Sponsored by the HealthcareTrainingInstitute.org providing Quality Education since 1979
Add to Shopping Cart

"I made him HIT me!" Strategies for Battered Women
Battered Women continuing education psychologist CEUs

Section 16
The Neurology of Explosive Rage:
The Dyscontrol Syndrome
By Frank A. Elliott, M.D.

CEU Question 16 | CEU Answer Booklet | Table of Contents | Domestic Violence
Psychologist CEs, Counselor CEUs, Social Worker CEUs, MFT CEUs

Explosive rage triggered by seemingly minimal provocation and accompanied by physical or verbal aggression occurs in two groups of conditions: functional psychoses and personality disorders on the one explosive rage Battered Women social work continuing edhand, and neurological and metabolic diseases on the other. The term “dyscontrol syndrome” is sometimes used for symptoms arising from poor impulse control, whether the cause is organic or functional. It is an important cause of wife and child battery, senseless assaults, motiveless homicides, self-injury, dangerously aggressive driving, domestic infidelity, divorce, and (in children) educational and social difficulties. Even if the violence is only verbal, it can destroy domestic relationships and wreck careers. All these disasters, including homicide, are represented in the cases of organic dyscontrol listed in this report.

Prevalence
The prevalence of explosive rage, whether psychogenic or organic in origin, is much underestimated. In the first place, it is often regarded as a quirk of personality rather than a matter for medical concern, especially in strata of society in which violence is so common that it excites little comment. Secondly, few patients are willing to admit to an uncontrollable temper, whether from a sense of shame, fear of commitment, or fear of legal sanctions, and the family often helps in the cover-up. Consequently the true state of affairs does not emerge unless the physician asks the right questions: “Do you have difficulty in controlling your temper? Have you been charged with traffic violations or dangerous driving? Are you especially sensitive to alcohol?” It is also necessary to inquire, but at later interview, about the more delicate question of inability to control sexual impulses, which is present in a few cases.

A third cause of under-reporting is that, despite the extensive literature on violent behavior, little of this information has found its way into medical teaching; we are not taught what to look for, and therefore fail to realize the significance of what we see. Moreover, as several authors have pointed out, we tend to shun violent patients because they can be troublesome. Symptomatic of this attitude is the frequent use of euphemisms in the literature. Patients are described as “irritable” or “hyperresponsive”, or “explosive personalities.”

The Anatomy of Explosive Rage
Experimental and clinical evidence links explosive rage to disorders involving the phylogenetically ancient limbic system, which includes the amygdala and hippocampus of the temporal lobe, the hypothalamus, the fornix, the cingulate gyri and cingulate bundle, the septum pellucidum, and the septal area (see illustration).

Diagrammatic view Limbic Structures Battered Women CEUs

The first hint of this relationship was given by Boerhaave who noted that in rabies, which involves the brainstem and hippocampus, the patient may gnash his teeth and snarl like a dog, and in 1892 Gowers spoke of them as “exhausted by attacks of fury.” In the same year Goltz reported that in dogs the removal of a large portion of the forebrain gave rise to savage behavior in response to minor provocation. Since then it has been shown that electrical stimulation of the amygdala can produce either rage or tameness, depending upon the precise placement of the electrodes, and that in man and animals explosive rage can be abolished by bilateral amygdalotomy. In the cat, damage to the ventromedial nucleus of the hypothalamus produces—after a delay of many weeks—a permanently savage animal; paradoxically, electrical stimulation of the same nucleus can elicit aggressive behavior. In man, tumors of the third ventricle and other midline structures can give rise to either rage or profound apathy, and pathological aggression can be abolished by bilateral postero-medial hypothalamotomy. Tumors of the corpus callosum which spread to involve the overlying cingulate gyri usually cause apathy, but explosive rage can occur if the septal area is involved. Bilateral cingulotomy can control aggressive behavior. Repeated attacks of rage were the outstanding feature of a case of a cyst of the septum pellucidum described by Leslie.

These few examples, drawn from an extensive literature, indicate that the limbic system contains within itself mechanisms for the production and control of angry aggression. This does not mean that the system is an autonomous “centre” for aggressive behavior, or that all forms of aggressive behavior are due to disorders of the limbic system. In mature individuals anger is subject to a measure of cortical control and some patients who are given to explosive rage can learn to contain it. On the other hand, in man at any rate, cold, calculating, predatory aggression, carried out for profit, is properly viewed as originating in the neocortex.
- Battered Women. Roy, Maria. Van Nostrand Reinhold Company: New York. 1997.
The article above contains foundational information. Articles below contain optional updates.


=================================
Personal Reflection Exercise #2
The preceding section was about the neurology of explosive rage. Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 16
Experimental and clinical evidence links explosive rage to disorders involving which system of the brain? Record the letter of the correct answer the CEU Answer Booklet.

 
Others who bought this Domestic Violence Course
also bought…

Scroll DownScroll UpCourse Listing Bottom Cap

CEU Answer Booklet for this course | Domestic Violence
Forward to Section 17
Back to Section 15
Table of Contents
Top

The article above contains foundational information. Articles below contain optional updates.
New Law Makes It Easier To Seek Murder Charges For Domestic Violence - July 11, 2017
A domestic violence bill named for a woman who was shot and killed by her boyfriend is now law. Gov. Roy Cooper signed the measure known as Britny's Law on Tuesday.
Bill Would Make It Easier To Seek First-Degree Murder Charges For Domestic Violence - April 11, 2017
A bill in the State Senate rules committee would help families of domestic violence homicide victims seek first degree murder charges.
Human Trafficking In North Carolina - August 11, 2016
North Carolina is among the top 10 states with the highest number of reported human trafficking cases , according to the National Human Trafficking Resource Center . Experts say the number of major interstates that cross through the state, the large agricultural population, and the state’s strategic location along the East Coast contribute to the issue. Host Frank Stasio talks with legal experts, victim services advocates, and a law enforcement officer about human trafficking in the state. Victim-services advocates Karen Arias of Western North Carolina Human Trafficking Rapid Response Team and Mamie Adams , coordinator of Working to End Sex Trafficking in North Carolina, discuss the experiences and challenges faced by trafficking survivors in the state. Major Richard Hoffman of the Raleigh Police Department talks about the role of law enforcement in investigating and stopping human trafficking, and his work on trafficking cases. And Caitlin Ryland from Legal Aid of North Carolina talks
‘The State Of Things’ Producer Picks: A Look Back At 2015 With Anita Rao - December 22, 2015
The year is coming to an end, and “The State of Things” staff is taking a moment to reflect on some of the year’s most memorable conversations. Producer Anita Rao’s favorite segments include a conversation commemorating Yusor Abu-Salha , one of the three Muslim students shot and killed in Chapel Hill in February. Rao also chose a piece that explores body image, fat shaming, and the social history of women’s bodies . She also picked a segment that shares the stories of three Latina women who work as house cleaners in Durham , and one that looks at how domestic violence impacted one couple’s life and relationship . She ends the hour talking about a conversation with Avett Brothers’ Cellist Joe Kwon . Host Frank Stasio talks with Producer Anita Rao about her favorite conversations of the year.
Marine Turned Entrepreneur Uses Technology To Reduce Violence - November 30, 2015
This is a rebroadcast of a program that aired earlier this year . CJ Scarlet is an entrepreneur who believes that technology can curb violence. She founded the company 10 for Humanity that aims to use emerging technology to reduce acts of crime and violence by 10 percent in the next decade, starting with the Tiger Eye Sensor , a wearable personal security device that will record video footage and call the police when a wearer yells “help.” Scarlet’s personal and professional experiences have informed the design and implementation of this sensor. She survived multiple assaults in her adolescence and early adulthood and has worked with victims of crime and assault for two decades, as a victims advocate and as the director of victim’s issues at the North Carolina Attorney General’s Office . She is full of unexpected stories, ranging from her experience as a firefighter to her day-to-day life as a photojournalist for the Marine Corps. Host Frank Stasio talks to CJ Scarlet about her life,

CEU Continuing Education for
Psychologist CEUs, Counselor CEUs, Social Worker CEUs, MFT CEUs

OnlineCEUcredit.com Login


Forget your Password Reset it!