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The Relationship Between Finger Ratio (2D:4D) and Criminal Behavior in Bipolar Disorder

Year 2025, Volume: 47 Issue: 1, 41 - 48, 29.03.2025

Abstract

ABSTRACT
Objective: The purpose of this study was to examine the relationship between 2D:4D digit ratio and aggression and impulsivity in manic patients (BP) with and without a history of criminal behavior.
Materials and Methods: The study included a total of 106 subjects, which included 41 healthy individuals, 34 bipolar (BP) patients with a history of criminal behavior (CBP) and 31 BP patients who had not engaged in criminal activity (NCBP). All participants were administered a socio-demographic data form, the Buss-Perry Aggression Scale (BAQ), Barratt Impulsiveness Scale-11 (BIS-11) and the Young Mania Rating Scale (YMRS) and 2D:4D ratio measurement.
Results: The right hand 2D:4D ratios of BP patients included in the study were significantly lower (p: 0.007) compared to the control group. Moreover the BAQ scores of BP patients were higher compared to the control group. In CBP patients, both the right hand 2D:4D (p: 0.007) and left hand 2D:4D (p: 0.036) were significantly lower when compared to the control group. Furthermore, the BIS-11 score (p: 0.046) and YMRS (p: 0.008) of CBP patients were significantly higher when compared to NCBP.
Conculusion: Based on results, we predict that in the future, the lower 2D:4D ratio in the right and left hand of bipolar manic patients who commit crimes compared to the control group, will guide in advance whether individuals prone to bipolar manic disorder will be involved in criminal activities, utilizing anatomical data (2D:4D) as the gold standard.

Ethical Statement

The study was approved by the Non-Interventional Local Ethics Committee of Fırat University under reference number 2023/13-06 (Meeting Date: 27.09.2023).

Supporting Institution

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Thanks

The authors would like to express their gratitude to individuals that participated in this study. We thank ResearchSquare for helping us reach more colleagues and improve the quality of our articles through feedback.

References

  • 1- APA, American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5), 2013.
  • 2- Guy MG. Bipolar disorder. Medicine. 2024; 52, 481-484. doi:10.1016/j.mpmed.2024.06.003
  • 3- Drachman R, Colic L, Sankar A, et al. Rethinking "aggression" and impulsivity in bipolar disorder: Risk, clinical and brain circuitry features. J Affect Disord. 2022; 303: 331-339.
  • 4- Dome P, Rihmer Z, Gonda X. Suicide risk in bipolar disorder: a brief review. Medicina (Kaunas). 2019; 55(8): 403. doi: 10.3390/medicina55080403.
  • 5- Li X, Gao Y, Liu Y, Wang Y, Wu Q.Clinical markers of physical violence in patients with bipolar disorder in manic states. Risk Manag Healthc Policy. 2023; 16:
  • 6- Ryles F, Meyer TD, Adan-Manes J, MacMillan I, Scott J. A systematic review of the frequency and severity of manic symptoms reported in studies that compare phenomenology across children, adolescents and adults with bipolar disorders. Int J Bipolar Disord. 2017; 5(1): 4.
  • 7- Dailey MW, Saadabadi A. Mania. StatPearls Publishing, Treasure Island (FL); 2023
  • 8- Canan F, Karaca S, Düzgün M, et al. The relationship between second-to-fourth digit (2d:4d) ratios and problematic and pathological internet use among turkish university students. J Behav Addict. 2017; 6(1): 30-41. doi: 10.1556/2006.6.2017.019.
  • 9- Emre E, Aydin S, Yildiz S. An overview of the assocation between the second and fourth finger ratio (2d/4d) and diseases. Academic Research and Reviews in Health Sciences-Chapter 7. Platanus Publishing.103-121, 2023.
  • 10- Tegin C, Canan F, El-Mallakh RS. The 2nd to 4th digit ratios (2D:4D) in patients with bipolar disorder. J Affect Disord. 2019; 259: 27-30.
  • 11- Fusar-Poli L, Rodolico A, Sturiale S, et al. Second-to-Fourth Digit Ratio (2D:4D) in Psychiatric Disorders: A Systematic Review of Case-control Studies. Clin Psychopharmacol Neurosci. 2021 Feb 28;19(1):26-45. doi: 10.9758/cpn.2021.19.1.26.
  • 12- Han Y, Deng W, Lei W, et al. Association between the 2D: 4D ratio and schizophrenia. Journal of International Medical Research. 2020; 48: 0300060520929148.
  • 13- Sanwald S, Widenhorn-Müller K, Wernicke J, Sindermann C, Kiefer M, Montag C. Depression Is Associated With the Absence of Sex Differences in the 2D:4D Ratio of the Right Hand. Front Psychiatry. 2019; 16: 10:483. doi:10.3389/fpsyt.2019.00483
  • 14- Egger ST, Bobes J, Theodoridou A, Seifritz E, Vetter S. Assessing the severity of psychiatric disorders using the Health of the Nation Outcome Scales: An equipercentile linking analysis. Aust N Z J Psychiatry. 2020; 54:1192-1199.
  • 15- Fazel S, Vazquez-Montes MDLA, Molero Y, et al. Risk of death by suicide following self-harm presentations to healthcare: development and validation of a multivariable clinical prediction rule (OxSATS). BMJ Ment Health. 2023; 26: e300673.
  • 16- Najafzadeh, MJ, Ghazanfari Pour S, Divsalar P. Aggression in schizophrenia, bipolar and major depression disorder. J Aggress Confl Peace Res. 2023; 15: 349-359. doi: 10.1108/JACPR-11-2022-0756.
  • 17- Sırlıer Emir B, Kazğan A, Kurt O, Yıldız S. Sociodemographic Characteristics of Persons Treated in the High Security Forensic Psychiatry Service: A Retrospective Study. Med Records. 2022; 4: 73-80.
  • 18- Patton JH, Stanford MS, Barratt ES. Factor structure of the Barratt impulsiveness scale. J Clin Psychol. 1995; 51: 768-774.
  • 19- 1Buss AH, Perry M. The Aggression Questionnaire. J Pers Soc Psych. 1992; 63: 452-459.
  • 20- Young RC, Biggs JT, Ziegler VE, Meyer DA. A Rating Scale for Mania: Reliability, Validity and Sensitivity. Br J Psychiatry. 1978; 133(5): 429-435.
  • 21- Güleç H, Tamam L, Yazıcı Güleç M, et al. Barratt Dürtüsellik Ölçeği -11 (BIS11)’ nin Türkçe uyarlamasının psikometrik özellikleri. Psychometric properties of Turkish version of BIS-11. Bull Clin Psychopharmacol. 2008; 18: 251–258.
  • 22- Evren C, Cınar O, Güleç H, Çelik S, Evren B. The validity and reliability of the Turkish version of the Buss-Perry’s Aggression Questionnaire in male substance dependent inpatients. Dusunen Adam Journal of Psychiatry and Neurological Sciences, 2011; 24, 283-295. doi:10.5350/DAJPN2011240404
  • 23- Karadağ F, Oral T, Yalçin FA, Erten E. Reliability and validity of Turkish translation of Young Mania Rating Scale. Turk Psikiyatri Dergisi. 2002;13(2): 107-114.
  • 24- Steinkamp RC. Body composition in relation to disease. Am J Public Health Nations Health. 1968, 58 (3): 473-476. doi:10.2105/AJPH.58.3.473
  • 25- Lake CR. Hypothesis: grandiosity and guilt cause paranoia; paranoid schizophrenia is a psychotic mood disorder; a review. Schizophr Bull. 2008; 34(6): 1151-62. doi:10.1093/schbul/sbm132.
  • 26- Ghiasi N, Azhar Y, Singh J. Psychiatric illness and criminality. In StatPearls [internet]. StatPearls Publishing. 2023.
  • 27- Evardone M, Alexander GM. Anxiety, sex-linked behaviors, and digit ratios (2D:4D). Arch Sex Behav. 2009; 38(3):442-55. doi: 10.1007/s10508-007-9260-6 doi:10.1007/s10508-007-9260-6.
  • 28- Lenz B, Mühle C. Cohort Study on Substance Use Risk Factors; Kornhuber, J. Lower digit ratio (2D:4D) in alcohol dependence: Confirmation and exploratory analysis in a population-based study of young men. Addict Biol. 2020; 25(4). doi: 10.1111/adb.12815.
  • 29- Kɪlɪç F, Işɪk Ü, Demirdaş A, İnci HE. Investigation of second to fourth finger length ratio (2D:4D) in patients with bipolar disorder. Braz J Psychiatry. 2020; 42(6):617-620.
  • 30- Sırlıe EB, Yıldız S, Kılıçaslan KA, et al. Inflammation Markers in Patients with Bipolar Disorder Who Have Committed Offenses and Their Relationship with Criminal Behavior. Medicina. 2023; 59(10), 1725. 31- Ballester J, Goldstein T, Goldstein B, et al. Is bipolar disorder specifically associated with aggression? Bipolar Disord. 2012, 14(3):283-90.
  • 32- Swann AC, Moeller FG, Steinberg JL, Schneider L, Barratt ES, Dougherty DM. Manic symptoms and impulsivity during bipolar depressive episodes. Bipolar Disord. 2007; 9(3):206-12. doi:10.1111/j.1399-5618.2007.00357.x.
  • 33- Yu C, Zhang J, Zuo X, Lian Q, Tu X, Lou C. Correlations of impulsivity and aggressive behaviours among adolescents in Shanghai, China using bioecological model: cross-sectional data from Global Early Adolescent Study. BMJ Open. 2021; 15;11(7). doi:10.1136/bmjopen-2020-043785.
  • 34- Gauthier KJ, Furr RM, Mathia CW, Marsh-Richard DM, Dougherty DM. Differentiating impulsive and premeditated aggression: self and informant perspectives among adolescents with personality pathology. J Pers Disord. 2009, 23(1):76-84.
  • 35- Azorin JM, Lefrere A, Belzeaux R. The Impact of Bipolar Disorder on Couple Functioning: Implications for Care and Treatment. A Systematic Review. Medicina (Kaunas). 2021, 29; 57(8):771.
  • 36- Rowland TA, Marwaha S. Epidemiology and risk factors for bipolar disorder. Ther Adv Psychopharmacol. 2018; 26; 8(9): 251-269. doi:10.1177/2045125318769235.
  • 37- Heffner JL, Strawn JR, DelBello MP, Strakowski SM, Anthenelli RM. The co-occurrence of cigarette smoking and bipolar disorder: phenomenology and treatment considerations. Bipolar Disord. 2011; 13(5-6):439-53. doi: 10.1111/j.1399-5618.2011.00943.x.
  • 38- Sonn SC, Brady KT. Bipolar Disorder and Alcoholism. Alcohol Res Health. 2002; 26(2):103–8.
  • 39- Teixeira ALDS, Fernandes Júnior W, Marques FA, Lacio MLD, Dias MRC. Influence of different phases of menstrual cycle on flexibility of young women. Revista Brasileira de Medicina do Esporte. 2012; 18: 361-364. doi: 10.1590/S1517-86922012000600002.
  • 40- Pletzer B, Noachtar I. Emotion recognition and mood along the menstrual cycle. Horm Behav. 2023; 154: 105406.
  • 41- Rasgon N, Bauer M, Glenn T, Elman S, Whybrow PC. Menstrual cycle related mood changes in women with bipolar disorder. Bipolar disord. 2003; 5(1): 48-52. doi: 10.1034/j.1399-5618.2003.00010.x.
  • 42- Teatero ML, Mazmanian D, Sharma V. Effects of the menstrual cycle on bipolar disorder. Bipolar disord. 2014; 16(1): 22-36.

Bipolar Bozuklukta Parmak Oranı (2D:4D) ile Suç Davranışı Arasındaki İlişki

Year 2025, Volume: 47 Issue: 1, 41 - 48, 29.03.2025

Abstract

ÖZET
Amaç: Bu çalışmanın amacı, suç davranışı öyküsü olan ve olmayan manik hastalarda (BP) 2D:4D rakam oranı ile saldırganlık ve dürtüsellik arasındaki ilişkiyi incelemektir.
Gereç ve Yöntem: Çalışmaya 41 sağlıklı birey, suç davranışı öyküsü olan 34 bipolar hasta (CBP) ve suç faaliyetinde bulunmamış 31 BP hastası (NCBP) olmak üzere toplam 106 denek dahil edilmiştir. Tüm katılımcılara sosyo-demografik veri formu, Buss-Perry Saldırganlık Ölçeği (BAQ), Barratt Dürtüsellik Ölçeği-11 (BIS-11) ve Young Mani Derecelendirme Ölçeği (YMRS) uygulanmış ve 2D:4D oranı ölçülmüştür.
Bulgular: Çalışmaya dahil edilen BP hastalarının sağ el 2D:4D oranları kontrol grubuna kıyasla anlamlı derecede düşüktü (p:0.007). Ayrıca BP hastalarının BAQ skorları kontrol grubuna kıyasla daha yüksekti. CBP hastalarında hem sağ el 2D:4D (p:0.007) hem de sol el 2D:4D (p:0.036) oranları kontrol grubuna kıyasla anlamlı derecede düşüktü. Ayrıca, CBP hastalarının BIS-11 skoru (p:0.046) ve YMRS (p:0.008) NCBP ile karşılaştırıldığında anlamlı derecede yüksekti.
Sonuç: Sonuçlara dayanarak, gelecekte suç işleyen bipolar manik hastaların sağ ve sol ellerindeki 2D:4D oranının kontrol grubuna kıyasla daha düşük olmasının, altın standart olarak anatomik verileri (2D:4D) kullanarak bipolar manik bozukluğa yatkın bireylerin suç faaliyetlerine karışıp karışmayacağı konusunda önceden yol göstereceğini tahmin ediyoruz.

References

  • 1- APA, American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5), 2013.
  • 2- Guy MG. Bipolar disorder. Medicine. 2024; 52, 481-484. doi:10.1016/j.mpmed.2024.06.003
  • 3- Drachman R, Colic L, Sankar A, et al. Rethinking "aggression" and impulsivity in bipolar disorder: Risk, clinical and brain circuitry features. J Affect Disord. 2022; 303: 331-339.
  • 4- Dome P, Rihmer Z, Gonda X. Suicide risk in bipolar disorder: a brief review. Medicina (Kaunas). 2019; 55(8): 403. doi: 10.3390/medicina55080403.
  • 5- Li X, Gao Y, Liu Y, Wang Y, Wu Q.Clinical markers of physical violence in patients with bipolar disorder in manic states. Risk Manag Healthc Policy. 2023; 16:
  • 6- Ryles F, Meyer TD, Adan-Manes J, MacMillan I, Scott J. A systematic review of the frequency and severity of manic symptoms reported in studies that compare phenomenology across children, adolescents and adults with bipolar disorders. Int J Bipolar Disord. 2017; 5(1): 4.
  • 7- Dailey MW, Saadabadi A. Mania. StatPearls Publishing, Treasure Island (FL); 2023
  • 8- Canan F, Karaca S, Düzgün M, et al. The relationship between second-to-fourth digit (2d:4d) ratios and problematic and pathological internet use among turkish university students. J Behav Addict. 2017; 6(1): 30-41. doi: 10.1556/2006.6.2017.019.
  • 9- Emre E, Aydin S, Yildiz S. An overview of the assocation between the second and fourth finger ratio (2d/4d) and diseases. Academic Research and Reviews in Health Sciences-Chapter 7. Platanus Publishing.103-121, 2023.
  • 10- Tegin C, Canan F, El-Mallakh RS. The 2nd to 4th digit ratios (2D:4D) in patients with bipolar disorder. J Affect Disord. 2019; 259: 27-30.
  • 11- Fusar-Poli L, Rodolico A, Sturiale S, et al. Second-to-Fourth Digit Ratio (2D:4D) in Psychiatric Disorders: A Systematic Review of Case-control Studies. Clin Psychopharmacol Neurosci. 2021 Feb 28;19(1):26-45. doi: 10.9758/cpn.2021.19.1.26.
  • 12- Han Y, Deng W, Lei W, et al. Association between the 2D: 4D ratio and schizophrenia. Journal of International Medical Research. 2020; 48: 0300060520929148.
  • 13- Sanwald S, Widenhorn-Müller K, Wernicke J, Sindermann C, Kiefer M, Montag C. Depression Is Associated With the Absence of Sex Differences in the 2D:4D Ratio of the Right Hand. Front Psychiatry. 2019; 16: 10:483. doi:10.3389/fpsyt.2019.00483
  • 14- Egger ST, Bobes J, Theodoridou A, Seifritz E, Vetter S. Assessing the severity of psychiatric disorders using the Health of the Nation Outcome Scales: An equipercentile linking analysis. Aust N Z J Psychiatry. 2020; 54:1192-1199.
  • 15- Fazel S, Vazquez-Montes MDLA, Molero Y, et al. Risk of death by suicide following self-harm presentations to healthcare: development and validation of a multivariable clinical prediction rule (OxSATS). BMJ Ment Health. 2023; 26: e300673.
  • 16- Najafzadeh, MJ, Ghazanfari Pour S, Divsalar P. Aggression in schizophrenia, bipolar and major depression disorder. J Aggress Confl Peace Res. 2023; 15: 349-359. doi: 10.1108/JACPR-11-2022-0756.
  • 17- Sırlıer Emir B, Kazğan A, Kurt O, Yıldız S. Sociodemographic Characteristics of Persons Treated in the High Security Forensic Psychiatry Service: A Retrospective Study. Med Records. 2022; 4: 73-80.
  • 18- Patton JH, Stanford MS, Barratt ES. Factor structure of the Barratt impulsiveness scale. J Clin Psychol. 1995; 51: 768-774.
  • 19- 1Buss AH, Perry M. The Aggression Questionnaire. J Pers Soc Psych. 1992; 63: 452-459.
  • 20- Young RC, Biggs JT, Ziegler VE, Meyer DA. A Rating Scale for Mania: Reliability, Validity and Sensitivity. Br J Psychiatry. 1978; 133(5): 429-435.
  • 21- Güleç H, Tamam L, Yazıcı Güleç M, et al. Barratt Dürtüsellik Ölçeği -11 (BIS11)’ nin Türkçe uyarlamasının psikometrik özellikleri. Psychometric properties of Turkish version of BIS-11. Bull Clin Psychopharmacol. 2008; 18: 251–258.
  • 22- Evren C, Cınar O, Güleç H, Çelik S, Evren B. The validity and reliability of the Turkish version of the Buss-Perry’s Aggression Questionnaire in male substance dependent inpatients. Dusunen Adam Journal of Psychiatry and Neurological Sciences, 2011; 24, 283-295. doi:10.5350/DAJPN2011240404
  • 23- Karadağ F, Oral T, Yalçin FA, Erten E. Reliability and validity of Turkish translation of Young Mania Rating Scale. Turk Psikiyatri Dergisi. 2002;13(2): 107-114.
  • 24- Steinkamp RC. Body composition in relation to disease. Am J Public Health Nations Health. 1968, 58 (3): 473-476. doi:10.2105/AJPH.58.3.473
  • 25- Lake CR. Hypothesis: grandiosity and guilt cause paranoia; paranoid schizophrenia is a psychotic mood disorder; a review. Schizophr Bull. 2008; 34(6): 1151-62. doi:10.1093/schbul/sbm132.
  • 26- Ghiasi N, Azhar Y, Singh J. Psychiatric illness and criminality. In StatPearls [internet]. StatPearls Publishing. 2023.
  • 27- Evardone M, Alexander GM. Anxiety, sex-linked behaviors, and digit ratios (2D:4D). Arch Sex Behav. 2009; 38(3):442-55. doi: 10.1007/s10508-007-9260-6 doi:10.1007/s10508-007-9260-6.
  • 28- Lenz B, Mühle C. Cohort Study on Substance Use Risk Factors; Kornhuber, J. Lower digit ratio (2D:4D) in alcohol dependence: Confirmation and exploratory analysis in a population-based study of young men. Addict Biol. 2020; 25(4). doi: 10.1111/adb.12815.
  • 29- Kɪlɪç F, Işɪk Ü, Demirdaş A, İnci HE. Investigation of second to fourth finger length ratio (2D:4D) in patients with bipolar disorder. Braz J Psychiatry. 2020; 42(6):617-620.
  • 30- Sırlıe EB, Yıldız S, Kılıçaslan KA, et al. Inflammation Markers in Patients with Bipolar Disorder Who Have Committed Offenses and Their Relationship with Criminal Behavior. Medicina. 2023; 59(10), 1725. 31- Ballester J, Goldstein T, Goldstein B, et al. Is bipolar disorder specifically associated with aggression? Bipolar Disord. 2012, 14(3):283-90.
  • 32- Swann AC, Moeller FG, Steinberg JL, Schneider L, Barratt ES, Dougherty DM. Manic symptoms and impulsivity during bipolar depressive episodes. Bipolar Disord. 2007; 9(3):206-12. doi:10.1111/j.1399-5618.2007.00357.x.
  • 33- Yu C, Zhang J, Zuo X, Lian Q, Tu X, Lou C. Correlations of impulsivity and aggressive behaviours among adolescents in Shanghai, China using bioecological model: cross-sectional data from Global Early Adolescent Study. BMJ Open. 2021; 15;11(7). doi:10.1136/bmjopen-2020-043785.
  • 34- Gauthier KJ, Furr RM, Mathia CW, Marsh-Richard DM, Dougherty DM. Differentiating impulsive and premeditated aggression: self and informant perspectives among adolescents with personality pathology. J Pers Disord. 2009, 23(1):76-84.
  • 35- Azorin JM, Lefrere A, Belzeaux R. The Impact of Bipolar Disorder on Couple Functioning: Implications for Care and Treatment. A Systematic Review. Medicina (Kaunas). 2021, 29; 57(8):771.
  • 36- Rowland TA, Marwaha S. Epidemiology and risk factors for bipolar disorder. Ther Adv Psychopharmacol. 2018; 26; 8(9): 251-269. doi:10.1177/2045125318769235.
  • 37- Heffner JL, Strawn JR, DelBello MP, Strakowski SM, Anthenelli RM. The co-occurrence of cigarette smoking and bipolar disorder: phenomenology and treatment considerations. Bipolar Disord. 2011; 13(5-6):439-53. doi: 10.1111/j.1399-5618.2011.00943.x.
  • 38- Sonn SC, Brady KT. Bipolar Disorder and Alcoholism. Alcohol Res Health. 2002; 26(2):103–8.
  • 39- Teixeira ALDS, Fernandes Júnior W, Marques FA, Lacio MLD, Dias MRC. Influence of different phases of menstrual cycle on flexibility of young women. Revista Brasileira de Medicina do Esporte. 2012; 18: 361-364. doi: 10.1590/S1517-86922012000600002.
  • 40- Pletzer B, Noachtar I. Emotion recognition and mood along the menstrual cycle. Horm Behav. 2023; 154: 105406.
  • 41- Rasgon N, Bauer M, Glenn T, Elman S, Whybrow PC. Menstrual cycle related mood changes in women with bipolar disorder. Bipolar disord. 2003; 5(1): 48-52. doi: 10.1034/j.1399-5618.2003.00010.x.
  • 42- Teatero ML, Mazmanian D, Sharma V. Effects of the menstrual cycle on bipolar disorder. Bipolar disord. 2014; 16(1): 22-36.
There are 41 citations in total.

Details

Primary Language English
Subjects Mental Health Services
Journal Section Research Article
Authors

Elif Emre 0000-0001-5659-3499

Sevler Yıldız 0000-0002-9951-9093

Suna Aydın 0000-0002-5857-0888

Düzgün Şimşek 0009-0002-2260-8255

Mehmet Gürkan Gürok 0000-0001-8998-0743

Early Pub Date March 29, 2025
Publication Date March 29, 2025
Submission Date January 16, 2025
Acceptance Date March 26, 2025
Published in Issue Year 2025Volume: 47 Issue: 1

Cite

AMA Emre E, Yıldız S, Aydın S, Şimşek D, Gürok MG. The Relationship Between Finger Ratio (2D:4D) and Criminal Behavior in Bipolar Disorder. CMJ. March 2025;47(1):41-48. doi:10.7197/cmj.1621482