CSF studies in violent offenders - I. 5-HIAA as a negative and HVA as a positive predictor of psychopathy

Low serotonin activity in man has been related to impulsive, self-destructi ve violence but not to instrumental aggression aimed at dominance. A relati onship has also been suggested between aggression and high catecholaminergi c activity. Several studies have reported signs of aberrant dopaminergic fu nction in attention deficit hyperactivity disorder, autism, and schizophren ia. In 22 violent offenders undergoing pretrial forensic psychiatric invest igation, interpersonal and behavioral features of psychopathy, measured by the Psychopathy Checklist Revised (PCL-R), were significantly predicted by low cerebrospinal fluid (CSF) concentrations of 5-HIAA and high CSF concent rations of HVA in multivariate regression models. CSF concentrations of MHP G did not contribute to the model. This seems to link the outward-directed aggression of psychopathy to serotonergic hypofunctioning and high dopamine turnover, which might account for disinhibition of destructive impulses.