Losing control: Assaultive behavior as a predictor of impulse control disorders in young adults
Introduction
Aggressive behaviors such as physical assaults and destruction of property are common among young people. Research focusing on adolescents has found that approximately one-third (32.8%) of high school students have been involved in at least one physical fight in the past twelve months [1]. Assaultive behavior and destruction of property among adolescents have been found to be associated with substance use [2], [3], [4], poor academic performance, smoking, earlier age at first sexual intercourse, and risky sexual behavior [5]. Previous research on aggression and specifically intermittent explosive disorder (IED), has noted the both types of physical aggression are common, suggesting that it is suitable to collapse general discussions of physical aggression across the two [6], [7], [8].
The health and social problems associated with assaultive behavior, however, are not limited to high school aged students. US crime reports show that public university campuses accounted for 1314 cases of aggravated assault alone during 2012 [9]. Similar to high school students, adults with histories of assaultive behavior appear to be at higher risk for a range of mental health and substance use disorders [10], [11]. While universities appear aware of the problems associated with assaultive behavior [12], our understanding of young adults enrolled in college who commit assaultive acts remains incomplete.
One area that has yet to be explored is assaultive behavior's potential interaction with impulse control disorders, such as pathological skin picking and gambling disorder. Since assaultive behavior in many individuals may be conceptualized as a problem with impulse control [13], one would hypothesize that assaultive behavior may be associated with a variety of other impulsive behaviors. For example, there is currently a growing body of literature demonstrating that young people with gambling problems are more likely to engage in serious physical fights as well as perpetrate violence in relationships [14], [15], [16]. Less is understood, however, about the relationship between assaultive behavior and other disorders of impulse control. To address an existing gap in knowledge, we examined university survey data to investigate the relationship of impulse control disorders in young adults who acknowledged a history of assaultive behaviors. Previous studies have noted the incidence rates of assaultive behavior in select areas, such as problem gambling [14], [15], [16], but no studies have looked at assaultive behavior as a general predictor for other impulse control disorders.
Rather than replicate epidemiological results from previous research, the present study sought to identify assaultive behavior as a risk factor for various other impulse control disorders and determine whether assaultive behavior had any predictive ability for a specific sub-group of impulse control disorders. We hypothesized that young adults with a previous lifetime assaultive incident would be more likely to endorse symptoms consistent with a range of DSM-IV impulse control disorders and, consistent with existing adolescent data [16], score lower on general health and functional measures.
Section snippets
Subjects
The Psychiatry Department and Student Health Center at a large Midwestern university collaborated to develop the College Student Computer User Survey (CSCUS) to assess mental and physical health in a large sample of college students. The CSCUS used questions from a number of different clinically validated screening tools to examine mental health, stress, quality of life, general physical health, and specific demographic information. All study procedures were carried out in accordance with the
Results
From the initial 6000 students invited to participate in the survey, 2108 completed the survey (35.1%). Of these students, only those who completed all relevant sections were included in the statistical analysis, yielding a final sample of 1845 (n = 989; 53.6% female) students. The mean age of the entire sample was 22.6 ± 5.07 (age range: 18–58, with 2% over the age of 40). This demographic information is reflective of the university's overall student population, as the online survey was sent to
Discussion
This study is one of few to address a potential association between assaultive behavior and impulse control disorders. The overall prevalence of lifetime assaultive behavior in this study of young adults found that 5.9% had assaulted someone or destroyed property during their life. Although the rate of perpetrating assaultive behavior in college students in this study is slightly lower than that reported in adolescents (9.8% with serious fighting histories, although the Slavin et al article
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Funding: Internal funds.
Conflicts of Interest: Dr. Grant has research grants from National Center for Responsible Gaming, Forest Pharmaceuticals and Roche Pharmaceuticals. He receives yearly compensation from Springer Publishing for acting as Editor-in-Chief of the Journal of Gambling Studies and has received royalties from Oxford University Press, American Psychiatric Publishing, Inc., Norton Press, and McGraw Hill. Mr. Odlaug has received research funding from the Trichotillomania Learning Center, has consulted for Lundbeck Pharmaceuticals, and receives royalties from Oxford University Press. Dr. Christenson receives royalties from American Psychiatric Publishing Inc, and New Harbinger Publications. Dr. Lust reports employment at Boynton Health Services. Ms. Derbyshire and Mr. Leppink report no financial relationships with commercial interest.