Personality, Schizophrenia, and Violence: A Longitudinal Study

Candini, Valentina; Ghisi, Marta; Bottesi, Gioia; Ferrari, Clarissa; Bulgari, Viola; Iozzino, Laura; Boero, Maria Elena; Francesco, Alessandra De; Maggi, Paolo; Segalini, Beatrice; Zuccalli, Vanessa; Giobbio, Gian Marco; Rossi, Giuseppe; Girolamo, Giovanni de

doi:10.1521/pedi_2017_31_304

Cited by 11 publications

(9 citation statements)

References 46 publications

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“… 1 , 9 – 11 , 44 Individuals with antisocial personality disorder are also inclined to display interpersonal manipulation and low affectivity. 45 In our study, we confirmed an association between these trait variables, although correlation coefficients were of limited size.…”

Section: Discussionsupporting

confidence: 77%

Young age and the risk of violent behaviour in people with severe mental disorders: prospective, multicentre study

Micciolo

Bianconi²,

Canal

et al. 2021

BJPsych open

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Background During adolescence and young adulthood people appear to be more prone to violent behaviour. A greater tendency to violent behaviour appears to be associated with hyperactivity, impulsivity and low tolerance for frustration and provocation in social settings. Aims This prospective cohort study aimed to evaluate rates of violent behaviour among young people with mental disorders, compared with older age groups. Method A total of 340 individuals with severe mental disorders (125 living in residential facilities and 215 out-patients) were evaluated at baseline with the SCID-I and II, Brief Psychiatric Rating Scale, Specific Level of Functioning scale, Brown–Goodwin Lifetime History of Aggression scale, Buss–Durkee Hostility Inventory, Barratt Impulsiveness Scale and State–Trait Anger Expression Inventory-2. Aggressive behaviour was rated every 15 days with the Modified Overt Aggression Scale (MOAS). Results The sample comprised 28 individuals aged 18–29 years, 202 aged 30–49 and 110 aged 50 and over. Younger age was associated with a personality disorder diagnosis, substance use disorder, being single and employed. These results were confirmed even controlling for the gender effect. The patterns of the cumulative MOAS mean scores showed that younger (18–29 years old) individuals were significantly more aggressive than older (≥50) ones (P < 0.001). Conclusions This study highlights how young age in people with severe mental disorders is correlated with higher levels of impulsivity, anger and hostility, confirming previous analyses. Our results may assist clinicians in implementing early interventions to improve anger and impulsivity control to reduce the risk of future aggressive behaviours.

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Section: Discussionsupporting

confidence: 77%

Young age and the risk of violent behaviour in people with severe mental disorders: prospective, multicentre study

Micciolo

Bianconi²,

Canal

et al. 2021

BJPsych open

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“…This may be related to the high proportion (56.6%) of cluster B personality disorders: these patients share many clinical characteristics with those who show alcohol and substance use (Moss et al, 2015). In addition, consistent with previous European data (Candini et al, 2017), in this study, patients with schizophrenia showed a prevalence of PNSU (54.5%) that is low compared with North American or Northern European patients (Carrà et al, 2012).…”

Section: Discussionsupporting

confidence: 92%

Substance use disorders and violent behaviour in patients with severe mental disorders: A prospective, multicentre study

Cavalera

Ferrari

Bianconi³

et al. 2020

Aust N Z J Psychiatry

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Objective: The relationship between alcohol and substance use and the risk of violence exhibited by patients with mental disorders is under-researched. This prospective cohort study aims to compare patients with severe mental disorders and with different substance use behaviors in terms of sociodemographic and clinical characteristics, hostility, impulsivity and aggressive behaviors. Furthermore, this study aims to assess differences in violent behaviors during a 1-year monitoring follow-up. Methods: A total of 378 participants with severe mental disorders from Italian residential facilities and from four Departments of Mental Health (244 outpatients and 134 residential patients) were enrolled. Participants were categorized as Persons with Current Substance Use, Persons with Former Substance Use and Persons with Non-Substance Use. All these patients underwent a complex multidimensional assessment, including the lifetime and current substance use; a subsample of outpatients was also assessed with a laboratory substance assay including the testing for specific substances. We assessed the differences among these three groups in hostility, impulsivity and aggressive behaviors. Results: The results of the close 1-year monitoring show a significantly higher risk of violence for patients with severe mental disorders Persons with Current Substance Use compared to Persons with Former Substance Use and Persons with Non-Substance Use. Persons with Current Substance Use showed significantly higher scores for irritability, negativism and verbal assault compared to Persons with Non-Substance Use. Persons with Former Substance Use showed significantly higher scores for lifetime history of aggressive behaviors compared with patients with Persons with Non-Substance Use. Conclusion: These findings suggest that patients with comorbid mental illness and substance use disorders should be referred for specific interventions to reduce aggressive behavior and ensure patient well-being and community safety.

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“…Another strong predictor of aggressive behavior is a history of violence. This result is confirmed by the VIORMED project (Bulgari et al [12]; Candini et al [14]; de Girolamo et al [21]) and by several studies on patients with SMD and/or offenders (Fazel et al [25,26]; Lund et al [38]). At the same time, the present study points out that people with a history of violence are characterized more frequently by poor metacognitive functioning compared to patients without such history; this data is supported by other studies [1,2,30].…”

Section: Predictors Of Aggressive and Violent Behavior And The Role Omentioning

confidence: 56%

“…The importance of personality traits as risk factors for aggressive and violent behavior has been demonstrated by numerous studies, including our own VIORMED study (Candini et al [14]). In a sample of patients living in residential facilities, Candini and colleagues [14] found that antisocial personality traits were strong predictors of aggressive behavior. In the same study, in an outpatient sample, several personality traits, including depressive, sadistic, passive-aggressive, schizotypal, borderline, and compulsive traits, were predictors of aggressive and violent behavior (Bottesi et al [11]).…”

Section: Predictors Of Aggressive and Violent Behavior And The Role Omentioning

confidence: 99%

Aggressive behavior and metacognitive functions: a longitudinal study on patients with mental disorders

Candini

Ghisi

Bianconi³

et al. 2020

Ann Gen Psychiatry

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Background: Metacognitive functions play a key role in understanding which psychological variables underlying the personality might lead a person with a severe mental disorder to commit violent acts against others. The aims of this study were to: (a) investigate the differences between patients with poor metacognitive functioning (PM group) and patients with good metacognitive functioning (GM group) in relation to a history of violence; (b) investigate the differences between the two groups in relation to aggressive behavior during a 1-year follow-up; and (c) analyze the predictors of aggressive behavior. Methods: In a prospective cohort study, patients with severe mental disorders with and without a lifetime history of serious violence were assessed with a large set of standardized instruments and were evaluated bimonthly with MOAS in order to monitor any aggressive behavior. The total sample included 180 patients: 56% outpatients and 44% inpatients, and the majority were male (75%) with a mean age of 44 (± 9.8) years, and half of them had a history of violence. The sample was split into two groups: poor metacognition (PM) group and good metacognition (GM) group, according to MAI evaluation scores. Results: The PM patients reported a history of violence more frequently than GM patients, during the 1-year followup, but no differences between groups in aggressive and violent behavior were found. The strongest predictors of aggressive behavior were: borderline and passive-aggressive personality traits and a history of violence, anger, and hostility. The metacognitive functions alone did not predict aggressive behavior, but metacognitive functions interacted with hostility and angry reactions in predicting aggressive behavior. Conclusions: This study led to some important conclusions: (a) some aspects closely related to violence are predictive of aggressive behavior only in patients with poor metacognition, thus good metacognition is a protective factor; (b) poor metacognition is associated with a history of violence, which in turn increases the risk of committing aggressive behavior.

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Personality, Schizophrenia, and Violence: A Longitudinal Study

Cited by 11 publications

References 46 publications

Young age and the risk of violent behaviour in people with severe mental disorders: prospective, multicentre study

Young age and the risk of violent behaviour in people with severe mental disorders: prospective, multicentre study

Substance use disorders and violent behaviour in patients with severe mental disorders: A prospective, multicentre study

Aggressive behavior and metacognitive functions: a longitudinal study on patients with mental disorders

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