OBJECTIVE: The authors examined associations between patient-related
characteristics and assaultiveness on six different psychiatric wards to
determine 1) the relative contributions of demographic, disorder- related,
and diagnostic variables to prediction of assaultiveness and 2) how ward
composition and type of victim affect prediction of assaultiveness. METHOD:
Hospital records of 1,025 inpatients residing in psychiatric wards within a
6-month time frame were reviewed for evidence of assaultiveness. Data on
all 260 assaultive patients and a sample of 136 of the nonassaultive
patients were analyzed with multiple regression to predict assaultiveness
scores for each ward and each victim category. RESULTS: The findings
indicated high rates of assaultive patients and assaults on fellow
patients. Multiple regression results produced different predictors of
assaultiveness for different wards but not for different categories of
assault victim within each ward. Overall, age and sex consistently failed
to predict assaultiveness, whereas greater assaultiveness was significantly
associated with a greater proportion of time hospitalized since first
admission. The most powerful unique predictors of assaultiveness scores
were diagnostic distinctions derived from data on coexistent diagnoses. The
most assaults were by acute patients whose diagnoses excluded organic
mental disorder but included either bipolar disorder or personality
disorder and longer-stay patients whose exclusive diagnosis was organic
mental disorder. CONCLUSIONS: This identification, albeit modest, of risk
factors for assaultiveness on different wards nevertheless provides
information fundamental to the management policies of psychiatric
institutions. The findings caution against aggregating different ward
populations for research on assaultiveness and endorse the usefulness of
coexistent diagnoses for predicting assaultiveness.
Abstract Teaser