Homicidal Ideation and Forensic Psychopathology: Evidence From the 2016 Nationwide Emergency Department Sample (NEDS)

Abstract

Homicide is the most serious and costly criminal offense and better forensic and criminological understanding of homicidal ideation as a potential psychobehavioral precursor to homicidal conduct is critical. Using data from the 2016 Nationwide Emergency Department Sample (NEDS) from the Healthcare Cost and Utilization Project (HCUP) distributed by the Agency for Healthcare Research and Quality (AHRQ), we found 64,910 cases of homicidal ideation among a sample of 25.6 + million—a prevalence of 0.25%. Numerous conditions conferred increased substantially the likelihood of homicidal ideation including antisocial personality disorder (2406%), schizoaffective disorder (1821%), borderline personality disorder (1557%), paranoid personality disorder (1,504%), schizophrenia (1,143%), obsessive–compulsive personality disorder (921%), brief psychotic disorder (771%), unspecified psychosis (737%), avoidant personality disorder (596%), and schizoid personality disorder (571%), delusional disorder (546%), and other psychotic disorder (504%). Homicidal ideation is comorbid with serious psychiatric and behavioral problems and has important implications for offender typologies and homicidality.

Comparing Homicidal Ideations with Homicides/Assaults Victimization among Various Racial/Ethnic Groups in the United States

“…23 Also consistent with previous studies, we found that homicidal ideation and homicide/assault victimizations were most common among patients in the lowest zipcode income quartile, regardless of race or ethnicity. 8,21,24 These findings also support previous published data on premature mortality in the US that found education was a significant predictor of potential loss of life due to homicide while race/ethnicity was not. 11 These results suggest that there are alternative circumstances other than previously established psychosocial factors (e.g.…”

“…with the highest prevalence between the ages of 15 and 29 years of age. 8 NH-Blacks aged 15-29 years had the highest prevalence of homicidal ideation and hospitalization for homicide or assault, followed by Hispanics. In addition, after adjustment for sociodemographic and hospital characteristics, NH-Blacks and Hispanics aged 15-29 years had extremely high likelihood of experiencing homicide or assault.…”

“…7 According to a national study, patients with homicidal ideations have a high likelihood of serious psychiatric illnesses. 8 In pediatric patients, the odds of homicidal ideation was increased with behavioral and emotional disorders, peaking in ages 5-17 years. 9 Researchers found an association between perpetrators or victims of bullying and homicidal ideations among middle and high school students in China.…”

Suicidal and violent ideation in acute psychiatric inpatients: prevalence, co‐occurrence, and associated characteristics

“…Use of different diagnostic categorization and inability to separate violent ideation from violent behavior in similar samples (Grisso et al, 2000; Roche et al, 2018) complicates direct comparison to our findings. However, one study have suggested similar prevalence patterns in psychiatric outpatients (Asnis et al, 1994) and in patients admitted to emergency departments (Carbone et al, 2019).…”

“…From the literature that does exist, prevalence rates of violent ideation seem to increase as symptom severity increase (Murray et al, 2017). One rare study (Carbone et al, 2019) examined the prevalence of homicidal ideation in individuals visiting emergency departments. Only 0.25% of assessed patients reported homicidal ideation, in which 70.0% were males.…”