0
August 1993, Vol 50, No. 8 >
Article | August 1993

Neurologist's Role in Understanding Violence

Jonathan H. Pincus, MD
[+] Author Affiliations

Accepted for publication December 10, 1993.

Reprint requests to Department of Neurology, Georgetown University Hospital, 3800 Reservoir Rd NW, Washington, DC 20007-2197 (Dr Pincus).


Arch Neurol. 1993;50(8):867-869. doi:10.1001/archneur.1993.00540080070017
Text Size: A A A
Published online
Article
References
Comments

Violence is one of the major public health problems in the United States today. Twenty thousand deaths per annum, the majority involving firearms, are the result of the intentional violence of one person toward another. Violence is the leading cause of death among young black males whose homicide rates are up to 142 per 100 000. Annually, there are four to six million rapes, two million cases of child abuse, and two to four million wife batterings.1-4Pari passu with this, and possibly contributing to it, the American family structure has deteriorated. In 1950,17% of black births and 2% of white births were out of wedlock. Today, the figures are 66% and 16%, respectively.5

Is there a role for a neurologist in the understanding, treatment, and prevention of violence? In the sense that all behavior derives from brain activity and abnormal behavior from abnormal brain activity, neurologists may

REFERENCES

1 +
The National Committee for Injury Prevention and Control. Injury Prevention: Meeting the Challenge . New York, NY: Oxford University Press; 1989;.
2 +
Rice DP, MacKenzie EJ. Cost of Injury in the United States: A Report to Congress . San Francisco, Calif. Institute for Health and Aging, University of California; 1989;.
3 +
Federal Bureau of Investigation. Crime in the United States: Uniform Crime Reports, 1986 . Washington, DC: US Department of Justice, 1987;;21.
4 +
Healthy People 2000: National Health Promotion and Disease Prevention Objectives . Washington, DC: US Department of Health and Human Services. 1991;.
5 +
Hacker A.  The myths of racial division . The New Republic . (March 23) , 1992;:21-25.
6 +
Lewis DO, Pincus JH, Lovely R, et al.  Biopsychosocial characteristics of matched samples of delinquents and nondelinquents . J Am Acad Child Psychiatry . 1987;;26:744-752.
7 +
Lewis DO.  Delinquency, psychomotor epileptic symptomatology, and paranoid ideation: a triad . Am J Psychiatry . 1976;;133:1395-1398.
8 +
Lewis DO, Shanok S.  Medical histories of delinquent and nondelinquent children: an epidemiological study . Am J Psychiatry . 1977;;134:1020-1025.
9 +
Shanok S, Lewis DO.  Juvenile court vs child guidance referral: psychosocial and perinatal factors . Am J Psychiatry . 1977;;134:1130-1133.
10 +
Lewis DO.  Psychobiological vulnerabilities to delinquency: a historical perspective . J Am Acad Child Psychiatry . 1978;;17:193-196.
11 +
Lewis DO, Shanok S.  Medical histories of psychiatrically referred delinquent children: an epidemiological study . Am J Psychiatry . 1979;;136: 231-233.
12 +
Lewis DO, Shanok S, Balla DA.  Parental criminality and the medical histories of delinquents . Am J Psychiatry . 1979;;136:288-292.
13 +
Lewis DO, Shanok S.  Perinatal difficulties, head and face trauma and child abuse in the medical histories of seriously delinquent children . Am J Psychiatry . 1979;;136:419-423.
14 +
Lewis DO, Shanok S, Pincus J, Glaser G.  Violent juvenile delinquents: psychiatric, neurological, psychological and abuse factors . J Am Acad Child Psychiatry . 1979;;18:307-319.
15 +
Lewis DO, Shanok S.  A comparison of the medical histories of incarcerated delinquent children and a matched sample of nondelinquent children . Child Psychiatr Hum Dev . 1979;;9:210-214.
16 +
Pincus JH, Lewis DO, Shanok S, Glaser G.  Neurologic abnormalities in violent delinquents . Neurology . 1979;;29:536.
17 +
Lewis DO, Shanok S, Pincus JH.  Juvenile male sexual offenders . Am J Psychiatry . 1979;;136:1194-1196.
18 +
Lewis DO, Shanok S, Balla DA, Bard B.  Psychiatric correlates of severe reading disabilities in an incarcerated delinquent population . J Am Acad Child Psychiatry . 1980;;19:611-622.
19 +
Lewis DO, Shanok S, Pincus JH.  A comparison of the neuropsychiatric status of female and male incarcerated delinquents: some evidence of sex and race bias . J Am Acad Child Psychiatry . 1982;;21:190-196.
20 +
Lewis DO, Pincus JH, Shanok SS, Glaser GH.  Psychomotor epilepsy and violence in an incarcerated adolescent population . Am J Psychiatry . 1992;;139:882-887.
21 +
Lewis DO, Shanok S, Pincus JH, Giammarino M.  The medical assessment of seriously delinquent boys: a comparison of pediatric, psychiatric, neurological and hospital record data . J Adol Health Care . 1982;;3:160-164.
22 +
Shanok S, Malani SC, Ninan OP, Guggenheim P, Weinstein H, Lewis DO.  A comparison of delinquent and nondelinquent psychiatric inpatients . Am J Psychiatry . 1983;;140:582-585.
23 +
Lewis DO, Moy E, Jackson L, et al.  Biopsychosocial characteristics of children who later murder: a prospective study . Am J Psychiatry . 1985;;142: 1161-1167.
24 +
Lewis DO, Pincus JH, Feldman M, Jackson L, Bard B.  Psychiatric, neurological, and psychoeducational characteristics of 15 death row inmates in the United States . Am J Psychiatry . 1986;;143:838-845.
25 +
Lewis DO.  Multiple personality . In: Lewis M, ed. Child and Adolescent Psychiatry: A Comprehensive Textbook . Baltimore, Md: Williams & Wilkins; 1991;:707-715.
26 +
Satterfield JH, Hope CM, Schell AM.  A prospective study of delinquency in 110 adolescent boys with attention deficit disorder and 88 normal adolescent boys . Am J Psychiatry . 1982;;139:795-798.
27 +
Lewis DO, Pincus JH, Bard B, et al.  Neuropsychiatric, psychoeducational and family characteristics of 14 juveniles condemned to death in the United States . Am J Psychiatry . 1988;;145:584-589.
28 +
Elliott FA.  Neurological findings in adult minimal brain dysfunction and the dyscontrol syndrome . J Nerv Ment Dis . 1982;;170:680-687.
29 +
Volkow ND, Tancredi L.  Neurol substrates of violent behavior: a preliminary study with positron emission tomography . Br J Psychiatry . 1987;; 151:668-673.
30 +
Virkunnen M, Nuutila A, Huusko S.  Brain injury and criminality: a retropsective study . Dis Nerv Sys . 1977;;38:907-908.
31 +
Taylor PJ, Gunn J.  Violence and psychosis, I: risk of violence among psychotic men . BMJ . 1984;;288:1945-1949.
32 +
Taylor PJ.  Motives for offending among violent and psychotic men . Br J Psychiatry . 1985;;147:491-498.
33 +
Yesavage JA.  Dangerous behavior by Vietnam veterans with schizophrenia . Am J Psychiatry . 1983;;140:1180-1183.
34 +
Wisdom CS.  The cycle of violence . Science . 1989;;244:160-166.
35 +
Rosslund B, Larson CA.  Crimes of violence and alcohol abuse in Sweden . Int J Addict . 1979;;14:1103-1115.
36 +
Shupe IM.  Alcohol and crime: a study of the urine alcohol concentration found in 882 persons arrested during or immediately after the commission of a felony . J Crime Law Criminol . 1954;;44:661-664.
37 +
Loberg T.  Belligerence in alcohol dependence . Scand J Psychol . 1983;;24:285-292.
38 +
Holcomb WR, Anderson WP.  Alcohol and multiple drug use in accused murderers . Psychol Rep . 1983;;52:159-164.
39 +
Yesavage JA, Becker JM, Werner PD, et al.  Family conflict, psychopathology, and dangerous behavior by schizophrenic inpatients . Psychiatry Res . 1983;;8:271-280.
40 +
Yesavage JA.  Bipolar illness: correlates of dangerous inpatient behavior . Br J Psychiatry . 1983;;143:554-557.
41 +
Yesavage JA.  Correlates of dangerous behavior by schizophrenics in hospital . J Psychiatr Res . 1984;;18:225-231.
42 +
Tardiff K, Sweillam A.  Factors related to increased risk of assaultive behavior in suicidal patients . Acta Psychiatr Scand . 1980;;62:63-68.
43 +
Petrie WM, Lawson EC, Hollender MH.  Violence in geriatric patients . JAMA . 1982;;248:443-444.
44 +
Zucker DK, Livingston RL, Nakra R, Clayton PJ.  B12 deficiency and psychiatric disorders: case report and literature review . Biol Psychiatry . 1981;;16:197-205.
45 +
Oliver JE.  Successive generations of child maltreatment: the children . Br J Psychiatry . 1988;;153:543-553.
46 +
Lewis DO, Lovely R, Yeager C, Femina DD.  Toward a theory of the genesis of violence: a follow-up study of delinquents . J Am Acad Child Adolesc Psychiatry . 1989;;28:431-436.
47 +
Roy-Bryne PP, Uhde TW, Post RM.  Carbamazepine as a treatment for aggression, schizophrenia and non-affective syndromes . Int Drug Ther Newslett . 1984;;19:9-12.
48 +
Elliott FA.  Propranolol for the control of belligerent behavior following acute brain damage . Ann Neurol . 1977;;1:489-491.
49 +
Yuofsky S, Williams D, Gorman J.  Propranolol in the treatment of rage and violent behavior in patients with chronic brain syndrome . Am J Psychiatry . 1981;;138:218-220.
50 +
Tupin JP, Smith DB, Clanon TL, et al.  The long term use of lithium in aggressive prisoners . Comp Psychiatry . 1973;;14:311-317.
51 +
Sheard MH, Marini JL, Bridges CI, et al.  The effect of lithium on impulsive, aggressive behavior in man . Am J Psychiatry . 1976;;133:1409-1413.
52 +
Marini JL, Sheard MH.  Antiaggressive effect of lithium in man . Acta Psychiatr Scand . 1977;;55:269-286.

First Page Preview

First page PDF preview

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
The National Committee for Injury Prevention and Control. Injury Prevention: Meeting the Challenge . New York, NY: Oxford University Press; 1989;.
2 +
Rice DP, MacKenzie EJ. Cost of Injury in the United States: A Report to Congress . San Francisco, Calif. Institute for Health and Aging, University of California; 1989;.
3 +
Federal Bureau of Investigation. Crime in the United States: Uniform Crime Reports, 1986 . Washington, DC: US Department of Justice, 1987;;21.
4 +
Healthy People 2000: National Health Promotion and Disease Prevention Objectives . Washington, DC: US Department of Health and Human Services. 1991;.
5 +
Hacker A.  The myths of racial division . The New Republic . (March 23) , 1992;:21-25.
6 +
Lewis DO, Pincus JH, Lovely R, et al.  Biopsychosocial characteristics of matched samples of delinquents and nondelinquents . J Am Acad Child Psychiatry . 1987;;26:744-752.
7 +
Lewis DO.  Delinquency, psychomotor epileptic symptomatology, and paranoid ideation: a triad . Am J Psychiatry . 1976;;133:1395-1398.
8 +
Lewis DO, Shanok S.  Medical histories of delinquent and nondelinquent children: an epidemiological study . Am J Psychiatry . 1977;;134:1020-1025.
9 +
Shanok S, Lewis DO.  Juvenile court vs child guidance referral: psychosocial and perinatal factors . Am J Psychiatry . 1977;;134:1130-1133.
10 +
Lewis DO.  Psychobiological vulnerabilities to delinquency: a historical perspective . J Am Acad Child Psychiatry . 1978;;17:193-196.
11 +
Lewis DO, Shanok S.  Medical histories of psychiatrically referred delinquent children: an epidemiological study . Am J Psychiatry . 1979;;136: 231-233.
12 +
Lewis DO, Shanok S, Balla DA.  Parental criminality and the medical histories of delinquents . Am J Psychiatry . 1979;;136:288-292.
13 +
Lewis DO, Shanok S.  Perinatal difficulties, head and face trauma and child abuse in the medical histories of seriously delinquent children . Am J Psychiatry . 1979;;136:419-423.
14 +
Lewis DO, Shanok S, Pincus J, Glaser G.  Violent juvenile delinquents: psychiatric, neurological, psychological and abuse factors . J Am Acad Child Psychiatry . 1979;;18:307-319.
15 +
Lewis DO, Shanok S.  A comparison of the medical histories of incarcerated delinquent children and a matched sample of nondelinquent children . Child Psychiatr Hum Dev . 1979;;9:210-214.
16 +
Pincus JH, Lewis DO, Shanok S, Glaser G.  Neurologic abnormalities in violent delinquents . Neurology . 1979;;29:536.
17 +
Lewis DO, Shanok S, Pincus JH.  Juvenile male sexual offenders . Am J Psychiatry . 1979;;136:1194-1196.
18 +
Lewis DO, Shanok S, Balla DA, Bard B.  Psychiatric correlates of severe reading disabilities in an incarcerated delinquent population . J Am Acad Child Psychiatry . 1980;;19:611-622.
19 +
Lewis DO, Shanok S, Pincus JH.  A comparison of the neuropsychiatric status of female and male incarcerated delinquents: some evidence of sex and race bias . J Am Acad Child Psychiatry . 1982;;21:190-196.
20 +
Lewis DO, Pincus JH, Shanok SS, Glaser GH.  Psychomotor epilepsy and violence in an incarcerated adolescent population . Am J Psychiatry . 1992;;139:882-887.
21 +
Lewis DO, Shanok S, Pincus JH, Giammarino M.  The medical assessment of seriously delinquent boys: a comparison of pediatric, psychiatric, neurological and hospital record data . J Adol Health Care . 1982;;3:160-164.
22 +
Shanok S, Malani SC, Ninan OP, Guggenheim P, Weinstein H, Lewis DO.  A comparison of delinquent and nondelinquent psychiatric inpatients . Am J Psychiatry . 1983;;140:582-585.
23 +
Lewis DO, Moy E, Jackson L, et al.  Biopsychosocial characteristics of children who later murder: a prospective study . Am J Psychiatry . 1985;;142: 1161-1167.
24 +
Lewis DO, Pincus JH, Feldman M, Jackson L, Bard B.  Psychiatric, neurological, and psychoeducational characteristics of 15 death row inmates in the United States . Am J Psychiatry . 1986;;143:838-845.
25 +
Lewis DO.  Multiple personality . In: Lewis M, ed. Child and Adolescent Psychiatry: A Comprehensive Textbook . Baltimore, Md: Williams & Wilkins; 1991;:707-715.
26 +
Satterfield JH, Hope CM, Schell AM.  A prospective study of delinquency in 110 adolescent boys with attention deficit disorder and 88 normal adolescent boys . Am J Psychiatry . 1982;;139:795-798.
27 +
Lewis DO, Pincus JH, Bard B, et al.  Neuropsychiatric, psychoeducational and family characteristics of 14 juveniles condemned to death in the United States . Am J Psychiatry . 1988;;145:584-589.
28 +
Elliott FA.  Neurological findings in adult minimal brain dysfunction and the dyscontrol syndrome . J Nerv Ment Dis . 1982;;170:680-687.
29 +
Volkow ND, Tancredi L.  Neurol substrates of violent behavior: a preliminary study with positron emission tomography . Br J Psychiatry . 1987;; 151:668-673.
30 +
Virkunnen M, Nuutila A, Huusko S.  Brain injury and criminality: a retropsective study . Dis Nerv Sys . 1977;;38:907-908.
31 +
Taylor PJ, Gunn J.  Violence and psychosis, I: risk of violence among psychotic men . BMJ . 1984;;288:1945-1949.
32 +
Taylor PJ.  Motives for offending among violent and psychotic men . Br J Psychiatry . 1985;;147:491-498.
33 +
Yesavage JA.  Dangerous behavior by Vietnam veterans with schizophrenia . Am J Psychiatry . 1983;;140:1180-1183.
34 +
Wisdom CS.  The cycle of violence . Science . 1989;;244:160-166.
35 +
Rosslund B, Larson CA.  Crimes of violence and alcohol abuse in Sweden . Int J Addict . 1979;;14:1103-1115.
36 +
Shupe IM.  Alcohol and crime: a study of the urine alcohol concentration found in 882 persons arrested during or immediately after the commission of a felony . J Crime Law Criminol . 1954;;44:661-664.
37 +
Loberg T.  Belligerence in alcohol dependence . Scand J Psychol . 1983;;24:285-292.
38 +
Holcomb WR, Anderson WP.  Alcohol and multiple drug use in accused murderers . Psychol Rep . 1983;;52:159-164.
39 +
Yesavage JA, Becker JM, Werner PD, et al.  Family conflict, psychopathology, and dangerous behavior by schizophrenic inpatients . Psychiatry Res . 1983;;8:271-280.
40 +
Yesavage JA.  Bipolar illness: correlates of dangerous inpatient behavior . Br J Psychiatry . 1983;;143:554-557.
41 +
Yesavage JA.  Correlates of dangerous behavior by schizophrenics in hospital . J Psychiatr Res . 1984;;18:225-231.
42 +
Tardiff K, Sweillam A.  Factors related to increased risk of assaultive behavior in suicidal patients . Acta Psychiatr Scand . 1980;;62:63-68.
43 +
Petrie WM, Lawson EC, Hollender MH.  Violence in geriatric patients . JAMA . 1982;;248:443-444.
44 +
Zucker DK, Livingston RL, Nakra R, Clayton PJ.  B12 deficiency and psychiatric disorders: case report and literature review . Biol Psychiatry . 1981;;16:197-205.
45 +
Oliver JE.  Successive generations of child maltreatment: the children . Br J Psychiatry . 1988;;153:543-553.
46 +
Lewis DO, Lovely R, Yeager C, Femina DD.  Toward a theory of the genesis of violence: a follow-up study of delinquents . J Am Acad Child Adolesc Psychiatry . 1989;;28:431-436.
47 +
Roy-Bryne PP, Uhde TW, Post RM.  Carbamazepine as a treatment for aggression, schizophrenia and non-affective syndromes . Int Drug Ther Newslett . 1984;;19:9-12.
48 +
Elliott FA.  Propranolol for the control of belligerent behavior following acute brain damage . Ann Neurol . 1977;;1:489-491.
49 +
Yuofsky S, Williams D, Gorman J.  Propranolol in the treatment of rage and violent behavior in patients with chronic brain syndrome . Am J Psychiatry . 1981;;138:218-220.
50 +
Tupin JP, Smith DB, Clanon TL, et al.  The long term use of lithium in aggressive prisoners . Comp Psychiatry . 1973;;14:311-317.
51 +
Sheard MH, Marini JL, Bridges CI, et al.  The effect of lithium on impulsive, aggressive behavior in man . Am J Psychiatry . 1976;;133:1409-1413.
52 +
Marini JL, Sheard MH.  Antiaggressive effect of lithium in man . Acta Psychiatr Scand . 1977;;55:269-286.

Correspondence

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems