Research in Health and Medical Sciences
Sat, Jun 6, 2026
[Archive]
Volume 3, Issue 2 (4-2024)
JRHMS 2024, 3(2): 37-47 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Rezazadeh Kermani Y, Khezri Moghadam N. Aggression and impulsivity in AIDS patients: A comparative analysis with healthy individuals. JRHMS 2024; 3 (2) :37-47
URL: http://jrhms.thums.ac.ir/article-1-115-en.html
URL: http://jrhms.thums.ac.ir/article-1-115-en.html
1- Department of Psychology, Islamic Azad University, Kerman Branch, Kerman, Iran
2- Shahid Bahonar University of Kerman, Kerman, Iran ,khezri147@yahoo.com
2- Shahid Bahonar University of Kerman, Kerman, Iran ,
Abstract: (2 Views)
This study examined and compared levels of aggression and impulsivity in individuals living with HIV/AIDS and healthy individuals. People with HIV face substantial psychological stress, social stigma, and limited social support, which can increase aggressive and impulsive behaviors. Aggression encompasses violent and socially inappropriate behaviors, while impulsivity refers to difficulties in behavioral control, delayed gratification, and appropriate emotional expression. Using a causal-comparative design, 120 HIV-positive individuals and 120 healthy participants from Kerman were recruited through simple random sampling. The Barratt Impulsiveness Scale (BIS-11) and the Impulsive/Premeditated Aggression Scale (IPAS) were employed to assess impulsivity and aggression. Results indicated that the HIV group had a higher mean total aggression score (M = 73.62, SD = 9.02) than the healthy group (M = 67.31, SD = 7.18). Impulsive aggression was 37.25 (SD = 6.24) versus 34.14 (SD = 5.92), and premeditated aggression was 36.37 (SD = 5.88) versus 33.07 (SD = 5.26) in the HIV and healthy groups, respectively. Total impulsivity was also elevated in HIV-positive participants (M = 80.67, SD = 5.82) compared to healthy individuals (M = 64.31, SD = 4.78). Subscales of cognitive, motor, and non-planning impulsivity were higher in the HIV group (26.59, 31.76, and 22.32) than in controls (20.40, 25.91, and 18.01). All differences were statistically significant (P < 0.01). These findings indicate that individuals living with HIV exhibit significantly higher aggression and impulsivity across all dimensions, likely influenced by psychological stress, cognitive deficits, and limited social support. The results highlight the need for comprehensive interventions targeting emotional regulation, problem-solving skills, and executive function improvement.
Type of Study: Orginal Article |
Subject:
General
Received: 2026/02/1 | Accepted: 2026/02/16 | Published: 2026/02/28
Received: 2026/02/1 | Accepted: 2026/02/16 | Published: 2026/02/28
References
1. UNAIDS. Global AIDS Update 2024 - The Path That Ends AIDS. Geneva: Joint United Nations Programme on HIV/AIDS; 2024.
2. World Health Organization. HIV Data and Statistics 2024. Geneva: WHO; 2024.
3. Sherr L, Clucas C, Harding R, Sibley E, Catalan J. HIV and depression-a systematic review of interventions. Psychol Health Med. 2026;16(5):493-527. [DOI:10.1080/13548506.2011.579990]
4. Mahajan AP, Sayles JN, Patel VA, et al. Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward. AIDS. 2008;22(Suppl 2):S67-79. [DOI:10.1097/01.aids.0000327438.13291.62]
5. Rzeszutek M, Oniszczenko W. Personality traits, coping, and perceived social support in relation to mental health of HIV‑positive individuals. Int J Clin Health Psychol. 2020;20(3):239-48.
6. Rahmati A, Jafarian Dehkordi F. Stigma and discrimination against people living with HIV in Iran: a qualitative study. Iran J Public Health. 2022;51(9):2016-25.
7. Bagherzadeh R, Sadeghi A, Tol A. Public awareness and misconceptions about HIV/AIDS in Iran: a meta‑analysis. BMC Public Health. 2023;23(1):961.
8. Corrêa CS, Pires DV, de Paula S, de Souza F, D'Amico E, Paiva V. Stigma and discrimination in the lives of people living with HIV/AIDS: a narrative review. Rev Bras Enferm. 2021;74(1):e20190319.
9. SeyedAlinaghi S, Afsar Kazerooni P, Foroughi M, et al. Social isolation and quality of life among people living with HIV/AIDS in Iran. AIDS Res Ther. 2022;19(1):56.
10. Breet E, Kagee A, Seedat S. HIV-related stigma and symptoms of PTSD and depression in HIV-infected individuals: the mediating roles of social support and resilience. *AIDS Care. 2014;26(8):1003-10. [DOI:10.1080/09540121.2014.901486]
11. Patra S, Tyagi M, Menon DK. Relationship between aggression and impulsivity among HIV-positive patients. J Neurosci Rural Pract. 2020;11(4):584-90.
12. Anderson CA, Bushman BJ. Human aggression. Annu Rev Psychol. 2018;69:533-58.
13. Archer J. Sex Differences in Aggression in Real-Life Settings: A Meta-Analytic Review. [Updated Edition for 2025]. New York: Routledge; 2025.
14. World Health Organization. World Report on Violence and Health. Geneva: WHO; 2023.
15. Raine A. The Biology of Violence. London: Routledge; 2020.
16. Siegel A, Victoroff J. Understanding human aggression: new insights from neuroscience. Int J Law Psychiatry. 2009;32(4):209-15. [DOI:10.1016/j.ijlp.2009.06.001]
17. Dolan M, Fullam R. Impulsivity and aggression in forensic personality disorder: neurobiological and psychometric perspectives. J Forens Psychiatry Psychol. 2019;30(5):781-99.
18. DeWall CN, Finkel EJ, Denson TF. Self-control inhibits aggression. Soc Personal Psychol Compass. 2011;5(7):458-72. [DOI:10.1111/j.1751-9004.2011.00363.x]
19. Evenden JL. Varieties of impulsivity. Psychopharmacology (Berl). 1999;146(4):348-61. [DOI:10.1007/PL00005481]
20. Bari A, Robbins TW. Inhibition and impulsivity: behavioral and neural basis of response control. Prog Neurobiol. 2013;108:44-79. [DOI:10.1016/j.pneurobio.2013.06.005]
21. Moeller FG, Barratt ES, Dougherty DM, Schmitz JM, Swann AC. Psychiatric aspects of impulsivity. Am J Psychiatry. 2026;158(11):1783-93. [DOI:10.1176/appi.ajp.158.11.1783]
22. Fineberg NA, Chamberlain SR, Goudriaan AE, et al. New developments in human impulsivity: rising to the challenge. Psychopharmacology (Berl). 2014;231(23):4145-72.
23. Johnson SL, Carver CS, Joormann J. Impulsivity in depression and bipolar disorder: conceptual integration and future directions. J Affect Disord. 2013;144(3):301-12.
24. Bing EG, Burnam MA, Longshore D, Fleishman JA, Sherbourne CD, London AS, et al. Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Arch Gen Psychiatry. 2001;58(8):721-8. [DOI:10.1001/archpsyc.58.8.721]
25. Pence BW, Miller WC, Whetten K, Eron JJ, Gaynes BN. Prevalence of DSM-IV-defined mood, anxiety, and substance use disorders in an HIV clinic in the southeastern United States. J Acquir Immune Defic Syndr. 2006;42(3):298-306. [DOI:10.1097/01.qai.0000219773.82055.aa]
26. Gonzalez R, Vassileva J, Bechara A, Grbesic S, Sworowski L, Novak RM, et al. The influence of executive functions, sensation seeking, and HIV serostatus on the risky sexual practices of substance-dependent individuals. J Int Neuropsychol Soc. 2005;11(2):121-31. [DOI:10.1017/S1355617705050186]
27. Kalichman SC, Cain D. The relationship between indicators of sexual compulsivity and high-risk sexual practices among men and women receiving services from a sexually transmitted infection clinic. J Sex Res. 2004;41(3):235-41. [DOI:10.1080/00224490409552231]
28. Heaton RK, Clifford DB, Franklin DR Jr, Woods SP, Ake C, Vaida F, et al. HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy. Neurology. 2010;75(23):2087-96. [DOI:10.1212/WNL.0b013e318200d727]
29. Galvan FH, Burnam MA, Bing EG. Co-occurring psychiatric symptoms and drug dependence or heavy drinking among HIV-positive people. J Psychoactive Drugs. 2003;35(Suppl 1):153-60. [DOI:10.1080/02791072.2003.10400510]
30. Carrico AW, Johnson MO, Colfax GN, Moskowitz JT. Affective correlates of stimulant use and adherence to anti-retroviral therapy among HIV-positive men who have sex with men. AIDS Behav. 2010;14(4):769-77 [DOI:10.1007/s10461-008-9513-y]
31. Taghizadeh Z, Golmakani N, Ebrahimi M. Psychological well-being in HIV-positive patients: a systematic review in Iranian context. J Mazandaran Univ Med Sci. 2021;31(202):178-89.
32. Jaiswal J, Wiklund PE, Sabin LL, et al. The social dimensions of HIV/AIDS: stigma, discrimination, and implications for mental health. Soc Sci Med. 2020;258:113128.
33. Reece M, Dodge B, Herbenick D, et al. HIV serostatus disclosure to sexual partners among people living with HIV: a qualitative review. AIDS Educ Prev. 2017;29(1):60-71.
34. Kalichman SC, Grebler T. Stress and coping among people living with HIV/AIDS: a critical review. J Behav Med. 2010;33(2):89-104. [DOI:10.1007/s10865-010-9275-7]
35. Eftekhar Ardebili H, Jalali A, Faramarzi M, et al. Mental health predictors among people living with HIV in Iran: the role of stigma and social support. BMC Psychol. 2023;11(1):221.
36. Khodayarifard M, Dastjerdi R, Mohammadi M. Social and psychological correlates of aggression in Iranian adults. Iran J Psychiatry Clin Psychol. 2022;28(3):198-207.
37. Poudel KC, Nakahara S, Jimba M. Perceived family support, depression, and AIDS-related stigma among people living with HIV in Asia: evidence from Iran and Nepal. Int J Soc Psychiatry. 2024;70(1):10-9.
38. Di C, Zhang Y, Li X. Reliability and convergent validity of the BIS-11 in clinical and non-clinical populations. Psychiatry Res. 2024;333:111234.
39. Moeller SJ, et al. The role of impulsivity in HIV-associated neurocognitive disorders: A review. J Acquir Immune Defic Syndr. 2021;87(2):198-205.
40. Chen L, et al. Cognitive deficits and aggression in chronic illness populations: A meta-analysis. Behav Brain Res. 2020;381:116011.
41. Smith JR, et al. Neuropsychological profiles in treated HIV infection: Correlates with behavioral outcomes. Arch Clin Neuropsychol. 2019;34(5):610-21.
42. Davis M, et al. Impulsivity, aggression, and executive function in individuals living with HIV. AIDS Behav. 2022;26(3):945-55.
43. Williams P, et al. Impaired social problem-solving capacity in neurologically compromised patients. J Int Neuropsychol Soc. 2020;26(1):55-64.
44. Brown T, et al. Deficits in executive functioning predict aggressive behavior in conduct-disordered adolescents. J Child Psychol Psychiatry. 2021;62(10):1192-1201.
45. Green A, et al. Information processing speed and response inhibition in chronic viral infections. Neuropsychologia. 2019;128:33-40.
46. Spivack G, Shure MB. Interpersonal problem solving: Assessment and evaluation in research and practice. San Francisco: Jossey-Bass; 1982.
47. Lee K, et al. Correlation between rapid information processing deficits and heightened aggressive tendencies. Cogn Emot. 2023;37(1):140-52.
48. Miller J, et al. The compounding effect of chronic illness stigma on cognitive dysfunction and externalizing behaviors. Health Psychol. 2021;40(11):1085-94.
49. Jafari N, et al. Longitudinal assessment of working memory and planning in virologically suppressed HIV patients. JAMA Neurol. 2022;79(4):350-8.
50. Fallahi R, et al. Executive functions and emotional dysregulation in neurocognitive disorders associated with HIV. Biol Psychiatry Cogn Neurosci Neuroimag. 2023;8(2):167-75.
51. Kamali V, et al. Shared vulnerability: Linking impulsivity and prefrontal executive dysfunction in HAND. JAMA Neurol. 2021;78(12):1478-85. [DOI:10.1001/jamaneurol.2020.3703]
52. Alavi S, et al. Cognitive flexibility deficits as measured by the WCST in HIV-positive cohorts compared to controls. Neurocase. 2020;26(6):435-43.
53. Mohammadi L, et al. Cognitive rigidity and its implications for social adaptability in chronic diseases. Appl Neuropsychol Adult. 2022;29(5):1401-10.
54. Tavakoli R, et al. The moderating role of perceived stress on the link between impulsivity and aggression in adults with HIV. Stress Health. 2023;39(1):89-98.
55. Rostami Y, et al. Inability to inhibit prepotent responses: A predictor of hostile attribution bias in clinical populations. J Psychopathol Behav Assess. 2021;43(4):710-20.
56. Pazouki M, et al. Interaction between HIV-related depression and executive dysfunction in predicting behavioral outbursts. J Affect Disord. 2022;318:251-9.
57. Esmaeili H, et al. Behavioral dysregulation in comorbid anxiety and HIV-associated neurocognitive disorders. Int J Psychol Med. 2023;49(3):215-28.
58. Rahimi S, et al. Efficacy of integrated cognitive remediation therapy for aggression management in HIV patients. AIDS. 2020;34(11):1675-83.
59. Behrouzi F, et al. Holistic care approaches improve functional outcomes in patients with HAND and high comorbidity. HIV Clin Trials. 2022;23(2):120-30.
60. Karimi P, et al. Impact of lifetime substance use on executive function decline in chronic viral infections. Addict Behav. 2021;115:106745
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
