Predictors of imminent violence in psychiatric inpatients

Linaker, Olav M.; Busch-Iversen, H.

doi:10.1111/j.1600-0447.1995.tb09578.x

Cited by 107 publications

(77 citation statements)

References 23 publications

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“…The BVC's development was based on earlier research suggesting that few incidents of aggression occur in the absence of identifiable precipitants (Sheridan et al, 1990). The work of Linaker and Busch-Iversen (1995), who identified frequently observed changes in behaviour in the 24 hours immediately preceding a violent incident in a maximum security unit in Norway, was particularly influential. Items included in the BVC include the six most frequently recorded behaviours in the Linaker and Busch-Iversen (1995) study: confusion, irritability, boisterousness, physical threats, verbal threats, and attacks on objects.…”

mentioning

confidence: 99%

The dynamic appraisal of situational aggression: an instrument to assess risk for imminent aggression in psychiatric inpatients

Ogloff

Daffern

2006

Behavioral Sci & The Law

225

204

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Considerable research has attempted to delineate the demographic and clinical characteristics of high-risk psychiatric patients and identify salient modifiable aspects of aggression prone environments. Recently, there has also been increased interest in the development and testing of structured schemes for the assessment of risk for aggression within inpatient psychiatric settings. Although some of these methods show acceptable predictive validity, their ability to inform day-to-day treatment and management decisions is limited. The current research was designed to identify existing and novel risk factors that would assist staff to identify and manage the risk for aggression in psychiatric inpatient populations. Results showed that assessments supported by structured risk measures were more accurate than unaided clinical judgements based only on nurses' clinical experience and knowledge of the patient alone. Seven test items emerged that were maximally effective at identifying acute psychiatric patients at risk for engaging in inpatient violence within 24 hours; these items have been combined in the development of the Dynamic Appraisal of Situational Aggression. Empirical analyses and clinical experience support the efficacy of the instrument in assisting clinical staff in the identification and management of inpatient aggression.

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confidence: 99%

The dynamic appraisal of situational aggression: an instrument to assess risk for imminent aggression in psychiatric inpatients

Ogloff

Daffern

2006

Behavioral Sci & The Law

225

204

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“…The focus of this article is on enduring patientrelated risk factors of violence in a long-term psychiatric in-patient setting, as opposed to the prediction of imminent violence in individual patients. 1,2 Moreover, the roles of nursing staff factors such as training and work experience, as well as environmental factors such as patient/nurse ratio and crowding in wards fall outside of the scope of this article. [3][4][5][6][7][8][9][10] Previous research has linked aggressive behaviour to certain genetic conditions, impaired socio-emotional information processing, demographic variables such as gender and age, and clinical variables such as diagnosis, the presence of mood symptoms, and substance abuse.…”

Section: Introductionmentioning

confidence: 99%

“…4,22,38 Furthermore, mood symptoms, especially irritability, and self-harm have been linked to an increased risk of violence. 2,10,25,27,30,44,50,65,66,[74][75][76] Regardless of diagnosis, violence in psychiatric patients has remained associated with long-stay hospital admissions. 77 But even more importantly, the most consistent finding concerning the prediction of violence in the psychiatric context has been that past violence predicts future violence.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for violence among long-term psychiatric in-patients: a comparison between violent and non-violent patients

Krüger

Rosema²

2011

Afr. J. Psych

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Objective: The problem of the prediction of violence in psychiatric patients has led to a proliferation of research over the last decade. This study focuses on enduring patient related risk factors of violence, and investigates which long-term patients in Weskoppies Hospital (a specialist psychiatric hospital) are the most likely to commit violent acts. Method: Nursing statistics on violent incidents and other security breaches were collected for 262 long-term in-patients over a six month period (AprilSeptember 2007). The 41 patients who committed violent acts were compared to the 221 non-violent patients in terms of demographic and clinical variables, using two-way tables and Chi-Square or Fisher's Exact Tests. Results: The prevalence of violence among the long-term patients was 16%. Fighting among patients was the most common form of violence (58%). The most significant risk factors of violence among the long-term patients are: A diagnosis of mental retardation; first hospital admission before the age of 40 years; total hospital stay >12 years; current accommodation in a closed ward; habitual verbal aggression; absence of disorganised behaviour; and being clinically evaluated as unsuitable for community placement. Conclusion: The findings will help to identify those long-term patients most at risk of violence. The subgroup of patients with mental retardation is responsible for a disproportionately large number of violent acts in the hospital. The risk lies not so much in their psychiatric symptoms, but more in their cognitive ability, coping skills and inappropriate admission circumstances. Efforts should be directed -at a provincial level -towards their community placement.

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“…Investigators have relied on second hand data such as review of chart notes or interviews with staff. Some have considered the behaviors' specificity to assault (17,18), but not others (14,19). Only one group (18) considered the dangerousness of the attack.…”

Section: Introductionmentioning

confidence: 99%

Assailant and Victim Behaviors Immediately Preceding Inpatient Assault

Crowner

Peric²,

Stepcic³

et al. 2005

Psychiatr Q

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The goals of this study were to detect and define victim and assailant behaviors immediately before inpatient assault and to determine their specificity to assault, to assailants, and to more serious assaults. Assault was defined as physical contact such as hitting and slapping and detected using video-cameras installed on a specialized ward for violent patients. Antecedent behaviors, or cues, were identified in victim and assailant in the five minutes preceding assault and in control periods, five minute segments in which both patients were present but no assault occurred. Fifty-five assaults between 59 patients were detected. Threatening and intrusive behaviors in assailant and victim preceded 60% of assaults and 10% of control periods. They were more than ten times more numerous before assaults. Assault was often the end of a set of overt, recognizable interactions between patients. In a chronically ill inpatient population these behaviors can be useful predictors of assault.

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Predictors of imminent violence in psychiatric inpatients

Cited by 107 publications

References 23 publications

The dynamic appraisal of situational aggression: an instrument to assess risk for imminent aggression in psychiatric inpatients

The dynamic appraisal of situational aggression: an instrument to assess risk for imminent aggression in psychiatric inpatients

Risk factors for violence among long-term psychiatric in-patients: a comparison between violent and non-violent patients

Assailant and Victim Behaviors Immediately Preceding Inpatient Assault

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