title: Modulation of central serotonin affects emotional information processing in impulsive aggressive personality disorder.
abstract: BACKGROUND
  The mechanistic model whereby serotonin affects impulsive aggression is not completely understood. The purpose of this study was to test the hypothesis that depletion of serotonin reserves by tryptophan depletion affects emotional information processing in susceptible individuals.
  
  
  METHODS
  The effect of tryptophan (vs placebo) depletion on processing of Ekman emotional faces was compared in impulsive aggressive personality disordered, male and female adults with normal controls. All subjects were free of psychotropic medications, medically healthy, nondepressed, and substance free. Additionally, subjective mood state and vital signs were monitored.
  
  
  RESULTS
  For emotion recognition, a significant interaction of Aggression × Drug × Sex (F(1, 31) = 7.687, P = 0.009) was found, with male normal controls but not impulsive aggressive males showing increased recognition of fear. For intensity ratings of emotional faces, a significant interaction was discovered of Drug × Group × Sex (F(1, 31) = 5.924, P = 0.021), with follow-up tests revealing that males with intermittent explosive disorder tended to increase intensity ratings of angry faces after tryptophan depletion. Additionally, tryptophan depletion was associated with increased heart rate in all subjects, and increased intensity of the subjective emotional state of "anger" in impulsive aggressive subjects.
  
  
  CONCLUSIONS
  Individuals with clinically relevant levels of impulsive aggression may be susceptible to effects of serotonergic depletion on emotional information processing, showing a tendency to exaggerate their impression of the intensity of angry expressions and to report an angry mood state after tryptophan depletion. This may reflect heightened sensitivity to the effects of serotonergic dysregulation, and suggests that what underlies impulsive aggression is either supersensitivity to serotonergic disturbances or susceptibility to fluctuations in central serotonergic availability.
authors.affiliation: Clinical Neuroscience Research Unit, Department of Psychiatry, University of Chicago Pritzker School of Medicine, Chicago, IL 60637, USA. rlee@yoda.bsd.uchicago.edu
authors.forename: Royce J
authors.initials: RJ
authors.lastname: Lee
authors.forename: Andrew
authors.initials: A
authors.lastname: Gill
authors.forename: Bing
authors.initials: B
authors.lastname: Chen
authors.forename: Michael
authors.initials: M
authors.lastname: McCloskey
authors.forename: Emil F
authors.initials: EF
authors.lastname: Coccaro
mesh_terms: D000328:Adult; D000374:Aggression; D000596:Amino Acids / Q000008:administration & dosage; D000786:Anger; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004032:Diet; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000097:blood / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate; D006801:Humans; D007175:Impulsive Behavior; D008297:Male; D008606:Mental Processes; D010554:Personality Disorders / Q000097:blood / Q000378:metabolism*; D021641:Recognition, Psychology; D012701:Serotonin / Q000502:physiology*; D012727:Sex Characteristics; D014364:Tryptophan / Q000097:blood / Q000172:deficiency
chemical_list: D000596:Amino Acids; D012701:Serotonin; D014364:Tryptophan