Vol. 7, No. 2, 2001 Page 3

Domestic violence, panic disorder: common roots?

Perpetrators of domestic violence may experience physiological reactions during episodes of abusive behavior that are similar to those seen in individuals with panic disorder, according to a recent study.

David George and colleagues studied 34 individuals (27 males and 7 females) with histories of domestic violence, and two control groups. One control group, consisting of nonviolent alcoholics, was used to control for the high rate of drinking among the violent subjects. The other group consisted of non-abusive, non-alcoholic subjects.

The researchers infused each subject either with either a placebo or sodium lactate, a substance that induces panic in up to 90 percent of individuals who experience panic attacks but in less than 10 percent of people not prone to panic disorder. Psychiatrists blind to the subjects' diagnoses and whether or not they received lactate infusions analyzed each subject for symptoms of fear, panic, and/or rage during and following infusions. The researchers also asked subjects to describe their physical and emotional states both before and after the infusions.

"During the lactate infusions," the researchers say, "perpetrators exhibited significantly greater fear, rage, and panic reactions as well as greater changes in [behavior]... than both groups of nonviolent comparison subjects." In addition, abusive subjects reported more feelings of unreality, fright, and loss of control.

The responses of the offenders, the researchers say, were often "very intense." For instance, they report that one 34-year-old violent subject reported feeling normal before the infusion, but "reported experiencing a number of physical symptoms [during lactate infusion]...as well as feelings of confusion, panic, and a fear that he did not know what he was going to do." At one point, the man reported an intense desire to yell, throw objects, or curse, and told the researchers, "This is how I feel when I hit my girlfriend."

The researchers say that 57 percent of the domestic abuse perpetrators in their study had suffered abuse themselves, which may have been a factor in their responses to lactate. However, they say, "It is possible that lactate, as a result of either its anxiogenic [anxiety producing] or its biochemical properties, causes the activation of specific neural pathways in the perpetrators that mediate fear-related fight and/or flight behaviors."

George and colleagues say their findings suggest that antidepressant medications, which can reduce symptoms of panic and anxiety, may be effective treatments for domestic abuse.

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"Lactate-induced rage and panic in a select group of subjects who perpetrate acts of domestic violence," David T. George, Joseph R. Hibbeln, Paul W. Ragan, John C. Umhau, Monte J. Phillips, Linda Doty, Daniel Hommer, and Robert R. Rawlings, Biological Psychiatry, Vol. 47, 2000, pp. 804-812. Address: David T. George, Laboratory of Clinical Studies, DICBR, Building 10, Room 6S-240, 10 Center Drive MSC-1610, Bethesda, MD 20892-1610.

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