Patterns of Adjustment to Violence in Families of the Mentally Ill

Abstract

Violent behavior of the psychologically handicapped individual and its effect on the family was studied using a large national sample (N = 1,156). Subjects answered a questionnaire concerning their relatives' behavior and their own reactions to aggressive and destructive acts. Approximately 38% of the sample was classified as violent. The variables that best discriminated between violent and nonviolent individuals were education, compliance with medication, alcohol abuse, employment, number of hospitalizations, income, and age. Resources and violence were inversely related. It was found that the higher the income, the better the self-reported level of family adjustment. Living in or out of the family home had no effect on adjustment. Families of nonviolent relatives reported a higher level of adjustment both in the first year of illness and at present. When families were asked how they altered their behavior in response to violence, five categories of response were reported: no alteration, self-restriction, distancing from relative, assertion of limits, and calming the patient. A significant difference in adjustment was found between the families using distancing and calming with the latter perceiving the best degree of adjustment.

Factors related to physical violence experienced by parents of persons with schizophrenia in Japan

“…Patients with schizophrenia, particularly females, were at increased risk for violent crimes compared with the general female population (Schanda et al, 2004;Fleischman et al, 2014). Regarding violence towards family members, Swan and Lavitt (1988) found no significant gender differences among patients with SMI. According to the study by Robbins and colleagues (2003), female patients with SMI were more likely to target family members and be violent at home, while males were more likely to commit serious violent acts outside of the home environment.…”

“…Multiple hospitalizations have been used as an indicator of illness severity and as a risk factor for physical violence by patients with SMI toward the general population (Arboleda-Florez et al, 1998;Fleischman et al, 2014) and family members (Swan and Lavitt, 1988). When interpreting the relationship between number of hospitalizations and violence, Fleischman et al (2014) indicated that the association could be interpreted in several ways, including as an indicator of severity of illness or non-adherence to medication.…”

“…A large national survey conducted on family groups of U.S. NAMI members almost 30 years ago revealed that higher family income were significantly related to fewer experiences of violence perpetrated by their patient relative. Respondents who had higher incomes rated themselves as being more effectively able to cope with their relative when they lived with the patient (Swan and Lavitt, 1988). In Japan, there is limited public space for parents to escape from their home environment for a short period of time.…”

“…In the case of caregiver characteristics, employment status was not included as the study sample consisted of almost 60% retirees (Zenkaren, 2006). The present study employed a multivariate analysis to compensate for the weaknesses of most prior studies, which primarily used descriptive statistics, with the exception of an older study by Swan and Lavitt (1988) and the research by Chan (2008) and Elbogen et al (2005).…”

A Stress-Coping Model for Conceptualizing the Impact of Substance Abuse on Families

“…A 1986 study of 1,156 National Alliance for the Mentally Ill (NAMI) members found that more than a third of these families (38%) were subjected to their family members' violent or destructive behavior. The longterm impact of these behaviors was an increase in burden-related limits in social and recreational activities and increased worries (Swan & Lavitt, 1986). It is important to note that violent and destructive behaviors are characteristic of a minority of persons with mental illness, primarily those individuals with co-occurring substance-abuse disorders (Skinner, Steinwachs, & Kasper, 1992;Steadman et al, 1998).…”