Abstract
Although there have been several studies of the characteristics of psychiatric patient assailants, there have been only six comprehensive, empirical assessments of precipitants to these assaults and no precipitant study has focused solely on elderly psychiatric patient assailants. This one and one-half year, retrospective study continued the inquiry into the nature of patient assault precipitants and focused only on elderly assailants. Older, male patients with a diagnosis of schizophrenia and histories of violence toward others and substance use disorder physically assaulted primarily male, mental health workers. These staff victims experienced disruptions in the domains of mastery, attachment, and meaning as well as the symptomatology associated with psychological trauma. The most common precipitants to these assaults were denial of services and acute psychosis. The findings and implications for health care providers in long-term care settings where elderly psychiatric patients reside are discussed.
Similar content being viewed by others
References
Meddaugh D: Staff abuse by the nursing home patient. Special issue: The elderly uncooperative patient. Clinical Gerontologist 6:45–47, 1986.
Lehmann LS, McCormick RA, Kizer KW: A survey of assaultive behavior in Veterans Health Administration facilities. Psychiatric Services 50:384–389, 1999.
Geiger-Brown J, Muntaner C, Lipscomb J, et al: Violence toward nurses aides in nursing homes: Effects on mental health. Journal of Health Care Safety 1:31–36, 2003.
Teri L, Rabins P, Whitehouse P, et al: Management of behavior disturbance in Alzheimer disease: Current knowledge and future directions. Alzheimer’s Disease and Associated Disorders 6:77–88, 1992.
American Psychiatric Association: Clinician Safety, Task Force Report #33. Washington, DC, American Psychiatric Press, 1992.
Blair DT: Assaultive behavior: Does provocation begin in the front office? Journal of Psychosocial Nursing, 29:21–26, 1991.
Busch A, Shore M: Seclusion and restraint: A review of the literature. Harvard Review of Psychiatry 8:261–270, 2000.
Davis S: Violence in psychiatric patients: A review. Hospital and Community Psychiatry 42:585–590, 1991.
Flannery RB Jr: Repetitively assaultive psychiatric patients: Updated review of published findings, 1978–2001. Psychiatric Quarterly 73:229–237, 2002.
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.
Flannery RB Jr, Hanson MA, Penk, WE: Risk factors for psychiatric inpatient assaults on staff. Journal of Mental Health Administration 21:24–31, 1994.
Cooper AJ, Mendonca JD: A prospective study of patient assaults on nurses in a provincial psychiatric hospital in Canada. Acta Psychiatrica Scandinavia 84:163–166, 1991.
Flannery RB Jr: Staff victims of elder patient abuse and the Assaulted Staff Action Program (ASAP): Preliminary empirical inquiry. American Journal of Alzheimer’s Disease and Other Dementias 18:93–96, 2003.
Krakowski MI, Czobor P: Clinical symptoms, neurological impairment, and prediction of violence in psychiatric inpatients. Hospital and Community Psychiatry 45:700–705, 1994.
Miller RJ, Zadolinnyji K, Hafner RJ: Profiles and predictors of assaultiveness for different psychiatric ward populations. American Journal of Psychiatry 150:1368–1373, 1993.
Flannery RB Jr: Precipitants to psychiatric patient assaults on staff: Review of empirical findings, 1990–2003. Psychiatric Quarterly 2005, in press.
Cospito E, Gift T: Assaultive patients in a chronic care medical facility. Journal of Psychiatric Treatment and Evaluation 4:422–436, 1982.
Flannery RB Jr: The Assaulted Staff Action Program (ASAP): Coping with the Psychological Aftermath of Violence. Ellicott City, MD, Chevron Publishing Company, 1998.
Lion JB, Snyder W, Merrill GC: Underreporting of assaults on staff in a state hospital. Hospital and Community Psychiatry 32:497–498, 1981.
Flannery RB Jr, Stevens V, Juliano J, et al: Past violence, substance use disorder, and subsequent violence toward others: Six year analysis of the Assaulted Staff Action Program (ASAP). International Journal of Emergency Mental Health 4:143–148, 2000.
Brasic JR Fogelman D: Clinician safety. The Psychiatric Clinics of North America 22:923–940, 1999.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Flannery, R.B., Peterson, B. & Walker, A.P. Precipitants of Elderly Psychiatric Patient Assaults on Staff: Preliminary Empirical Inquiry. Psychiatr Q 76, 167–175 (2005). https://doi.org/10.1007/s11089-005-2337-z
Issue Date:
DOI: https://doi.org/10.1007/s11089-005-2337-z