Elsevier

Addictive Behaviors

Volume 31, Issue 12, December 2006, Pages 2169-2187
Addictive Behaviors

The influence of difficult temperament on alcohol-related aggression: Better accounted for by executive functioning?

https://doi.org/10.1016/j.addbeh.2006.02.019Get rights and content

Abstract

The purpose of this investigation was to test the hypothesis that executive functioning (EF) would mediate the relation between difficult temperament (DT) and intoxicated aggression. Participants were 165 social drinking men and women between the ages of 21–35 years old. DT was measured using the Dimension of Temperament Scale – Revised and EF was measured using seven well-established neuropsychological tests. Following consumption of an alcoholic beverage, participants were tested on a laboratory aggression measure in which electric shocks were received from and administered to a fictitious opponent under the guise of a competitive reaction time task. Aggression was operationalized as shock intensities administered to the fictitious opponent under conditions of low and high provocation. Results indicated that EF successfully mediated the relation between DT and intoxicated aggression for men but not for women. These findings are discussed with regard to how they influence current models of aggressive behavior as well as their implications for future violence prevention efforts.

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)

  • B.B. Lahey et al.

    Validity of DSM-IV subtypes of conduct disorder based on age of onset

    American Academy of Child and Adolescent Psychiatry

    (1998)
  • D. Lapierre et al.

    Ventral frontal deficits in psychopathy: Neuropsychological test findings

    Neuropsychologia

    (1995)
  • P. Malloy et al.

    Determinants of neuropsychological impairment in antisocial substance abusers

    Addictive Behaviors

    (1990)
  • T.W. McAllister

    Neuropsychiatric sequelae of head injuries

    Psychiatric Clinics of North America

    (1992)
  • B. Milner et al.

    Behavioural effects of frontal-lobe lesions in man

    Trends in Neurosciences

    (1984)
  • A. Morgan et al.

    A meta-analytic review of the relation between antisocial behavior and neuropsychological measures of executive function

    Clinical Psychology Review

    (2000)
  • D.J. Parrott et al.

    Perpetration of partner violence: Effects of cocaine and alcohol dependence and posttraumatic stress disorder

    Addictive Behaviors

    (2003)
  • M. Paschall et al.

    Executive cognitive functioning and aggression: A public health perspective

    Aggression and Violent Behavior

    (2002)
  • M. Petrides

    Deficits on conditional associative-learning tasks after frontal- and temporal-lobe lesions in man

    Neuropsychologia

    (1985)
  • C. Anderson et al.

    External validity of “trivial” experiments: The case of laboratory aggression

    Review of General Psychology

    (1997)
  • T. Arbuckle et al.

    Social drinking and cognitive functioning revisited: The role of intellectual endowment and psychological distress

    Journal of Studies on Alcohol

    (1994)
  • L. Arseneault et al.

    Mental disorders and violence in a total birth cohort: Results from the Dunedin Study

    Archives of General Psychiatry

    (2000)
  • R. Baron et al.

    The moderator–mediator variable distinction in social psychology research: Conceptual, strategic, and statistical considerations

    Journal of Personality and Social Psychology

    (1986)
  • M. Beauregard et al.

    Neural correlates of conscious self-regulation of emotion

    Journal of Neuroscience

    (2001)
  • J.S. Beer et al.

    The regulatory function of self-conscious emotion: Insights from patients with orbitofrontal damage

    Journal of Personality and Social Psychology

    (2003)
  • T. Blackson et al.

    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

    (1996)
  • K. Boone et al.

    Neuropsychological and behavioral abnormalities in an adolescent with frontal lobe seizures

    Neurology

    (1988)
  • B. Bushman et al.

    Effects of alcohol on human aggression: An integrative research review

    Psychological Bulletin

    (1990)
  • R. Cabeza et al.

    Imaging cognition: II. An empirical review of 275 PET and fMRI studies

    Journal of Cognitive Neuroscience

    (2000)
  • B. Casey et al.

    A developmental functional MRI study of prefrontal activation during performance of go–no-go task

    Journal of Cognitive Neuroscience

    (1997)
  • K.D. Cicerone et al.

    Remediation of executive function deficits after traumatic brain injury

    Neuro Rehabilitation

    (1992)
  • C. Cloninger et al.

    Implications of sex differences in the prevalence of antisocial personality, alcoholism, and criminality for familial transmission

    Archives of General Psychiatry

    (1978)
  • C. Cloninger et al.

    The multifactorial model of disease transmission: II. Sex differences in the familial transmission of sociopathy (antisocial personality)

    British Journal of Psychiatry

    (1975)
  • J. Collins et al.

    Acute and chronic effects of alcohol use

    Journal of Studies on Alcohol

    (1988)
  • J.J. Curtin et al.

    Alcohol and cognitive control: Implications for regulation of behavior during response conflict

    Journal of Abnormal Psychology

    (2003)
  • A. Damasio

    Descartes' error

    (1994)
  • A. Damasio

    Toward a neurobiology of emotion and feeling: Operational concepts and hypotheses

    The Neuroscientist

    (1995)
  • R. Davidson et al.

    Approach–Withdrawal and cerebral asymmetry: Emotional expression and brain physiology: I

    Journal of Personality and Social Psychology

    (1990)
  • G. Demakis

    A meta-analytic review of the sensitivity of the Wisconsin card sorting test to frontal and lateralized frontal brain damage

    Neuropsychology

    (2003)
  • A. Diamond

    Guidelines for the study of brain–behavior relationships during development

  • M.B. Donnellan et al.

    Cognitive abilities in adolescent-limited and life-course-persistent criminal offenders

    Journal of Abnormal Psychology

    (2000)
  • C. Duggan

    Does personality change and, if so what changes?

    Criminal Behaviour and Mental Health

    (2004)
  • P.R. Finn et al.

    Working memory, executive processes and the effects of alcohol on Go/No-Go learning: Testing a model of behavioral regulation and impulsivity

    Psychopharmacology

    (1999)
  • D. Fishbein

    Neuropsychological function, drug abuse, and violence: A conceptual framework

    Criminal Justice and Behavior

    (2000)
  • D. Fishbein

    Differential susceptibility to comorbid drug abuse and violence

    Journal of Drug Issues

    (2003)
  • N. Fox et al.

    Pathways to aggression and social withdrawal: Interactions among temperament, attachment, and regulation

  • J. Fuster

    Memory and planning: Two temporal perspectives of frontal lobe function

  • J. Fuster

    The prefrontal cortex: Anatomy, physiology, and neuropsychology of the frontal lobe

    (1997)
  • P.R. Giancola

    Executive functioning: A conceptual framework for alcohol-related aggression

    Experimental and Clinical Psychopharmacology

    (2000)
  • P.R. Giancola

    Executive functioning and alcohol-related aggression

    Journal of Abnormal Psychology

    (2004)
  • Cited by (20)

    • History of childhood abuse and alcohol use disorder: Relationship with intermittent explosive disorder and intoxicated aggression frequency

      2020, Journal of Psychiatric Research
      Citation Excerpt :

      In the laboratory, acute intoxication (versus placebo) increases aggressive responding to provocation (e.g., electric shock; Giancola et al., 2009; Gussler-Burkhardt and Giancola, 2005; Hoaken and Pihl, 2000). This link between AUD and intoxicated aggression may be even more salient among those with greater pathology, including more severe AUD symptoms (McMurran et al., 2006) and greater overall aggression (Miller et al., 2016; Tremblay et al., 2008; Giancola et al., 2006; Parrott and Giancola, 2004). However, no study to date has examined how those who engage in pathological levels of aggression may differ on intoxicated aggression, nor how AUD severity may impact this relationship.

    • Reduced frontal grey matter, life history of aggression, and underlying genetic influence

      2018, Psychiatry Research - Neuroimaging
      Citation Excerpt :

      The mPFC has an established role in both social-emotional information processing (Fellows, 2007a, 2007b) and moral decision making (Phan et al., 2002; Walker et al., 2009). Previous reports have also implicated the lPFC in aggressive behavior; although much of the evidence has been indirect, coming from animal lesion studies and studies of executive functioning in antisocial populations (Giancola et al., 2006; Morgan and Lilienfeld, 2000). The lPFC has an important role in two processes underlying the executive function known as cognitive control: 1) representation of conflict; and 2) selective attention (Mansouri et al., 2009).

    • PTSD, alcohol dependence, and conduct problems: Distinct pathways via lability and disinhibition

      2017, Addictive Behaviors
      Citation Excerpt :

      We posit that labile affect will mediate associations between PTSD and dependence syndrome symptoms. Disinhibition has been linked to alcohol use and associated conduct problems (e.g., assault, interpersonal conflict; Carver, 2005; Fernie et al., 2013; Giancola, Parrott, & Roth, 2006; Sher & Trull, 1994; Wills et al., 2013). Disinhibition mediates associations between PTSD and alcohol-related problems (Miller, Vogt, Mozley, Kaloupek, & Keane, 2006), predicts externalizing problems over and above the effects of alcohol consumption (Simons et al., 2009, 2005a), and moderates the relationship between alcohol use and conduct problems, increasing the strength of associations (Neal & Carey, 2007; Simons, Gaher, et al., 2005).

    • Forensic psychology

      2021, Forensic Psychology
    View all citing articles on Scopus

    This research was supported by grant R01-AA-11691 from the National Institute on Alcohol Abuse and Alcoholism.

    View full text