Violence and delusions: Data from the MacArthur Violence Risk Assessment Study
Violence and delusions: Data from the MacArthur Violence Risk Assessment Study
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DOI：
10.1176/appi.ajp.157.4.566
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发表时间：
2000-04-01
影响因子：
17.7
通讯作者：
Monahan, J
中科院分区：
文献类型：
--
作者：
Appelbaum, PS;Robbins, PC;Monahan, J
目的：先前的研究表明，妄想与更高的暴力风险有关，特别是患者认为人们试图伤害他们或外部力量控制他们的思想的妄想（称为“威胁/控制覆盖”妄想）。本研究旨在探讨精神科急性住院患者近期出院后妄想与暴力行为之间的关系。方法：数据来自麦克阿瑟暴力风险评估研究，这是一项对社区暴力的研究，对1，136名最近出院的精神病患者进行了为期一年的随访。在出院时和五个10周的时间间隔进行访谈，收集临床，历史，情境和性格信息，包括妄想思想的存在和性质。暴力行为是从受试者的报告、间接线人和官方记录中确定的。结果：无论是一般的妄想，还是特别的威胁/控制覆盖妄想，都与更高的暴力行为风险无关。与先前研究的比较表明，依赖受试者自我报告的妄想症状可能会导致错误标记为妄想，其他现象可能有助于暴力。结论：虽然妄想在个别情况下可能会引发暴力，但这些数据表明，它们不会增加精神病患者在出院后一年内遭受暴力的总体风险。
Objective: Previous work has suggested that delusions are associated with a higher risk of violence, particularly delusions in which patients believe that people are seeking to harm them or that outside forces are controlling their minds (denoted as "threat/control override" delusions). This study explores the relationship between delusions and violence among patients recently discharged from acute psychiatric hospitalization. Method: Data were drawn from the MacArthur Violence Risk Assessment Study, a study of violence in the community that followed 1,136 recently discharged psychiatric patients for 1 year. Interviews at discharge and at five 10-week intervals gathered clinical, historical, situational, and dispositional information, including the presence and nature of delusional thoughts. Violence was ascertained from reports of subjects, collateral informants, and official records. Results: Neither delusions in general nor threat/control override delusions in particular were associated with a higher risk of violent behavior. Comparisons with prior studies suggest that reliance on subject self-reports of delusional symptoms may result in mislabeling as delusions other phenomena that can contribute to violence. Conclusions: Although delusions can precipitate violence in individual cases, these data suggest that they do not increase the overall risk of violence in persons with mental illness in the year after discharge from hospitalization.