NCJ Number
94987
Journal
Medicine Science and the Law Volume: 24 Issue: 3 Dated: (July 1983) Pages: 199-207
Date Published
1984
Length
9 pages
Annotation
A high score on an arousal-level ratings scale developed for use with predominately psychotic patients in a locked British hospital psychiatric ward was found to relate to an increased chance of serious assaultive behavior.
Abstract
The ratings scale was devised from staff observation of the behavioral signs that occurred prior to the assault. In 6 months in the 17-bed acute psychiatric admitting ward, 41 violent incidents occurred against 23 staff. Six incidents caused serious injuries, and 21 caused significant injuries. At the time of the violent episodes, 18 patients were diagnosed as schizophrenic, 9 as manic, and 14 as having other illnesses, including personality disorder and paranoid psychosis. There was no significant association between injury severity and patient diagnosis. A history of past severity and patient diagnosis. A history of past violence against property or persons was known in 18 of the 19 involved patients. While there were changes in speech and movement prior to the assault in 80 percent of incidents, changes in patients' postures and movements were significantly associated with serious injuries. The victim's own positive prediction of assault was most likely to be influenced by the patient's speech, but positive prediction was not statistically associated with the patient's posture or movement and not by patient/staff distance. Reasons for the violent incidents included wishing to leave the ward and disputes over medication, money, and cigarettes. Paranoid delusional beliefs played an important part in at least eight incidents. Over half the incidents were thought by the victims to have been avoidable. Tabular data and 18 references are provided.