Executive cognitive functioning and aggression: A public health perspective

A large body of research from diverse fields suggests that impaired executive cognitive functioning (ECF) may play an important role in the etiology of aggression and violent behavior (AVB). A number of studies examining subjects without significant psychopathology has found compelling evidence for a relationship between subclinical impaired ECF and AVB. These findings provide an empirical foundation for research on the epidemiology of impaired ECF as a risk factor for AVB in the general population. Unfortunately, however, most research on the ECF-AVB relationship has been limited to clinical, incarcerated, and other small nonrepresentative samples of human subjects. Thus, little is known about the public health significance of impaired ECF and its implications for behavioral disorders. Research is reviewed that may shed light on the epidemiology of impaired ECF and its relationship to AVB. Other conditions that correlate with, define, or contribute to ECF impairments that may also relate to AVB are discussed. Because ECF is considered to be malleable, an introduction to interventions with potential to improve ECF and, in turn, AVB is included. Finally, an agenda, along with a conceptual framework to guide this work, is proposed for future research on the ECF-AVB relationship from a public health perspective, with attention to anticipated methodological and ethical challenges.