The influence of difficult temperament on alcohol-related aggression: Better accounted for by executive functioning?☆
Introduction
It is well known that alcohol consumption is related to interpersonal aggression (reviewed in Bushman & Cooper, 1990, Chermack and Giancola, 1997, Fishbein, 2003, Ito et al., 1996). Correlational studies have found that alcohol is present in about 50% of sexual assaults, homicides, and other violent crimes (reviewed in Murdoch et al., 1990, Pernanen, 1991) and suggested that it is the acute effects of alcohol, rather than its chronic effects, that have the largest impact on aggressive behavior (Chermack & Blow, 2002, Collins & Schlenger, 1988, Wiley and Weisner, 1995). Similarly, laboratory-based studies, in which participants have the opportunity to aggress against a fictitious opponent under the guise of a competitive task, have clearly demonstrated that persons who receive alcohol behave more aggressively than those who receive a placebo or a nonalcoholic beverage (reviewed in Bushman & Cooper, 1990, Chermack and Giancola, 1997, Kelly and Cherek, 1993, Taylor and Chermack, 1993).
A number of theories have been advanced to explain the mechanisms by which alcohol facilitates aggressive behavior. One of the most well-accepted theories, relevant to the present investigation, is that alcohol's pharmacological properties facilitate aggression by disrupting executive cognitive functioning (EF) which is important in maintaining inhibitory control over behavior (Giancola, 2000, Pihl et al., 1993, Steele and Josephs, 1990, Taylor and Leonard, 1983). EF is defined as a higher-order cognitive construct involved in the self-regulation of goal-directed behavior (Luria, 1980, Milner, 1995, Stuss and Alexander, 2000, Tranel et al., 1994). The cognitive abilities subsumed within this construct include attentional control, previewing ability, strategic goal planning, abstract reasoning, temporal response sequencing, cognitive flexibility, set shifting, self-monitoring, hypothesis generation, inhibition, and the ability to organize and adaptively utilize information contained in working memory (Kimberg and Farah, 1993, Stuss and Alexander, 2000). When considered in a more functional context, it becomes clear that the ability to correctly appraise a problematic situation, determine a plan of action to adaptively cope with that situation, and then adroitly carry out that plan, making appropriate changes when necessary, is heavily dependent upon possessing good EF (Damasio, 1994, Stuss and Alexander, 2000).
Therefore, EF is posited to play the role of a mediator inasmuch as acute alcohol consumption causes a disruption in EF which then dysregulates goal-directed behavior thereupon increasing the probability of an aggressive reaction. Indeed, extant literature suggests that alcohol consumption disrupts EF (Curtin & Fairchild, 2003, Finn et al., 1999, Arbuckle et al., 1994, Hoaken et al., 1998, Lyvers and Maltzman, 1991, Peterson et al., 1990) and that impairment in EF is related to, and even predicts, aggressive behavior (reviewed in Fishbein, 2000, Hawkins & Trobst, 2000, Morgan and Lilienfeld, 2000, Paschall and Fishbein, 2002, Stevens et al., 2003). However, it is well known that alcohol consumption does not lead to aggression in all persons. Thus, the extent to which this mediational model is successful in explaining the alcohol-aggression relation will be determined, or moderated, by the amount of EF that is present in the sober state (Giancola, 2000). In support of this hypothesis, Giancola (2004a) reported that alcohol facilitated aggression to a greater extent among persons who possessed lower levels of sober state EF.
Pertinent research has also identified deviations in temperament as an important risk factor for alcohol-related aggression (Giancola, 2004b). Temperament can be defined as a latent construct comprising a series of trait dimensions depicting individual differences in various types of behavioral and affective response and self-regulatory styles (Rothbart, 1989, Rothbart and Ahadi, 1994, Thomas and Chess, 1977). Examples of such trait dimensions include: Rhythmicity, which refers to the degree of regularity in performing various behavioral activities; Approach–Avoidance, which refers to the proclivity to respond with an approach or an avoidance style to novel situations; and Mood, which refers to a positive or a negative affective quality. The term difficult temperament (DT) denotes behaviors and affective states characterized by withdrawal from novel stimuli, intense reactions to stimuli, irritability, negative mood, low adaptability to change, distractibility, irregularities in biological functions, as well as poor attention and persistence (Tarter and Vanyukov, 1994, Thomas and Chess, 1984, Windle, 1991).
It is interesting to note that both DT and EF predict aggressive behavior among persons in the sober state. DT is associated with a greater degree of behavior problems, aggression, and delinquency in young children (Jansen et al., 1995, Kingston and Prior, 1995) and adolescents (Fox & Calkins, 1993, Giancola et al., 1998, Sanson and Prior, 1999, Tarter et al., 1993, Windle, 1992a). It is also linked to greater levels of violence and attempted suicide as well as a hostile interpersonal style in adult males (Engstrom et al., 1999, Patrick, 1994, Windle, 1994). A large study demonstrated that DT measured in 3- to 5-year-old males predicted convictions for violent offenses at age 18 (Henry, Caspi, Moffitt, & Silva, 1996). Finally, neurobiologists have determined that neural circuits related to temperament are involved in the expression affective/emotional aggression (Rothbart, Derryberry, & Posner, 1994).
A large literature indicates that EF also contributes, in part, to the expression of non-intoxicated aggressive behavior (reviewed in Fishbein, 2000, Hawkins & Trobst, 2000, Paschall and Fishbein, 2002, Stevens et al., 2003). In fact, a recent meta-analytic study reported that the effect size of EF on antisocial behavior is in the “medium” to “large” range (Morgan & Lilienfeld, 2000). More specifically, studies with clinical samples indicate that adult (Lapierre et al., 1995, Smith et al., 1992) and adolescent psychopaths (Roussy & Toupin, 2000), adolescent sex offenders (Kelly, Richardson, Hunter, & Knapp, 2002), adults with antisocial personality disorder (Gorenstein, 1987, Malloy et al., 1990), and adolescents with conduct disorder (Moffitt, 1993, Moffitt and Henry, 1989), all exhibit poorer performance on neuropsychological measures of EF compared with controls. In addition, EF has been shown to be negatively associated with verbal aggression in adolescents (Santor, Ingram, & Kusumakar, 2003), fighting in normal preadolescent boys (Seguin, Pihl, Harden, Tremblay, & Boulerice, 1995), impulsive aggression in college students (Villemarette-Pittman, Stanford, & Greve, 2002), violent and nonviolent conduct disorder symptoms in adolescent females (Giancola et al., 1998), as well as physical aggression measured in a laboratory setting (Giancola & Zeichner, 1994, Hoaken et al., 2003, Lau and Pihl, 1996).
Although DT and EF have been implicated as independent predictors of aggression in the sober state, neuropsychological research suggests that EF may mediate the relation between DT and aggression. It is well accepted that the prefrontal cortex represents the primary cortical substrate that subserves EF (Fuster, 1997, Luria, 1980, Milner and Petrides, 1984, Cabeza & Nyberg, 2000, Stuss and Levine, 2002). The prefrontal cortex also plays a significant role in expression and regulation of different aspects of temperament (Beer et al., 2003, Damasio, 1995, Davidson et al., 1990, Heller, 1993, Kolb and Taylor, 1981, Tarter et al., 1985). For example, the prefrontal cortex has both direct and indirect reciprocal connections with the amygdala, a limbic structure involved in attaching affect to incoming information (Barbas, 2000, Girgis, 1971, Petrides, 1989), thus permitting some degree of “top-down” control over emotional experiences (e.g., Beauregard et al., 2001, Jackson et al., 2003). Such findings strongly indicate that the cognitive functions subserved by prefrontal circuitry directly impact individual differences in temperament. This argument is supported by empirical evidence indicating that EF deficits are associated with DT in children and adults (reviewed in Giancola, 1995, Tarter, 1988, Tarter and Vanyukov, 1994) and by clinical data showing that individuals who have sustained damage to the prefrontal cortex display a behavioral profile resembling that of non-brain damaged individuals with DT (Starkstein and Robinson, 1991, Stuss et al., 1992). Given this, it is not surprising that alterations in mood, increased irritability, and emotional as well as behavioral dysregulation have been observed subsequent to damage to the prefrontal cortex (Boone et al., 1988, Price et al., 1990, Stuss et al., 1992).
Based on the preceding review, one could argue that EF is involved in the regulation of temperament. One of the first accounts of this hypothesis was advanced by the Russian neuropsychologist, Alexander Luria, 1961, Luria, 1980. Based on his systematic program of brain–behavior research, Luria concluded that the cognitive regulation of affect and behavior is governed predominantly by the prefrontal cortex, which, as noted above, is the primary neural substrate for EF. Following Luria, Tarter and colleagues (Tarter et al., 1985, Tarter, 1988) later put forth a similar theoretical stance to explain the neurobehavioral underpinnings of alcoholism. Specifically, Tarter's model implicated childhood DT as an “upstream” risk factor for alcoholism. However, he also made it clear that the overt manifestations of DT (e.g., overactivity, poor soothability, low sociability) were regulated by EF. Finally, this hypothesis was further elaborated upon by Moffitt (1993) who hypothesized that neuropsychological disturbances in EF underlie behavioral and affective manifestations of DT such as irritability, emotional dysregulation, and poor impulse control. In summary, these theorists all seem to be making the point that EF plays an important role in regulating temperament.
Given the theoretical formulations and empirical data reviewed above, it is reasonable to hypothesize that EF plays a mechanistic role underlying the relation between DT and aggression. To our knowledge, only one study has tested this model. Giancola et al. (1998) found that EF mediated the relation between DT and physical aggression in a sample of adolescent females with comorbid diagnoses of conduct disorder and substance use disorder. Insofar as this is the only study that has tested this model and given that it was conducted on a sample of adolescents with psychiatric diagnoses, further research is required in order to better determine whether EF underlies the relation between DT and aggression. In particular, it is not known whether this mechanism also explains the relation between DT and intoxicated aggression. Determining whether EF underlies the relation between DT and intoxicated aggression is of clear import because such a finding will have significant implications for both etiology and treatment/prevention research. Specifically, if such a finding is ultimately confirmed it will prompt clinical researchers to focus on habilitating EF skills as a means of “regulating” temperament. From a clinical perspective, this is an important distinction because it is significantly more difficult to modify an individual's temperament (Duggan, 2004, Paris, 2003) than it is to alter one's beliefs and cognitive skills (McDonald et al., 2002, Stevenson et al., 2002, Wykes et al., 1999). Therefore, the purpose of the present study was to test the hypothesis that EF mediates the relation between DT and intoxicated aggression.
Section snippets
Participants
Participants were 165 (82 men and 83 women) healthy social drinkers between 21 and 35 years of age (M = 22.96, S.D. = 2.75). Social drinking was defined by consuming at least 3–4 alcoholic beverages per occasion at least twice per month. Participants were recruited through advertisements placed in various newspapers in Lexington, Kentucky. Respondents were initially screened by telephone. Individuals reporting any past or present drug- or alcohol-related problems, serious head injuries, learning
Gender differences
Gender differences were examined using t-tests. Results indicated that men and women did not differ significantly with respect to age, years of education, salary, EF or DT. However, as would be expected, men displayed higher levels of intoxicated aggression than women (see Table 1).
Analysis of provocation as a repeated measure
Because the dependent variable in this study was a repeated-measure (Low Provocation and High Provocation), the use of standard regression techniques was not possible unless separate models were computed for each
Discussion
Results of the present study reported herein demonstrated that EF mediated the relation between DT and intoxicated aggression. However, this model was upheld for men only. This is an interesting contrast with the Giancola et al. (1998) study described above which found that EF did mediate the relation between DT and self-reported acts of non-intoxicated physical aggression in adolescent females. It has been suggested that women do not exhibit physical aggression to the same degree as men due to
References (141)
Connections underlying the synthesis of cognition, memory, and emotion in primate prefrontal cortices
Brain Research Bulletin
(2000)- et al.
Violence among individuals in substance abuse treatment: The role of alcohol and cocaine consumption
Drug and Alcohol Dependence
(2002) - et al.
The relationship between alcohol and aggression: An integrated biopsychosocial approach
Clinical Psychology Review
(1997) - et al.
Temperament traits in male suicide attempters and violent offenders
European Psychiatry
(1999) Difficult temperament, acute alcohol intoxication, and aggressive behavior
Drug and Alcohol Dependence
(2004)- et al.
Construct validity of laboratory aggression paradigms: A response to Tedeschi and Quigley (1996)
Aggression and Violent Behavior
(1998) - et al.
Are the frontal lobes implicated in “planning” functions? Interpreting data from the tower of Hanoi
Neuropsychologia
(1995) - et al.
Frontal lobe dysfunction and aggression: Conceptual issues and research findings
Aggression and Violent Behavior
(2000) - et al.
Mental planning and anticipatory processes with acute and chronic frontal lobe lesions: A comparison of maze performance in routine and non-routine situations
Neuropsychologia
(1991) - et al.
The development of patterns of stable, transient, and school-age onset aggressive behavior in young children
Journal of the American Academy of Child and Adolescent Psychiatry
(1995)
Validity of DSM-IV subtypes of conduct disorder based on age of onset
American Academy of Child and Adolescent Psychiatry
Ventral frontal deficits in psychopathy: Neuropsychological test findings
Neuropsychologia
Determinants of neuropsychological impairment in antisocial substance abusers
Addictive Behaviors
Neuropsychiatric sequelae of head injuries
Psychiatric Clinics of North America
Behavioural effects of frontal-lobe lesions in man
Trends in Neurosciences
A meta-analytic review of the relation between antisocial behavior and neuropsychological measures of executive function
Clinical Psychology Review
Perpetration of partner violence: Effects of cocaine and alcohol dependence and posttraumatic stress disorder
Addictive Behaviors
Executive cognitive functioning and aggression: A public health perspective
Aggression and Violent Behavior
Deficits on conditional associative-learning tasks after frontal- and temporal-lobe lesions in man
Neuropsychologia
External validity of “trivial” experiments: The case of laboratory aggression
Review of General Psychology
Social drinking and cognitive functioning revisited: The role of intellectual endowment and psychological distress
Journal of Studies on Alcohol
Mental disorders and violence in a total birth cohort: Results from the Dunedin Study
Archives of General Psychiatry
The moderator–mediator variable distinction in social psychology research: Conceptual, strategic, and statistical considerations
Journal of Personality and Social Psychology
Neural correlates of conscious self-regulation of emotion
Journal of Neuroscience
The regulatory function of self-conscious emotion: Insights from patients with orbitofrontal damage
Journal of Personality and Social Psychology
The influence of paternal substance abuse and difficult temperament in fathers and sons on sons' disengagement from family to deviant peers
Journal of Youth and Adolescence
Neuropsychological and behavioral abnormalities in an adolescent with frontal lobe seizures
Neurology
Effects of alcohol on human aggression: An integrative research review
Psychological Bulletin
Imaging cognition: II. An empirical review of 275 PET and fMRI studies
Journal of Cognitive Neuroscience
A developmental functional MRI study of prefrontal activation during performance of go–no-go task
Journal of Cognitive Neuroscience
Remediation of executive function deficits after traumatic brain injury
Neuro Rehabilitation
Implications of sex differences in the prevalence of antisocial personality, alcoholism, and criminality for familial transmission
Archives of General Psychiatry
The multifactorial model of disease transmission: II. Sex differences in the familial transmission of sociopathy (antisocial personality)
British Journal of Psychiatry
Acute and chronic effects of alcohol use
Journal of Studies on Alcohol
Alcohol and cognitive control: Implications for regulation of behavior during response conflict
Journal of Abnormal Psychology
Descartes' error
Toward a neurobiology of emotion and feeling: Operational concepts and hypotheses
The Neuroscientist
Approach–Withdrawal and cerebral asymmetry: Emotional expression and brain physiology: I
Journal of Personality and Social Psychology
A meta-analytic review of the sensitivity of the Wisconsin card sorting test to frontal and lateralized frontal brain damage
Neuropsychology
Guidelines for the study of brain–behavior relationships during development
Cognitive abilities in adolescent-limited and life-course-persistent criminal offenders
Journal of Abnormal Psychology
Does personality change and, if so what changes?
Criminal Behaviour and Mental Health
Working memory, executive processes and the effects of alcohol on Go/No-Go learning: Testing a model of behavioral regulation and impulsivity
Psychopharmacology
Neuropsychological function, drug abuse, and violence: A conceptual framework
Criminal Justice and Behavior
Differential susceptibility to comorbid drug abuse and violence
Journal of Drug Issues
Pathways to aggression and social withdrawal: Interactions among temperament, attachment, and regulation
Memory and planning: Two temporal perspectives of frontal lobe function
The prefrontal cortex: Anatomy, physiology, and neuropsychology of the frontal lobe
Executive functioning: A conceptual framework for alcohol-related aggression
Experimental and Clinical Psychopharmacology
Executive functioning and alcohol-related aggression
Journal of Abnormal Psychology
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This research was supported by grant R01-AA-11691 from the National Institute on Alcohol Abuse and Alcoholism.