Şiddet ve Agresyonun Nörobiyolojik, Psikososyal ve Çevresel Nedenleri

Psikiyatrinin klinik uygulamalarında psikotik bozukluklar, mani, madde ve alkol kullanım bozuklukları, antisosyal ve borderline kişilik bozuklukları, dikkat eksikliği hiperaktivite bozukluğu, davranım bozukluğu, mental retardasyon, organik beyin sendromu, deliryum, stereotipik hareket bozuklukları, trikotillomani, yeme bozuklukları ve diğer obsesif-kompülsif spektrum bozuklukları, yaygın gelişimsel bozukluklar, major depresif bozukluk, karma epizodlar kişinin çevresine, diğer kişilere ve kendine yönelttiği agresyonla yakından ilişkilidir. İntiharda olduğu gibi, agresyon ve şiddet her zaman belirgin bir psikopatoloji ile ilişkili olmayabilir. Fakat şiddet ve agresyon suçla yakından ilişkilidir. Belli toplumlarda özellikle törensel kendine yönelik şiddet davranışları kültürel olarak normal algılanabilir. Cinsiyet, mizaçsal ve bilişsel özellikler, tıbbi faktörler ayrıca nörotransmitterler ve hormonal faktörler (özellikle arka hipofiz hormonları) ve metabolizmaları, glukokortikoid ve kolesterol metabolizması, genetik faktörler gibi nörobiyolojik ve nöropsikiyatrik nedenler, ekolojik, toksik, nutrisyonel faktörler, psikososyal, psikodinamik faktörler çevreye ve kişilere yönelik şiddet ve agresyonun ortaya çıkmasında ve ağırlığında etkili olabilir. Genellikle şiddete eğilimdeki bireysel farklılıkları açıklayan tek bir neden olmadığı kabul edilse de, araştırmacılar arasında hangi risk faktörünün daha önemli olduğuna dair görüş farklılıkları mevcuttur. Yüksek olasılıkla psikososyal, psikodinamik, mizaçsal, nöropsikiyatrik, çevresel, genetik faktörlerin, ebeveynlik stilleri, eğitim ve bakım kalitesi ve okul ruh sağlığı girişimlerinin karşılıklı etkileşimi şiddet davranışının gelişmesi ya da baskılanmasında etkili olmaktadır. Olumlu psikososyal, ailesel, eğitimsel faktörler, psikiyatrik girişimler, koruyucu ruh sağlığı ve olumlu devlet politikalarının şiddete yatkınlıkla ilişkili olumsuz genetik ve nörobiyolojik bireysel farklılıklar üzerine iyileştirici etkileri olabilir. Bu gözden geçirmede şiddet ve agresyonla ilişkili tüm bu faktörler ve kişinin kendine yönelltiği şiddet ve özkıyımda önemli olabilecek psikolojik, genetik ve nörobiyolojik faktörler gözden geçirilecektir.

Anahtar Kelimeler:

şiddet, agresyon, suç, özkıyım

Neurobiological, Psychosocial and Environmental Causes of Violence and Aggression

In psychiatric practice psychotic disorders, mania, substance and alcohol related disorders, antisocial and borderline personality disorders, attention deficit hyperactivity disorder, conduct disorder, mental retardation, organic brain syndrome, delirium, stereotypical movement disorders, trichotillomania, eating disorders and other obsessive-compulsive spectrum disorders, pervasive developmental disorders, major depressive disorder, mixt episodes are closely related with agression towards surrounding and other people and towards self. Although as in suicide agression and violence are not always related to prominent psychopatology, violence and agression are closely associated with crime. In some societies, especially ritualistic agressive behaviours towards self are perceived as culturally normative. Sex, temperamental and cognitive patterns, medical factors also neurobiological and neuropsychiatric causes like neurotransmitters and hormonal factors and their metabolism, glucocorticoid and cholesterol metabolism, genetic factors and also ecological, toxical, nutritional factors, psychosocial and psychodynamic factors can be related with development and severity of agression and violence towards surrounding, other people and towards self. Although it is accepted that there isn't single explanation of the individual differences about the tendency to violence, there are contradicting points of view among researchers about the most significant risc factor. Probably development or alleveation of violent behavior is influenced by the reciprocal interaction between psychosocial, psychodynamic, temperamental, neuropsychiatric, enviromental, genetic factors, parenting styles, quality of nurturition and education and school mental health interventions. Positive psychosocial, familial, educational factors, psychiatric interventions, protective mental health quality and positive government political attitudes can restorate negative genetic, neurobiological individual tendencies to crime. In this review all these factors related with violence and agression above and possibly related psychological, genetic and neurobiological factors with suicide and agression towards self will be reviewed.

Keywords:

violence, agression, crime, suicide,

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Yazışma Adresi/Correspondence: Özhan Yalçın, Bakırköy Prof. Dr. Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, Çocuk ve Ergen Psikiyatrisi Bölümü, Bakırköy-İstanbul, Turkey. E-mail: cpozhan@yahoo.com Yazarlar bu makale ile ilgili herhangi bir çıkar çatışması bildirmemişlerdir. The authors reported no conflict of interest related to this article. Çevrimiçi adresi / Available online at: www.cappsy.org/archives/vol5/no4/ Çevrimiçi yayım / Published online 26 Aralık/December 26, 2013; doi:10.5455/cap.20130526