Recurrent Violent Behavior: Revised Classification and Implications for Global Psychiatry

Interpersonal violent acts are a worldwide problem. Deterrence of violence has been, and remains a complicated and often unsuccessful enterprise, given that violence is multi-factorial, and occurs in a variety of contexts (e.g., domestic violence; serial killing; mass slaying; terrorism; collective violence), and on a global scale within diverse socio-cultural populations (1). Given this broad impact, there have been, and continue to be public and political calls—if not demands—to employ research findings to both better identify and mitigate or prevent causes and occurrences of violent behavior (2–4). Current research and interventions in violent behavior are mainly focused upon four domains: (a) attention to the trauma and needs of victims (5), (b) recidivism of violent crime (6), (c) violence as an expressed trait of certain neuropsychiatric disorders (7), and (d) seeking predictive variables (8). Previously, we have suggested that recurrent violent behavior (RVB)1 should be considered as a psychiatric classifier that can be employed to initiate further medical and public safety interventions within an interdisciplinary approach, as we acknowledge that RVB is often multi-etiologic, and involves biological as well as psychosocial factors (9). In this light, we have explored the viability of using RVB in DSM and/or ICD frameworks, which could be applicable in developed as well as developing and non-developed countries’ as a component of the proposed global mental health (GMH) plan (10). We believe that this could yield novel opportunities for studying chronic violence as an international mental health issue. However, we also note the potentially controversial nature of such classification, and acknowledge the need to prudently address validity, viability, benefits, risks, and harms that could be incurred by using neuroscience and neurotechnology to assess and intervene against recurrent violence (11).