Understanding aggressive behaviour in patients with schizophrenia through social cognitive theory: a narrative literature review

Abstract

Background/Aims Studies have shown that some people diagnosed with schizophrenia are more predisposed to distress than others because of positive and negative symptoms of schizophrenia, leading to aggressive and violent behaviour. Moreover, there is no conclusive evidence to substantiate the reasons for the causes of aggression and what suitable interventions can be used. The aim of this study was to explore evidence-based literature through social cognitive theory to find effective strategies to manage aggression among patients with a diagnosis of schizophrenia. Methods A background literature review search was conducted from the following databases: Medline, Cinhal and PsychInfo. The Boolean operator OR was used to search for Aggression OR Violence OR Cognitive theory OR Interventions OR Mental illness OR Schizophrenia OR Self-control OR Self-efficacy OR Social learning theory. Suitable papers were hand searched and seven papers were selected. Results Research studies are in favour of social cognitive interventions to manage aggression in patients with schizophrenia as they have fewer side effects and can be used alongside other pharmacological interventions as the second line of treatment. However, findings from these studies should be viewed with caution, resulting from the contradiction that still exists in whether psychotic symptoms are correlated to aggression and violent behaviours among patients with schizophrenia. Conclusions Social cognitive models can enable health care professionals to explore the causes of aggression from a broad perspective, using appropriate risk assessment tools to design appropriate strategies.

Aggression, Alexithymia and Sense of Coherence in a Sample of Schizophrenic Outpatients

“…Predisposing factors—namely genotype; prenatal and perinatal insults; early adversity as in childhood maltreatment; conduct disorders; comorbid antisocial personality disorder/psychopathy; and precipitating factors, in particular emergence of psychotic symptoms, neurocognitive impairment, substance abuse, nonadherence to treatment and stressful experiences in adult life—can result in risk interactions, increasing the likelihood for the emergence of aggressive behavior [ 3 , 4 , 5 ]. In particular, comorbidity with substance abuse increases the incidence of aggressive behavior in patients with schizophrenia with personality traits and social factors probably mediating the relationship between substance abuse and aggressive behavior in these patients [ 6 , 7 , 8 , 9 ]. Medication nonadherence may also serve as a contributing factor, particularly if it precedes substance abuse [ 10 ].…”