The Cycle of Alcohol Addiction National Institute on Alcohol Abuse and Alcoholism NIAAA

A careful assessment, leading to a correct diagnosis, optimizes treatment selection. Clozapine appears to be more effective than other antipsychotics in reducing aggressivity in patients with schizophrenia or schizoaffective disorder. A case of posttraumatic belligerence (patient described as “extremely hostile, argumentative, impulsive, and threatening”) was successfully managed with buspirone, which was started several months after the head injury. The current interest in the role of certain antidepressants in aggression treatment is based on the crucial role of serotonergic regulation of impulsive aggression against self and others. Antidepressants with specific effects on serotonin receptors are now available. In summary, patients with acute agitation first must be assessed for the possibility of comorbid conditions.

Excess norepinephrine is hypothesized to contribute to hyperarousal states such as agitation and panic. Dexmedetomidine acts on the alpha-2 autoreceptor, thus decreasing norepinephrine release in the locus coeruleus. Another study that explored the impact of alcohol consumption on facial recognition found that individuals with alcohol use disorder exhibited a bias toward misidentifying emotional facial expressions as hostile or disgusted (Freeman et al., 2018). Interestingly, those in the control group tended to misidentify expressions as happy. Spousal abuse is a concern among adults, not only for the physical toll it can take but also for the emotional trauma involved. Although both genders can commit spousal abuse, men are responsible for a majority of incidents.

Treatment – Management of Acute Agitation/Aggression

Mentally, individuals may not know where they are and may become highly emotional whether meaning affectionate or aggressive. Physical signs of alcohol impairment include indifference to pain and dizziness and staggering along with the symptoms from the previous excitement stage of intoxication. Those in the confusion stage can experience “Blacking out” meaning that they may lose memory of the chain of events that took place while intoxicated. Another double-blinded placebo-controlled study of adjunctive nadolol in 30 violent inpatients, of whom 23 were schizophrenic, found a trend towards lower hostility for the active treatment group. Nadolol was as effective as propranolol in suppressing aggressive behavior in a patient who was had intellectual disabiilty and who received a separate trial of each of these 2 agents. Metoprolol, a selective beta-adrenergic receptor blocker, was effective in 2 cases of intermittent explosive disorder and 2 cases of intellectual disability.

Furthermore, evidence also shows that the convergence of men and women has usually been stronger in the age group of young adults in comparison to any other age group (Wilsnack et al., 2018). Data from 2006 to 2018 indicate that both the men and women increasingly in which stage of intoxication does an individual become aggressive binge drink; in women, the largest increase was found in the age group 30–44 years without children (Sarah and Keyes, 2019). Alcohol intoxication refers to a temporary condition that occurs when a person drinks an excess of alcohol at one time.

Effects of Alcohol (Blood Alcohol Concentration or BAC)

In many species, the serotonergic system is involved in the modulation of aggressive behavior. A disturbance of this system has been implicated in impulsive violence in humans. Impulsive violent behavior may be directed against others or against oneself.

Emotional states such as anger, frustration, and hostility are said to lead an individual to perform expressive murders. In this context, alcohol is said to be the credible factor leading to emotional loss and instability and eventually leading to expressive-based murders. A national study of 16,698 inmates found that alcohol had a stronger role in violent offending such as homicide, physical assaults, and sexual assaults compared to offenses such as burglary and robbery.

Observation of couple conflicts: Clinical assessment applications, stubborn truths, and shaky foundations

Postpartum nurses can instruct parents about proper parenting skills and the importance of breastfeeding. However, there is conflicting evidence about whether breastfeeding protects against behavior problems or not (Kramer, 2010; Kramer et al., 2008; Oddy et al., 2010). Although not directly classified in the DSM-IV, it can fall under the category of Intermittent Explosive Disorder.