Male Violent Offenders Research Articles

Assessing protective factors in treated violent offenders: Associations with recidivism reduction and positive community outcomes.

The present study examined the assessment of protective factors and their linkages to treatment change, institutional and community recidivism, and positive community outcomes in a high-risk treated sample of violent male offenders. Participants included 178 federally incarcerated adult male violent offenders who participated in a high-intensity violence reduction program and were followed up 10 years postrelease in the community. A collection of risk- and protective-factor measures were rated archivally at multiple time points-the Violence Risk Scale (Wong & Gordon, 1999-2003), Historical Clinical Risk Management-20 (Version 2; Webster, Douglas, Eaves, & Hart, 1997), Structured Assessment of Protective Factors (SAPROF; De Vogel, De Ruiter, Bouman, & De Vries Robbé, 2009), and Protective Factors (PF) List. Measures of community and institutional recidivism and positive community outcomes were coded. Large correlations were observed between risk and protection scores, suggesting shared risk variance. The SAPROF and PF List each predicted decreased community recidivism and, to a lesser degree, decreased institutional recidivism. Positive changes in protective factors were significantly associated with reductions in violent and general community recidivism and serious institutional misconducts after controlling for baseline scores. In addition, risk and protection scores significantly predicted most positive community outcomes; improvements in protective factors were linked to an increase in positive outcomes. Protective factors are more than the inverse of risk factors and might have important benefits in violence risk assessment and treatment planning when other positive community outcomes are considered. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Personality and Cognitive Functions in Violent Offenders - Implications of Character Maturity?

Previous research has suggested that personality and cognitive functions are essential in the emergence of persistent aggressive antisocial behaviors and that character maturity could be an important protective factor against these behaviors. The aims of this study were (1) to determine associations between personality traits, intellectual ability, and executive function in young male violent offenders, and (2) to investigate differences in intellectual ability and executive function between groups of violent offenders with low, medium, and high character maturity. A cohort of 148 male violent offenders (18–25 years of age) participated in this study. The Temperament and Character Inventory was used as a self-report measure of personality traits, and cognitive functions were measured with the Wechsler Adult Intelligence Scale – Third Edition and the Cambridge Neuropsychological Test Automated Battery. Intellectual ability was negatively correlated to the temperament dimension Harm Avoidance and the character dimension Self-Transcendence, and positively correlated to the character dimensions Self-Directedness and Cooperativeness and the temperament dimension Novelty Seeking. Visual sustained attention correlated positively to the temperament dimension Persistence and negatively to the temperament dimension Harm Avoidance. Spatial working memory correlated negatively to the character dimension Cooperativeness. Character maturity, however, did not affect intellectual and executive functions to a statistically significant degree. Our findings indicate that offender personality characteristics such as optimism, responsibility, empathy, curiosity, and industry that would seem more favorable to positive intervention outcomes are related to better cognitive functioning. Possible implications are that interventions in offender populations could be more effective if tailored to participants’ personality dimensions and cognitive proficiencies, rather than offered as “one size fits all.”

A Latent Profile Analysis of Violent Offenders Based on PCL-R Factor Scores: Criminogenic Needs and Recidivism Risk.

Clinicians and theorists have often proposed the two psychopathic subtypes of “primary” and “secondary” psychopathy, with recent research indicating some empirical support for both psychopathy subtypes, though the findings across studies are far from uniform. For the current study, latent profile analysis was used to investigate if homogeneous latent classes exist within a sample of 215 adult male violent offenders from Berlin, Germany. The age of the offenders at the time of the index offense ranged from 19 to 59 years. The results indicated a solution with four latent classes, which we refer to as prototypical psychopaths (LC1), callous-conning offenders (LC2), sociopathic or dyssocial offenders (LC3), and general offenders (LC4). Validation of the four subtypes involved examination of differences on recidivism risk; criminogenic needs; and general, violent, and sexual reoffending. The results also are discussed in terms of the issue of treatment amenability.

Reduced gray matter volume in male adolescent violent offenders.

BackgroundPrevious studies reported that reduced gray matter volume (GMV) was associated with violent-related behaviors. However, the previous studies were conducted on adults and no study has studied the association between GMV and violent behaviors on adolescents. The purpose of the study was to investigate GMV’s effects in adolescent violent offenders based on a Chinese Han population, which can address the problem of possible confounding factors in adult studies.MethodsWe recruited 30 male adolescent violent offenders and 29 age- and sex-matched healthy controls (HCs). Differences in both whole-brain and GMV were evaluated using voxel-based morphometry (VBM). We assessed the accuracy of VBM using the receiver operating characteristic curve (ROC) and discriminant analysis.ResultsCompared with HCs, the male adolescent offenders showed significantly reduced GMV in five cortical and subcortical brain regions, including the olfactory cortex, amygdala, middle temporal gyrus and inferior parietal lobe in the left hemisphere, as well as the right superior temporal gyrus. Both ROC curve and discriminate analyses showed that these regions had relatively high sensitivities (58.6%–89.7%) and specificities (58.1%–74.2%) with 76.7% classification accuracy.ConclusionsOur results indicated that reduced volume in the frontal-temporal-parietal-subcortical circuit may be closely related to violent behaviors in male adolescents, which might be an important biomarker for detecting violent behaviors in male adolescents.

The Perpetration of Violence and the Experience of Trauma: Exploring Predictors of PTSD Symptoms in Male Violent Offenders

Incarcerated offenders are more likely to experience Posttraumatic Stress Disorder (PTSD) and associated symptoms than the general population. PTSD may develop from a variety of events, including being a victim of violence, witnessing violence, or from committing a violent offense. This study examined symptoms and predictors of PTSD in 150 male violent offenders. Participants recalled acts of reactive and instrumental violence, poorly recalled violence, and subjectively disturbing events (e.g., victim of violence), and rated each event for symptoms of PTSD using the Impact of Events Scale (IES). Subjectively disturbing events were associated with higher IES scores than the acts of violence. Hierarchical linear modeling showed that more recent events were associated with a greater number of trauma symptoms and peritraumatic dissociation was positively associated with trauma symptoms. As well, trauma symptoms were more likely to develop if the victim was a family member or a friend, as compared to a stranger or acquaintance. These results support the need for trauma-informed assessment and treatment for offenders. Knowing more about the predictors of trauma symptoms is a first step in effectively treating PTSD in this population.

Latent constructs in the measurement of risk and protective factors for violent reoffending using the HCR-20v3 and SAPROF: implications for conceptualizing offender assessment and treatment planning

ABSTRACTThis paper describes a retrospective data analysis, examining the relationship between protective factors against violence, as measured by the Structured Assessment of Protective Factors for Violence Risk (SAPROF), and conceptually similar risk factors assessed in the Historical-Clinical-Risk Management-20 Version 3. The sample comprised 201 adult male violent offenders who completed a violence intervention programme in an Australian prison. Structural equation modelling revealed that conceptually similar risk and protective factors loaded onto correlated, but independent, factors. This suggests that these items from the two assessment tools may assess distinct latent constructs relevant to violence risk. SAPROF items did not, however, load onto the domains that are commonly targeted in violence treatment programmes. This study’s conclusion that assessment of protective factors may offer supplementary conceptual value in clinical practice with violent offenders is tempered by limitations, including the retrospective file review design, small sample, and lack of predictive validity of SAPROF ratings.

Facets of Psychopathy, Intelligence, and Aggressive Antisocial Behaviors in Young Violent Offenders.

Psychopathy continues to be a challenge in forensic contexts, and evidence of its association with destructive behaviors, such as aggressive antisocial behaviors, is extensive. However, the potential role of intelligence as moderator of the well-established association between psychopathy and aggressive antisocial behaviors has largely been neglected, despite intelligence having been independently related to both concepts. Increased knowledge of whether intelligence is relevant to this association is needed because of its possible implications on the assessment and treatment of individuals with psychopathic traits and aggressive antisocial behaviors. This study aimed to investigate the association between psychopathic traits, aggressive antisocial behaviors, and intelligence in young violent offenders and to test whether intelligence moderates the relationship between psychopathic traits and aggressive antisocial behaviors. Participants were 269 male violent offenders aged 18–25 years, assessed on the Psychopathy Checklist-Revised (PCL-R), the Life History of Aggression (LHA), and the General Ability Index from the Wechsler Adult Intelligence Scale, 3rd edition. Associations were tested with Spearman’s rho, and moderation analysis was performed through ordinary least squares regressions. The PCL-R four-facet structure was used for the analyses. We found a positive association between psychopathic traits and aggressive antisocial behaviors, and a small negative association between the Affective PCL-R facet and intelligence. In the moderation analyses, a small yet statistically significant moderation effect of intelligence on the association between the Interpersonal facet and LHA total scores was demonstrated. However, the amount of variance in the LHA total score explained by the model was very small: 2.9%. We suggest that intelligence, however, important for rehabilitation strategies and everyday functioning, is not necessarily pertinent to understanding aggressive antisocial behaviors in young offenders with psychopathic traits.

Cognitive functioning and aggressive antisocial behaviors in young violent offenders

Studies have shown that offenders have impaired cognitive abilities yet it is unclear if cognitive dysfunction per se contributes to aggressive antisocial behaviors. Our aims were to (1) determine associations between cognitive functioning and different forms of aggressive antisocial behaviors, (2) describe prevalence of, and covariates to, uneven intellectual profiles, and (3) investigate associations between cognitive functioning and age at onset of aggressive antisocial behaviors. A cohort (n = 269) of 18–25 years old male violent offenders were assessed for general intellectual functioning with the Wechsler Adult Intelligence Scales–third edition, and for executive functions with the Cambridge Neuropsychological Test Automated Battery. Only one measure of cognitive functioning – slower reaction times in a response inhibition test – was significantly correlated with higher occurrence of aggressive, but not exclusively antisocial, behaviors. Furthermore, offenders with even intellectual profiles showed more aggressive antisocial behaviors than offenders with uneven intellectual profiles. Finally, increased errors in tests of cognitive flexibility and slower reaction times in a response inhibition test were associated with a younger age at onset of general, but not exclusively violent, criminality. Overall, effect sizes were small. The findings emphasize the need of research investigating how cognitive functioning in offenders affects susceptibility to treatment interventions.

Treatment responsiveness of replicated psychopathy profiles.

Theory and accumulating data suggest systematic heterogeneity among offenders with psychopathic traits. Several empirical investigations converge on the nature of subtypes, but little is known about differences in treatment responsivity. We have used the 4-facet model of the Psychopathy Checklist-Revised (PCL-R) to provide a framework for detecting subtypes. The present study used the full range of PCL-R scores in a sample of male violent offenders (N = 190) to replicate subtypes found in a partly overlapping sample by Neumann, Vitacco, and Mokros (2016), using Latent Profile Analysis (LPA), and subsequently to examine potential differences in treatment responsivity. Four subtypes emerged. Within the prototypical psychopathic group, the distinction between intent-to-treat and completers was crucial. Prototypical psychopathic offenders were significantly more likely to drop out, but completers appeared to proceed through the different phases of treatment in much the same way as the other groups. Clearly, more research is needed to elucidate treatment interfering mechanisms and their associated patient characteristics, particularly for the prototypical psychopathic group. Developing therapeutic strategies to improve treatment compliance is a necessary step in the development of specialized treatment programs for these difficult patients. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Assessing Dynamic Violence Risk in a High-Risk Treated Sample of Violent Offenders.

The present study featured an investigation of the predictive properties of risk and change scores of two violence risk assessment and treatment planning tools-the Violence Risk Scale (VRS) and the Historical, Clinical, Risk-20, Version 2 (HCR-20)-in sample of 178 treated adult male violent offenders who attended a high-intensity violence reduction program. The cases were rated on the VRS and HCR-20 using archival information sources and followed up nearly 10 years postrelease. Associations of HCR-20 and VRS risk and change scores with postprogram institutional and community recidivism were examined. VRS and HCR-20 scores converged in conceptually meaningful ways, supporting the construct validity of the tools for violence risk. Receiver operating characteristic curve analyses demonstrated moderate- to high-predictive accuracy of VRS and HCR-20 scores for violent and general community recidivism, but weaker accuracy for postprogram institutional recidivism. Cox regression survival analyses demonstrated that positive pretreatment and posttreatment changes, as assessed via the HCR-20 and VRS, were each significantly associated with reductions in violent and general community recidivism, as well as serious institutional misconducts, after controlling for baseline pretreatment score. Implications for use of the HCR-20 and VRS for dynamic violence risk assessment and management are discussed.

Anger provocation increases limbic and decreases medial prefrontal cortex connectivity with the left amygdala in reactive aggressive violent offenders

Neurobiological models propose reactive aggression as a failure in emotion regulation, caused by an imbalance between prefrontal cortical control and excessive bottom-up signals of negative affect by limbic regions, including the amygdala. Therefore, we hypothesize a negative correlation between PFC and amygdala activity (pre/post resting-state scans) in violent offenders. In this study resting-state fMRI was administered before and after an emotion (anger and happiness) provocation or engagement task within 18 male violent offenders scoring high on reactive aggression, and 18 male non-offender controls. Research in emotional pre/post resting-state showed altered connectivity by task performance. Therefore, bilateral amygdala region of interest (ROI) whole brain functional connectivity analysis tested dynamic change differences between pre and post resting-state connectivity between groups. Self-reported anger showed a positive significant relationship with medial prefrontal cortex activity in the pre-task scan and significantly increased during the emotion task in both the violent and control group. Imaging results showed a significant decrease in amygdala – medial prefrontal functional connectivity in the violent offenders and an increase in the non-offender controls after the emotion task. The opposite pattern was found for amygdala connectivity with the (para) limbic regions: violent offenders showed increased connectivity and non-offender controls showed decreased connectivity. The present results indicate that reactive aggression might stem from a focus on emotion processing, as indicated by an increase in limbic functional connectivity. The combination of a focus on emotion, along with a lack of medial prefrontal cortex regulation, has the potential to grow out of control e.g. in reactive aggression.

Examining Associations Between Psychopathic Traits and Executive Functions in Incarcerated Violent Offenders.

Executive functions (EFs) are essential in almost all aspects of daily life and have been robustly related to antisocial behavior. However, the relationship between psychopathy and EFs has remained equivocal. Research investigating lower-level trait dimensions of psychopathy using standardized EF measures could be beneficial in addressing this issue. In this study, we examined associations between four EFs and four dimensions of psychopathic traits (interpersonal, affective, lifestyle, antisocial) using zero-order correlation and a combination of classical and Bayesian statistical methods. Two hundred and fourteen incarcerated male violent offenders were assessed with the Psychopathy Checklist-Revised and completed tests of cognitive flexibility, spatial working memory, response inhibition, and planning and problem-solving using the Cambridge Neuropsychological Test Automated Battery. Lifestyle psychopathic traits were significantly associated with reduced initial thinking time in a planning and problem-solving task, with a Bayes factor indicating substantial evidence for the observed correlation, and antisocial psychopathic traits showed a significant association with reduced initial thinking time in the same task, although the Bayes factor indicated only anecdotal evidence. Significant associations were also found between affective and antisocial psychopathic traits and less efficient strategic thinking in a spatial working memory task, and between affective, lifestyle and antisocial psychopathic traits and fewer problems solved in a planning and problem-solving task, although these findings were not corroborated by the Bayesian analysis. While the observed effects ranged between small and medium, our study suggests that reduced initial thinking times in planning and problem-solving is robustly associated with higher degrees of lifestyle and antisocial psychopathic traits.

Gambling Disorder in Male Violent Offenders in the Prison System: Psychiatric and Substance-Related Comorbidity

Gambling disorder is an addiction that can cause major suffering, and some populations seem to be more vulnerable than others. Offender populations have a remarkably high prevalence of gambling problems and they are also over-represented in a number of diagnoses related to gambling disorder, like substance use disorders and antisocial personality disorder. Yet, there are few studies investigating gambling disorder prevalence and related psychiatric comorbidity in this group. This study aims to investigate the prevalence of, and association between, gambling disorder and other psychiatric diagnoses in a sample of young, male violent offenders. Two hundred and sixty-four male offenders, all serving sentences for violent crimes (recruited between 2010 and 2012) participated in this study and went through comprehensive psychiatric evaluation, including assessment for Diagnostic and Statistical Manual of Mental Disorders 4th Edition criteria. Sixteen percent of the participants met criteria for gambling disorder. Antisocial personality disorder, cannabis, cocaine and anabolic steroids abuse were significantly more common among participants with gambling disorder. The gambling disorder group also showed significantly lower educational attainment. Cocaine abuse and failure to graduate elementary and middle school in expected time were independently associated with gambling disorder in a regression analysis. This study confirms the previously described high prevalence of gambling disorder in offenders. The psychiatric comorbidity was high and the problems had started early, with lower educational attainment in the gambling disorder group. The findings stress the importance of increased awareness of gambling problems among convicted offenders and of gambling research on young people with delinquent behavior. There is a need of more research to investigate this further, in order to develop preventive strategies and treatment.

Emotion regulation and aggression: The incremental contribution of alexithymia, impulsivity, and emotion dysregulation facets.

Objective: Prior research has long emphasized the role of alexithymia and impulsivity to explain aggressive tendencies. Recently, a growing body of research seems to support the relevance of the broader construct of emotion dysregulation to understand aggression. The present study was the first to comprehensively examine the relative contribution of, and the mechanisms linking alexithymia, impulsivity, and emotion dysregulation in predicting aggression dimensions. Method: Male violent offenders (N = 221) and community participants (N = 245) completed multifaceted self-report measures of alexithymia, impulsivity, emotion dysregulation, and aggression. Regression analyses tested the independent contribution of each facet on aggression dimensions. Bootstrap analyses examined the indirect effect of alexithymia on aggression through emotion dysregulation and impulsivity. Results: Offenders reported higher levels of difficulties identifying feelings, emotional nonacceptance, physical aggression, and hostility. Difficulties in identifying and describing feelings, and motor and attentional impulsivity, explained unique variance in physical aggression, anger, and hostility in both samples, and also in verbal aggression among community participants. In both samples, negative urgency and emotional nonacceptance explained additional variance in aggression dimensions above and beyond the influence of alexithymia and impulsivity. Emotion dysregulation and impulsivity mediated the relation between alexithymia and aggression in both samples, with emotion dysregulation demonstrating a relatively stronger effect. Conclusions: Findings emphasize the unique relevance of alexithymia, impulsivity, and emotion dysregulation facets in explaining aggressive tendencies. Clinical implications include the importance of focusing on emotion regulation skills-such as accepting emotions and do not act on them-to reduce aggression tendencies.

Difficulties in emotion regulation and psychopathic traits in violent offenders

PurposeThe present study aimed to advance our understanding of the relevance of emotion dysregulation (ED) for psychopathy. MethodsLatent Profile Analysis (LPA) and Structural Equation Modeling (SEM) were employed to examine person- and variable-centered associations between ED domains and psychopathic traits in a moderately-large (N = 268) sample of violent male offenders. ResultsLPA results indicated a 3-class solution with offenders most accurately classified based on ED levels (low, medium, high) across domains. The three ED subgroups revealed linear positive associations with psychopathy total, affective, and lifestyle facet scores, such that elevated levels of these traits were found in subgroups with greater ED. A similar linear trend emerged for the antisocial – but not interpersonal – facet, in-line with recent studies showing positive associations between executive functioning and interpersonal features of psychopathy. In SEM analyses, a latent ED factor positively predicted a super-ordinate psychopathy factor, controlling for psychopathological distress. ConclusionsTaken together, current findings support the notion that ED involves broad difficulties across emotion regulation domains, which vary by degree rather than in kind, and that these difficulties have linear positive relations with psychopathic traits among violent offenders.

Are Generalist Batterers Different from Generally Extra-Family Violent Men? A Study among Imprisoned Male Violent Offenders

Research on male batterers has found that in some cases of severe intimate partner violence (IPV) against women, male aggressors were also generally violent beyond the family realm. These findings have been used by researchers to illustrate the common etiology of both general and IPV. Using data from imprisoned male violent offenders, we d the individual, family, and community characteristics of two groups of violent offenders: generalist batterers (GB) and generally extra-family violent men (GEVM). GB offenders had a judicial sentence on IPV-related offenses (gender violence according to the Spanish legislation), while GEVM offenders did not have any IPV-related judicial sentence. The sample s 153 imprisoned male violent offenders of the Penitentiary Center of Villabona (Asturias, Spain). Sociodemographic measures, and criminal and justice official records of participants are available. Two groups of participants (GB and GEVM) distinction was done based on official records. Multivariate analyses of covariance (MANCOVA) was carried out to study differences between each group of participants in self-reported measures of personal, family, and community context variables. MANCOVA showed no statistical differences among the individual, family, and community characteristics of these two groups, giving empirical support to the theoretical view that general violence and IPV might share a common etiology. These results are discussed in light of the debate about the potentially common etiology of these two types of violence.

Evidence for Two Levels of Intimate Partner Violence and Aggression Among Incarcerated Young Male Violent Offenders.

Furthering knowledge of the subset of incarcerated partner violent offenders distinguished by aggression, anger, and hostility is relevant, as these offenders are guilty of the more severe kinds of intimate partner violence (IPV). Our aim was to identify groups with different patterns of IPV among convicted young Swedish male offenders, using data from the Development of Aggressive Antisocial Behavior Study, including 171 young men (18-25 years) convicted of a violent crime. Cluster analysis was used to identify different clusters based on amount and severity of IPV in combination with measures of anger, hostility, aggression, and psychopathic personality traits. The results point to an association between antisocial development, criminal history, the severity of current crime, and measures of aggression, hostility, and partner abuse. The cluster defined by higher levels of partner abuse and aggression was significantly associated with early onset conduct disorder.

Deliberate self-harm behavior among young violent offenders.

Deliberate self-harm behavior (DSH) can have profound effects on a person’s quality of life, and challenges the health care system. Even though DSH has been associated with aggressive interpersonal behaviors, the knowledge on DSH in persons exhibiting such behaviors is scarce. This study aims to (1) specify the prevalence and character of DSH, (2) identify clinical, neurocognitive, psychosocial, and criminological characteristics associated with DSH, and (3) determine predictors of DSH among young violent offenders. Data were collected from a nationally representative cohort of 270 male violent offenders, 18–25 years old, imprisoned in Sweden. Participants were interviewed and investigated neuropsychologically, and their files were reviewed for psychosocial background, criminal history, mental disorders, lifetime aggressive antisocial behaviors, and DSH. A total of 62 offenders (23%) had engaged in DSH at some point during their lifetime, many on repeated occasions, yet without suicidal intent. DSH was significantly associated with attention deficit hyperactivity disorder, mood disorders, anxiety disorders, various substance use disorders, being bullied at school, and repeated exposure to violence at home during childhood. Mood disorders, anxiety disorders, and being bullied at school remained significant predictors of DSH in a total regression model. Violent offenders direct aggressive behaviors not only toward other people, but also toward themselves. Thus, DSH must be assessed and prevented in correctional institutions as early as possible, and more knowledge is needed of the function of DSH among offenders.

Boldness psychopathic traits predict reduced gaze toward fearful eyes in men with a history of violence

Research with developmental and adult samples has shown a relationship of psychopathic traits with reduced eye gaze. However, these relationships remained to be investigated among forensic samples. Here we examined the eye movements of male violent offenders during an emotion recognition task. Violent offenders performed similar to non-offending controls, and their eye movements varied with the emotion and intensity of the facial expression. In the violent offender group Boldness psychopathic traits, but not Meanness or Disinhibition, were associated with reduced dwell time and fixation counts, and slower first fixation latencies, on the eyes compared with the mouth. These results are the first to show a relationship of psychopathic traits with reduced attention to the eyes in a forensic sample, and suggest that Boldness is associated with difficulties in orienting attention toward emotionally salient aspects of the face.

Anger provocation in violent offenders leads to emotion dysregulation

Anger and anger regulation problems that result in aggressive behaviour pose a serious problem for society. In this study we investigated differences in brain responses during anger provocation or anger engagement, as well as anger regulation or distraction from anger, and compared 16 male violent offenders to 18 non-offender controls. During an fMRI adapted provocation and regulation task participants were presented with angry, happy and neutral scenarios. Prior research on violent offenders indicates that a combination of increased limbic activity (involved in emotion), along with decreased prefrontal activity (involved in emotion regulation), is associated with reactive aggression. We found increased ventrolateral prefrontal activity during anger engagement in violent offenders, while decreased dorsolateral and ventrolateral prefrontal activity was found during anger distraction. This activity pattern was specific for anger. We found no exclusive pattern for happiness. In violent offenders, this suggests an increased need to regulate specifically during anger engagement and regulation difficulties when explicitly instructed to distract. The constant effort required for violent offenders to regulate anger might exhaust the necessary cognitive resources, resulting in a risk for self-control failure. Consequently, continuous provocation might ultimately contribute to reactive aggression.