Am J Psychiatry 1994; 151:1669-1672
Copyright © 1994 by American Psychiatric Association
Typology of patient-patient assaults detected by videocameras
ML Crowner, F Stepcic, G Peric and P Czobor
Manhattan Psychiatric Center, Ward's Island, New York, NY 10035.
OBJECTIVE: Previous studies of inpatient assault have relied on reports by
ward staff, data from which are often incomplete. The authors observed
patient-patient assaults with videocameras, obtaining previously
unavailable data. In this article they report a systematic method for
assault description and classification. METHOD: Assault was defined by
behaviors such as hitting, kicking, and choking, with physical contact.
Raters reviewed videotapes to make a global judgment of assailant intent to
hurt; assault class was based on this judgment. At the same time the raters
chose descriptors to better define classes. For external validation, the
authors compared classes for resulting injuries, detection by incident
reports, and patients' accounts of their motivations. RESULTS: Of 155
assaults detected, 21 were classified as least serious, 57 were in an
intermediate group, and 76 were classified as most potentially hurtful. One
assault could not be classified. Descriptor variables each made independent
significant contributions to assault classification. Almost all assaults
detected by incident report or resulting in injuries were in the most
serious class. Assailants' claims that they were playing were significantly
associated with the least serious class. CONCLUSIONS: With videocameras a
variety of interactions between patients involving hitting, slapping, etc.,
were detected and documented. Some events seemed playful, others seemed
intended to hurt, and some were of an intermediate type. This basic,
descriptive work can lead to advances in the study of assault predictors.
