Predictors for self‐directed aggression in Italian prisoners include externalizing behaviors,childhood trauma and the serotonin transporter gene polymorphism 5‐HTTLPR |
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| Authors: | E Gorodetsky V Carli M Sarchiapone A Roy D Goldman M‐A Enoch |
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| Affiliation: | 1. Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, NIH, Rockville, MD, USA;2. Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy;3. National Center for Suicide Research and Prevention of Mental Ill‐Health (NASP), Karolinska Institutet, Stockholm, Sweden;4. National Institute of Health for Migration and Poverty, Rome, Italy;5. Veterans Affairs Medical Center, Psychiatry Service, East Orange, NJ, USA |
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| Abstract: | Suicidal behavior and self‐mutilation can be regarded as the expression of self‐directed aggression and both are common in prison populations. We investigated the influence of externalizing behaviors, depressive symptoms, childhood trauma, 5‐HTTLPR variants on self‐directed aggression (N = 145) in a group of 702 male Italian prisoners. Participants were comprehensively evaluated, including for psychiatric disorders, impulsive traits, lifetime aggressive behavior Brown‐Goodwin Lifetime History of Aggression (BGHA)], hostility, violent behavior during incarceration, depressive symptomatology Hamilton Depression Rating Scale (HDRS)], childhood trauma Childhood Trauma Questionnaire (CTQ)]. Logistic regression analysis showed false discovery rate corrected independent main effects of externalizing behaviors: BGHA (P = 0.001), violent behavior in jail (P = 0.007), extraversion (P = 0.015); HDRS (P = 0.0004), Axis I disorders (P = 0.015), CTQ (P = 0.004) and 5‐HTTLPR genotype (P = 0.02). Carriers of 5‐HTTLPR high (LALA), intermediate (LALG, SLA) activity variants were more likely to have exhibited self‐directed aggression relative to the low activity (LGLG, SLG, SS) variant: high/low: odds ratio (OR) = 2.3, 95% confidence interval (CI) 1.27–4.68, P = 0.007; intermediate/low: OR = 1.96, 95% CI 1.09–3.68, P = 0.025. The CTQ main effect was driven by physical abuse. There was no interactive effect of 5‐HTTLPR and CTQ. Secondary logistic regression analyses in (1) all suicide attempters (N = 88) and (2) all self‐mutilators (N = 104), compared with controls showed that in both groups, childhood trauma (P = 0.008–0.01), depression (P = 0.0004–0.001) were strong predictors. BGHA, violent behavior in jail predicted self‐mutilation (P = 0.002) but not suicide attempts (P = 0.1). This study was able to distinguish differing influences on self‐directed aggression between groups of closely related predictor variables within the externalizing behavioral domain. 5‐HTTLPR had an independent, variant dosage effect. |
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| Keywords: | 5‐HTTLPR genotype BGHA childhood trauma CTQ externalizing behaviors extraversion prisoners self‐directed aggression self‐mutilators serotonin transporter gene polymorphism suicide attempters |
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