George David T, Phillips Monte J, Doty Linda, Umhau John C, Rawlings Robert R
Laboratory of Clinical and Translational Studies, DICBR, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive MSC-1540, Bldg 10 - Hatfield CRC Room 2-2352, Bethesda, MD 20892-1540, USA.
Med Hypotheses. 2006;67(2):345-53. doi: 10.1016/j.mehy.2006.01.049. Epub 2006 Mar 31.
Research indicates that perpetrators of domestic violence have abnormalities in central serotonin and testosterone metabolism, an increased sensitivity to anxiogenic stimuli, and an impaired neuro-connection between their cortex and the amygdala. Clinical evaluations show that perpetrators of domestic violence also have a distinguishing set of behaviors and diagnoses related to anxiety, depression, intermittent explosive disorder, and borderline personality disorder. In this paper we propose a model to understand how the biological abnormalities can potentially explain the behaviors and diagnoses exhibited by the perpetrators. Changes in the perpetrator's neurotransmitters lead to a heightened sensitivity to environmental stimuli, anxiety, and conditioned fear. Lack of cortical input to the amygdala impairs the perpetrator's ability to extinguish anxiety and/or conditioned fear and gives rise to either innate behaviors (e.g., fight, flight, and shut down) or learned fear avoidant behaviors designed to avoid anxiety (e.g., alcohol consumption, self-injurious acts, and obsessive behaviors). Linking conditioned fear and fear avoidance to the behaviors and psychiatric diagnoses will serve to change the way the medical community perceives and treats perpetrators of domestic violence.
研究表明，家庭暴力的施暴者在中枢血清素和睾酮代谢方面存在异常，对焦虑性刺激的敏感性增加，且其大脑皮层与杏仁核之间的神经连接受损。临床评估显示，家庭暴力的施暴者还具有一系列与焦虑、抑郁、间歇性爆发障碍和边缘型人格障碍相关的独特行为和诊断特征。在本文中，我们提出了一个模型，以理解生物学异常如何可能解释施暴者所表现出的行为和诊断特征。施暴者神经递质的变化导致对环境刺激、焦虑和条件性恐惧的敏感性增强。大脑皮层向杏仁核的输入缺失会损害施暴者消除焦虑和/或条件性恐惧的能力，并引发先天行为（如战斗、逃跑和僵住）或为避免焦虑而习得的恐惧回避行为（如饮酒、自我伤害行为和强迫行为）。将条件性恐惧和恐惧回避与这些行为及精神疾病诊断联系起来，将有助于改变医学界对家庭暴力施暴者的认知和治疗方式。
