Citation

Costopoulos JS. J. Forensic Psychol. Res. Pract. 2019; 19(3): 242-259.

Copyright

(Copyright © 2019, Informa - Taylor and Francis Group)

DOI

10.1080/24732850.2019.1603505

PMID

unavailable

Abstract

Assaults in psychiatric hospitals are problematic for vulnerable patients, staff, and the treatment system as a whole. This study reflects the challenges state hospitals experience managing risk by evaluating differing legal statuses and comorbid diagnoses to demonstrate their differential impact on behavior while hospitalized. Assault data from 4495 admissions was gathered over eight years to provide each patient's assault rate per month of hospitalization. Primary diagnoses, comorbid personality disorders, and legal-criminal status were shown to be related to inpatient aggression. Patients with psychotic disorders were associated with fewer assaults, while those with any comorbid personality disorder were associated with more assaults. Patients with antisocial and borderline personality disorders had the highest assault rate. Legal statuses with limited consequence for aggression were strongly associated with assault rate. Specific combinations of commitment status with diagnoses were noted to have a particularly high rate of assaults. This suggested that assaults were often volitional, motivated by personality and legal circumstance. The results indicate empirically demonstrated factors that influence assaults and can be targeted to improve the management of risk in patients.

Language: en

Keywords

diagnosis; Inpatient assault; involuntary commitment; personality disorder