Social Isolation, Impulsivity and Depression as Predictors of Aggression in a Psychiatric Inpatient Population

Abstract

Aggressive behavior among psychiatric inpatients remains an issue of concern for staff, families and patients themselves. At the present time, studies examining prediction of aggression among psychiatric inpatients have focused mainly on diagnostic or demographic risk factors. Unfortunately little is known about specific social functioning and personality risk factors that may help identify specific individuals at risk for aggressive behavior. Given that many individuals who have engaged in violent criminal behavior have been observed to experience a combination of social isolation, depression and impulsiveness, it is possible that this same combination of traits may function as a predictor of aggression among psychiatric inpatients. The current study examines whether psychiatric inpatients with a combination of social isolation, depression and impulsivity are significantly more likely to become aggressive than other psychiatric inpatients without that combination of factors. Results indicated that impulsivity functioned as a positive predictor of aggression, whereas depression acted as a protective factor. Perceived social support did not appear to relate strongly to aggression. Further, physicians' ratings of hostility were more predictive of aggressive incidents than were self-reports of hostility. Clinical implications of these findings are discussed.

Attitudes of clinical staff toward the causes and management of aggression in acute old age psychiatry inpatient units

“…These findings suggest that while the respondents were less likely to attribute blame to patients for aggression, they perceived those with certain conditions were more susceptible to these forms of behaviours. This view is consistent with some literature suggesting patients with persecutory delusions [5,16] and impulsivity [17] are particularly prone to aggression; the risk is greater during the acute phase of psychotic illness; and thought disorder, impairment of neuropsychological functioning, disorganized behaviour and substance misuse, are lesser contributing factors [2,13,43-45]. …”

Relationship between heart rate variability and aggressive behavior among patients with schizophrenia hospitalized in acute wards

“…It is worth noting that the scores on the AQ and the physical aggression, verbal aggression, and anger subdimensions in the first week of acute hospitalization showed an upward trend, although not a statistically significant change; however, it is still worthy as a reference for clinical staff. The literature notes that external factors, such as interpersonal conflicts with the patient or staff, limit setting, and incorrect management methods, will significantly enhance the risk of aggression. Therefore, the correlation between aggression risk and environmental adaptation in the first week of acute hospitalization among patients with schizophrenia is worthy of in‐depth research in the future to prevent the high risk of aggression.…”

Hostile Attributional Bias, Negative Emotional Responding, and Aggression in Adults: Moderating Effects of Gender and Impulsivity

“…Impulsivity has been found to predict aggression both cross-sectionally [e.g., Barry et al, 2007; Campbell and Muncer, 2009; Ferguson et al, 2005; Houston and Stanford, 2005; Raine et al, 2006; Vigil-Colet et al, 2008] as well as longitudinally [e.g., Fite et al, 2008; Luengo et al, 1994; Ostrov and Godlecki, 2009]. Moreover, impulsivity has been associated with multiple forms of aggression, including general aggression [Fite et al, 2008; Houston and Stanford, 2005], verbal aggression [Campbell and Muncer, 2009; Vilgil-Colet et al, 2008], and physical aggression [Campbell and Muncer, 2009; Ferguson et al, 2005; Ostrov and Godlecki, 2009; Vigil-Colet et al, 2008], although its relationship with relational aggression is less clear [Ostrov and Godlecki, 2009]. 1 …”