Cortical thinning, functional connectivity, and mood-related impulsivity in schizophrenia: relationship to aggressive attitudes and behavior
Open accessAbstract
OBJECTIVE: Aggression in schizophrenia is a major societal issue, leading to physical harm, stigmatization, patient distress, and higher health care costs. Impulsivity is associated with aggression in schizophrenia, but it is multidetermined. The subconstruct of urgency is likely to play an important role in this aggression, with positive urgency referring to rash action in the context of positive emotion, and negative urgency referring to rash action in the context of negative emotion. METHOD: The authors examined urgency and its neural correlates in 33 patients with schizophrenia or schizoaffective disorder and 31 healthy comparison subjects. Urgency was measured using the Urgency, Premeditation, Perseverance, and Sensation-Seeking scale. Aggressive attitudes were measured using the Buss-Perry Aggression Questionnaire. RESULTS: Positive urgency, negative urgency, and aggressive attitudes were significantly and selectively elevated in schizophrenia patients (Cohen's d values, 1.21-1.50). Positive and negative urgency significantly correlated with the Aggression Questionnaire total score (r>0.48 in all cases) and each uniquely accounted for a significant portion of the variance in aggression over and above the effect of group. Urgency scores correlated with reduced cortical thickness in ventral prefrontal regions including the right frontal pole, the medial and lateral orbitofrontal gyrus and inferior frontal gyri, and the rostral anterior cingulate cortex. In patients, reduced resting-state functional connectivity in some of these regions was associated with higher urgency. CONCLUSIONS: These findings highlight the key role of urgency in aggressive attitudes in people with schizophrenia and suggest neural substrates of these behaviors. The results also suggest behavioral and neural targets for interventions to remediate urgency and aggression.
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In patients with schizophrenia, the construct of urgency correlated strongly with aggression, and was inversely correlated with functional connectivity in a cortical circuit believed to modulate impulsivity.
“in patients with schizophrenia, in whom the construct of “urgency”, defined as the tendency to act rashly in the context of positive or negative emotion, correlated strongly with aggression, and was inversely correlated with functional connectivity in a cortical circuit believed to modulate impulsivity (Hoptman et al., 2014)”
From Mood and anxiety regulation by nicotinic acetylcholine receptors: A potential pathway to modulate aggression and related behavioral states (2015) · cites this paper as Hoptman et al., 2014
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- Authors
- Hoptman, M. J., Antonius, D., Mauro, C. J., Parker, E. M., & Javitt, D. C.
- Affiliations
- Nathan Kline Institute for Psychiatric Research (US)
- Corresponding author
- Hoptman, Matthew J.
- Venue
- American Journal of Psychiatry
- Published
- 2014-09
- Volume
- 171
- Issue
- 9
- Pages
- 939-948
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC4178944
- OpenAlex
- W2170932549
- Cited by
- 152
- References
- 46
- Citations by year
- 2026: 2 · 2025: 12 · 2024: 16 · 2023: 7 · 2022: 16 · 2021: 7 · 2020: 14 · 2019: 23 · 2018: 10 · 2017: 15 · 2016: 16 · 2015: 12 · 2014: 2
- FWCI
- 11.45
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (P50MH086385, R01MH049334, R21MH084031)
- National Center for Research Resources (S10RR022972)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- schizophrenia, aggression, impulsivity, urgency, positive urgency, negative urgency, aggressive attitudes, cortical thinning, resting-state functional connectivity, ventral prefrontal cortex, orbitofrontal cortex, rostral anterior cingulate cortex, Aggression Questionnaire, schizoaffective disorder
- MeSH terms
- Adult, Aggression, Female, Gyrus Cinguli, Humans, Impulsive Behavior, Magnetic Resonance Imaging, Male, Middle Aged, Psychiatric Status Rating Scales, Psychological Tests, Psychotic Disorders, Schizophrenia, Schizophrenic Psychology, Statistics as Topic, Prefrontal Cortex
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