A model linking biology, behavior and psychiatric diagnoses in perpetrators of domestic violence
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Updated: Aug 9, 2026

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Published on: May 2, 2025
David T George1, Monte J Phillips, Linda Doty
1Laboratory of Clinical and Translational Studies, DICBR, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive MSC-1540, Bldg 10 - Hatfield CRC Room 2-2352, Bethesda, MD 20892-1540, USA. tedg@mail.nih.gov
Abstract:
Research indicates that perpetrators of domestic violence have abnormalities in central serotonin and testosterone metabolism, an increased sensitivity to anxiogenic stimuli, and an impaired neuro-connection between their cortex and the amygdala. Clinical evaluations show that perpetrators of domestic violence also have a distinguishing set of behaviors and diagnoses related to anxiety, depression, intermittent explosive disorder, and borderline personality disorder. In this paper we propose a model to understand how the biological abnormalities can potentially explain the behaviors and diagnoses exhibited by the perpetrators. Changes in the perpetrator's neurotransmitters lead to a heightened sensitivity to environmental stimuli, anxiety, and conditioned fear. Lack of cortical input to the amygdala impairs the perpetrator's ability to extinguish anxiety and/or conditioned fear and gives rise to either innate behaviors (e.g., fight, flight, and shut down) or learned fear avoidant behaviors designed to avoid anxiety (e.g., alcohol consumption, self-injurious acts, and obsessive behaviors). Linking conditioned fear and fear avoidance to the behaviors and psychiatric diagnoses will serve to change the way the medical community perceives and treats perpetrators of domestic violence.
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