Neuropsychological function, drug abuse, and violence: A conceptual framework

Delineation of the biological substrates of violence in substance abusers would be valuable in developing therapeutic interventions for substance abusers who tend to be refractory to conventional treatments. Substance abusers with chronically violent behavior show more severity and poorer prognosis of their substance abuse disorder and more criminal activity. Violence may share many of the same underlying mechanisms as substance abuse, given the comorbidity and commonalities in behavioral dimensions, including childhood and personality disorders with biological underpinnings. Neuropsychological dysfunction consistently characterizes both drug abuse and violence and may contribute to traits often cited as precursors to both, for example, impulsivity, poor decision-making ability, disinhibition, and inability to assess consequences. Deficits in executive cognitive functioning subserved specifically by the prefrontal cortex are implicated in substance abusers with violent behavior.