Training programs intended to enhance clinician confidence in coping with patient aggression have been only cursorily researched-In previous studies researchers have typically used ad hoc instrumentation and have omitted control conditions and follow-up assessment. This investigation included psychometric development of an instrument to assess self-attributed clinician confidence in coping with patient aggression, and a comparison of groups who did and who did not undergo training. Although untrained groups showed no change in confidence over time. trained groups reported substantial pretest/postlcst gains in confidence that were maintained during an 18-month follow-up period. Implications of this study for subsequent research and training are discussed.

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Negative emotion exhibited by the board and care providers toward residents, resident behavior, medication dosage, medication noncompliance, and gender were used to predict resident relapse over a 6-month period. Relapse was defined as movement to a higher, more intensive level of care. Eighty-four residents with a diagnosis of chronic schizophrenia disorder, living in board and care homes in the Fresno, California, area participated in the study. Board and care providers were interviewed using Kreisman's Patient Rejection Scale and Gurel's Behavior Rating Scale. Neither patient rejection nor resident behavior was predictive of relapse; however, medication noncompliance did predict relapse with the male residents and lower medication dose predicted relapse with the female residents. Rejection of the patient by the board and care operator was found to correlate .73 and .64 with negative behavior of the male and female residents respectively. Implications of these results for expressed emotion research were discussed.

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