Abstract
Rationale
Diazepam, a benzodiazepine with a relatively rapid onset of clinical effects, has been associated with suicide and other self-aggressive acts. The evidence for this association, however, comes exclusively from retrospective non-experimental studies. Although suggestive, the results of these studies do not support a cause-and-effect relationship between benzodiazepine consumption and self-aggressive behavior.
Objective
To experimentally examine the effect of diazepam on human self-aggressive behavior under controlled laboratory conditions.
Method
Forty-six healthy men and women were randomly assigned to receive placebo, or 5 mg or 10 mg diazepam in a double-blind, between-groups design. Participants were then provided the opportunity to self-administer electric shocks during a competitive reaction-time task (the self-aggression paradigm, SAP). Self-aggression was defined by the intensity of shock chosen.
Results
Diazepam (10 mg) was associated with higher average shock self-administered than placebo. Subjects receiving 10 mg diazepam were also more likely to attempt to self-administer a shock that they were led to believe was “severe” and painful. Sedation effects were found, but diazepam consumption did not impair memory, attention, concentration, pain threshold, or reaction-time performance.
Conclusions
Clinically relevant diazepam doses may be associated with self-aggressive behaviors at levels that do not significantly impair basic cognitive processes or psychomotor performance.
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References
Alsén M, Ekedahl A, Löwenhielm P, Niméus A, Regnéll G, Träskman-Bendz L (1994) Medicine self-poisoning and the sources of the drugs in Lund, Sweden. Acta Psychiatr Scand 89:255–261
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Press, Washington
Anderson CA, Bushman BJ (1997) External validity of “trivial” experiments: the case of laboratory aggression. Rev Gen Psychol 1:19–41
Beck AT, Weissman A, Lester D, Trexler L (1974) The measurement of pessimism: the hopelessness scale. J Consult Clin Psychol 42:861–865
Beck AT, Steer RA, Brown GK (1996) Manual for Beck depression inventory—II. Psychological Corporation, San Antonio
Ben Porath DD, Taylor SP (2002) The effects of diazepam (Valium) and aggressive disposition on human aggression: an experimental investigation. Addict Behav 27:167–177
Berman ME, Taylor S (1995) The effects of triazolam on aggression in men. Exp Clin Psychopharmacol 3:411–416
Berman ME, Walley JC (2003) Imitation of self-aggressive behavior: an experimental test of the contagion hypothesis. J Appl Soc Psychol 5:1036–1057
Berman M, Taylor S, Marged B (1993) Morphine and human aggression. Addict Behav 18:263–268
Bond AJ (1998) Drug-induced behavioural disinhibition: incidence, mechanisms and therapeutic implications. CNS Drugs 9:41–57
Buss AH, Perry M (1992) The aggression questionnaire. J Pers Soc Psychol 63:452–459
Coccaro EF, Berman ME, Kavoussi RJ (1997) Assessment of life-history of aggression: development and psychometric characteristics. Psychiatry Res 73:147–157
Cole DA (1988) Hopelessness, social desirability, depression, and parasuicide in two college student samples. J Consult Clin Psychol 56:131–136
Dietch JT, Jennings RK (1988) Aggressive dyscontrol in patients treated with benzodiazepines. J Clin Psychiatry 49:184–188
Dupuy TR, Greenberg LM (1993) T.O.V.A. manual for test of variables of attention computer program. University of Minnesota, Minneapolis
First MB, Gibbon M, Spitzer RL, Williams JBW (1998) Computer-assisted SCID—Clinician Version (CAS—CV) [Computer software]. Multi-Health Systems, North Towanda
Forrest MS, Hokanson JE (1975) Depression and autonomic arousal reduction accompanying self-punitive behavior. J Abnorm Psychol 84:346–357
Friedman H, Greenblatt DJ, Peters GR, Metzler CM, Charlton MD, Harmatz JS, Antal EJ, Sanborn EC, Francom SF (1992) Pharmacokinetics and pharmacodynamics of oral diazepam: effect of dose, plasma concentration, and time. Clin Pharmacol Ther 52:139–150
Fuller GN, Rea AJ, Payne JF, Lant AF (1989) Parasuicide in central London 1984–1988. J R Soc Med 82:653–656
Gantner AB, Taylor SP (1988) Human physical aggression as a function of diazepam. Pers Soc Psychol Bull 14:479–484
Gardner DL, Cowdry RW (1985) Alprazolam-induced dyscontrol in borderline personality disorder. Am J Psychiatry 142:98–100
Gardos G, DiMascio A, Salzman C, Shader RI (1968) Differential actions of chlordiazepoxide and oxazepam on hostility. Arch Gen Psychiatry 18:757–760
Ghoneim MM, Mewaldt SP (1990) Benzodiazepines and human memory: a review. Anesthesiology 72:926–938
Giancola PR (2000) Executive functioning: a conceptual framework for alcohol-related aggression. Exp Clin Psychopharmacol 8:576–597
Gray JA (1988) Behavioural and neural-system analyses of the actions of anxiolytic drugs. Pharmacol Biochem Behav 29:767–769
Hall RCW, Zisook S (1981) Paradoxical reactions to benzodiazepines. Br J Clin Pharmacol [Suppl 11]:45–49
Hoddes E, Zarcone V, Smythe H, Phillips R, Dement WC (1973) Quantification of sleepiness: a new approach. Psychophysiology 10:431–436
Krsiak M, Sulcova A (1990) Differential effects of six structurally related benzodiazepines on some ethological measures of timidity, aggression and locomotion in mice. Psychopharmacology 101:396–402
Lester D (1995) Case consultation: diffusion of responsibility in the care of a difficult patient. Suicide Life Threat Behav 25:415–421
Licata A, Taylor S, Berman M, Cranston J (1993) Effects of cocaine on human aggression. Pharmacol Biochem Behav 45:549–552
McCloskey MS, Berman ME (2003) Alcohol intoxication and self-aggressive behavior. J Abnorm Psychol 112:306–311
Neutel CI, Patten SB (1997) Risk of suicide attempts after benzodiazepine and/or antidepressant use. Ann Epidemiol 7:568–574
Patton JH, Stanford MS, Barratt ES (1995) Factor structure of the Barratt impulsiveness scale. J Clin Psychol 51:768–774
Rappaport M, Braff DL (1985) Alprazolam and hostility. Am J Psychiatry 142:146
Rosenkrans FM (1967) Choosing to suffer as a consequence of expecting to suffer: a replication. J Pers Soc Psychol 7:419–423
Rothschild AJ, Shindul-Rothschild JA, Viguera A, Murray M, Brewster S (2000) Comparison of the frequency of behavioral disinhibition on alprazolam, clonazepam, or no benzodiazepine in hospitalized psychiatric patients. J Clin Psychopharmacol 20:7–11
Spielberger CD, Gorsuch RL, Vagg PR, Jacobs GA (1983) State-trait anxiety inventory for adults. Consulting Psychologists, Palo Alto
Steele CM, Josephs RA (1990) Alcohol myopia: its prized and dangerous effects. Am Psychol 45:921–933
Taiminen TJ (1993) Effect of psychopharmacotherapy on suicide risk in psychiatric inpatients. Acta Psychiatr Scand 87:45–47
Walster E, Aronson E, Brown Z (1966) Choosing to suffer as a consequence of expecting to suffer: an unexpected finding. J Exp Soc Psychol 2:400–406
Weisman AM, Berman ME, Taylor SP (1998) Effects of chlorazepate, diazepam, and oxazepam on a laboratory measure of aggression in men. Int Clin Psychopharmacol 13:183–188
Wilkinson C (1985) Effects of diazepam and trait anxiety on human physical aggression and emotional state. J Behav Med 8:101–104
Acknowledgements
This study was supported in part by grants from the National Institute of Mental Health (MH57133) and the Alcoholic Beverage Medical Research Foundation. The authors thank Virginia Crawford for serving as medical director for this study. The authors complied with all laws of the United States during the conduct of this study.
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Berman, M.E., Jones, G.D. & McCloskey, M.S. The effects of diazepam on human self-aggressive behavior. Psychopharmacology 178, 100–106 (2005). https://doi.org/10.1007/s00213-004-1966-8
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DOI: https://doi.org/10.1007/s00213-004-1966-8