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Motivation and emotion/Book/2014/Methamphetamine and aggression

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Methamphetamine and aggression:
How does methamphetamine affect emotions, particularly aggression?

Overview

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The relation concerning methamphetamine and aggressive behaviours has been recently recongised[spelling?] as a growing epidemic throughout Australia and the United States of America[factual?]. Evidence has suggested that there could be an existing correlation associating the use of methamphetamine with an increase in aggressive and adverse behaviours within an individual[factual?]. This chapter explores whether the chemical components are primarily contributing to the onset of anger, or whether external, and biological factors are more influential?[grammar?]

What is aggression?

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According to Baron and Richardson (1994) the term aggression can be defined as any form of behaviour focused on the goal of emotionally harming or damaging another living being, who in particularly is driven to avoid a treatment (Krahe, 2013)[say what?]. Theorist Baron and Richardson, defined the term aggression with three fundamental components. Such as[grammar?] exemplifying aggressive behaviour by an underlying motivation, meaning that if a behaviour was steered with the objective to harm, it is considered an aggressive act (Krahe, 2013). Secondly, the individual must understand that the behaviour in action may cause harm to an outsider. Conclusively,[grammar?] the individual portraying the aggressive behaviour would display the features that usually would be avoided due to harmful elements, are exploited regardless of the consequence in action (Krahe, 2013). The emotion or act of aggression, can take a variety of different forms but are not limited to verbal, physical, psychological, emotional, postural, proactive, unprovoked instigation, as well as individual e.g. domestic violence, or within groups e.g. wars (Krahe, 2013).

What is methamphetamine?

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Methamphetamine as a crystal formation

According to The Meth Project (2005), methamphetamine can also be distinguished as meth, ice, speed, crystal, tweak and class (The Meth Project, 2014). It is a synthetic stimulant that is manufactured which is available as a powder, crystal or in pill formation, and can be consumed orally, injected, exhaled or snorted (The Meth Project, 2014). As methamphetamines are synthetic and manmade, the ingredients used can fluctuate among the different methods used. Most commonly the central ingredients used consist of acetone, lithium, toluene, hydrochloric acid, pseudoephedrine, red hydroxide, anhydrous ammonia and sulfuric acid (The Meth Project, 2014). These ingredients are acknowledged as extremely toxic and flammable, and are typically used in the construction of plastic, explosives, bathroom cleaner, fertilizers, brake fluid and batteries (The Meth Project, 2014). In particularly[grammar?] when approaching contact with these elements, extreme caution must be implemented as majority are known to burn through human flesh (The Meth Project, 2014).

How Does Methamphetamine Affect the Body?

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Short-term effects

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The effects of methamphetamine on the human body

After consumption, methamphetamine has a number of immediate and short-term effects on the body both physically and mentally. The powerful stimulant generates a false sense of euphoria and instant rush within the body, allowing the individual to feel alert and wide awake (Jenkinson, Johnston, McClean, Miller, & Pearce, 2008). The instant rush produced allows the user to feel a sense of power and strength, the user can experience extreme mood swings, including most frequently violent acts of behaviour and aggression (Jenkinson, Johnston, McClean, Miller, & Pearce, 2008). This high can precede[grammar?] anywhere from several hours to a day depending on the quantity of the drug consumed, the individuals tolerance and the body’s reaction (Jenkinson, Johnston, McClean, Miller, & Pearce, 2008). Methamphetamine can also cause uncontrollable muscle twitches and spasms, as well as facial twitches, an elevated body temperature, hallucinations (in particular, that insects are crawling under their skin and users must scratch them out), suppressed appetite, violent behaviour, irritability and death (Degenhardt & Topp, 2003). The most critical short-term effects include hallucinations, anxiety and paranoia (Degenhardt & Topp, 2003).

Long-term effects

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Suspected meth mouth caused from repeated use of methamphetamine

If an individual uses methamphetamine for a prolonged period of time, or becomes an addict or substance abuser, the synthetic stimulant can have serious consequential outcomes. Chronic users display concerning behavioural changes, which can result in mood disturbances, suicidal thoughts, insomnia, unprovoked rages, and exceedingly violent behaviour (Covey, 2007). Studies have observed that these behavioural changes can take place for months or even years after the user no longer [missing something?] the drug (Covey, 2007). Further extensive use can lead to mental disorders or illness such as depression and psychosis. Due to the toxic chemicals and acidity in the drug, severe tooth decay and poor gym hygiene occur also known as the term ‘meth mouth’ (Drug-Free World, 2006). 'Meth Mouth - Definition'

Other effects are but are not limited to suppressed appetite, malnutrition, loss of muscle tissue and bone density, development of irregular heartbeat, stroke, high blood pressure and profound damage to every organ in the body (Drug-Free World, 2006). Individuals who abuse meth have also displayed significant prematurely ageing on their skin, especially dramatically ageing on their face (Drug-Free World, 2006). Methamphetamine also has a serious effect on the central nervous system, cardiovascular system, respiratory and immune system. Due to the inconsistent increases and decreases in heart blood pressure, the use of meth can onset cardiac arrest, aneurysms, and create damage to the heart (Covey, 2007). Respiratory concerns consist of severe chest pain, coughing spams, fluid in the lungs, and eventually chronic lung disease (Covey, 2007).

The brain

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The influence of methamphetamine on the brain. The brain on the right displays a decrease in mental function

Methamphetamine releases a surge of dopamine (Dopamine Definition) into the brain, essentially a neurotransmitter that regulates pleasure (Frontline PBS, 2011). This surge causes an intense rush of pleasure within the individual, creating a sense of euphoria (Rawson, 2006). This state of euphoria originates from the rewards pathway in the brain, located from an area in the midbrain through the medial forebrain bundle, to the nucleus accumbens and onto the prefrontal cortex (Weiten, 2010). The increased dopamine activity in this pathway, has been recognised to be accountable for the reinforcing effects on methamphetamine and further drugs (Weiten, 2010). However, over time, meth destroys the dopamine receptors within the body making it challenging for the individual to feel the rush, even though they may be increasing their quantity of the drug (Frontline PBS, 2011). Chronic damage can cause sever[spelling?] impairment in memory, judgment and motor coordination in the user (Frontline PBS, 2011). The memory and learning circuit, located in the amygdala and the hippocampus is implicated significantly with the use of meth (Rawson, 2006). Brain imaging research has indicated that the memory and learning circuit is very impaired within meth addicts, relating to deficiency in recalling previous memory and learning new knowledge (Rawson, 2006). The amygdala is also highly affected within meth uses, explaining the extreme irrational emotional responses including fear, anxiety, irritability and anger (Rawson, 2006). Abnormalities within the prefrontal cortex have also been discovered, displaying the inability in the decision making process, impairment of one's judgement, rational thinking, as well as the inability to reason (Rawson, 2006).

Dopamine pathways in the brain, displaying the reward's pathway.

How does Aggression and Methamphetamine Interact?

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The biology of aggression

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Recent studies have suggested that in fact aggression in an individual can be due to heritability and an individuals genes (Brendgen et al., 2005). However, this research conveys that only particular elements in relation to aggression, such as physical expression can be deemed heritable (Brendgen et al., 2005). Recent research had founded that several areas of the brain are highly stimulated when an individual is highly aggressive or expresses violent behaviour (Weiten, 2010). The locations in the brain that are effected, key areas are within the pre-frontal cortex. Most commonly associated with aggression are the amygdala, lateral, medial and dorsal hypothalamus (Weiten, 2010). Previous studies (Grafman, Schwab, Warden, Pridgen, Brown, & Salazar, 1996), have indicated that when an individual experiences impairment within these locations, an individual is more likely to expressive elevated aggressive behaviour than those who haven’t. In particular Grafman et al., (1996), examined veterans who had suffered from penetrations to the head during their service in Vietnam, and results indicated significant increase risk of aggressive and violent behaviour from damage to the frontal lobe. Supporting evidence conducted by Brower and Price (2001), also established significant evidence associating the frontal lobe in the brain, if it is damaged or dysfunctional, it highly increases the likelihood of the individual acting in an aggressive manner or behaviour. These two supporting research experiments state that the relation between aggressive behaviours and the brain may be more subjected to damage in the area, than heritability components. Thus [grammar?] explaining that with the use of illicit drugs, such as methamphetamine an individual may be initiating self-induced impairment to their brain increasing their probabilities of being aggressive.

Serotonin and aggression

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Although damage to the brain and dopamine have proven to be suggestive in the relation causing an aggressive emotional state upon an individual[grammar?]. Research indicates that, serotonin – a neurotransmitter, also coveys a connection with the constant regulation and maintaining of emotion and behaviour (Seo & Patrick, 2008). Prior research with animals, has indicated that low levels of serotonin (5-hydroxytryptamine; 5-HT) have been linked to impulsive and aggressive behaviours (Seo & Patrick, 2008). In humans, longitudinal research conveyed by Moore, Scarpa and Raine (2002) scrutinised 20 separate studies finding that low levels of serotonin (5-HIAA) considerably contribute to aggressive behaviours (Seo & Patrick, 2008), [missing something?] than any other level of serotonin. The genetic predispositions such as behavioural genetics and the influences on serotonin, have proven to have a vast impact on the contribution of developing aggressive behaviours and the onset of personality disorders (Seo & Patrick, 2008).

The biology of aggression is a significant aspect to acknowledge, when understanding the relation between methamphetamine and aggressive behaviour. Further research will need to be conducted in order to observe just how influential heritability and genetics is in the disposure of aggressive behaviours. It is evident that aggressive behaviour can stem from many influences, not just psychologically but biologically too.

Why do people get aggressive: Theories of aggression

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Numerous theories and research have been developed over the years in order to provide explanation as to why individuals become aggressive or react the way that they do. Some theories focus on the social aspects, whilst others believe it is more psychological or external. The following theories provide diverse reasoning as to why aggressive behaviour occur.

Frustration-Aggression Hypothesis:Proposed by Dollard and Miller in the late 1980’s, suggesting that aggression occurs at the result of experiencing frustration (Weiten, 2010). Although this hypothesis is quite simplified, it is believed that it can remain reliable to some extent to explain the causation that some frustrations can lead to aggressive responses. However due to the simplicity of this theory, one would not suggest that it is advisable that all acts of aggression can be explained with this hypothesis (Tucker-Ladd, 2005). While not all acts of aggressive behaviour can be clarified, the feeling of frustration and irritability have been known to consume and rupture aggressive actions in many individuals when the feelings become too extensive (Krahe, 2013).

Social-Learning Theory: Conducted by Albert Bandura (1978), the social learning theory suggests that individual’s behaviour is learned through the process of imitation and observation (Tucker-Ladd, 2005). The learning process occurs when a behaviour is perceived as rewarding and pleasurable, and therefore reinforces the behaviour through imitation by others (Weiten, 2010). If an individual witnesses a friend or associate taking methamphetamine and observes the euphoric stage, the individual may be susceptible to trying the drug themselves. In relation to aggression, if the individual continually acts in an aggressive manner whilst on the drug, individuals surrounded may believe that this is an acceptable behaviour, and therefore imitate the behaviour themselves.

James-Lange Theory: Developed by Carl Lange and William James in the 19th century, suggesting that behaviours and physiological responses are directly produced by a situation, and the onset of emotion is created by the reaction from these behaviours (Weiten, 2010). These physiological responses can include increased heart rate, sweating and experiencing trembles, leading to the onset of behaviours such as fear, aggression, anxiety and so on (Weiten, 2010). It is believed that the physiological response comes first, followed by the emotion and reaction of the individual (Weiten, 2010). In the case of aggression, an individual may be faced with an intimidating situation, producing an increase in heart rate (physiological response), thus being fuelled with aggression (emotion), and prepare to fight (aggressive reaction).

Does methamphetamine produce an onset of aggressive behaviour?

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Evidence

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The major present debate specifies whether or not the use of methamphetamine is positively correlated with the emotion aggression. Is it the due to the drug itself and its influencing toxins, which chemically trigger the emotion aggression? Or perhaps it all originates down to an individuals environmental, genetics and behavioural influences, which simply provide a foundation for aggressive behaviour to occur in the first place. Other suggestions belief that the association of the relationship between meth and aggression is due a combination of underlying factors, such as both genetics and the effects of the drug (Degenhardt & Topp, 2003).

Since the early 1930s research has examined the effect that methamphetamine can have on aggression, and in several instances proven that prolonged high doses of meth, can in fact lead to an increase emotions, in particular aggression (McKetin, McLaren, Riddell, & Robins, 2006). Experimenters Sokolov, Schindler and Cadet (2004), evaluated a series of repeated methamphetamine injections into mice, and whether or not this provoked aggressive behaviours. Chronic injections of meth displayed significant violent reactions in the animal, displaying an increase in bite attacks and violent fighting (Sokolov, Schindler, & Cadet, 2004). In contrast, no increase in aggression was displayed when the animal was administered a singular injection, signifying that repeatedly uses of methamphetamine can lead to an increase in aggressive and violent behaviours but not in a one-off instance (Sokolov, Schindler, & Cadet, 2004).

Similarly, Lapsworth (2011) examined 237 methamphetamine users within Australia, and observed the interaction between methamphetamine use and aggression. The study revealed that users with higher levels of dependence on methamphetamine, displayed increased aggression and irritability (Lapsworth, 2011), than those with lower substance use. Further investigation also revealed that overall, methamphetamine users compared to non-users reported behaving more aggressive generally, as well as displaying excessive levels of aggression overall (Lapsworth, 2011). Research supporting Sokolov et al., (2004) also supplied supportive evidence of the quantity of methamphetamine and aggression correlation. Although the evidence is compelling, the Meth Project Organisation (2014) states that methamphetamine is the significant and most fundamental factor, for producing the onset of aggression in users. The significant reasoning supporting this reasoning is due to the chemical changes in the brain when ingested with the substance, the short-term effects the user will feel, the inability to interpret situations appropriately and the inability to supress mood swings; Click here to observe a personal encounter of aggression and methamphetamine (Siebel, Thomas M; 'The Meth Project', 2014).

Conversely, McKetin et al., (2006) further states that despite the evidence, it still is not clear whether methamphetamine creates aggressive and violent behaviour among users. Overwhelming evidence suggest that perhaps the inebriation of methamphetamine solitary[explain?] provides a trigger among users who are already affected by aggression mentally or physiologically (McKetin, McLaren, Riddell, & Robins, 2006). Other contributing factors that in combination with methamphetamine; in which effect aggression are alcohol consumption, personality and lifestyle choices (McKetin, McLaren, Riddell, & Robins, 2006). Similarly, supportive evidence provided by Boles and Miotto (2001), reviewed external forces and there[grammar?] contributions to the onset of aggression among methamphetamine users. Results revealed that stimulants play a vital role in aggressive and violent behaviour, nonetheless considers social processes such as drug distribution systems and economic factors to be just as influential as the substance itself (Boles & Miotto, 2003).

Mental Illness and Disorder

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Methamphetamine Psychosis: A mental disorder categorised by a loss of communication with an individual’s reality (Siebel, Thomas M; 'The Meth Project', 2014). Psychosis can be established as an individual uses methamphetamine, creating an onset of aggressive behaviour, personality variations, paranoia, delusions and hallucinations (Siebel, Thomas M; 'The Meth Project', 2014). The individual can experience extreme fear and the feeling that they are continuously in danger. This sense of danger can irrationally heighten the sense of impulsion to act aggressively to others in perceiving others as a threat (McKetin, McLaren, Riddell, & Robins, 2006).

Sleep Disorder: The insomnia-like and paranoia involved with methamphetamine can lead to disruptions in the circadian rhythm (Jenkinson, Johnston, McClean, Miller, & Pearce, 2008). The individual can begin to experience sleep disturbances due to their increased anxiousness and fear that they are constantly feeling, making it near impossible for the individual to rest (Degenhardt & Topp, 2003). These adverse effects are highly common when taking methamphetamines, and are believed to be a vast influence on sleep deprivation.

Schizophrenia: Although there is limited research conveying a positive association with methamphetamine and schizophrenia, methamphetamine is believed to induce severe symptoms equally similar to schizophrenia (McKetin, McLaren, Riddell, & Robins, 2006). Previous research has anticipated that through repeated use of methamphetamine, mental disorders such as schizophrenia can be triggered in the brain (Drug-Free World, 2006). This trigger of psychotic symptoms has also been correlated with an increase in aggressive behaviour within users (McKetin, McLaren, Riddell, & Robins, 2006).

Mood Disorder: Due to the manufactured stimulant and chemical components incorporated, methamphetamine produces an onset of chemical changes within the body and in particularly the brain (Siebel, Thomas M; 'The Meth Project', 2014). These rapid changes create abrupt mood swings in the individual, from feelings of euphoria and pleasure to violent and aggressive outbreaks (Jenkinson, Johnston, McClean, Miller, & Pearce, 2008). The individual can experience a variety of mood and personality changes within minutes to hours after consuming methamphetamine. If the individual begins using methamphetamine on a continuous basis, than the psychotic symptoms will begin to take control (Covey, 2007), loosing the power over their moods.

Present Issues

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Implications for today's society

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The correlation of methamphetamine use and aggressive behaviours is a growing epidemic that is being investigated in Australia (McKetin, McLaren, Riddell, & Robins, 2006) and the United States of America (Fox & Brown, 2007). In the US, an estimated 10.4 million people aged twelve and over have experimented with methamphetamine at least once (Fox & Brown, 2007). In Australia, approximately 395,000 people have reported recent use of the illicit drug and in 2006, 73,000 people were considered addicted users (McKetin, McLaren, Riddell & Robins, 2006) with numbers increasing. The effects of methamphetamine use on the individual contribute to the onset of aggressive behaviour and violence, as well as having the potential to trigger psychotic symptoms and disorders (Jenkinson, Johnston, McClean, Miller, & Pearce, 2008). These effects not only implicate the individual, but also their family and friends. Although the exact correlation between methamphetamine use and aggressive behaviour still remains uncertain, research has verified that there is a strong association consistent with methamphetamine and an onset of aggression (Lapsworth, 2011). At present, the debate remains open on whether the use of methamphetamine is a singular trigger of aggressive emotions, or purely a biological imbalance combined with external factors (Brendgen et al., 2005). Further research regarding the relation of methamphetamine and aggression is required in order to determine the accuracy of this connection.


Quotes from methamphetamine users and family about their aggressive experiences
Methamphetamine users and family speaking out about their personal experiences concerning aggressive behaviours.

'I get a random wave of bad mood, very angry feeling, I felt like a bomb about to explode. I almost put some holes in my room walls and felt like breaking stuff or just beating someone up. I raged hard, I also got removed on a forum and there I just went almost mental, my teeth were grinding from anger, I was swearing. I never been that angry in my whole life!'

User: Hapomen22 (Bluelight,2012)

'I ended up smoking meth with one of my friends that did it. We ended up getting into an argument and I had my gun in my hand, I was swinging it around like a manic. The gun ended up going off and killing my best friend. I ended up getting really paranoid and thought I would go to prison, so I buried this guy. Meth made me do it, its evil in its purest form.'

Justin, (Meth Project, 2014)

'That’s one of the things that makes methamphetamine so scary. It can happen out of nowhere. Methamphetamine is an extremely potent drug and it can be volatile, unpredictable.'

User: Tricomb (Bluelight, 2012)

'I feel so much anger building inside me. I don't know why I am so angry. Any little thing sets me off and I see red - I feel like I want to hurt whoever it is no matter if I know them or not.'

User: Kathy1982 (Bluelight, 2011)

'I’m most ashamed about how violent I get, the things that I have done because of meth. I started doing meth when I was 12, I remember jumping down on the couch and I hit my head. My mother and brother were laughing at me, I just lost it. I hit her. You cant take something like that back…'

Oriah (Meth Project, 2014)

'Its like walking on eggs shells. She can be two, three, four people at the same time, one minute shes fine talking to you, and you say one more word to her and she snaps.'

Family of a meth addict (Meth Project, 2014)

'Me and my brother were walking down a trail smoking some meth. He said something to me and it set me off, I picked up a tree limb and I started hitting him with it. Busted his head open, and I think it broke one or two of his ribs, broke his nose. I turned into a horrible person.'

Devin, (Meth Project, 2014)

'My addiction, forced me to do things that I’m not even capable of.'

Justin, (Meth Project, 2014)

  

1 What are the main forms of methamphetamine?

Powder
Both Powder, Crystal and Pill
Pill
Crystal

2 Lower levels of serotonin in an animal mean that they are more likely to have?

Calmer behaviours
Violent behaviours
Disorientated behaviours
More aggressive and and impulsive behaviours

3 The more CORRECT short-term effect for methamphetamine is?

Aggressive behaviour
Stroke
Meth-mouth
Damage to organs

4 Methamphetamine releases what neurotransmitter in the brain, referring to experiencing pleasure or a euphoric sensation?

Dopamine
Serotonin
Glutamate
Norepinephrine


==See also

References

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Bluelight Organisation. (2012, September 10). Meth comedown anger issues. Retrieved October 15, 2014, from Bluelight - The Front Page: http://www.bluelight.org/vb/threads/642096-Meth-comedown-anger-issues

Boles, S. M., & Miotto, K. (2003). Substance abuse and violence: A review of the literature. Aggression and Violent Behavior , 8 (2), 155-174.

Brendgen, M., Dionne, G., Girard, A., Boivin, M., Vitaro, F., & Pérusse, D. (2005). Examining Genetic and Environmental Effects on Social Aggression: A Study of 6-Year-Old Twins. Child Development, 76(4), 930-946. doi:10.1111/j.1467-8624.2005.00887.x

Brower, M. C., & Price, B. H. (2001). Neuropsychiatry of frontal lobe dysfunction in violent and criminal behaviour: a critical review. Advances in Neuropsychiatry , 71, 720-726.

Covey, H. C. (2007). The Methamphetamine Crisis: Strategies to Save Addicts, Families, and Communities. Westport, CT, United States of America: Praeger Publishers Inc.

Degenhardt, L., & Topp, L. (2003). ‘Crystal meth’ use among polydrug users in Sydney's dance party subculture: characteristics, use patterns and associated harms. International Journal of Drug Policy , 14 (1), 17-24.

Drug-Free World. (2006). Foundation for a Drug-Free World: find out the truth about drugs. Retrieved October 10, 2014, from Short and Long Term Side Effects of Crystal Methamphetamine on the Body : http://www.drugfreeworld.org/drugfacts/crystalmeth/the-deadly-effects-of-meth.htm

Fox, M. S., & Brown, S. E. (2007). Methamphetamine: One of America’s Greatest Challenges Part I . USA: University of Nebraska–Lincoln Extension Publications

Frontline PBS. (2011, May 17). How Meth Destroys the Body | The Meth Epidemic. Retrieved October 12, 2014, from FRONTLINE - Documentary Films and thought - provoking journalism | PBS: http://www.pbs.org/wgbh/pages/frontline/meth/body/

Grafman, J., Schwab, K., Warden, M., Pridgen, B., Brown, H. R., & Salazar, M. (1996). Frontal lobe injuries, violence and aggression . A report of the Vietnam Head Injury Study , 46 (5).

Jenkinson, R., Johnston, J., McClean, R., Miller, C., & Pearce, B. (2008). Prevention Research Quarterly, Current Evidence Evaluated: Methamphetamine. The Australian Drug Foundation. Victoria: DrugInfo Clearinghouse.

Krahe, B. (2013). The Social Psychology of Aggression (2nd Edition ed.). New York, United States of America: Psychology Press.

Lapsworth, k. N. (2011). An Investigation of Aggression in Methamphetamine Users. Griffin University, NSW.

McKetin, R., McLaren, J., Riddell, S., & Robins, L. (2006). The relationship between methamphetamine use and violent behaviour. National Drug and Alochol Research Centre, UNSW . NSW: NSW Bureau of Crime Statistics and Research. Rawson, R. A. (2006). Methamphetamine: New Knowledge, New Treatments: Clinician's Manual. Minnesota, USA: Hazelden Organisation .

Seo, D., & Patrick, C. J. (2008). Role of Serotonin and Dopamine System Interactions in the Neurobiology of Impulsive Aggression and its Comorbidity with other Clinical Disorders. Aggressive Violent Behaviour , 13 (5), 383-395.

Siebel, Thomas M; 'The Meth Project'. (2014). What's In Meth. Retrieved October 10, 2014, from Meth Project Organisation: http://www.methproject.org/answers/whats-meth-made-of.html#Whats-in-Meth

Siebel, Thomas M; 'The Meth Project'. (2014) 'Methamphetamine Signs, Violence & Effects of Meth', Retrieved October 10 2014, from Meth Project Organisation: http://www.methproject.org/answers/does-meth-make-you-violent.html#Oriahs-Story

Sokolov, B., Schindler, C., & Cadet, J. (2004). Chronic methamphetamine increases fighting in mice. Pharmacol Biochem Behav , 77 (2), 319-26.

The No-Way Campaign., (2009). 60 Minutes “Ice” Special. Retrieved from: https://www.youtube.com/watch?v=AFcfyA1a0Hs

Tucker-Ladd, E. C. (2005). Psychological Self-Help. USA: Self-Help Foundation .

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