Risk factors for violence among long-stay psychiatric patients: national study.

This study identified risk factors for violence among long-stay (1 year or more) psychiatric patients in Israel (n = 2946) using data from a national reevaluation of such patients. Patients were rated as being violent if hospital staff or patient charts indicated an incident of physical violence at least every few months. The relationship between violence and patients' functioning, living conditions, treatment, background and hospitalization history was studied. In total, 22.8% of patients were violent. Based on logistic regression analysis, the risk factors for being violent were younger age, younger age at first hospitalization, poorer self-care, having more frequent visitors, and the patient not having his or her own clothing. The data for age and lack of gender differences confirm previous findings. However, the results regarding clothing, visitors, poor self-care and age of onset are unique. The results of this study suggest that the violent behaviour of in-patients is related to both individual and environmental variables.     

遭受工作场所暴力的精神科护士心理状况调查

目的 了解精神科护士遭受工作场所暴力后的心理压力状况,分析原因,探索对策.方法 采用症状自评量表(SCL-90)对203例遭受工作场所暴力的精神科护士进行调查.结果 203例护士SCL-90除人际敏感因子分低于中国常模,其余的阳性项目数和躯体化、焦虑、敌对因子分明显高于中国常模,差异均有统计学意义(P＜0.01).按不同年龄段及不同职称比较SCL-90各因子分,其中护士各年龄段之间差异均无统计学意义(P＞0.05),护士组的人际敏感、恐怖、精神病性因子分高于主管护师及以上职称护士,差异有统计学意义(P＜0.05);护师组的量表总分、阳性项目数、强迫、人际敏感、抑郁、恐怖、精神病性因子分高于主管护师及以上职称护士,差异均有统计学意义(P＜0.05).结论 遭受工作场所暴力的精神科护士心理压力普遍存在,低职称的护士心理压力要高于中级及以上职称护士,建议医院管理层根据不同的护士群体采取不同的干预对策.     

Family support predicts psychiatric medication usage among Mexican American individuals with schizophrenia

Background Support provided by family caregivers to persons with schizophrenia is a viable intervention focus to improve psychiatric medication usage. However, little is known about the relation between medication usage and family support as well as other key caregiving factors. Method Family support and Expressed Emotion (EE) dimensions were tested as predictors of medication usage during a 9-month period following psychiatric hospital discharge in a sample of 30 individuals of Mexican descent with schizophrenia. Results Family instrumental support predicted higher medication usage (Odds Ratio = 4.8) in multivariate analyses that statistically adjusted for the impact of emotional support, family EE, and psychiatric status (e.g., positive symptoms) on medication usage. Conclusions Findings suggest that efforts to improve medication usage among Mexican American individuals with schizophrenia should take into account social supportive factors such as instrumental or directive, hands-on assistance from family caregivers.     

The contribution made by the clinical setting to violence among psychiatric patients

Both the characteristics of the violent patients and the characteristics of the milieu contribute to violence in clinical settings. Until now the contri.bution of milieu characteristics has been a neglected area. Violent patients seem to be prone to (mis)perceive other people as hostile, and, due to low impulse control, they react with violence. Staff ought to give patients a sense of predictability and safety in the environment to prevent outbreaks of violence. This is best obtained in wards with a stable, experienced staff, clear leadership and predictable, clearly structured staff roles and events. Some studies indicate that crowding increases violence rates, but the relationship is not clearly established, and the importance of the physical milieu seems hardly to have been investigated empirically. There are some indications that the rates of violence may be related to the perceived ward milieu. The likelihood of violence is probably higher in milieus with a high level of anger and aggression and low levels of order and organization and staff control. Interventions to prevent violence can aim at individual patients and/or the milieu. The individual interventions ought to aim at establishing a working alliance and at teaching patients appropriate behavioural responses to anger and frustration. The milieu interventions should aim at training staff in how to solve conflicts and handle their relationship with potentially violent patients. Special teams to take care of staff victims of violence seem useful in preventing the development of PTSD.     

Psychological impact of verbal abuse and violence by patients on nurses working in psychiatric departments

The aim of this study was to assess the psychological impact of verbal abuse or violence by patients on nurses working in psychiatry departments and to identify factors related to their impact. Survey sheets were distributed to a total of 266 nurses working at two hospitals, and replies were obtained from 232 of them. Because three of them had less than 1 month of experience working in the psychiatry department and four of them failed to answer all the questions, valid replies were obtained from 225 nurses. Among the 225 whose replies were valid, 141 nurses who replied that they had experienced verbal abuse or violence that left an impression on them remained as the subjects of the final analysis. The Impact of Event Scale-Revised (IES-R) was used to evaluate psychological impact. Of the nurses who had been exposed to verbal abuse or violence that left an impression, 21% had scores that exceeded the IES-R cut-off point (24/25), and low satisfaction with family support, and neuroticism on the Eysenck Personality Questionnaire-Revised were shown to have contributed to the psychological impact. Nurses working in psychiatry departments were shown to experience a severe psychological impact when exposed to verbal abuse or violence. These results suggest the need for mental care approaches for nurses working in psychiatry departments.     

Inpatient violence and the schizophrenic patient. A study of Brief Psychiatric Rating Scale scores and inpatient behavior

A correlational analysis of Brief Psychiatric Rating Scale (BPRS) ratings and measures of inpatient violence in 207 schizophrenic patients is presented. Significant correlations were found between BPRS measures of schizophrenic symptomatology and several measures of inpatient violence including assault. BPRS subscales which related to paranoid symptoms were also significantly correlated with inpatient danger-related measures; however, to a lesser degree.     

The Attempted and Actual Assault Scale (Attacks)

The Attempted and Actual Assault Scale (Attacks) was designed to record the nature and severity of inpatient assaults. To explore the psychometric properties of the Scale, a videotape of interpersonal assaults was compiled with clips from regular television broadcasts. During a meeting of the European Violence in Psychiatry Research Group (EVIPRG), 22 members from 14 different countries were instructed to rate the videotaped assaults on both the MOAS and the Attacks. Inter-rater reliability--in terms of intra-class correlation coefficients--was 0.70 for Attacks and 0.48 for MOAS severity scores. Attacks severity scores turned out to be significantly associated with the judgments of the raters about the severity of the observed assaults (Spearman's rho = 0.70). It is concluded that the psychometric properties of the newly developed Attacks are promising.     

Family Violence in Japan—A Compilation of Data from the Department of Psychiatry, Nagoya University Hospital—

Summary: In the United States and in most other countries, "family violence" refers to all forms of violence that occur in the family. But in Japan, this term is used to indicate only the violent behavior which a child exhibits toward other family members such as his parents. This form of violence is said to be increasing in Japan, and has recently attracted public attention. But it seems to us that there is no country that pays as much attention to this kind of violent behavior as Japan. We studied the problem of this type of family violence using the data of patients at the psychiatric clinic of Nagoya University Hospital.     

Depressive symptoms among young Norwegian adolescents as measured by The Mood and Feelings Questionnaire (MFQ)

In a stratified random and representative sample of 2560 13- to 14-year-old Norwegian girls and boys, depressive symptoms were assessed by means of the Mood and Feelings Questionnaire (MFQ). The MFQ showed a good internal consistency (α), and test-retest correlations (r) for three-week and three-month intervals were 0.84 and 0.80 respectively. Convergent and discriminative validity were also assessed. The mean total MFQ score for the whole sample was 10.6 (SD 9.5). The results showed a significant sex by age interaction effect in that girls increased their mean total MFQ sum score by age while the boys' scores decreased slightly. Reports of unattractiveness, restlessness, indecisiveness and transient feelings of low mood were common in the total sample, while unhappiness, irritability, self-dislike and concentration problems were common among high-scoring subjects. Girls experienced more often lowered mood, were more concerned with their appearance and had more self-depreciatory notions than boys, while boys more often than girls had lower school satisfaction. Girls were preponderant among the high-scoring subjects. The results of logistic regression analyses showed that concentration problems were the strongest predictor of high scores. The findings are discussed in view of similar epidemiological studies in which DSM-IV criteria have been used in the assessment of depressive symptoms and disorders among adolescents. Accepted: 6 March 2001     

The impact of political violence on psychosocial functioning of individuals and families: the case of palestinian adolescents

Background: The impact of political violence on the psychosocial functioning of adolescents and their families was compared for surveyed populations from two regions of Palestine. Method: A randomly‐selected sample of 971 adolescents (521 from the West Bank and 450 from the Gaza Strip regions, 42% male/57% female) completed scales measuring traumatic event, post‐traumatic stress disorder (PTSD), peer relations, mental health, aggression, and family functioning. Results: (1) West Bank participants reported a significantly higher level of exposure to political violence and significantly more aggression, mental health symptoms, problems in family and social functioning; (2) Participants exposed to greater political violence reported higher levels of depression, hostility, paranoid ideation, and PTSD; (3) Economic status and level of parental education were related to reduced levels of mental health symptoms and greater family functioning; (4) There were gendered differences. Conclusions: The study provides a starting point to begin to compare the experiences and outcomes between Palestinian adolescents in the West Bank and Gaza Strip and a basis for considering implications for service delivery and policy makers concerned with the well being of Palestinian communities.     

Personality profiles among normal aged individuals as measured by the NEO-PI-R

The revised Neuroticism (N), Extraversion (E), Openness (O) to experience Personality Inventory (NEO-PI-R) is a multidimensional measure of normal personality traits that is intended to assess five major personality dimensions or domains-N, E, O, Agreeableness (A), and Conscientiousness (C). Although several studies have been conducted examining N, E, and O factors in people 65 through to 85 years old, there has been little research examining all five-core domains of personality in individuals 85 and older. We compared the NEO-PI-R domains and facet traits in the middle-aged/young-old versus old-old normal subjects. Thirty-eight community-dwelling subjects (22 women, 16 men) free from major neuropsychiatric disorders were given the NEO-PI-R, a self-administered 240-item personality inventory, assessing 30 facet traits within the five domains. We compared the scores of 21 middle-aged and young-old (age 50-84) individuals, to those of 17 old-old (age 85-100) subjects. The personality profiles of the two groups were similar except that the old-old group had lower scores on Extraversion, and four of the 30 facet traits (warmth, positive emotions, impulsiveness, and order) compared to the middle-aged/young-old group. These results were limited by the cross-sectional design and small sample size. Nonetheless, the findings suggest that the middle-aged/young-old and the old-old normal subjects have fairly similar personality traits.     

The new violence type of the era: Cyber bullying among university students: Violence among university students

Backgrounds

Researchers have stated that internet has both positive and negative features just like all the other information technology tools. The most important example to give of the negative outcomes is peer-to-peer cyber bullying. The most general definition of peer-to-peer cyber bullying is to harm individuals deliberately and repetitively through electronic media.

Methods

The survey study was conducted in Istanbul Bilgi University Law School, Istanbul Ticaret University Law School and Marmara University Law School by the students to the faculties’ students. All results were evaluated with SPSS (Statistical Package for Social for Sciences).

Results

579 persons in the range of 18-30 years were included in the survey. A total of 346 (59.8%) cases were cyberbullied on electronic media. 20.7% stated that they were disturbed through internet, 27.7% by mobile phone and 51.7% both by internet and mobile phone. 80% of those who have been exposed to violence through electronic means have been found to be exposed to more than one form of violence.

Conclusions

More than half of our subjects have notified that they have been negatively affected by cyber violence. Prevention strategies should be created as well as the recognition of cyber bullying.     

Depression Scale (DEPS) among suicide attempters

The Depression Scale (DEPS), a new screening instrument for detecting depression in primary health care, was compared with the Hamilton Depression Scale (HDS) among 50 suicide attempters. Using the HDS as a gold standard, the positive and negative predictive values of the DEPS for the diagnosis of depression were 98% and 20%, respectively. The correlation between the total HDS scores and the total DEPS scores was 0.60. The DEPS may help general practitioners to detect depression among suicide attempters, but it should not be used to exclude depression.     

Validation of the Extreme Experiences Scale (EX2) for Armed Conflict Contexts

Psychiatric Quarterly - Psychological approaches to the study of armed conflict have focused on analyzing post-traumatic stress outcomes, and on evaluating the intensity of exposure to violent...     

Reactions to dating violence among Latino teenagers: an experiment utilizing the Articulated Thoughts in Simulated Situations paradigm

Dating violence is a serious problem among adolescents and young adults. Understanding teens' reactions to dating violence offers the potential to understand the factors that lead to perpetration of violent behavior and to elucidate prevention strategies. Knowledge concerning youth attitudes about dating violence is limited, and has largely come from self-report questionnaires to date. We utilized the Articulated Thoughts in Simulated Situations (ATSS) paradigm to assessing Latino teens' reactions to dating violence. Forty-one 9th grade students were presented with four simulated dating violence scenarios, and articulated their thoughts in response to them. Teens' reactions to dating violence differed on a variety of dimensions as a function of their gender, the gender of the perpetrator, and familiarity with the perpetrator.     

The Youth Self-Report (YSR) and the Depression Self-Rating Scale (DSRS) as measures of depression and suicidality among adolescents

Two hundred and thirty-seven adolescents from a junior high school in a small community outside G?teborg, Sweden, completed the Youth Self Report (YSR) and the Depression Self Rating Scale (DSRS). Self-reported suicidality and biographical data were also recorded. The school doctor and nurse assessed the adolescents' somatic, psychological and behavioural problems using school health-records. The convergent validity of the YSR total problems scale and syndrome scales were tested against the DSRS. Discriminant validity was assessed by the two measures' ability to predict suicidality and school health problems. The Internalising (r = 0.65**) and Anxious/Depressed (r= 0.61**) syndrome scales of the YSR had the highest correlations with the DSRS. However, all YSR syndrome scales were significantly, though more modestly, correlated with the DSRS. Using stepwise logistic regression analysis, four YSR sub-scales [Social Withdrawal, Anxious/Depressed, Attention problems and Delinquency] predicted mild-severe self-reported depression (DSRS scores 12 and above). The YSR syndrome scales Anxious/Depressed and Delinquency predicted suicide ideation whereas the Self-destructive/Identity problem and Social Withdrawal (low scores) scales predicted Suicide attempts. The YSR Anxious/Depressed sub-scale and the DSRS total score seem to measure a similar dimension. However, the Anxious/Depressed and Selfdestructive/Identity problem scales were superior in predicting suicidality.     

Development and validity of the Family Stigma in Alzheimer's disease Scale (FS-ADS)

Although it is widely assumed that persons with Alzheimer disease (AD) and their family caregivers are victims of stigmatization, family stigma in the area of AD has received surprisingly limited attention. Reliable, valid, and user-friendly scales are a first step in expanding this body of knowledge. The aim of this study was to develop and examine the validity of the Family Stigma in Alzheimer's disease Scale. Interviews were conducted with 185 children of persons with AD. A pool of 100 items was identified from the literature and an earlier qualitative study including 3 dimensions (caregivers' stigma, lay persons' stigma, and structural stigma). Exploratory factor analyses, theoretical relevance, and internal reliability analyses allowed us to reduce the pull to 62 items. Regarding construct validity, statistically significant associations were found between family stigma and caregivers' burden and behavioral problems, in most of the scales. Although further testing is warranted, these findings indicate that the Family Stigma in Alzheimer's disease Scale is a reliable and valid instrument for assessing stigma in the context of AD.     

Assessing the reliability,predictive and construct validity of historical,clinical and risk management-20 (HCR-20) in Mexican psychiatric inpatients

Introduction: Assessing dangerousness to gauge the likelihood of future violent behaviour has become an integral part of clinical mental health practice in forensic and non-forensic psychiatric settings, one of the most effective instruments for this being the Historical, Clinical and Risk Management-20 (HCR-20). Objective: To examine the HCR-20 factor structure in Mexican psychiatric inpatients and to obtain its predictive validity and reliability for use in this population. Method: In total, 225 patients diagnosed with psychotic, affective or personality disorders were included. The HCR-20 was applied at hospital admission and violent behaviours were assessed during psychiatric hospitalization using the Overt Aggression Scale (OAS). Construct validity, predictive validity and internal consistency were determined. Results: Violent behaviour remains more severe in patients classified in the high-risk group during hospitalization. Fifteen items displayed adequate communalities in the original designated domains of the HCR-20 and internal consistency of the instruments was high. Conclusion: The HCR-20 is a suitable instrument for predicting violence risk in Mexican psychiatric inpatients.