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The incidence of aggressive behaviors is higher among persons with schizophrenia spectrum disorders (SSDs) than among persons without such disorders. This phenomenon represents a risk to the well-being of patients, their families, and society. The authors undertook a systematic review of the English language literature to determine the efficacy of neuropharmacological agents for the management of hostility and aggression among persons with SSDs. The search combined findings from the Medline, EMBASE, and PsycINFO databases. Ninety-two full text articles were identified that reported relevant findings. The American Academy of Neurology criteria were used to determine levels of evidence. Paliperidone-extended release is probably effective for the management of hostility among inpatients with SSDs who have not been preselected for aggression (Level B). Clozapine is possibly more effective than haloperidol for the management of overt aggression and possibly more effective than chlorpromazine for the management of hostility among inpatients with SSDs who have not been preselected for aggression (Level C). Clozapine is also possibly more effective than olanzapine or haloperidol for reducing aggression among selected physically assaultive inpatients (Level C). Adjunctive propranolol, valproic acid, and famotidine are possibly effective for reducing some aspects of hostility or aggression among inpatients with SSDs (Level C). Paliperidone-extended release currently appears to be the agent for the management of hostility among inpatients with SSDs for which there is the strongest evidence of efficacy.

Hormones seem to play important roles in the regulation of human aggression. Multiple studies have confirmed that testosterone (T) levels exhibit complex relationships with aggression, dominance, and/or risk-taking behavior. Some evidence suggests that cortisol (CORT) interacts with T and may also be associated with aspects of mood and aggression. However, almost no research to date has investigated the possibility that these neuroendocrine factors are associated with variations in political attitudes or with political aggression. During the second intifada, we tested the hypothesis that morning salivary T and/or salivary CORT levels might be associated with self-rated aggression or with support for religio-political aggression (RPA) among 14-year-old Palestinian boys living in Gaza. We obtained and averaged weekly 09:00 hr salivary measures of T and CORT for more than 1 month. Averaged morning T levels did not correlate with self-rated aggression, but were positively associated with agreement with the statement "religious ends justify any means," (r = .355, P = .014) and marginally associated with a composite measure of support for RPA (r = .247, P = .094). Average CORT levels were inversely correlated with self-rated aggression (r = -.328, P = .037) and with anger (r = -.373, P = .016), but CORT levels were not associated with support for RPA or with the statement "religious ends justify any means." Acknowledging that a modest sample size and methodological issues necessarily limit confidence in our conclusions, these results may represent the first findings regarding neurobiological correlates of support for political aggression., (© 2010 Wiley-Liss, Inc.)

Politically aggressive militant groups usually rely on support from a larger community, although evidence suggests that only some members of that larger community support that aggression. A major subtype of political aggression is that associated with religious differences--or Religio-Political Aggression (RPA). Little previous research has explored demographic or psychological factors that might distinguish supporters from non-supporters of RPA. In an exploratory study, we investigated whether factors previously associated with aggression might correlate with support for RPA in the case of the Israeli/Palestinian conflict. During the second intifada, fifty-two 14-year-old Palestinian boys in Gaza completed self-report measures of life events, emotional status, and political attitudes. Teenaged boys who reported family members having been wounded or killed by the Israeli Defense Forces (IDF) expressed greater support for RPA (t(50) = -2.30, P = .026). In addition, boys who felt their group was treated unjustly reported greater support for RPA compared with those who did not (t(50) = -2.273, P = .027). Implications of these preliminary data are discussed.

The present paper reviews and summarizes the basic findings concerning the nature of the neurobiological and behavioral characteristics of aggression and rage. For heuristic purposes, the types of aggression will be reduced to two categories - defensive rage (affective defense) and predatory attack. This approach helps explain both the behavioral properties of aggression as well as the underlying neural substrates and mechanisms of aggression both in animals and humans. Defensive rage behavior is activated by a threatening stimulus that is real or perceived and is associated with marked sympathetic output. This yields impulsivity with minimal cortical involvement. Predatory attack behavior in both animals and humans is generally planned, taking minutes, hours, days, weeks, months, or even years (with respect to humans) for it to occur and is directed upon a specific individual target; it reflects few outward sympathetic signs and is believed to require cortical involvement for its expression. Predatory attack requires activation of the lateral hypothalamus, while defensive rage requires activation of the medial hypothalamus and midbrain periaqueductal gray (PAG). Both forms of aggressive behavior are controlled by components of the limbic system, a region of the forebrain that is influenced by sensory inputs from the cerebral cortex and monoaminergic inputs from the brainstem reticular formation. Control of aggressive tendencies is partly modifiable through conditioning and related learning principles generated through the cerebral cortex.

Human societies have formalized instincts for compliance with reciprocal altruism in laws that sanction some aggression and not other aggression. Neuroscience makes steady advances toward measurements of various aspects of brain function pertinent to the aggressive behaviors that laws are designed to regulate. Consciousness, free will, rationality, intent, reality testing, empathy, moral reasoning, and capacity for self-control are somewhat subject to empirical assessment. The question becomes: how should law accommodate the wealth of information regarding these elements of mind that the science of aggression increasingly makes available? This essay discusses the evolutionary purpose of aggression, the evolutionary purpose of law, the problematic assumptions of the mens rea doctrine, and the prospects for applying the neuroscience of aggression toward the goal of equal justice for unequal minds. Nine other essays are introduced, demonstrating how each of them fits into the framework of the permanent debate about neuroscience and justice. It is concluded that advances in the science of human aggression will have vital, but biologically limited, impact on the provision of justice.