Violence and violent behaviour continue to plague societies, especially in the developing world. Latin America and the Caribbean is a region with some of the highest per capita rates of violent acts, both toward persons and property. Why is this so?
Recent studies suggest that risk factors which increase the chance of becoming addicted to substances also increase the risk of engaging in violent behaviour. These include being brought up in homes where there is marital instability, homes in which members had chronic mental health problems and where one or both parents had criminal records. None of these are mutually exclusive and may reflect an overriding genetic risk made manifest in different ways.
A social atmosphere of violence, benign tolerance and lax law enforcement also contribute to the social facilitators of violent behaviour. Substance use is a great predictor. One study in the United States suggested that alcohol use was the single greatest predictor of violent behaviour among adults.
Studies of violent behaviour found many contributing factors to violence. These have been identified as predisposing though not necessarily predicting violent behaviour. They may be categorized as follows:
- Socioeconomic
- Psychological
- Psychiatric
- Familial
- Cognitive
Socioeconomic
There is a high correlation between lower socioeconomic class and violent behaviour. People who come from poorer backgrounds are overrepresented in the serious offender population and it has been shown that socioeconomic deprivation at age eight is one of the best predictors of adolescent delinquency. For some children, exposure to violence in their community, also correlated with socioeconomic status, was a reliable predictor of their own violence. This has not been a consistent finding and may be mediated by other factors.
Socioeconomic deprivation is also associated with substance abuse and drug users tend to fight more, including committing assaults after drinking alcohol.
Psychological
Some personality traits are particularly associated with violence. They include high degrees of impulsivity, decreased empathy and an external locus of control. An external locus of control refers to functioning with a sense that the factors that influence the course of one’s life are located outside of oneself. It creates a tendency to blame others for one’s situation without taking enough personal responsibility.
Early aggressiveness and conduct disorder are associated with later violent offending and specific antisocial acts such as fire-setting and cruelty indicate later dangerousness. Predictors of these personality traits include experience of childhood abuse and exposure to chaotic home and community environments.
 Psychiatric
Some psychiatric disorders influence violence. While psychotic illness in not overrepresented in the violent population, violence is frequent in the psychotic population when compared to other psychiatric sub groups. One study found that all homicidal adolescents interviewed fulfilled DSM-III criteria for a major depressive episode. Also, youths exposed to family or street violence may suffer from Post-Traumatic Stress Disorder (PTSD). This may contribute to violent behaviour, as discussed in the sections on socioeconomic status and familial factors. Developmental conditions such as Attention Deficit Hyperactvitiy Disorder (ADHD) are also associated with an increased risk of aggression and violence likely related to the increased impulsivity seen in these conditions. Hyperactivity alone is a risk factor for later aggression and delinquency.
Familial
Developmental impairment is the strongest predictor of violent behaviour in adolescence and adulthood. The factors influencing this impairment include severe marital discord, large family size, paternal criminality, maternal mental disorder and foster placement. Mental disorder, marital discord and paternal criminality may indicate underlying biological predisposition, passed on through genes as well as developmental experience.
While no one factor in particular predicted impairment, the more that were present indicated a greater chance of developmental impairment. Social and psychological developmental impairment is usually consistent with violence.
It seems that maladaptive parenting and childhood maltreatment—potential consequences of the above factors—affect the risk of violence. This may be mirrored by an elevated risk for interpersonal difficulties in relationships at every level.
Cognitive
Interestingly, in all the mentioned studies, some reference was made to improper cognitive functioning. Cognition is the process of thinking and learning. It is involved in decision-making and problem-solving. Cognitive skills include a range of skills, like IQ, language ability, non-verbal communication, critical thinking, reasoning and problem-solving. It also refers to some social skills, such as appropriate emotional reactions, ability to interpret situations, and ability to assign emotions (accurately) to others.
Limited intelligence (low IQ) has been associated with poor problem-solving skills, poor social skills, and risk for aggression and violence. IQ scores for delinquent youth is approximately eight points lower than the general population, after being corrected for race, family size and economic status. Low levels of abstract and moral reasoning as well as inappropriate interpretation of others’ behaviours correlate with violent behaviour in youth.
In terms of cognitive disorders, a clear correlation has been established between the presence of an educational disability, school failure and subsequent criminal behaviour. Educational disabilities occur as a result of cognitive deficits and while not all disabled youth are delinquent, school failure and educational disabilities significantly increase the risk for involvement with the courts and for incarceration.
Another finding for those who exhibit aggressive, delinquent or violent behaviour is their tendency to make cognitive misattributions and to have impaired social judgement. Specifically, violent individuals are more likely to label neutral cues in their environment as hostile, thus increasing the likelihood that they will react aggressively to a particular situation. Males with restlessness and concentration difficulties were five times more likely to be arrested for violence than boys without these characteristics.
Indirectly, cognitive deficits influence other factors (such as psychiatric disorders and drug abuse). Improved cognitive skills can help an individual cope with other factors (such as familial and socioeconomic factors), and contribute to an increased propensity to resolve difficult and violence-inducing situations.
Outcomes of Violence
While there are many predictors of violent behaviour, violence itself has been found to predict more serious problems in the lives of those who exhibit it. The obvious consequence is the risk of incarceration and a criminal record. In addition, there is a greater chance of becoming unemployed, being separated from family and becoming socially ostracised. In younger people, it is likely to decrease educational progress and facilitate criminal activity.
There is an intricate relationship between substance use, crime and incarceration. Numerous studies have found relationships among the three, so that the prevalence of substance use is a predictor of criminal behaviour and vice versa, and the presence of either is a predictor of adult incarceration. Societies with high levels of violence have co-existing high levels of substance use and abuse. International multi-country research found exposure to violence in a variety of settings to be a significant predictor of later substance use in adolescents. This study controlled for any violence that the subjects were exhibiting, and so shows the effect that violence can have on young people who are not directly involved in violent behaviour. Violence that begins in schools is also a predictor of future criminal behaviour and there is evidence that this future criminal behaviour can be prevented through curbing it in schools. An important component of this process is the reduction of bullying. Bullying is also a predictor of criminal behaviour, as well as other negative outcomes such as depression and suicide for both perpetrators and victims.
Domestic violence in adulthood has numerous predictors, but being constantly exposed to violence as a means of conflict resolution creates the basis for an increased tendency to be violent in intimate relationships. This is in addition to the risk factors listed above; the most powerful of which is alcohol use. Children exposed to repeated domestic violence are more likely to engage in bullying and more overt violent behaviour in schools.
Recent evidence suggests that suicidal behaviour can emerge in individuals who are constantly exposed to violence and are therefore more likely to be aggressive. Risk factors for suicide include both victimisation and perpetration of violence.
Apart from the contribution to general social malaise, the impact of increased violence in a society falls on every member of that society. It affects how people perceive their environment, affects the business and industrial climate and the developmental trajectory of the younger population. To address it requires a multidisciplinary response incorporating mental health and social scientists, perhaps more necessarily than legal and law enforcement input.
This is the final of a six-part series on mental health issues by Professor of Psychiatry, Gerard Hutchinson. Professor Hutchinson is the head of Department, Clinical Medical Sciences, School of Medicine, Faculty of Medical Sciences, EWMSC, UWI. |
