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Tijdschrift voor Psychiatrie 47 (2005) 8, 533 - 542

Review article

Impulsive violent behaviour: a review of the literature

R.C. Brouwers, M.T. Appelo, T.I. Oei

background Impulsive violent behaviour occurs frequently in our society and is a major feature in a number of psychiatric diagnoses.
aim To obtain answers to the following questions. Which neurobiological, cognitive and socio- psychological factors are connected with impulsive violent behaviour? Is this behaviour a separate psychopathological phenomenon? And particularly, is there evidence of sudden increase in arousal in relation to impulsive violent behaviour?
method We reviewed the literature on neurological, cognitive and socio-psychological aspectsof impulsive violent behaviour. We used Pubmed, Medline, Psychinfo, Online Contents, Winspirs and the Cochrane database. The main search terms that we used were 'violence', 'aggression' and 'impulsiveness'. These were combined with terms as 'arousal', 'cognition', 'hostility'.
results There are several factors that we associated with impulsive violent behaviour, but none of these factors discriminated such behaviour. There is some evidence for regarding impulsive violent behaviour in reaction to provocation as a separate psychopathological syndrome. Our theory about the relationship between impulsive violent behaviour and a sudden increase in arousal has acquired a basis for further investigation.
conclusion Impulsive violent behaviour should be regarded as a separate psychopathological syndrome. It is related to a complex risk-profile, the neurobiological core of which seems to be an arousal 'jump' upon provocation. Further research will be needed in order to demonstrate which combination of risk factors will differentiate between various groups of persons who show this impulsive violent behaviour.

keywords arousal, impulsive behaviour, review, violence