Depression as a risk marker for aggression: A critical review

Depression is commonly thought of as counter-indicative of aggression because of apparent contradictions in energy requirements and blame orientation. However, empirical studies indicate that the presence of depression elevates risk for general aggression, intimate partner aggression, and self-aggression. Most of these studies are cross-sectional and retrospective, hence, there is scant empirical evidence for depression as a causal factor for aggression. However, there is considerable evidence for an association between depression and aggression. Depression as a risk marker for aggression may stem from a third factor such as genetics, personality disorder or insecure attachment. There are also a number of sequelae of depression that may contribute to this increased risk for aggression including isolation, lost social support, increased alcohol use, angry rumination, and impulsivity. Furthermore, affective swamping clouds attributional clarity so that internal and external attributions for negative feelings become fused and undifferentiated. Hence, negative events of sufficient affective impact can generate both depression and anger. One form of this affective swamping is scapegoating: finding an external person or persons to blame for “causing” aversive affect. For these reasons, depression should constitute a routine aspect of mental health assessment and where present, should be viewed as a risk factor for aggression.