of conflict communication. The subject is phrasemes denoting a certain type of verbal aggression, selected through a continuous survey of the academic dictionary of phraseology of the Ukrainian. Purpose: to identify and characterize the manifestations of verbal aggression (based on the typology of Dominic A. Infante) in Ukrainian phrasemics. The stated goal motivates the solution of the following tasks: 1) to outline the basic components of the terminological apparatus of the theory of verbal aggression in studies of Dominic A. Infante, his colleagues and students (‘verbal aggressiveness’, ‘verbal aggression’, ‘physical aggression’, ‘manifestation of verbal aggression’); 2) to describe the types of verbal aggression recorded in Ukrainian phrasemics, illustrating a specific communicative situation. Ukrainian phrasemics records all types of verbal aggression proposed by Dominic A. Infante: attack, curse, teasing, ridicule, threat, swearing, nonverbal emblems. A thorough analysis of the source base of the study shows that: а) the verbal aggression contains a negative evaluation nomination and serves as a marker of negative emotions towards the opponent (hostility, dislike, unfriendliness, dissatisfaction, anger, condemnation, evil, etc.); b) the verbal aggression actualizes severe / sharp attack, sensitive attack, attack with excessive demands; sharp condemnation with an ominous wish of failure, disaster, all evil; ridicule with caustic remarks, insulting words; calling someone names, giving nicknames; a promise to cause some evil, trouble; rude, unfriendly words and expressions and the spread of rumors, etc.; c) the attack correlates with swearing / quarreling and is accompanied by sharp, offensive words, condemnation, reproach with varying degrees of intensification; d) the threat is positioned as a warning, a warning about the transition to physical aggression; e) the main nonverbal sign is the look. We see the prospect of research in the further identification of the phrasemic specificity of the verbal aggression in a comparable aspect.

The aim of the study was to determine whether there are relationships between the family system of origin, i.e. the structure of the family and the parenting styles, and aggression in the final stages of adolescence. 60 people (30 girls and 30 boys) were examined using the following methods: A.H. Bussa and A. Durkee Questionnaire to study aggressiveness and the Questionnaire of the M. Ryś Family Environment Analysis - Family of Origin (FO) to examine the family system including the structure of the family and the parenting styles. The following interdependencies were observed: there is no significant difference in the level of aggression between girls and boys, however, there is a variety of types of aggression between the sexes. The authoritarian family correlates significantly positively with all types of aggression and most with irritability and guilt among girls. The overprotective family correlates significantly positively with all types of aggression and most often with trauma. The authoritarian family correlates significantly positively with the occurrence of all types of aggression, and most with irritability and guilt among boys. A chaotic family correlates significantly positively with all types of aggression, and especially with negativity and irritability. A normal family negatively correlates with all types of aggression. In the perception of the surveyed girls and boys, there is a positive and statistically significant relationship between autocratic and liberal-non-loving parenting styles and the occurrence of aggressive behaviour. The autocratic style positively correlates with physical, verbal, indirect aggressiveness, negativity, mistrust, resentment, irritability and guilt, while the liberal-unloving style positively correlates with physical, verbal, indirect aggressiveness, negativity, mistrust, resentment, irritability and guilt. The democratic style correlates positively with one type of aggression: verbal aggressiveness, and negatively with other types of aggression.

To explore quality of life (QoL) improvement after treatment of patients with chronic olfactory disorders; and to correlate QoL with olfactory rehabilitation and evaluate olfactory improvement values over which QoL outcomes are significantly recovered. Prospective clinical study. Eighty-nine patients following endoscopic sinus surgery for chronic rhinosinusitis (CRS) and immunotherapy for allergic rhinitis (AR) were studied. Olfactory function was evaluated using Sniffin' Sticks test pre-and 12 months after treatment. All patients completed six validated QoL questionnaires either specific for olfaction (Questionnaire of Olfactory Deficits-QOD) and for assessing mental health (Zung Anxiety Scale, State-Trait Anxiety Inventory, Zung Depression Scale, Beck Depression Inventory), or generic one (Short Form-36). Significant improvement (all P < 0.001) of olfactory function by 27.4% in total cohort (AR: 10.4%, P = 0.004; CRS: 39.9%, P < 0.001), expressed by the combined Threshold-Discrimination-Identification (TDI) score-and of all QoL questionnaires scores (all P < 0.01) as well, was observed after treatment. There was a positive correlation between olfactory recovery and improvement of patients' QoL. ROC analysis revealed that an increase in the TDI score by 3.50 points in AR and 4.75 points in CRS was necessary for a clinically significant improvement in all QoL questionnaires results. QoL and mental health of patients suffering from chronic sinonasal diseases are totally recovered after treatment, presenting a direct positive relationship with smell improvement. An increase of olfactory function by 3.50 points for AR and 4.75 points for CRS might be considered the cutoff point for patients' QoL significant recovery.

BackgroundRates of aggression in inpatient secure care are higher than in other psychiatric inpatient settings. People with intellectual disabilities in secure care require adapted psychological treatments. Interpersonal art psychotherapy incorporates the use of creative art making approaches by participants, thus reducing sole reliance upon verbal interactions during psychotherapy for people who may have communication difficulties. During interpersonal art psychotherapy, participants are individually supported by their therapist to consider how they conduct relationships. This includes the influence and impact of interpersonal issues resulting in repeated patterns of conflict. The key feasibility objectives were to assess recruitment and retention rates, follow-up rates and trial procedures such as randomisation, allocation and identifying any practical or ethical problems. In addition, a preliminary ‘signal’ for the intervention was considered and an indicative sample size calculation completed. The acceptability of a potential third trial arm attentional control condition, mindful colouring-in, was assessed using four single-case design studies and a UK trial capacity survey was conducted.MethodsAdult patients with intellectual disabilities in secure care were recruited and randomised to either interpersonal art psychotherapy or delayed treatment in this multi-site study. Outcomes were assessed using weekly observations via the Modified Overt Aggression Scale and a range of self-report measures. Within study reporting processes, qualitative interviews and a survey were completed to inform trial feasibility.ResultsRecruitment procedures were successful. The target of recruiting 20 participants to the trial from multiple sites was achieved within 8 months of the study opening. All participants recruited to the treatment arm completed interpersonal art psychotherapy. Between-group differences of interpersonal art psychotherapy versus the delayed treatment control showed a ‘signal’ effect-size of .65 for total scores and .93 in the verbal aggression sub-scale. There were no amendments to the published protocol. The assessment of key feasibility objectives were met and the trial procedures were acceptable to all involved in the research.ConclusionThis study suggested that a randomised controlled trial of interpersonal art psychotherapy is acceptable and feasible.Trial registrationISRCTN14326119 (Retrospectively Registered).

IntroductionDespite growing evidence supporting the mental health benefits of physical activity (PA), the nature of its relationship with anxiety symptoms remains uncertain in student populations. This study aimed to investigate differences in mean scores on the Zung Anxiety Scale among groups of students with different levels of PA and to determine whether there is a dose-response relationship between PA and anxiety symptoms, taking into account various sociodemographic and lifestyle factors and study year.MethodsCross-sectional data were collected from 1,266 fifth-year medical students at five Serbian universities during two academic years. PA was assessed using the International Physical Activity Questionnaire (IPAQ), and categorized into three MET-min/week groups: <600, 601–6,000, and >6,000. Anxiety symptoms were measured using the Zung Self-Rating Anxiety Scale. Logistic regression was used to estimate odds ratios for anxiety by PA category, accounting for sociodemographic and lifestyle factors.ResultsStudents engaging in 601–6,000 MET-min/week of PA were less likely to report anxiety symptoms compared to those engaging in less than 600 MET-min/week. No additional benefit was observed among participants exceeding 6,000 MET-min/week, suggesting a plateau effect. Compared to students in the <600 MET-min/week group, those in the 601–6,000 MET-min/week group were less likely to study in Novi Sad and reported an average or good self-rated financial status, but were more likely to consume alcohol. Participants in the >6,000 MET-min/week group were more likely to be male and belong to the 2023–2024 academic year, and less likely to report an average financial status compared to their peers in the <600 MET-min/week group. Female sex was negatively associated with being in the >6,000 MET-min/week group compared to the 601–6,000 MET-min/week group.ConclusionThe most significant protective benefits against anxiety symptoms were seen in individuals who participated in PA for 601 to 6,000 MET-minutes per week. No additional benefits were observed for PA levels exceeding 6,000 MET-minutes, suggesting a potential plateau effect. These findings emphasize the importance of promoting sustainable PA habits among students. Future research is needed to establish causality and examine the underlying psychophysiological mechanisms in the relationship between PA and mental health.

The ways of expressing aggression may differ by gender and change with advancing age becoming more indirect or covert. In contrast to other types of aggression, boys and girls may be similar in their use of relational aggression (RA), which may replace other types of aggression by adolescence. Despite this, the relationships between RA and other types of aggression by gender and age are underexplored. This study aimed to compare RA in adolescents from Northwestern Russia and to explore its associations with other types of aggression, related emotions and cognitions, and peer victimization, taking into account the interaction effects between RA, gender, and age. The analytic sample consisted of 2,838 participants, aged 13 to 17 years (57.9% female; 95.8% ethnic Russian). RA, physical, verbal, and proactive aggression, anger rumination, trait anger, and peer victimization were assessed by self-reports. A full path analysis was conducted to explore the associations between the variables. The prevalence of RA was largely similar by gender. Boys reported higher levels of overt aggressive behavior and peer victimization, but lower anger and anger rumination, as compared to girls. Girls and boys with greater RA similarly engaged in a wide range of other types of aggression and experienced more peer victimization, but some gender-specific patterns associated with RA were also found. Increasing age was associated with greater anger rumination and lower peer victimization. This is the first study among Russian adolescents to explore RA in relation to other types of aggression and its emotional correlates by gender. The greater variety of aggressive behavior in more relationally aggressive youth is worrying, given that chronic engagement in multiple forms of aggression carries a greater risk for subsequent problems in social adjustment. The results were in line with those from North American populations, indicating that the findings may be generalizable to other cultures.

The present study examined depression among Japanese college students and its relationship to four types of aggression: physical aggression, verbal aggression, anger, and hostility. We used Japanese version of Aggression Questionnaire (Buss & Perry, 1992; Ando et al., 1999). Analysis of correlation coefficients of the data from 140 undergraduates showed that depression had a positive correlation with anger and hostility, while it showed a negative correlation with verbal aggression. The result suggested that college students with high depression tended to feel anger and hostility easily. However, they were less likely to show verbally aggressive behavior.

Backgrounds: Psychiatric comorbidity is common in vertiginous patients. The risk of psychiatric disorder is increased in patients with previous mental problems, but earlier mentally healthy may develop symptoms as well. Especially in chronic phase of vertigo, psychological factors have a significant role in the morbidity. Aims: The aim of this study was to evaluate the prevalence of psychiatric problems in vertiginous patients in a community sample. Methods: A prospective evaluation of psychiatric symptoms based on self-rating scales [Beck Depression Inventory (BDI), Zung Anxiety Scale (SAS), DSM-IV and ICD-10 Personality Questionnaire (DIP-Q)] in a community sample of 100 vertiginous subjects in the Academic Tertiary Otolaryngology Department at the Helsinki University Hospital, Finland. Results: The prevalence of any psychiatric problem was 68% (68 patients); 19% had depressiveness and 12% symptoms of anxiety. Altogether 63 (63%) patients met the criteria of personality disorder. The most prevalent personality disorder was obsessive–compulsive (46 patients). Personality disorder alone seems not to affect functional capacity and is of importance only when comorbid with symptoms of anxiety and depression. The prevalence of psychiatric symptoms did not correlate with severity of vertigo symptoms or other co-occurring diseases. Conclusions: The prevalence of any psychiatric symptoms was high among vertiginous patients. In the chronic phase of vertigo, it seems that vertigo symptoms themselves do not influence on subjective feelings of debilitation. Psychiatric disorders worsen the clinical picture of vertigo along a more debilitating and disabling course. Psychiatric differential diagnoses should accompany the neuro-otology diagnostic procedure in patients with a chronic state of vertigo and greater disability.

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The need to analyze the phenomenon of a combination of diseases of various nature is dictated by its high prevalence and insufficient knowledge; it is known, that their comorbidity aggravates the course of the underlying disease, worsening its prognosis. Information about comorbidity is insufficiently systematized, materials about particular combinations of certain mental disorders with somatic ones prevail, there is clearly not enough information about the coexistence of mental and somato-neurological pathology recorded in children and adolescents. Objective: to study the prevalence and nosological distribution of chronic somatic, neurological, infectious comorbid diseases detected in children and adolescents suffering from mental disorders; analyze the social adaptation of these patients. Material and methods. We examined 602 patients, 410 boys (68%) and 192 (32%) girls, who were observed on an outpatient basis in one of the neuropsychiatric dispensaries in Moscow. The study included only cases of a combination of mental and chronic somatic, neurological, infectious and other diseases. To rank patients according to the level of social functioning in adolescence, the «Map of registration of social skills and abilities of adolescents with chronic mental disorders» was used. Research methods: clinical-psychopathological, statistical. Results. The most common comorbid pathology was orthopedic diseases, in the second place was the pathology of vision, in the third place was endocrine pathology, the fourth place was taken by neurological diseases, the fifth place was the pathology of the ENT organs. In combinations of mental and comorbid disorders, pathogenetic variants were observed: 1. comorbid diseases accompanied mental disorder; 2.comorbid and mental disorders were pathogenetically associated with each other, or occurred as a result of a single primary disorder or disease; 3. somatic diseases were mental complications; 4. The occurrence of somatic diseases was explained by the side effects of psychotropic therapy. The severity of social inadequacy depended both on the severity of mental pathology and on the severity and number of somatic diseases. A comorbid disorder can cause more significant difficulties in certain areas of life than the underlying disease. Conclusion. Comorbidity is a multicomponent negative phenomenon. To reduce the incidence of comorbid pathology and achieve its maximum compensation, a multidisciplinary approach is required.

In attempting to explain the familial predisposition to panic disorder, most studies have focused on the heritability of physiologic characteristics (e.g., CO2 sensitivity). A heretofore unexplored possibility is that a psychological characteristic that predisposes to panic-anxiety sensitivity-might be inherited. In this study, the authors examined the heritability of anxiety sensitivity through use of a twin group. Scores on the Anxiety Sensitivity Index were examined in a group of 179 monozygotic and 158 dizygotic twin pairs. Biometrical model fitting was conducted through use of standard statistical methods. Broad heritability estimate of the Anxiety Sensitivity Index as a unifactorial construct was 45%. Additive genetic effects and unique environmental effects emerged as the primary influences on anxiety sensitivity. There was no evidence of genetic discontinuity between normal and extreme scores on the Anxiety Sensitivity Index. This study suggests that one psychological risk factor for the development of panic disorder-anxiety sensitivity-may have a heritable component. As such, anxiety sensitivity should be considered in future research on the heritability of panic disorder.