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Characteristics of American Assaultive Psychiatric Patients: Review of Published Findings, 2000–2012

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Abstract

Previous reviews of the literature from 1976 to 2000 documented two categories of assaultive psychiatric patients: (1) male patients with schizophrenic illness and histories of violence toward others and substance use disorder and (2) male/female patients with personality disorders and histories of violence toward others, personal victimization, and substance use. The present study reviewed the published findings on American assaultive patients from 2000 to 2012. The present findings partially supported the earlier findings in that patients with schizophrenic illness continued to present the greatest risk for assault. However, personality disordered patients were not equal in assault risk to patients with affective disorders. Possible explanations for these findings and a detailed methodological review are presented.

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References

  1. Blair DT: Assaultive behavior: Does provocation begin in the front office? Journal of Psychosocial Nursing 20:21–26, 1991.

    Google Scholar 

  2. Davis D: Violence by psychiatric inpatients: A review. Hospital and Community Psychiatry 42:585–590, 1991.

    CAS  PubMed  Google Scholar 

  3. Flannery RB Jr: Characteristics of assaultive psychiatric inpatients: Updated review of findings, 1995–2000. American Journal of Alzheimer’s Disease and Other Dementias 16:153–156, 2001.

    Article  PubMed  Google Scholar 

  4. Flannery RB Jr: Repetitively assaultive patients: Review of published findings, 1978–2001. Psychiatric Quarterly 73:229–237, 2002.

    Article  PubMed  Google Scholar 

  5. Cornaggia CM, Beghi M, Pavone F, et al.: Aggression in psychiatry wards: A systematic review. Psychiatry Research 189:10–20, 2011.

    Article  PubMed  Google Scholar 

  6. Dack C, Ross J, Papadopoulas C, et al.: A review and meta-analysis of the patient factors associated with psychiatry inpatient aggression. Acta Psychiatrica Scandinavia 127:255–268, 2013.

    Article  CAS  Google Scholar 

  7. Lam JN, McNeil DE, Binder RL, et al.: The relationship between patients’ gender and violence leading to staff injuries. Psychiatric Services 51:1176–1170, 2000.

    Google Scholar 

  8. Flannery RB Jr, Fisher W, Walker A, et al.: Assaults on staff by psychiatric patients in community residences. Psychiatric Services 51:111–113, 2000.

    PubMed  Google Scholar 

  9. Flannery RB Jr, Fisher W, Walker AP, et al.: Nonviolent psychiatric patients and subsequent assaults on community patients and staff. Psychiatric Quarterly 72:19–27, 2001.

    Article  PubMed  Google Scholar 

  10. Flannery RB Jr, Schuler AP, Farley EM et al.: Characteristics of assaultive psychiatric patients: Ten -year analysis of the Assaulted Staff Action Program (ASAP). Psychiatric Quarterly 73:59–69, 2002.

    Article  PubMed  Google Scholar 

  11. Flannery RB Jr, Rachlin S, Walker A: Characteristics of repetitively assaultive patients: Ten-year analysis of the Assaulted Staff Action Program (ASAP). International Journal of Emergency Mental Health 4:173–179, 2002.

    PubMed  Google Scholar 

  12. Flannery RB Jr, Rachlin S, Walker AP: Single- versus multiple victim psychiatric patient assaults on staff: A preliminary inquiry. Journal of Healthcare Safety 1:11–16, 2003.

    Google Scholar 

  13. Flannery RB Jr, Hanson MA, Rego J Jr, et al.: Precipitants to psychiatric patient assaults on staff: Preliminary inquiry of the Assaulted Staff Action Program (ASAP). International Journal of Emergency Mental Health 5:141–146, 2003.

    PubMed  Google Scholar 

  14. Nolan KA, Czobor P, Roy B, et al.: Characteristics of assaultive behavior among psychiatric inpatients. Psychiatric Services 54:1012–1016, 2003.

    Article  PubMed  Google Scholar 

  15. Krakowski M, Czobor P: Gender differences in violent behaviors: Relationship to clinical symptoms and psychosocial factors. American Journal of Psychiatry 161:459–465, 2004.

    Article  PubMed  Google Scholar 

  16. Kraus JE, Sheitman BB: Characteristics of violent behaviors in a large state psychiatric hospital. Psychiatric Services 55:183–185, 2004.

    Article  PubMed  Google Scholar 

  17. Linhorst DM, Scott LP: Assaultive behavior in state psychiatric hospitals. Journal of Interpersonal Violence 8:857–874, 2004.

    Article  Google Scholar 

  18. Waldheter EJ, Jones NT, Johnson ER, et al.: Utility of social cognition and insight in the prediction of inpatient violence among individuals with serve mental illness. Journal of Nervous and Mental Disease 193:609–618, 2005.

    Article  PubMed  Google Scholar 

  19. Fujii DEM, Tokioka AB, Lichton AI, et al: Ethnic differences in predictions of violence risk with the HCR-20 among psychiatric inpatients. Psychiatric Services 56:711–716, 2005.

    Article  PubMed  Google Scholar 

  20. Ferguson CJ, Averill PM, Rhoades H, et al.: Social isolation, impulsivity, and depression as predictors of aggression in a psychiatric inpatient population. Psychiatric Quarterly 67 (1):123–127, 2005.

    Article  Google Scholar 

  21. Crowner ML, Gordana P, Stepic F, et al.: Assailant and victim behaviors immediately preceding inpatient assault. Psychiatric Quarterly 76:242–256, 2005.

    Article  Google Scholar 

  22. Flannery RB Jr, Juliano J, Cronin S, et al: Characteristics of assaultive psychiatric patients: Fifteen-year analysis of the Assaulted staff Action Program (ASAP). Psychiatric Quarterly 77:239–249, 2006.

    Article  PubMed  Google Scholar 

  23. Goldberg BR, Serper MR, Sheets M, et al.: Predictors of aggression on the psychiatric inpatient service: Self-esteem, narcissism, and theory of mind deficits. Journal of Nervous and Mental Disease 195:436–442, 2007.

    PubMed  Google Scholar 

  24. Quanbeck CD, McDermott BE, Lam J, et al: Categorization of aggressive acts committed by chronically assaultive state hospital patients. Psychiatric Services 58:521–528, 2007.

    Article  PubMed  Google Scholar 

  25. Hellerstein DJ, Staub AB, Lequesne E: Decreasing use of restraint and seclusion among psychiatric inpatients. Journal of Psychiatric Practice 13:308–317, 2007.

    Article  PubMed  Google Scholar 

  26. Flannery RB Jr, Walker AP: Repetitively assaultive psychiatric patients: Fifteen-year analysis of the Assaulted Staff Action Program (ASAP) with implications for emergency services. International Journal of Emergency Mental Health 10:1–8, 2008.

    PubMed  Google Scholar 

  27. Flannery RB Jr, Walker AP: Characteristics of patients in restraints: Fifteen-year analysis of the Assaulted Staff Action Program (ASAP) with EMS implications International Journal of Emergency Mental Health 10:191–198, 2008.

    PubMed  Google Scholar 

  28. Vitacco MJ, Van Rybroek GJ, Rogstad JE, et al.: Predicting short-term institutional aggression in forensic patients: A multi-trait method for understanding subtypes of aggression. Law and Human Behavior 33:308–309, 2009.

    Article  PubMed  Google Scholar 

  29. Flannery RB Jr, Farley, E, Tierney T, et al.: Characteristics of assaultive psychiatric patients: 20-year analysis of the Assaulted Staff Action Program (ASAP). Psychiatric Quarterly 82:1–10, 2011.

    Article  PubMed  Google Scholar 

  30. Newton VM, Elbogen EB, Brown CL, et al.: Clinical decision-making about inpatient violence risk at admission to a public sector acute psychiatric hospital. The Journal of the American Academy of Psychiatry and the Law 40:203–214, 2012.

    Google Scholar 

  31. Papadopoulos C, Ross J, Stewart D, et al: The antecedents of violence and aggression within psychiatric in-patient settings. Acta Psychiatrica Scandinavica 125:425–439, 2012.

    Article  CAS  PubMed  Google Scholar 

  32. Flannery RB Jr, Staffieri A, Hildum S, et al.: The violence triad and common single precipitants of psychiatric patient assaults: Sixteen year analysis of the Assaulted Staff Action Program (ASAP). Psychiatric Quarterly 82:85–93, 2011.

    Article  PubMed  Google Scholar 

  33. Jin H, Meyer J, Jeste D: Atypical antipsychotics and glucose dysregulation: A systematic review. Schizophrenia Research 71:195–212, 2004.

    Article  PubMed  Google Scholar 

  34. Smith GH, Davis RH, Bixler EO, et al.: Pennsylvania State Hospital system’s seclusion and restraint reduction program. Psychiatric Services 565:1115–1122, 2005.

    Article  Google Scholar 

  35. Moylan LB, Cullinan M: Frequency of assault and severity injury of psychiatric nurses in relation to nurses’ decision to restrain. Journal of Psychiatric Mental Health Nursing 18:526–534, 2011.

    Article  CAS  PubMed  Google Scholar 

  36. Palmstierna T, Wistedt B: Staff Observation Aggression Scale, SOAS: Presentation and evaluation. Acta Psychiatrica Scandinavica 76:657–673, 1987.

    Article  CAS  PubMed  Google Scholar 

  37. Lion JR, Snyder W, Merrill GL: Understanding of assaults on staff in a state hospital. Hospital and Community Psychiatry 32:497–498, 1981.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Harvard Medical School, Boston, MA, USA

    Raymond B. Flannery Jr. & Grace Wyshak

  2. Boston College, Chestnut Hill, MA, USA

    Joseph J. Tecce

  3. Newton Free Library, Newton, MA, USA

    Georgina J. Flannery

  4. Department of Psychiatry, Cambridge Health Alliance, 1493 Cambridge Street, Cambridge, MA, 02139, USA

    Raymond B. Flannery Jr.

Authors
  1. Raymond B. Flannery Jr.
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  2. Grace Wyshak
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  3. Joseph J. Tecce
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  4. Georgina J. Flannery
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Correspondence to Raymond B. Flannery Jr..

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Flannery, R.B., Wyshak, G., Tecce, J.J. et al. Characteristics of American Assaultive Psychiatric Patients: Review of Published Findings, 2000–2012. Psychiatr Q 85, 319–328 (2014). https://doi.org/10.1007/s11126-014-9294-6

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  • DOI: https://doi.org/10.1007/s11126-014-9294-6

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