Substance use and community violence: A test of the relation at the daily level.

Prior research has consistently demonstrated an association between substance use and involvement in violence among individuals with mental illness. Yet little is known about the temporal quality of this relationship, largely because longitudinal data required to address this issue are not readily available. This study examined the relationship between substance use (alcohol, marijuana, and other drug use) and violence at the daily level within a sample of mentally ill individuals at high risk for frequent involvement in violence (N = 132). Results support the serial nature of substance use and violence, with an increased likelihood of violence on days following the use of alcohol or multiple drugs, but not the inverse relationship. Implications for the utility of substance use as a risk marker for the assessment of future violence are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between medical and psychiatric symptoms.

The Cornell Medical Index, Taylor scale, and the Saslow Psychosomatic Inventory were administered to in-patients and out-patients in the medical and psychiatric hospitals and clinics of a medical school. The result was that "number of medical symptoms was a good predictor (correlated highly) of psychiatric symptomatology and vice versa." Females had more medical symptoms than men, but no such distinction appeared, re: psychiatric symptoms. From Psyc Abstracts 36:01:3HI55M. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using a Five-Factor Lens to Explore the Relation Between Personality Traits and Violence in Psychiatric Patients.

Recent work suggests that predictors of violence are similar for individuals with and without mental illness. Although psychopathy is among the most potent of such predictors, the nature of its relation to violence is unclear. On the basis of a sample of 769 civil psychiatric patients, the authors explore the possibility that measures of psychopathy provide a glimpse of higher order personality traits that predispose individuals toward violence. Results indicate that general traits captured by a measure of the 5-factor model, particularly antagonism, were relatively strongly associated with violence and shared most of their violence-relevant variance with a leading measure of psychopathy. Because interpersonal and affective features of psychopathy are less important than basic traits of antagonism in postdicting violence, it may be appropriate to broaden focus in risk assessment to patients' basic personality traits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An ecological-transactional understanding of community violence: Theoretical perspectives.

Community violence has emerged as a major risk factor for the development of mental health problems in children and adolescents. If mental health providers are to meet the needs of children and communities dealing with community violence, then they will need to integrate principles from various subdisciplines in psychology (e.g., developmental psychology, school psychology, developmental psychopathology) as well as disciplines outside of psychology (e.g., sociology, public health, medicine) to understand fully the developmental impact of exposure to community violence. The development of such a model is necessary to identify the pathways, risk, and protective factors on which prevention and intervention programs can be built. The goal of this article is to present an ecological-transactional model of community violence as a conceptual framework for understanding the existing literature and for guiding future research on community violence exposure and child development. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Subtypes of partner violence perpetrators among male and female psychiatric patients.

The goal of this naturalistic study was to examine heterogeneity among female and male civil psychiatric patients with a history of intimate partner violence (IPV) perpetration. Participants were 567 patients drawn from the MacArthur Violence Risk Assessment Study (J. Monahan et al., 2001). The authors examined subtype composition among 138 women and 93 men with positive histories of IPV and compared these groups with 111 women and 225 men with no histories of IPV. Findings for men and women were consistent with reports from studies of male perpetrators in forensic and community settings in that generally violent/antisocial, borderline/dysphoric, and family only/low-psychopathology subtypes of perpetrators were identified in both men and women. This study provides preliminary evidence for the generalizability of typologies derived from nonpsychiatric partner violence perpetrators to psychiatric populations and suggests that typologies derived from studies of male IPV perpetrators may provide useful guidance for the investigation of female IPV perpetration. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and violence: The importance of factor level interactions.

The power of scales based on the Psychopathy Checklist (PCL; R. D. Hare, 1980) for prediction of violent behavior is well established. Although evidence suggests that this relationship is chiefly due to the impulsive and antisocial lifestyle component (Factor 2), the predictive power of psychopathy for violence may also reflect the multiplicative effects of this component with interpersonal and unemotional traits (Factor 1). The determination of the extent to which psychopathy subcomponents interact to predict violence has theoretical and practical implications for PCL-assessed psychopathy. However, the relationship between violence and the interactive effects of psychopathy subcomponents remains largely undetermined. The authors used prospective and cross-sectional designs to examine the independent and interactive effects of the factors of PCL-assessed psychopathy in 2 samples: (a) 199 county jail inmates and (b) 863 civil psychiatric patients. The Factor 1 × Factor 2 interaction predicted violence in both samples, such that the predictive power of Factor 2 was attenuated at lower levels of Factor 1. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosis as a risk factor for violence to others: A meta-analysis.

The potential association between psychosis and violence to others has long been debated. Past research findings are mixed and appear to depend on numerous potential moderators. As such, the authors conducted a quantitative review (meta-analysis) of research on the association between psychosis and violence. A total of 885 effect sizes (odds ratios) were calculated or estimated from 204 studies on the basis of 166 independent data sets. The central tendency (median) of the effect sizes indicated that psychosis was significantly associated with a 49%–68% increase in the odds of violence. However, there was substantial dispersion among effect sizes. Moderation analyses indicated that the dispersion was attributable in part to methodological factors, such as study design (e.g., community vs. institutional samples), definition and measurement of psychosis (e.g., diagnostic vs. symptom-level measurement, type of symptom), and comparison group (e.g., psychosis compared with externalizing vs. internalizing vs. no mental disorder). The authors discuss these findings in light of potential causal models of the association between psychosis and violence, the role of psychosis in violence risk assessment and management, and recommendations for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of personality disorder symptoms and the risk for partner violence.

In a community sample (N = 543) followed over 20 years, the authors studied associations among childhood family violence exposure, personality disorder (PD) symptoms, and adult partner violence. PD symptoms (DSM-III-R Clusters A, B, and C) in early adulthood partially mediated the effect of earlier childhood risks on the odds of perpetrating partner violence. The authors tested whether stability of PD symptoms from adolescence to the early 20s differs for individuals who later perpetrated partner violence. Cluster A ("Odd/Eccentric") symptoms declined less with age among partner violent versus nonviolent men and women. Cluster B ("Dramatic/Erratic") symptoms were more stable through late adolescence in partner violent men, compared with nonviolent men and violent women. Cluster C ("Anxious") symptoms were most stable among partner violent men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between aggressive attributional style and violence by psychiatric patients.

The authors propose a new theoretical construct for understanding the risk of violent behavior by psychiatric patients: the aggressive attributional style. They propose that a cognitive style characterized by external hostile attributions increases the risk of violence by mentally ill persons. To evaluate this hypothesis, they administered several self-report measures relevant to the aggressive cognitive style, as well as measures of violent behavior in the community, to 110 psychiatric inpatients. Higher scores on several indicators of the aggressive attributional style were associated with violence. Multivariate logistic regression analyses showed that the relationship between attributional style and violence held up when demographic and diagnostic characteristics and impulsiveness were controlled. The authors discuss implications for development of cognitive interventions to reduce violence risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of posttraumatic distress 1 year after exposure to community violence: The importance of acute symptom severity.

In this longitudinal study of 333 primarily male, Hispanic survivors of community violence, the authors investigated the effects of 4 categories of risk factors on posttraumatic stress disorder (PTSD) symptom severity: demographic characteristics, pretraumatic psychological factors, characteristics of the trauma, and reactions to the trauma. Replicating past research, exemplars from all 4 categories predicted PTSD symptom severity at 12-month follow-up. Acute symptom severity, measured approximately 5 days posttrauma, accounted for the largest proportion of variance among all the predictors included. No other predictors remained significant after 5-day distress was included in the model. These findings suggest that the effects of several purported risk factors for chronic posttraumatic distress may already be reflected in acute distress following trauma exposure. These results bear on current conceptions of the fundamental nature of PTSD and suggest that initial distress during the immediate aftermath of the trauma may be an important target for intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A behavioral study of staff attitudes toward mental illness.

65 nurses and aides completed 2 factor analyzed attitude questionnaires. Hospitalized psychiatric patients (N = 188) screened for ability to identify their staff and make valid behavioral ratings, rated their ward staff on a 55-item interpersonal behavior inventory. Relationships between perceived behavior and endorsed attitudes were examined. Restrictive attitudes were consistently related to controlling and restricting behavior. Protective Benevolence was related to such behaviors as aloofness, distance, and dishonesty. Hence, some attitudes were related to behaviors which were congruent with the endorsed attitude, some attitudes were related to seemingly incongruent behaviors, while other attitudes had no significant behavioral correlates. A new attitude area, highly related to outgoing interpersonal behavior, was identified. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beliefs about mental illness as a functon of psychiatric status and psychiatric hospitalization.

Beliefs about mental illness were assessed among psychiatric inpatients at a VA hospital, the mental health staff responsible for their treatment, and a group of medical and surgical (control) patients. Results indicated that: (a) Psychiatric and nonpsychiatric patients generally hold similar opinions regarding mental illness. Severely disturbed psychiatric patients, however, view mental illness in more moralistic terms than do "normals." (b) Psychiatric hospitalization is generally accompanied by a change in the patient's beliefs concerning mental illness, toward those held by the staff. (c) Psychiatric patients whose beliefs about mental illness are most strikingly influenced by the staff tend to respond most favorably to treatment, as measured by length of hospital stay and gains in self-esteem during the 1st month of treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and community violence among civil psychiatric patients: Results from the MacArthur Violence Risk Assessment Study.

Although psychopathy is recognized as a relatively strong risk factor for violence among inmates and mentally disordered offenders, few studies have examined the extent to which its predictive power generalizes to civil psychiatric samples. Using data on 1,136 patients from the MacArthur Violence Risk Assessment project, this study examined whether the 2 scales that underlie the Psychopathy Checklist: Screening Version (PCL:SV) measure a unique personality construct that predicts violence among civil patients. The results indicate that the PCL:SV is a relatively strong predictor of violence. The PCL:SV's predictive power is substantially reduced, but remains significant, after controlling for a host of covariates that reflect antisocial behavior and personality disorders other than psychopathy. However, the predictive power of the PCL:SV is not based on its assessment of the core traits of psychopathy, as traditionally construed. Implications for the 2-factor model that underlies the PCL measures and for risk assessment practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What Do Clinicians Expect? Comparing Envisioned and Reported Violence for Male and Female Patients.

Mental health professionals' (MHPs') accuracy in assessing the risk of violence in female patients is particularly limited. Based on assessments made by 205 MHPs of 605 patients in an emergency room, this study explored potential causes of MHPs' poorer accuracy in assessing women's potential for violence. The dimensions that underlie MHPs' envisioned violence in patients were identified and were compared with those that characterized patients' reported violence during a 6-month follow-up period. There were three key findings from their study. First, violence envisioned by MHPs differed depending on their professional role and varied in its congruence with patients' reported violence. Second, patients' violence was organized by dimensions of domesticity and substance relatedness; women's violent incidents were more domestic than were men's. Third, when MHPs envisioned violence that was highly conditional on psychiatric deterioration and medication noncompliance, violence often did not occur. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlates of expressed and received violence across relationship types among men and women substance abusers.

This study examined expressed and received violence among men and women in substance abuse treatment. Rates of past-year partner violence (PV) did not differ by gender, although men reported markedly higher rates of nonpartner violence (NPV). Compared with PV, NPV was associated with more demographic and background factors (e.g., childhood aggression and conduct problems, family history of violence). The most consistent correlates of violence across relationship types were age, minority status, drug-related consequences, psychiatric distress, and frequency of childhood aggression. Only a few gender-specific correlated were identified; most notably, witnessing father-to-mother violence was related to received PV only for women. Identification of correlates of expressed and received violence in partner and nonpartner relationships is essential for the assessment and treatment of individuals in substance abuse treatment settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Opinions about mental illness in the personnel of two large mental hospitals.

The present research is directed at clarifying the attitudes of the people who work with psychiatric patients. A sample of over 1000 such individuals, ranging from office and kitchen help to psychiatrists in 2 VA hospitals, filled out a specially devised attitude scale. Factor analysis isolated 5 major factors: 2 reflecting negative attitudes (one in which their difference and inferiority to normals was stressed, the other reflecting a desire to place strong social restrictions on them both during and after hospitalization); 2 positive attitude factors (one based on an almost moral sense of obligation to help unfortunates, the other on more professional attitudes towards their treatability). The 5th factor was defined by attitudes towards etiology of psychiatric illness in relation to psychological development. Clear-cut differences of opinion were at the different levels of professional training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatric disorders and sexual risk among adolescents in mental health treatment.

Objective: To examine the relationship between psychiatric disorders and sexual behaviors among adolescents receiving mental health treatment. Adolescents in mental health treatment have been found to have higher rates of HIV risk behavior than their peers, but data concerning the relationship between psychopathology and risk are inconsistent and limited. Method: Eight hundred and forty adolescents (56% female, 58% African American, mean age = 14.9 years) and their parents completed computerized assessments of psychiatric symptoms via the Computerized Diagnostic Interview Schedule for Children (Shaffer, 2000a, 2000b). Adolescents also reported on sexual risk behaviors (vaginal/anal sex, condom use at last sex) and completed urine screens for a sexually transmitted infection (STI). Results: Adolescents meeting criteria for mania, externalizing disorders (oppositional defiant, conduct, and attention-deficit/hyperactivity disorders), or comorbid for externalizing and internalizing disorders (major depressive, generalized anxiety, and posttraumatic stress disorders) were significantly more likely to report a lifetime history of vaginal or anal sex than those who did not meet criteria for any psychiatric disorder (odds ratio [OR] = 2.0, 2.3, and 1.9, respectively). Adolescents meeting criteria for mania were significantly more likely to have 2 or more partners in the past 90 days (OR = 3.2) and to test positive for a STI (OR = 4.3) relative to adolescents who did not meet criteria for a psychiatric disorder. Conclusions: The presence of internalizing and externalizing disorders, especially mania, suggests the need for careful screening and targeting of adolescent sexual behavior during psychiatric treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The potential impact of violent victimization on somatic symptoms among Asian American adolescents: A national longitudinal study.

This study explored the mental health repercussions among Asian American adolescents following experiences of violent victimization. Utilizing a subsample of Asian American adolescents from Waves I and II of the National Longitudinal Study of Adolescent Health (Add Health), this study examined the relationship between violent victimization and somatic symptoms one year later, as well as moderators of this relationship. Results from a hierarchical multiple regression analysis showed that emotional bonds with fathers were negatively related to somatic symptoms. In addition, instrumental bonds with mothers weakened the link between violent victimization and somatic symptoms. The practical implications of these results for addressing the psychosocial needs of Asian American adolescents were discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Review of The mental hospital. A study of institutional participation in psychiatric illness and treatment.

Reviews the book, The mental hospital. A study of institutional participation in psychiatric illness and treatment by Alfred H. Stanton and Morris S. Schwartz (see record 2005-02933-000). This is a rich and rewarding book. It is a report of research, conducted in collaboration by a psychiatrist and a sociologist, into the social organization of a psychiatric hospital and into the effects of this social organization on the behavior of patients. Although it is primarily intended as a contribution to administrative psychiatry, it is also a major contribution to the general literature of social science and, in particular, to the broad area of personality and social structure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)