Abstract
Objective: This study examined factors motivating inpatient aggression in a sample of chronically assaultive state hospital patients. Methods: Inpatients who had committed three or more assaults over a one-year period were identified by using an incident report database. Aggressive episodes were categorized as impulsive, organized, or psychotic by using a procedure for classifying assaultive acts based on record review. Each assault type was further subcategorized. The relationship between assault type, victim (staff or patient), and legal status of the assaulter was also assessed. Results: A total of 839 assaults committed by 88 chronically aggressive patients were reviewed. Although most patients had a primary psychotic disorder, the most common type of assault was impulsive (54%), rather than psychotic or organized. Staff were most often victimized by impulsive assaults in situations involving attempts to change a patient's unwanted behavior and refusal of a patient request. Organized and psychotic assaults occurred less frequently (29% and 17%, respectively) and were more likely to target other patients. Organized assaults were most often motivated by a desire to seek revenge. Psychotic assaults were most often committed by an assailant acting under the influence of paranoid ideations. Civilly committed patients were overrepresented in the sample. Criminally committed patients committed more acts of organized aggression, although this finding did not reach significance. Conclusions. These findings indicate that assaultive behavior among state hospital inpatients is complex and heterogeneous. Because each type of assault requires a different management approach, characterizing aggressive behavior may be important in determining which institutional programs and treatment-plan interventions to implement when addressing inpatient aggression.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 521-528 |
| Number of pages | 8 |
| Journal | Psychiatric Services |
| Volume | 58 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2007 |
Fingerprint
ASJC Scopus subject areas
- Psychiatry and Mental health
- Public Health, Environmental and Occupational Health
- Health(social science)
- Health Professions(all)
Cite this
Categorization of aggressive acts committed by chronically assaultive state hospital patients. / Quanbeck, Cameron David; McDermott, Barbara E; Lam, Jason; Eisenstark, Howard; Sokolov, Gregory; Scott, Charles L.
In: Psychiatric Services, Vol. 58, No. 4, 04.2007, p. 521-528.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Categorization of aggressive acts committed by chronically assaultive state hospital patients
AU - Quanbeck, Cameron David
AU - McDermott, Barbara E
AU - Lam, Jason
AU - Eisenstark, Howard
AU - Sokolov, Gregory
AU - Scott, Charles L
PY - 2007/4
Y1 - 2007/4
N2 - Objective: This study examined factors motivating inpatient aggression in a sample of chronically assaultive state hospital patients. Methods: Inpatients who had committed three or more assaults over a one-year period were identified by using an incident report database. Aggressive episodes were categorized as impulsive, organized, or psychotic by using a procedure for classifying assaultive acts based on record review. Each assault type was further subcategorized. The relationship between assault type, victim (staff or patient), and legal status of the assaulter was also assessed. Results: A total of 839 assaults committed by 88 chronically aggressive patients were reviewed. Although most patients had a primary psychotic disorder, the most common type of assault was impulsive (54%), rather than psychotic or organized. Staff were most often victimized by impulsive assaults in situations involving attempts to change a patient's unwanted behavior and refusal of a patient request. Organized and psychotic assaults occurred less frequently (29% and 17%, respectively) and were more likely to target other patients. Organized assaults were most often motivated by a desire to seek revenge. Psychotic assaults were most often committed by an assailant acting under the influence of paranoid ideations. Civilly committed patients were overrepresented in the sample. Criminally committed patients committed more acts of organized aggression, although this finding did not reach significance. Conclusions. These findings indicate that assaultive behavior among state hospital inpatients is complex and heterogeneous. Because each type of assault requires a different management approach, characterizing aggressive behavior may be important in determining which institutional programs and treatment-plan interventions to implement when addressing inpatient aggression.
AB - Objective: This study examined factors motivating inpatient aggression in a sample of chronically assaultive state hospital patients. Methods: Inpatients who had committed three or more assaults over a one-year period were identified by using an incident report database. Aggressive episodes were categorized as impulsive, organized, or psychotic by using a procedure for classifying assaultive acts based on record review. Each assault type was further subcategorized. The relationship between assault type, victim (staff or patient), and legal status of the assaulter was also assessed. Results: A total of 839 assaults committed by 88 chronically aggressive patients were reviewed. Although most patients had a primary psychotic disorder, the most common type of assault was impulsive (54%), rather than psychotic or organized. Staff were most often victimized by impulsive assaults in situations involving attempts to change a patient's unwanted behavior and refusal of a patient request. Organized and psychotic assaults occurred less frequently (29% and 17%, respectively) and were more likely to target other patients. Organized assaults were most often motivated by a desire to seek revenge. Psychotic assaults were most often committed by an assailant acting under the influence of paranoid ideations. Civilly committed patients were overrepresented in the sample. Criminally committed patients committed more acts of organized aggression, although this finding did not reach significance. Conclusions. These findings indicate that assaultive behavior among state hospital inpatients is complex and heterogeneous. Because each type of assault requires a different management approach, characterizing aggressive behavior may be important in determining which institutional programs and treatment-plan interventions to implement when addressing inpatient aggression.
UR - http://www.scopus.com/inward/record.url?scp=34247366446&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34247366446&partnerID=8YFLogxK
U2 - 10.1176/appi.ps.58.4.521
DO - 10.1176/appi.ps.58.4.521
M3 - Article
C2 - 17412855
AN - SCOPUS:34247366446
VL - 58
SP - 521
EP - 528
JO - Psychiatric Services
JF - Psychiatric Services
SN - 1075-2730
IS - 4
ER -