Aggressive behavior during the first 24 hours of psychiatric admission

Calegaro, Vítor Crestani; Dotto, Amanda Bolson; Freitas, Denise de; Brum, Anderson Barcellos; Valério, Andrei Garziera; Schetinger, Christina Chitolina; Cunha, Ângelo Batista Miralha da

doi:10.1590/2237-6089-2014-0016

Cited by 7 publications

(11 citation statements)

References 19 publications

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“…Our results are in line with the existing evidence indicating a higher risk of aggressions during the first days of hospitalization as we found that almost 29.8% of the reports regarded the 5 days after admission (Barlow et al, 2000; Calegaro et al, 2014) and 35.1% after 20 days. A high percentage of incidents in the first 5 days might be explained by partial ineffectiveness of pharmacotherapy as well as that the acute psychiatric symptoms that lead to the hospitalization.…”

Section: Discussionsupporting

confidence: 93%

Reporting Incidents in the Psychiatric Intensive Care Unit

Mele¹,

Buongiorno²,

Montalbò³

et al. 2022

J Nerv Ment Dis

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To evaluate the characteristics of the reported workplace violence in a psychiatric intensive care unit (PICU) by analyzing an electronic hospital incident reporting system (IRS). One hundred thirty reports were retrieved from January 2017 to June 2020, referring to assaults committed by patients (71% males) with an average age of 29.8 years (SD, 14.9). The most frequent psychiatric diagnosis was a neurodevelopmental disorder (33%). Physical aggression (84%) was more frequent than the other types of aggression. Nurses and unlicensed assistive personnel were the most frequent victims (65%). Aggressions were more frequent on Friday (18%) and between 4 p.m. and 8 p.m. (35%). A total of 64.9% of the incidents happened in the first 5 days of hospitalization. A significant association between physical aggression and diagnosis of neurodevelopmental disorder emerged. IRS could be helpful to identify high-risk patient groups and develop clinical strategies to reduce adverse events in clinical practice.

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Section: Discussionsupporting

confidence: 93%

Reporting Incidents in the Psychiatric Intensive Care Unit

Mele¹,

Buongiorno²,

Montalbò³

et al. 2022

J Nerv Ment Dis

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“…In the first 24 hours or first week, the highest percentages of aggression were measured [53,72,79,81]. Only a minor proportion of the admitted patients were involved in the majority of incidents [51, 54, 56, 62, 72, 78, 85-88, 90, 93].…”

Section: Plos Onementioning

confidence: 99%

“…In 12 papers diagnosis had no significant contribution to the development of aggression [50,53,60,70,75,77,78,88,90,92,99,101].…”

Section: Patient Factors Associated To Aggressionmentioning

confidence: 99%

Aggression on the psychiatric ward: Prevalence and risk factors. A systematic review of the literature

et al. 2021

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Introduction On psychiatric wards, aggressive behaviour displayed by patients is common and problematic. Understanding factors associated with the development of aggression offers possibilities for prevention and targeted interventions. This review discusses factors that contribute to the development of aggression on psychiatric wards. Method In Pubmed and Embase, a search was performed aimed at: prevalence data, ward characteristics, patient and staff factors that are associated with aggressive behaviour and from this search 146 studies were included. Results The prevalence of aggressive behaviour on psychiatric wards varied (8–76%). Explanatory factors of aggressive behaviour were subdivided into patient, staff and ward factors. Patient risk factors were diagnosis of psychotic disorder or bipolar disorder, substance abuse, a history of aggression, younger age. Staff risk factors included male gender, unqualified or temporary staff, job strain, dissatisfaction with the job or management, burn-out and quality of the interaction between patients and staff. Staff protective factors were a good functioning team, good leadership and being involved in treatment decisions. Significant ward risk factors were a higher bed occupancy, busy places on the ward, walking rounds, an unsafe environment, a restrictive environment, lack of structure in the day, smoking and lack of privacy. Conclusion Despite a lack of prospective quantitative data, results did show that aggression arises from a combination of patient factors, staff factors and ward factors. Patient factors were studied most often, however, besides treatment, offering the least possibilities in prevention of aggression development. Future studies should focus more on the earlier stages of aggression such as agitation and on factors that are better suited for preventing aggression such as ward and staff factors. Management and clinicians could adapt staffing and ward in line with these results.

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“…Hostility has been conceptualized by anger/aggression scholars as an enduring attitudinal disposition toward anger and aggressive behavior (e.g., Berkowitz, 1993; Buss, 1961; Novaco, 1994). Like traditional anger disposition measures, BPRS Hostility has been found to be associated with inpatient aggression incidents (e.g., Amore et al, 2008; Carr et al, 2019; McNiel & Binder, 1994; Calegaro et al, 2014) and with inpatient anger measures, as well as violence (Doyle & Dolan, 2006a). It has very good inter‐rater reliability, with r = 0.86 for a clinical sample (Overall & Gorham, 1962).…”

Section: Methodsmentioning

confidence: 99%

“…Hostility has been found to be associated with inpatient aggression incidents (e.g., Amore et al, 2008;Carr et al, 2019;McNiel & Binder, 1994 ;Calegaro et al, 2014) and with inpatient anger measures, as well as violence (Doyle & Dolan, 2006a). It has very good inter-rater reliability, with r = 0.86 for a clinical sample (Overall & Gorham, 1962).…”

mentioning

confidence: 99%

Anger rumination and imagined violence as related to violent behavior before and after psychiatric hospitalization

et al. 2022

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Objective: Anger rumination and imagined violence, in the context of anger/aggression proclivity, are examined for their direct and conjoint associations with violent behavior by psychiatric patients. Method: A secondary analysis of data from the MacArthur Violence Risk Study was conducted with 1136 acute civil commitment patients, assessed during hospitalization and after hospital discharge. Anger/aggression proclivity was assessed with the Brief Psychiatric Rating Scale hostility subscale, anger rumination was indexed using items from the Novaco Anger Scale, and imagined violence was measured with Grisso's Schedule of Imagined Violence. Violence, prehospitalization and posthospitalization, was indexed by the MacArthur project measure.Results: Correlational analyses, mediation analyses, and moderated mediation analyses were conducted. Anger rumination significantly predicted pre-and posthospitalization violence, when controlling for age, sex, race, childhood physical abuse, and anger/aggression proclivity; and it partially mediated the relation between anger/aggression proclivity and violence.Imagined violence and anger rumination were highly interrelated. When imagined violence was added to the regression model, it was a significant predictor of prehospitalization violence; however, it did not moderate the association of anger rumination with pre-or posthospitalization violence.

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Aggressive behavior during the first 24 hours of psychiatric admission

Cited by 7 publications

References 19 publications

Reporting Incidents in the Psychiatric Intensive Care Unit

Reporting Incidents in the Psychiatric Intensive Care Unit

Aggression on the psychiatric ward: Prevalence and risk factors. A systematic review of the literature

Anger rumination and imagined violence as related to violent behavior before and after psychiatric hospitalization

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