Predicting self- and other-directed violence among discharged psychiatric patients: the roles of anger and psychopathic traits.
Predicting self- and other-directed violence among discharged psychiatric patients: the roles of anger and psychopathic traits.
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预测出院精神病患者的自我和他人暴力：愤怒和精神病特征的作用。
DOI：
10.1017/s0033291711001243
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发表时间：
2012
影响因子：
6.9
通讯作者：
Conner,KR
中科院分区：
文献类型：
--
作者：
Swogger,MT;Walsh,Z;Homaifar,BY;Caine,ED;Conner,KR
研究背景我们考察了特质愤怒和心理病态特征对精神病患者出院后自我定向暴力(SDV)和他人定向暴力(ODV)的预测程度。参与者在医院接受基线访谈，并在社区每隔大约10周进行五次后续访谈。分别采用精神病筛查量表(PSC：SV)和Novaco愤怒量表(NAS)评定心理变态和特质愤怒。在对参与者的后续跟踪中评估了SDV，在与参与者和间接告密者的访谈中评估了ODV。在Logistic回归模型中输入精神病方面和愤怒，以预测在随访期间表明暴力状态的四组之一的成员：(1)SDV，(2)ODV，(3)共发生暴力(COV)，(4)无暴力。在未调整的模型中，所有精神变态方面都预测了随访期间的ODV和COV。在调整后的模型中，精神变态的人际和反社会特征预测了ODV组的成员身份，而只有反社会特征预测了COV组的成员身份。结论尽管我们的结果为特质愤怒在预测出院精神病患者的SDV和ODV中发挥了广泛的作用提供了证据，但它们表明，精神变态特征的独特模式对针对自己和他人的暴力行为具有不同的预测作用。在精神病患者出院计划期间对愤怒和精神变态方面的测量可以为临床医生提供关于特定类型暴力的风险的信息。
BackgroundWe examined the extent to which trait anger and psychopathic traits predicted post-discharge self-directed violence (SDV) and other-directed violence (ODV) among psychiatric patients.MethodParticipants were 851 psychiatric patients sampled from in-patient hospitals for the MacArthur Violence Risk Assessment Study (MVRAS). Participants were administered baseline interviews at the hospital and five follow-up interviews in the community at approximately 10-week intervals. Psychopathy and trait anger were assessed with the Psychopathy Checklist: Screening Version (PSC:SV) and the Novaco Anger Scale (NAS) respectively. SDV was assessed during follow-ups with participants and ODV was assessed during interviews with participants and collateral informants. Psychopathy facets and anger were entered in logistic regression models to predict membership in one of four groups indicating violence status during follow-up: (1) SDV, (2) ODV, (3) co-occurring violence (COV), and (4) no violence.ResultsAnger predicted membership in all three violence groups relative to a non-violent reference group. In unadjusted models, all psychopathy facets predicted ODV and COV during follow-up. In adjusted models, interpersonal and antisocial traits of psychopathy predicted membership in the ODV group whereas only antisocial traits predicted membership in the COV group.ConclusionsAlthough our results provide evidence for a broad role for trait anger in predicting SDV and ODV among discharged psychiatric patients, they suggest that unique patterns of psychopathic traits differentially predict violence toward self and others. The measurement of anger and facets of psychopathy during discharge planning for psychiatric patients may provide clinicians with information regarding risk for specific types of violence.