Young age and the risk of violent behaviour in people with severe mental disorders: prospective, multicentre study

Abstract

Background During adolescence and young adulthood people appear to be more prone to violent behaviour. A greater tendency to violent behaviour appears to be associated with hyperactivity, impulsivity and low tolerance for frustration and provocation in social settings. Aims This prospective cohort study aimed to evaluate rates of violent behaviour among young people with mental disorders, compared with older age groups. Method A total of 340 individuals with severe mental disorders (125 living in residential facilities and 215 out-patients) were evaluated at baseline with the SCID-I and II, Brief Psychiatric Rating Scale, Specific Level of Functioning scale, Brown–Goodwin Lifetime History of Aggression scale, Buss–Durkee Hostility Inventory, Barratt Impulsiveness Scale and State–Trait Anger Expression Inventory-2. Aggressive behaviour was rated every 15 days with the Modified Overt Aggression Scale (MOAS). Results The sample comprised 28 individuals aged 18–29 years, 202 aged 30–49 and 110 aged 50 and over. Younger age was associated with a personality disorder diagnosis, substance use disorder, being single and employed. These results were confirmed even controlling for the gender effect. The patterns of the cumulative MOAS mean scores showed that younger (18–29 years old) individuals were significantly more aggressive than older (≥50) ones (P < 0.001). Conclusions This study highlights how young age in people with severe mental disorders is correlated with higher levels of impulsivity, anger and hostility, confirming previous analyses. Our results may assist clinicians in implementing early interventions to improve anger and impulsivity control to reduce the risk of future aggressive behaviours.

Effectiveness of Artificial Intelligence Methods in Personalized Aggression Risk Prediction within Inpatient Psychiatric Treatment Settings—A Systematic Review

“…In terms of predictors of aggression, patients with certain demographic and social characteristics were more prone to aggression. The findings in this review were congruent with previous findings which included younger age [37][38][39][40][41][42], older age [43], being unmarried [38,[44][45][46], being childless [47], lower education [44], unemployment [44,[48][49][50], lower intelligence [38], financial issues [51,52] and homelessness [53]. Of note, an earlier study found an association between homelessness and crimes, but not specifically aggressive crimes [54].…”

Psychotherapy case formulation for patients with aggressive behaviours in clinical settings: an adaptation of the Multimodal Functional Model

“…Another difficulty for the clinician is to conceptualise the client's aggressiveness in the absence of a framework to guide the assessment of aggression in a systematic and comprehensive manner. While there are instruments for assessing dangerousness in people with severe mental disorders (Hodgins et al, 2003;Micciolo et al, 2021), risk of recidivism in correctional settings (Desmarais et al, 2016;Olver et al, 2022), and severe behavioural disorders in people with intellectual disabilities or autism spectrum disorders (Hastings et al, 2021;Hemmings et al, 2008;Hill et al, 2014), these methods are not always adapted to the clientele seen in private office, outpatient clinics, and hospitals. Knowing when and how to assess aggressive behaviours is essential to avoid the negative consequences of not conducting an assessment or of conducting it hastily, and not planning interventions that address each of the possible causes of aggression and thus maximise the chances of therapeutic success.…”

The Link Between Cannabis Use and Violent Behavior in the Early Phase of Psychosis: The Potential Role of Impulsivity

“…A meta-regression analysis of risk factors for VB in psychosis (EPP or chronic patients) found that, among several dynamic psychopathological risk factors, high impulsivity was an important one ( 34 , 35 ). Several studies have shown the impact of impulsivity on VB with different populations [chronic patients ( 34 – 36 , 84 , 85 ), EEP patients ( 37 , 50 , 86 ), and forensic populations ( 85 )] and different measures of impulsivity (clinical self-report or hetero-report and behavioral scales) ( 73 , 86 – 88 ). In the EEP, prospective cohort studies have also shown that impulsivity is associated with serious aggression ( 37 , 50 ), either directly or indirectly.…”