Environment Contributors to Aggression in Two Forensic Psychiatric Hospitals

Daffern, Michael; Mayer, Maggie M; Martin, Trish

doi:10.1080/14999013.2004.10471200

Cited by 68 publications

(42 citation statements)

References 10 publications

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“…It is likely that other, unmeasured factors play a large part. For example, it has been argued that the close quarters in which patients are expected to live contributes greatly to the exhibited aggression (Daffern, Mayer, & Martin, 2004;Kumar, Ng, & Robinson, 1999;, Nijman & Rector, 1999). Anecdotally we have found this to be true in reading incident reports.…”

Section: Discussionmentioning

confidence: 96%

The accuracy of risk assessment instruments in the prediction of impulsive versus predatory aggression

McDermott

Quanbeck

Busse

et al. 2008

Behavioral Sci & The Law

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Actuarial violence risk assessments, many of which include the construct of psychopathy, have been shown to be superior to clinical judgment in the prediction of long-term risk of community violence and recidivism. While these instruments initially appeared to provide similarly accurate judgments of risk of institutional aggression, recent research has indicated that such assessments may be less robust in this setting. One explanation may lie in the types of aggression most frequently observed in each setting. Impulsive (or reactive/affective) is the type of physical aggression most commonly exhibited in psychiatric facilities. This research examines the relationship between risk assessments and aggression in an inpatient forensic setting, with such aggression categorized as impulsive, predatory or psychotic aggression. Consistent with previous research, impulsive aggression was the most frequent type observed (58%). Anger (as measured by the Novaco Anger Scale) and clinical issues (as measured by the HCR-20) were most associated with impulsive aggression, with AUC values of .73 and .71 respectively. In contrast, anger and psychopathy (as measured by the PCL-R) were more associated with predatory aggression, with AUC values of .95 and .84 respectively. Psychotic symptoms were highly associated with psychotically motivated aggression (AUC=.90). These results suggest that traditional violence risk assessments may have limited utility in predicting aggression in an institutional setting and that psychiatric symptoms and heightened affect are more relevant.

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Section: Discussionmentioning

confidence: 96%

The accuracy of risk assessment instruments in the prediction of impulsive versus predatory aggression

McDermott

Quanbeck

Busse

et al. 2008

Behavioral Sci & The Law

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show abstract

“…As Shepherd and Lavender (1999) stated, 60% of incidents were preceded by external factors such as refusal of a patient's request. Daffern et al (2004) asserts that aggression is usually precipitated by identifiable events such as denial of a request, which is perceived by patients as being provocative.…”

Section: Requests Of Patients/relativesmentioning

confidence: 99%

Violence in the emergency department: An ethnographic study (part II)

Lau

Magarey

Wiechula

2012

International Emergency Nursing

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“…Locking wards may be seen as paternalistic, stigmatizing, and coercive; and, for 'voluntary' service users, contradicts their status (Cleary et al, 2009). A custodial, physically restrictive approach conflicts with relational containment strategies and may lead to user aggression (Daffern et al, 2004), since users who perceive themselves as powerless may use aggression as a form of self-empowerment. Secker et al (2004, p. 172) argue that patients' violent behaviour may be partly due to social tensions arising from a 'lack of staff engagement with clients'.…”

Section: Contextualising Our Research In the Interdisciplinary Literamentioning

confidence: 99%

“…'Expert' definitions of risk in psychiatric hospitals draw on 'linear' knowledge of the 'risk factors' that might be involved (Daffern, Mayer, & Martin, 2004;Hage, van Meijel, Flutterts, & Berden, 2009;Secker, Benson, Balfe, Lipsedge, Robinson, & Walker, 2004). These risk factors include the personal characteristics of users (e.g., age, gender, personality traits, diagnosis, attitudes and behaviours) and environmental factors (e.g., family background, social disadvantage, physical characteristics of wards, and staff attitudes and behaviours).…”

Section: Contextualising Our Research In the Interdisciplinary Literamentioning

confidence: 99%

Compassionate containment? Balancing technical safety and therapy in the design of psychiatric wards

Curtis

Gesler

Wood

et al. 2013

Social Science & Medicine

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'Compassionate containment? Balancing technical safety and therapy in the design of psychiatric wards.', Social science medicine., 97 . pp. 201-209. Further information on publisher's website:http://dx.doi.org/10. 1016/j.socscimed.2013.06.015 Publisher's copyright statement: NOTICE: this is the author's version of a work that was accepted for publication in Social science medicine. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reected in this document. Changes may have been made to this work since it was submitted for publication. A denitive version was subsequently published in Social science medicine, 97, 2013, 10.1016/j.socscimed.2013.06.015 Additional information: Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-prot purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. landscapes. There were also more subtle implications, partly relating to 'Panopticist' theories about how the institution uses technical safety to supervise its own mechanisms, through the observation of staff behaviour as well as patients and visitors. Furthermore, staff seemed to feel that in relying on technical safety measures they were, to a degree, divesting themselves of human responsibility for risks they are required to manage. However, their critical assessment showed their concerns about how this might conflict with a more therapeutic approach and they contemplated ways that they might be able to engage more effectively with patients without the imposition of technical safety measures. These findings advance our thinking about the construction of therapeutic landscapes in theory and in practice.4

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Environment Contributors to Aggression in Two Forensic Psychiatric Hospitals

Abstract: We would like to thank Professor James Ogloff for his assistance with data analysis and Professor Kevin Howells and Professor Paul Mullen for their valuable comments on an earlier draft of this article.

Cited by 68 publications

References 10 publications

The accuracy of risk assessment instruments in the prediction of impulsive versus predatory aggression

The accuracy of risk assessment instruments in the prediction of impulsive versus predatory aggression

Violence in the emergency department: An ethnographic study (part II)

Compassionate containment? Balancing technical safety and therapy in the design of psychiatric wards

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