A neuropsychological investigation into violence and mental illness

Barkataki, Ian; Kumari, Veena; Das, M.B.; Hill, Mary; Morris, Robin; O’Connell, Paul; Taylor, Pamela J.; Sharma, Tonmoy

doi:10.1016/j.schres.2004.08.001

Cited by 80 publications

(59 citation statements)

References 55 publications

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“…Moreover, antisocial individuals frequently show deficits in recognizing the facial expression of fear [53]. Other studies have shown that the antisocial trend found in paranoid schizophrenia was often an instance of hostility, emotional coldness and poor impulse control, which might be due to a lack of empathy, indifference to others, psychotic symptoms or cognitive deficits [54,55]. All these characteristics might help to explain the association between the PERM antisocial style and TAS difficulty identifying feelings in paranoid schizophrenia.…”

Section: Discussionmentioning

confidence: 99%

Alexithymia and Personality Disorder Functioning Styles in Paranoid Schizophrenia

Li²,

Liu³

et al. 2011

Psychopathology

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Objectives: Personality disorder functioning styles might contribute to the inconclusive findings about alexithymic features in schizophrenia. We therefore studied the relationship between alexithymia and personality styles in paranoid schizophrenia. Methods: We administered the Chinese versions of the Toronto Alexithymia Scale (TAS-20), the Parker Personality Measure (PERM), the Positive and Negative Syndrome Scale as well as the Hamilton Anxiety and Depression Scales to 60 paranoid schizophrenia patients and 60 healthy control subjects. Results: Patients scored significantly higher on the Positive and Negative Syndrome Scale, TAS ‘difficulty identifying feelings’ and ‘difficulty describing feelings’, Hamilton Depression Scale and most PERM scales. In healthy subjects, difficulty identifying feelings predicted the PERM ‘dependent’ style, and the Hamilton Anxiety Scale predicted difficulty identifying feelings and difficulty describing feelings. In patients, difficulty identifying feelings nonspecifically predicted all the PERM scales; by contrast, the PERM ‘antisocial’ style predicted difficulty identifying feelings, the ‘avoidant’ style predicted difficulty describing feelings, and the ‘histrionic’ and ‘paranoid (–)’ styles predicted ‘externally oriented thinking’. Conclusions: Personality disorder functioning styles – instead of anxiety, depression, psychotic symptoms or disease duration – were specifically associated with alexithymia scales in our patients, which sheds light on a cognitive-personological substrate in paranoid schizophrenia on the one hand, and calls for a longitudinal design to discover how premorbid or postacute residual personality styles contribute to the sluggish disorder on the other.

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Section: Discussionmentioning

confidence: 99%

Alexithymia and Personality Disorder Functioning Styles in Paranoid Schizophrenia

Li²,

Liu³

et al. 2011

Psychopathology

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“…Numerous investigators have reported that patients with schizophrenia with histories of aggression manifest poorer cognitive functioning than their nonviolent peers on cognitive tasks, particularly executive functioning tasks. 40, 41 Serper et al 42 examined the relationship between executive functioning, psychiatric symptomatology, and aggressive behavior in 85 patients presenting with schizophrenia over an acute hospital admission using structure equation modelling techniques. In this study, it was found that the level of patients' executive impairment significantly predicted the formation of positive and negative symptoms, which in turn significantly contributed to the manifestation of inpatient aggressive behavior.…”

Section: Item Contentmentioning

confidence: 99%

Structured Assessment of Violence Risk in Schizophrenia and Other Psychiatric Disorders: A Systematic Review of the Validity, Reliability, and Item Content of 10 Available Instruments

Singh

Serper

Reinharth

et al. 2011

Schizophrenia Bulletin

125

110

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Objectives: To undertake a systematic review on structured violence risk assessment tools in individuals with schizophrenia. Methods: A systematic search was conducted from 1990 to 2011 to identify violence risk assessment tools and studies examining their predictive validity. Item content of the identified instruments was analyzed, and areas under the curve (AUC) from the studies were extracted. In addition, an 11-item checklist was developed to assess the utility and psychometric properties of these tools. Results: Ten risk assessment tools designed to predict community violence in psychiatric patients were identified, but only 2 studies reporting predictive validity estimates in patients with schizophrenia were found (median AUC 5 0.69; interquartile range 5 0.60-0.77). When inclusion criteria was broadened to include studies measuring accuracy for any diagnostic group, mixed evidence of predictive validity was found, with median AUCs ranging from 0.62 to 0.85 depending on the population. Item content included mostly clinical, sociodemographic, and criminal history factors. As only 1 tool included a neurobiological item, a structured review of brain-based and cognitive risk factors for violence was included, and 3 clusters (neurocognitive ability, neurocognitive awareness, and attitudinal cognition) were identified. Conclusions: While a number of violence risk assessment tools exist that can be used to predict the likelihood of community violence in psychiatric patients, there is currently little direct evidence for their utility in individuals with schizophrenia. In addition, there is large variation in item content between instruments, and further research is necessary to determine whether the inclusion of alternative factors could improve risk assessment.Key words: psychotic disorders/forensic psychiatry/crime/ review/antisocial/neurocognitive Introduction Current treatment guidelines published by the American Psychiatric Association 1 and the UK's National Institute for Health and Clinical Excellence 2 recommend that violence risk be assessed for individuals diagnosed with schizophrenia. While unstructured assessments of risk, in which mental health professionals use their clinical experience to make subjective judgments as to whether an individual is likely to offend, remain common, 3 a recent metareview (a systematic overview of systematic reviews and meta-analyses) identified over 120 structured instruments that have been designed for use in predicting violence in psychiatric and correctional populations. 4 Furthermore, questionnaire surveys suggest that some form of structured risk assessment is currently used by over 80% of forensic psychologists in the United States 5 and in over 80% of forensic and 70% of general psychiatric hospitals in the United Kingdom. 3,6 Generally, structured risk assessment tools adopt 1 of 2 approaches: actuarial prediction or structured clinical judgment (SCJ). Actuarial risk assessment tools are composed of weighted factors found to have been empirically associated with ...

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“…Our group has studied neuropsychological, 155 brain volume, 156 and brain functional distinctions 157,158 among men with schizophrenia with (n = 13) and without a violence history (n = 15), violent men with PD (n = 13), and healthy nonviolent men (n = 15). On structural and functional measures, the schizophrenia groups showed more deficits than the others, with a tendency, regardless of measure, for the violent men with schizophrenia to show most dysfunction or damage.…”

Section: Organic Brain Studies Of Individuals With Psychosis Who Are mentioning

confidence: 99%

Psychosis and Violence: Stories, Fears, and Reality

Taylor

2008

Can J Psychiatry

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Individuals with psychosis are often feared. In fact, they are themselves likely to be victims of violence; however, the main aim of this review is to provide an overview of the evidence on relations between psychosis and violence to others. The terms psychosis and violence were used in a literature search limited to the Cochrane Library and PubMed, a manual search of 8 journals, and a follow-up of additional references in the articles found. The overview draws on new empirical data and major reviews. Almost all sound epidemiologic data on psychosis and violence dates from 1990. There is consistency on a small but significant relation between schizophrenia and violent acts. Since then there has also been movement toward understanding the nature of associations and progress on strategies for managing individuals who have psychosis and are violent. Public fears about individuals with psychotic illnesses are largely unfounded, although there would be benefit in greater attention to the safety of those in their close social circle. The task for the next 10 years must be the development and application of knowledge to improve specific treatments—that is, interventions that go beyond holding and caring to bring about substantial change.

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A neuropsychological investigation into violence and mental illness

Cited by 80 publications

References 55 publications

Alexithymia and Personality Disorder Functioning Styles in Paranoid Schizophrenia

Alexithymia and Personality Disorder Functioning Styles in Paranoid Schizophrenia

Structured Assessment of Violence Risk in Schizophrenia and Other Psychiatric Disorders: A Systematic Review of the Validity, Reliability, and Item Content of 10 Available Instruments

Psychosis and Violence: Stories, Fears, and Reality

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