Abstract
Human studies of the link between serum cholesterol and aggression have yielded equivocal results. Depending on the type of aggression studied (e. g., criminal violence or Type A hostility), investigators have found either a negative or a positive association between cholesterol and aggressive behavior. We conducted a retrospective analysis of aggressive incidents in a sample of hospitalized male forensic patients. The whole sample had lower cholesterol levels than the general population. Patients with low cholesterol levels (<200 mg/dl) engaged in more frequent aggressive behavior but showed no difference in severity of aggression. They also showed no difference in verbal vs physical aggression. The relationship between cholesterol and frequency of aggression was curvilinear, with the most frequent acts of aggression committed by patients with moderately low cholesterol levels. Current research findings regarding the cholesterol-aggression association suggest the need for further clarification of the behavioral parameters under investigation.
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References
Adler, T. (1993). Researchers sing low cholesterol blues.APA Monitor April: 14–15.
Brown, S. L., Botsis, A., and van Praag, H. M. (1994). Serotonin and aggression. In Hillbrand, M. (ed.),Psychobiology of Aggression, Haworth Press, Binghamton, NY.
Coccaro, E. F., and Astill, J. L. (1990). Central serotonergic function in parasuicide.Prog. Neuro-Psychopharmacol. Biol. Psychiat. 14: 663–674.
Epstein, F. H. (1993). Low serum cholesterol and death due to accidents, violence, or suicide.Lancet 34: 1150.
Expert Panel (1988). Report of the National Cholesterol Education Program on detection, evaluation and treatment of high blood cholesterol in adults.Arch. Inten. Med. 148: 36–39.
Friedman, M., Rosenman, R. H., and Carroll, V. (1958). Changes in the serum cholesterol and blood clotting time in men subjected to cyclic variation of occupational stress.Circulation 17: 852–861.
Gray, R. F., Corrigan, F. M., Strathdee, A., Skinner, E. R., van Rhijn, A. G., and Horrobin, D. F. (1993). Cholesterol metabolism and violence: A study of individuals convicted of violent crimes.NeuroReport 4: 754–756.
Harvard Heart Letter (1993).Cholesterol Levels Continue to Fall in U.S., HHL, Boston, MA.
Hawton, K., Cowen, P., Owens, D., Bond, A., and Elliott, M. (1993). Low serum cholesterol and suicide.Br. J. Psychiat. 162: 818–825.
Hillbrand, M., and Foster, H. G. (1993). Serum cholesterol and severity of aggression.Psychol. Rep. 72: 270.
Hillbrand, M., Krystal, J. H., Sharp, K., and Foster, H. G. (1994). Clinical predictors of self-mutilation in hospitalized forensic patients.J. Nerv. Ment. Dis. 182: 9–13.
Jorgensen, R. S., Nash, J. K., Lasser, N. L., Hymowitz, N., and Langer, A. W. (1988). Heart rate acceleration and its relationship to total serum cholesterol, triglycerides, and blood pressure reactivity in men with mild hypertension.Psychophysiology 25: 39–44.
Kaplan, R. M., Manuck, S. B., and Shumaker, S. (1992). Does cholesterol lowering cause increases in depression suicide and accidents? In Friedman, H. S. (ed.),Hostility, Coping & Health, American Psychological Association, Washington, DC, pp. 117–123.
Kaplan, J. R., Manuck, S. B., and Shivley, C. (1991). The effects of fat and cholesterol on social behavior in monkey.Psychosom. Med. 53: 634–642.
Kay, S. R., Wolkenfeld, F., and Murrill, K. M. (1988a). Profiles of aggression among psychiatric patients.J. Nerv. Ment. Dis. 176: 539–546.
Kay, S. R., Wolkenfeld, F., and Murrill, L. M. (1988b). Profiles of aggression among psychiatric patients.J. Nerv. Ment. Dis. 176: 547–557.
Lundberg, V., Hedman, M., Melin, B., and Frankenhaeuser, M. (1989). Type A behavior in healthy males and females as related to physiological reactivity and blood lipids.Psychosom. Med. 51: 113–122.
Muldoon, M. F., Manuck, S. B., and Matthews, K. A. (1990). Lowering cholesterol concentrations and mortality: A quantitative review of primary prevention trials.Br. Med. J. 301: 309–314.
Muldoon, M. F., Kaplan, J. R., Manuck, S. B., and Mann, J. J. (1992). Effects of a low-fat diet on brain serotonergic responsivity in cynomolgus monkeys.Biol. Psychiat. 31: 739–742.
Peer, D. A., and Stoukides, C. A. (1992). Association of low cholesterol and aggression.Ann. Pharmacother. 26: 785–786.
Rao, U., Carlson, G. A., and Rapport, M. D. (1991). Serum cholesterol and aggressive behavior in psychiatrically hospitalized children.Acta Psychiat. Scand. 83: 77–78.
Ratey, J. J., and Gutheil, C. M. (1991). The measurement of aggressive behavior.J. Neuropsychiat. Clin. Neurosc. 3(Suppl.): 57–60.
Schuit, A. J., Dekker, J. M., Schouten, E. G., and Kok, F. J. (1993). Low serum cholesterol and death due to accidents, violence, or suicide.Lancet 341: 827.
Silver, J. M., and Yudofsky, S. C. (1987). Documentation of aggression in the assessment of the violent patient.Psychiat. Ann. 17: 375–384.
Silver, J. M., and Yudofsky, S. C. (1991). The Overt Aggression Scale: Overview and guiding principles.J. Neuropsychiat. Clin. Neurosci. 3(Suppl.): 22–29.
Spitz, R. T., Hillbrand, M., and Foster, H. G. (1994). Serum cholesterol levels and frequency of aggression.Psychol. Rep. 74: 622.
Suarez, E. C., Williams, R. B., Kuhn, C. M., Zimmerman, E. H., and Schanberg, S. M. (1991). Biobehavioral basis of coronary-prone behavior in middle-aged men. II. Serum cholesterol, the Type A behavior pattern, and hostility as interactive modulators of physiological reactivity.Psychosom. Med. 53: 528–537.
Virkkunen, M. (1979). Serum cholesterol in antisocial personality.Neuropsychobiology 5: 27–30.
Virkkunen, M. (1983). Serum cholesterol levels in homicidal offenders.Biol. Psychiat. 10: 65–69.
Virkkunen, M., and Penttinen, H. (1984). Serum cholesterol in aggressive conduct disorder: A preliminary study.Biol. Psychiat. 19: 435–439.
Virkkunen, M., Horrobin, D. F., Jenkins, D. K., and Manku, M. S. (1987). Plasma phospholipid essential fatty acids and prostaglandins in alcoholic, habitually violent, and impulsive offenders.Biol. Psychiat. 22: 1087–1096.
Weidner, G., Sexton, G., McLellern, R., Connor, S. L., and Matarazzo, J. D. (1987). The role of Type A behavior and hostility in an elevation of plasma lipids in adult men and women.Psychosom. Med. 49: 136–145.
Weidner, G., Connor, S. L., Hollis, J. F., and Connor, W. E. (1992). Improvements in hostility and depression in relation to dietary change and cholesterol lowering.Ann. Intern. Med. 117: 820–823.
Wysowski, D. K., and Gross, T. P. (1990). Deaths due to accidents and violence in two recent trials of cholesterol-lowering drugs.Arch. Intern. Med. 150: 2169–2172.
Yudofsky, S. C., Silver, J. M., Jackson, W., Endicott, J., and Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression.Am. J. Psychiat. 143: 45–49.
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Hillbrand, M., Spitz, R.T. & Foster, H.G. Serum cholesterol and aggression in hospitalized male forensic patients. J Behav Med 18, 33–43 (1995). https://doi.org/10.1007/BF01857703
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DOI: https://doi.org/10.1007/BF01857703