Aggression and autoagression (suicide) - a neurobiological analysis

In suicidology, the concept of "autoaggression" is often used both as aggression directed at the subject and as a synonym for suicidality, mainly based on psychoanalytic ideas formulated by Z. Freud. The aim of this descriptive review is to analyze these ideas as objectively as possible using neurobiological, neuropsychological, and neurogenomic data. Results. In modern suicidological discourse, the concept of "aggressive suicide" is substantiated, that is, suicide committed in the most lethal ways, in which aggression acts as a personality trait that directly predisposes to committing suicide. We reviewed the basic ideas about the relationship between aggression and auto-aggression from the standpoint of the conceptual apparatus, some statistical data and general neurobiological factors. The data presented in the review indicate that the modern understanding of aggressive behavior (for example, in the context of psychopathy or antisocial personality disorder) and suicidal behavior, with all the variety of approaches, comes from largely coinciding ideas. In both cases, the same neurobiological systems are involved (serotonin, catecholamine, neuroendocrine regulation system, and a number of others), neuropsychological and psychophysiological parameters are very similar, neuromorphological deviations (volumetric and functional assessments of the activity of the prefrontal cortex, amygdala, and emotional structures) have similar features. A significant number of genetic markers are common for aggression and suicide. Neurobiological evidence reveals the factors that underlie the close association between aggressiveness and suicidality as measured by questionnaires and psychological tools. The aggressive instinct or trait acts as a suicidal endophenotype, along with other endophenotypes such as stress vulnerability and some personality traits. The heterogeneity of aggression (reactive, impulsive and emotionally loaded, and proactive, planned, prudent and cold) has its analogies in the form of impulsive suicide against the background of the disinhibitory effect of alcohol and conscious and planned suicide against the background of depressive states. Conclusion. The neurobiological approach confirms the productivity of the ideas expressed by psychoanalysts and opens up new perspectives on the study of both aggression and suicide.