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Correlates With Aggression and Serotonin Function in Personality-Disordered Subjects

Emil F. Coccaro, MD; Richard J. Kavoussi, MD; Richard L. Hauger, MD; Thomas B. Cooper, MA; Craig F. Ferris, PhD

Arch Gen Psychiatry. 1998;55:708-714.

Background  Animal studies suggest that central vasopressin plays a facilitatory role in aggressive behavior. To examine this possibility in humans, the relationship between cerebrospinal fluid (CSF) arginine vasopressin (AVP) and indices of aggression and central serotonin system function was examined in personality-disordered subjects.

Methods  We used CSF (AVP), CSF 5-hydroxyindoleacetic acid, and the prolactin response to d-fenfluramine challenge (PRL[d-FEN]) as central indices of vasopressin and serotonergic system function, respectively, in 26 subjects who met the DSM-IV criteria for personality disorder. Measures of aggression and impulsivity included the Life History of Aggression assessment and the Barratt Impulsiveness Scales.

Results  The CSF AVP level was correlated directly with life history of general aggression and aggression against persons and inversely with PRL[d-FEN] responses (but not with CSF 5-hydroxyindoleacetic acid), which in turn was correlated inversely with these 2 measures of life history of aggression. The positive relationship between CSF AVP and life history of aggression remained even when the variance associated with PRL[d-FEN] responses in these subjects was accounted for.

Conclusion  Central AVP may play a role in enhancing, while serotonin plays a role in inhibiting, aggressive behavior in personality-disordered individuals. In addition to the possibility of central AVP and serotonin interacting to influence human aggression, central AVP may also influence human aggressive behavior through a mechanism independent of central serotonin in personality-disordered subjects.

From the Clinical Neuroscience Research Unit, Department of Psychiatry, MCP-Hahnemann School of Medicine, Philadelphia, Pa (Drs Coccaro and Kavoussi); Department of Psychiatry, University of California at San Diego (Dr Hauger); Nathan Kline Institute, Orangeburg, NY (Mr Cooper); New York State Psychiatric Institute, New York (Mr Cooper); and Department of Psychiatry, University of Massachusetts School of Medicine, Worcester (Dr Ferris).

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