violent impulsive behavior
Introduction
Introduction Impulsive behavior refers to an act that suddenly occurs and usually causes adverse consequences; a violent behavior refers to an act that intentionally causes damage to property or other person's body and mind. The attacking object may be itself, another person, or an object. Attacks on others include physical and sexual attacks that can cause injury, disability, and death. Attacks on objects can cause economic losses. In addition to the specific behaviors that appear, impulsive and violent tendencies can be expressed as potential behaviors, such as threatening speech or gestures. WHO (2002) has a broader definition of violence: Threats to use or have deliberately used force or power against themselves, others, a specific group of people or a particular society, causing or highly likely to cause injury, death, Psychological injury, deformity or living conditions are deprived." The global mortality rate associated with violence in 2000 was estimated at 28.8 people per 100,000. Violent impulsive behavior is not a mental symptom in nature. Normal people can also do it. The violent impulsive behavior caused by psychological or mental disorders reflects the attack drive under the disorder of values. The high-risk groups of such behaviors are mostly Psychiatric patients, substance abusers and patients with personality disorders. Moreover, victims of violence are also prone to psychological behavior problems. Therefore, violent impulsive behavior is one of the situations in which psychiatric emergency treatment is required. It should be pointed out that most people with mental disorders do not have violent impulsive behavior. Statistics on violence involving mentally ill patients are often repeated violence by very few patients.
Cause
Cause
The occurrence of this disease is an unacceptable response to an obvious situational change or a stressful life event, or a life adaptation disorder caused by a serious physical illness.
Examine
an examination
Related inspection
EEG check EEG sharp wave
Psychiatric symptoms associated with violent impulsive behavior include: delusions, logical barriers of thinking, hallucinations, pathological passions, disturbances of consciousness, etc., among which delusions are most common. Specific types of behavior include: deaf or screaming, verbal threats, attacks on property, and attacks on other people's bodies. The attack targets are most relatives, followed by close friends, acquaintances, colleagues, and neighbors. Patients generally have a hostile attitude towards the victim beforehand.
Diagnosis
Differential diagnosis
Differential diagnosis of violent impulsive behavior:
(1) Schizophrenia:
It is generally believed that the impulses and violent acts of schizophrenia occur under the influence of hallucinations or delusions, in which the most common thoughts of victimization are followed by fear of self-defense; followed by delusions and imperative auditory hallucinations; Impulsive and violent behavior is caused by psychotic disorders and psychomotor excitement. Symptoms are obvious and the diagnosis of schizophrenia is easy to make.
(2) Mood disorders:
People with mania can have impulsive and violent behaviors, which are common in acute mania. Patients are unsatisfied due to increased irritability, and their activities are limited. Depressed patients can have a pity murder, that is, they are afraid of their sins and their loved ones or their own children. After the death of the children, they will kill the loved ones (usually young children) and then commit suicide. Expand sexual suicide. Depression can also lead to indirect suicide, that is, by murder to achieve the purpose of sentenced to death.
The diagnosis of mania with impulsive and violent behavior is not difficult, because the symptoms of mania are easily recognized. Depressive violent behavior is easily misdiagnosed as schizophrenia, which needs to be carefully identified. It is found that the group of depressive symptoms is the key to differential diagnosis.
(3) Organic mental disorders:
Brain organic disorders, whether acute (such as sputum, head trauma) or chronic (such as dementia), can cause impulsivity and violence. Often characterized by suddenness, turbulence, volatility, and sudden disappearance, may be due to decreased patient judgment or disturbance of consciousness or pathological passion. Among them, epileptic mental disorders can cause impulsivity and violence when consciousness is blurred, while patients with epilepsy personality changes are prone to impulsivity and violence due to stubbornness and vengeance. Violent behaviors such as hypoxia and hyperthyroidism can also occur in medical conditions. In general, this behavior is parallel to the primary somatic symptoms.
(4) Abuse of psychoactive substances:
Substance abuse of amphetamines, cocaine, alcohol, etc. is often associated with violent attacks, especially when abstinence. The lifetime chance of violent behavior among alcohol-dependent people is 46.5%, which is more than 10 times higher than that of normal people. When drunk, the patient is in a state of "de-suppression". The patient's emotional instability, impaired judgment, weakened control, and easy to lead to impulsive and violent behavior. Sudden abstinence can cause the patient to be irritated or embarrassed, prone to impulsive and violent behavior. Impulsive and violent behaviors of substance-dependent patients often occur when craving for drugs or drugs are rejected. Excessive cocaine can cause madness and serious violence. A long history of alcohol abuse or a history of drug use can help diagnose the disease.
(5) Mental retardation:
Patients usually have a naive judgment and understanding of things, lack of coping skills, and poor impulsive control. If they are in a state of stress, they can produce impulsive and violent behavior. The patient's attack is usually unplanned and unpredictable; but the attacker is more directed at the object. It is not difficult to diagnose.
(6) Personality disorder:
The lifetime chance of violent behavior in antisocial personality disorder is 50.1%, which is higher than that of material dependent, while the latter often incorporates personality problems. One of the diagnostic criteria for antisocial personality disorder is poor control of violent attacks. People with borderline personality disorder are also prone to impulsive attacks, but their attacks tend to point to themselves as a means of manipulating others.
(7) Paranoid psychosis:
Patients may be attacked by their imaginary person, such as their spouse or loved one. The systemicity and content of the delusion and the relative integrity of the personality are the characteristics of such mental illness.
(8) Domestic violence:
Mainly spousal abuse and child abuse. This type of husband is characterized by low self-evaluation and contradictions with his wife in terms of economy and sex.
