Introduction
Aggression is defined as a behavior that is violent or hostile in nature towards another person that positions the person in a state of attack or confrontation. Aggression can be verbal or physical once the individual has become angry or hostile. Aggression has been a controversial issue within many areas of research. Some researchers have posited that individuals with a diagnosis of a mental illness have no higher incidences of violence than the general population. Others have suggested that individuals with severe mental illness are more likely than the general population to have higher incidences of violence. There are multiple forms of aggression which will be addressed. There are also multiple etiological and epidemiological factors which are theorized to contribute to aggression.
Types of Aggression
Aggression is defined as any threatening physical or verbal behavior directed towards self or others (Owen, Tarantello, Jones, & Tennant, 1998). There are two types of aggression: will be physical aggression and verbal aggression. Physical aggression is synonymous with violence and consists of pinching, hitting, throwing objects, punching, spitting, scratching, biting, and kicking (Isaksson, Graneheim, Astrom, and Karlson 2011). Physical aggression can be categorized into four distinct groups including violence directed against fellow patients, self, staff, and property. Physical aggression is used to explain instances during which an individual uses physical force against an object or another person. Verbal aggression is defined as verbal threats directed towards self or others with or without the intent to cause harm (Owen, Tarantello, Jones, & Tennant, 1998). Verbal Aggression is yelling and cursing towards others or self in a threatening manner.
Causes of Aggression
Aggression and violent behavior is caused by various biological and social factors. It is agreed upon that a combination of these factors plays a role in an individual’s aggressive and violent behavior. However, there is no common consensus regarding which individual factor holds the most importance (Rueve & Welton, 2008). Biological Factors It is suggested that genetics plays a role in an individual’s violent behavior. Rueve and Welton (2008) posited that “violence is likely a polygenetic phenomenon with many genes acting in a coordinated fashion to produce an aggressive phenotype” (p. 37). However, currently there is no evidence that proves that this phenotype exists as well as the existence and identification of a specific genetic locus which is associated with aggression. Pathological research suggests that neurotransmitters are also involved in aggression (Rueve &Welton, 2008). Research suggests that there is a relationship between 5-hydroxyindoleacetic acid (5-HIAA) in an individual’s cerebrospinal fluid and violence. Further it is suggested that a low concentration of 5-HIAA in an individual is associated with aggressive behavior in patients with severe mental illness (Rueve & Welton, 2008).
There is also research that suggests that circuitry and specific regions of the brain may be involved in aggression and violence. Deficits have been observed in the frontal or prefrontal functioning. Thus, suggesting problems with interpreting environmental stimuli and executive functions (Rueve & Welton, 2008). According to Lidberg, neurochemistry has been implicated in aggression, suggesting that hormonal and 9 neurotransmitter influences can contribute to aggressive behavior. In particular, serotonin has been found to have a profound impact on inhibitory control over aggression. Low levels of cerebrospinal fluid (CSF) 5-HIAA was found in individuals who had attempted a violent suicide, while it was not present in individuals whose suicide attempt was not violent. Feldmann (2001) further reports that previous researchers found that low CSF 5-HIAA was associated with impulsivity and violence in a criminal population. Research conducted by Volavka (1995) indicated that endocrine and hormonal factors have an influence on violence. Their findings suggest that hypoglycemia which is a deficiency of the endocrine system contributes to irritability, confusion, and aggression. They found that increased levels of androgens including testosterone predispose individuals to aggressive behaviors and that decreased levels of these same hormones raised the threshold for aggression. The research also found that decreased estrogen and progesterone coupled with increased levels of prolactin increased irritability and irritative aggression (Volavka, 2005).
Social Factors
Multiple environmental factors are closely associated with violence and aggressive behavior. Sociological approaches to the etiology of aggression suggest that adverse social conditions play a significant role in the development of aggression. This further suggests that specific factors including illiteracy, poverty, drugs, and a dysfunctional family environment are often causative in their relationship to aggression (Feldmann, 2001). Social learning theorists suggested that “violent behavior is a product of past experiences, which involved predisposing environmental conditions and reinforcing rewards” (Rueve & Welton, 2008, p. 39). Further suggesting that exposure to violent images in the media may desensitize individuals to violence. Most research has found that past experiences and desensitization are important determinants in violent and aggressive behavior.
According to Feldmann (2001), a number of factors have an influence on aggression. The presence of frequent exposure to violence, a history of sexual or physical abuse, and ongoing psychosocial stressors increases the likelihood of violence. In societal terms the opinions on violence in the individual’s social and family environment have a strong influence on the individual’s development of aggressive behavior. Of the many theories explaining violent behavior, in the mentally ill population or the populace at large, the work of two recent control theorists, has stood out as widely acknowledged, yet often challenged at the same time. In 1969, Travis Hirschi proposed the argument that social bonds influenced violence and criminal behavior (Hirschi, 1969). Twenty years later, he and Michael Gottfredson refined this argument in part to suggest that such behavior was not only influenced by social bonding, but by the ability to exercise self-control as well, which touches on mental and emotional stability (Lilly et al., 2011, pp. 121-128.)
When first stated, Hirschi argued that examination of social bonds could explain violence and criminality. He defined the social bond theory as encompassing “attachment to families, commitment to social norms and institutions (school, employment), involvement in activities, and the belief that these things are important” (Hirschi, 1969). The more attached individuals were to their families, the less likely they were to commit acts of violence. Likewise, if individuals were committed to community institutions, if they were involved in activities, and if they had a belief system that attached value to such concepts, they were more likely to make choices against violent activity and be law-abiding.
In 1990, Hirschi and Gottfredson developed the self-control corollary to Hirschi’s previously-stated social bond theory. Basically, they argued that individuals with low degrees of self-control are more likely to commit violent behavior (Lilly et al., 2011, pp. 121-128). Persons with low self-control are less likely to delay gratification. They are impulsive and often selffocused. Such behavioral traits would support choices to act criminally. A thief wants something now, so rather than earn money to purchase it, he or she steals it, possibly using force or violence in the process. Someone becomes angry with another person, and impulsively lashes out at them or hurts them. Little or no thought is given to the consequences of behavior on others, since people with low self-control are driven by self-need. Underlying this lack of self-control, according to Hirschi and Gottfredson, is where the social bond theory comes into play. Rather than from a lack of attachment, low self-control arises from a deficiency in parenting (Lilly et al., 2011, pp. 121-128). In essence, they argued that children from families where parenting skills were ineffective were never taught how to properly behave in society. Because they did not receive attention, affection or appropriate behavioral instruction at home, they focused on rewards from things—material objects become the objects of their desires. Such children did not learn to wait for things they want, but demanded to get them immediately. They may have formed attachments with their families, but these attachments were defective if the parents were poor at parenting, causing their children to shift focus from the feelings of others to the need for things. These attachments could not override low self-control if the parents did not impart ethical and moral values to their children.
Without proper parenting at an early age, children would never learn to exhibit self-control, and later in life would likely make choices that reflect the negative traits formerly listed, such as impulsiveness and need for immediate gratification (Lilly, et al., 121-128). The bottom line of such behavior was that, given a choice between criminal behavior that will gratify the individual’s need, or complying with societal rules and laws, persons with low self-esteem would not think twice, and would most likely choose the criminal activity.
The significance of Hirschi and Gottfredson’s argument is that the tendency to commit violent behavior is, in some sense, learned through neglect or negative role models like parents or guardians, and may manifest in behavior of emotionally challenged or mentally ill adults.. If this could be used as a reliable predictor of criminality or delinquency, then society might be able to construct methods to counteract the negative impacts of poor parenting. This in turn could decrease the incidence of violent behavior, before it even occurs, in persons diagnosed with mental illnesses. Low self-control based on poor parenting has been shown to create the likelihood of future violent behavior and is statistically supportable (Lilly et al., 2011, pp. 126), although some may argue that numerous other factors besides inadequate parenting might influence an individual’s lack of self-control.
In theory, both the original social bond argument and the later self-control or revised “social control” argument (Lilly et al., 2011, pp. 126.) make sense in explaining an individual’s likelihood to act out aggressively. If one does not have proper family attachments, commitments, involvements, or beliefs there is nothing to inform him or her what choices are beneficial and what choices are detrimental, to self and society. Likewise, without self-control, persons would seem likely to demand immediate gratification, to act impulsively and without regard to others, assuming one is capable of making rational choices. That the family, in particular parents or guardians, can affect or even control the development of these traits seems consistent with ideas of social interaction and learned behavior.
Bandura’s social learning theory states that behaviors are learned from the environment a person is in through a process that he called observational learning (McLeod, 2011). The notion is that a child encodes behavior from adult models and mimics the behavior whether it is negative or positive. Further, the theory suggests that people are more likely to adopt behaviors from the same sex. Can et al., (2013) investigated the application of social learning theory to the aggressive behaviors of police, both at home and at work. They found that the father in the person's family of origin and were crucial examples that affected each person's level of aggression (Can et al., 2013).
In considering the explanatory power of theories of aggression, it is useful to explore the motives behind aggressive behavior. Westmarland (2011) discussed an ethnographic study in which she identified five potential motives: violence as punishment, violence as revenge, violence as entertainment, violence to save face, and last, violence to encourage or discourage particular behaviors in the interaction. She highlighted the need for violence in certain circumstances, but cautioned that there is, as yet, no shared definition of excessive force, which makes it difficult to decide when behavior has crossed the line.
Mental Illness and Aggression
As previously mentioned the relationship between aggression and mental illness is a controversial and often debated topic. According to Feldmann (2001) many advocates for mental health attempt to minimize the link between aggression and psychopathology, suggesting that studies such as this attempt to further stigmatize individuals suffering from psychiatric illness. According to research conducted by Fazel and Grann (2006) one in twenty violent crimes are committed by individuals with severe mental illness. In addition, findings have suggested that psychosis elevates the risk of homicide as much as 20% and violence between two and seven times (Fazel & Grann, 2006). Other risk factors for aggression in individuals suffering from schizophrenia are comorbid antisocial personality disorder and/or psychopathy. Comorbid substance abuse is also a risk factor for violence but is treatable.
Research by Erkiran et al. (2006) aimed at determining whether violence is differentially related to negative and positive symptoms of schizophrenia. The negative symptoms include flat affect, alogia, avolition-apathy, anhedonia, and asociality. The positive symptoms include hallucinations, delusions, bizarre behavior, and thought disorder. The study sampled 133 adults that were diagnosed with schizophrenia and treated in a psychiatric hospital. Contrary to 14 previous belief, there was no proof that persecutory delusions enhanced the subjects risk for violence. Findings of research conducted by Erkiran et al. (2006) suggest that the symptoms of bizarre behavior and apathy predicted violence.
Conclusion
This paper looked at the definitions, types and proposed theories for the causes of aggression. Social psychological theories of aggression are discussion. Mention is also made of biological theories involving aggression. This explorations in this paper can provide a means of awareness to people of the need to be conscious of the stressors in life and the role and presence of aggression as it appears. Mental health is one of those interventions needed for all people to be more open to seeking mental health services to decompress and deal with their stress more effectively, thus, providing higher quality services to the communities they serve.
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