A Prospective Study of Assault Against Staff by Youths in a State Psychiatric Hospital

Abstract

Preconceived notions about why youths assault staff at psychiatric hospitals do not appear to be validated by these data, which suggest a more complex picture.

Drug-Metabolizing Enzyme Genotypes and Aggressive Behavior Treatment Response in Hospitalized Pediatric Psychiatric Patients

“…In one study, 33% of youths in an inpatient psychiatric facility were involved in an assault on hospital staff (Ryan et al 2004). Because patients' aggressive behaviors put them, their families, and their inpatient caretakers at great risk, limiting and decreasing aggressive behavior is a key objective of patients' hospitalization 3 (Foster et al 2007;Jensen et al 2007) This study used BIS as the measure of short-term drug efficacy because as medication efficacy improves, the BIS should decrease.…”

Collaborative Problem Solving (CPS) as a Primary Method of Addressing Acute Pediatric Pathological Aggression Along with Other Modalities

“…In such an unstable environment, the staff is susceptible to assaults, which can be verbal or physical. In 2001-2002, Ryan and colleagues conducted a prospective study of physical assaults against staff by children and adolescents in a state psychiatric hospital [5]. Within two months, a total of 215 assaults occurred.…”

“…46% of these assaults resulted in physical injuries, and 3% of the assaults needed medical assistance due to the severity of these injuries. The trigger for the assaults was often limit setting or verbal exchange by the staff [5].…”

Relation of Callous-Unemotional Traits to Length of Stay Among Youth Hospitalized at a State Psychiatric Inpatient Facility

“…According to this model, C/U traits are then linked to chronic and severe conduct problems by increasing the child's propensity to ignore potential punishments and societal prohibitions while pursuing the rewards of antisocial behavior. To our knowledge, the relationship between C/U traits and length of stay among youth hospitalized in a psychiatric facility has not yet been empirically examined; however, research findings that link aggression to long lengths of stay among youth receiving psychiatric care [21,22] suggest the possibility of a connection.…”

“…Consequently, public psychiatric hospitalization is often the only viable emergency treatment option for dangerous youth [24]. In fact, in the United States youth receiving inpatient psychiatric services are typically just as aggressive as children detained in forensic settings [22] and the reduction of aggression and dangerousness is now the principal focus of inpatient psychiatric treatment in a majority of institutions nationwide [25]. Therefore, we believe that the current utilization trends for children's inpatient care in the United States suggest that clinical constructs like psychopathic traits that have previously been used to explain patterns of chronic aggression among adolescent offenders [26][27][28] may prove useful for understanding the clinical profiles of aggressive, treatmentrefractory youth receiving public psychiatric services.…”