Alcoholic Violent Offenders: Behavioral, Endocrine, Diurnal Rhythm, and Genetic Correlates of Low Csf 5-Hiaa Concentrations

Abstract

In a series of studies on Finnish alcoholic violent offenders, low cerebrospinal fluid (CSF) 5-hydroxyindoleacetic acid (5-HIAA) concentrations have been associated with impulsive, unprovoked offenses committed under the influence of alcohol. In impulsive violent offenders, lowest CSF 5-HIAA concentrations are associated with a history of suicide attempts, with a family history of paternal alcoholism, and with a polymorphism of the tryptophan hydroxylase gene on chromosome 11. On the Karolinska Scales of Personality (KSP) impulsive violent offenders with low CSF 5-HIAA concentrations are characterized by traits such as impulsivity, irritability, and monotony avoidance. Their diurnal activity rhythm recordings show increased activity during night-time hours compared to healthy volunteers, and they exhibit a hypoglycemic tendency in response to an oral glucose load. Comparisons to healthy volunteers show that low CSF 5-HIAA alone is not sufficient to cause an individual to be interpersonally violent, but it is associated with irritability and impaired impulse control. High CSF free testosterone concentrations are more directly related to aggressiveness.