Violence is a critical health issue but its clinical treatment is neglected in medicine. There are biological factors that are amenable to treatment. Exposure to adverse experiences, violence, and other stressors can lead to problematic fear-related responses (panic, rage) and patients with sensitivity to perceived threats and impaired cognitive control can cause injury to self or others. Living with this condition has profound effects on afflicted patients. Providers can use medical exam questions to assess and discuss problematic fear responses with their patients. Treatments include addressing: nutritional factors (hypoglycemia, omega-3); traumatic brain injury, dementia or cognitive insults; inflammation; drugs; trauma focused CBT; and access to lethal means. We propose a “10 Things” fact sheet and medical guidelines to help providers diagnose, refer and treat patients with problematic fear responses. This could lower violence and improve overall health outcomes for patients.
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