Fink! Still at Large: Exposure to Violent Media Results in Brain Changes That Might Desensitize Teen Boys to Aggression. Should We Advise Patients in Therapy to Stay Away from Violent Media?

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Research tends to narrow a question to a researchable conclusion. The question above is not only of concern to those of us in psychiatry; it worries parents and teachers alike.

The question refers to an article published last month ("On-Screen Violence May Desensitize Teen Boys," CLINICAL PSYCHIATRY NEWS, November 2010, p. 19). That article was based on a study published online (Soc. Cogn. Affect. Neurosci. 2010 [doi:10.1093/scan/nsq079]) that traces these matters to the brain and leaves out environmental, social, and psychological possibilities.

Instead of approaching the issue from a biopsychosocial point of view, it is immediately medicalized, and conclusions and solutions are derived from the major premise. I am a great believer in the biopsychosocial ethos and our need to rise above the rest of medicine.

Even if these researchers are correct in their findings, this is just a tiny corner of the data we have on the causes of adolescent violence. Desensitization is important, but its causes are many. One example is growing up in a house devoid of empathy so that the child has no one to whom he can talk and receive an empathetic response. Empathy is learned and only can be achieved through love. If the child has not felt love, he cannot be empathic. It is a critical factor when we try to understand how an adolescent could take the life of another. He has no ability to put himself in the other person's shoes.

This area of youth violence is one that I have been working in for almost 2 decades, and I am pleased to have some biological evidence about aggression. Experiments using neuroimaging are always engaging, but they still leave many psychosocial discoveries as peripheral to the central biological theses.

For example, we have discovered markers for murdering someone or getting murdered. These include bullying; dropping out of school; being a chronic truant - often leading to illiteracy; and getting suspended from school multiple times. None of these markers correlate with parts of the brain underlying these kinds of behaviors.

Perhaps researchers in the future will be able to trace each of these markers to functional magnetic resonance imaging (fMRI) changes, which, in turn, could help develop methods for reducing these behaviors. But I doubt it.

Bullying has recently received much attention, especially the phenomenon of cyberbullying, which has resulted in numerous suicides across the country. In each of the markers I have mentioned, multiple factors are driving the child to make them happen.

Negative self-image is a major factor that causes adolescents to strike out, retaliate, take action to preserve their manhood, and find ways to feel better about themselves.

A young man went to apply for a job and kept saying to his mentor after the interview: "They'll never hire me," over and over again. It was an inappropriate reaction, but his self-esteem was so poor that he could only have a negative response. Feeling worthless is not a genetic trait. It is imbued in the child from early life. If a mother tells her son: "You can't do it"; "You're worthless"; "Everything you touch is ruined," the child's sense of value is permanently damaged.

Many aggressive adolescents are angry - very angry! The most important reason for their anger is the absence of a father in their lives. They feel it keenly. If their father was never there, is in jail, or is on the streets, the child feels it. The key is the absence of a relationship or interaction between the two. I recommend that every psychiatrist see an outstanding documentary called "Oh Father ... Where Art Thou?" It is a provocative movie filmed across two continents that demonstrates the value of a father or male mentor in the life of a young boy.

Another reason for the anger is the continual punishment a child receives, perhaps for an aggressive act. The failure on the part of the adult to understand why the child did what he did is a key factor that stimulates anger. …