Disinhibition: From behavior to neurobiology

Background

Disinhibition may be described as a personality traits leading to a tendency to “move the foot away from the brake”. Disinhibition is thought to function as a vulnerability towards many of the behaviors and diagnoses characterized by reduced impulse control that we see within

forensic psychiatry, such as violence, aggression, substance use, and antisocial personality disorder. Disinhibition is a transdiagnostic construct, which means that it is relevant to many of the most demanding patients within forensic psychiatry, but it is also relevant within the Prison and Probation Service and the general public. For instance, disinhibition is related to increased alcohol and substance use.

Purpose

The overarching purpose of the project is to study different behaviors related to disinhibition, and especially the role of the brain in these behaviors. In four separate studies, disinhibition is studies using a variety of different methods in forensic psychiatric patients, prisoners, and young adults from the general population. It is hoped that results from this project, in the long term, may lead to novel methods for early detection and prevention of behaviors characterized by disinhibition.

Methods

The project utilizes a range of technical and statistical methods. Cognitive tests are combined with brain imaging, using both single-photon emission computed tomography (SPECT) and functional and anatomic magnetic resonance imaging (MRI). Electroencephalography (EEG) us used to study neural activity on a microsecond level. The use of self-report instruments, clinical assessments, and diagnostic and pharmacological data leads to a broad and detailed data material.

Resultat

Preliminary results show that while disinhibition is a broad and not entirely agreed upon construct, behaviors characterized by disinhibition show several associations with multiple forms of sneurocognitive and neurobiological alterations.

Significance

The project aims to create knowledge that, in a longer perspective, may lead to novel ways of identifying, treating, and preventing mental disorders characterized by disinhibition. The width of the project makes its findings relevant both in forensic psychiatry, in prison populations, and in the general public. In forensic psychiatry, patients characterized by a high degree of disinhibitory behaviors are demanding, with little knowledge on how to best treat such patients. In the general population, disinhibition is related to increased alcohol and substance use. Locally, the project may lead to increased cooperation between general psychiatry, forensic psychiatry, and the newly created substance use and addiction ward in Region Kronoberg. There is a great need for increased knowledge on disinhibition in such areas.

Time Plan
Manuscript writing 2016–2020
Data analysis 2016–2020
Data collection 2017–2019
Publication 2018–2020

Research group
Carl Delfin, MA Psychology, Behavioral Scientist, PhD Candidate
Centre for Ethics, Law, and Mental Health (CELAM), Sahlgrenska Academy, University of Gothenburg
Regional Forensic Psychiatric Clinic, Växjö

Peter Andiné, Docent, Attending Physician
Centre for Ethics, Law, and Mental Health, Sahlgrenska Academy (CELAM), University of Gothenburg
Forensic Psychiatry Rågården, Region Västra Götaland
Swedish National Board of Forensic Medicine

Märta Wallinius, Docent, Psychologist
Centre for Ethics, Law, and Mental Health (CELAM), Sahlgrenska Academy, University of Gothenburg
Department of Clinical Sciences, Lund, Child and Adolescent Psychiatry, Lund University
Regional Forensic Psychiatric Clinic, Växjö

Malin Björnsdotter, PhD, MsC Engineering
Centre for Ethics, Law, and Mental Health (CELAM), Sahlgrenska Academy, University of Gothenburg
Center for Social and Affective Neuroscience (CSAN), Linköping University

Collaboration
Regional Forensic Psychiatric Clinic, Växjö
Centre for Ethics, Law, and Mental Health (CELAM)
Forensic Psychiatry Rågården, Region Västra Götaland

Funding
The project is funded by the Regional
Forensic Psychiatric Clinic in Växjö, Sweden, and through grants awarded from Region Kronoberg, Södra sjukvårdsregionen, and the ALF agreement in Region Västra Götaland.