Department of Psychiatry, Weill Cornell Medicine, White Plains, NY, USA.
Department of Psychology, Long Island University, Brookville, NY, USA.
Psychiatry Res. 2018 Jan;259:350-357. doi: 10.1016/j.psychres.2017.11.003. Epub 2017 Nov 7.
Schizophrenia is associated with an elevated risk of aggression. Cognitive deficits have been associated with inpatient aggression and future violence. The relationship between cognitive deficits and violent behavior has however been inconsistent across studies. In addition, studies have failed to inform how cognitive deficits may contribute to aggression in schizophrenia. The current study examined the association of cognitive deficits with schizophrenia-related aggression and violent offending. It also explored the putative mediating role of negative emotionality on the impact of cognitive deficits on aggression. People with schizophrenia and schizoaffective disorder (N = 78) were recruited from a state hospital. Participants were classified based on their history of violent offending. Participants completed measures of cognition, symptoms, and aggression. Deficits in working memory, reasoning/problem-solving, and verbal learning were the most prioritized for the prediction of violent offender status. Violent offenders demonstrated greater impairments in most cognitive domains especially working memory and verbal learning. Offenders also demonstrated greater negative emotionality, excitement/agitation, and incidents of verbal and physical aggression. Negative emotionality and excitement/agitation fully transmitted the effect of cognitive deficits on impulsive aggression in meditational models. Cognitive deficits increase the risk of impulsive aggression in schizophrenia via inefficient regulation of negative affective states.
精神分裂症与攻击风险升高有关。认知缺陷与住院期间的攻击行为和未来的暴力行为有关。然而，在不同的研究中，认知缺陷与暴力行为之间的关系并不一致。此外，研究未能说明认知缺陷如何导致精神分裂症患者的攻击行为。本研究探讨了认知缺陷与精神分裂症相关攻击行为和暴力犯罪之间的关系。它还探讨了负性情感在认知缺陷对攻击行为的影响中的中介作用。从州立医院招募了精神分裂症和分裂情感障碍患者（N=78）。根据他们的暴力犯罪史对参与者进行分类。参与者完成了认知、症状和攻击行为的测量。工作记忆、推理/解决问题和言语学习方面的缺陷是预测暴力犯罪者身份的最优先考虑因素。暴力犯罪者在大多数认知领域，尤其是工作记忆和言语学习方面表现出更大的障碍。犯罪者还表现出更高的负性情感、兴奋/激动以及言语和身体攻击的事件。在中介模型中，负性情感和兴奋/激动完全传递了认知缺陷对冲动攻击的影响。通过对负性情绪状态的低效调节，认知缺陷增加了精神分裂症中冲动攻击的风险。
