Examining the use of dynamic risk factors to predict high risk behaviours in people with schizophrenia

• Main Author: Spencer, Michelle Kerry
• Format: Dissertation
• Language: English
• Published: University of Warwick 2009
• Subjects: HV Social pathology. Social and public welfare; RC Internal medicine

The following thesis discusses aspects of risk management within a dynamic framework. It focuses on risk management with people with schizophrenia, as they are considered to be at more risk than the general population both of harming others and harming themselves. The literature review summarises current research into suicide risk factors in the schizophrenia population. People with a diagnosis other than schizophrenia, such as schizoaffective disorder, are not included in the review. Studies that are dealing with factors that are open to change (dynamic), or that indicate or trigger imminent acute risk, are discussed. The literature is evaluated in terms of its methodologies, its findings and its place within a dynamic risk framework. Recommendations are made for future research. The main research paper explores a developing methodology to produce a high risk behaviour signature, utilising the concepts of early warning signs, psychosis relapse signatures, functional analysis and a dynamic risk model conceptualised from the sexual offending field. Support was found for staff’s ability to agree on relevance at a crude level for early warning signs of high risk behaviours compared to dummy signs, the occurrence of early warning signs, and the occurrence of high risk behaviour. Results are discussed further within the context of dynamic assessments of risk. The reflective review discusses philosophical, clinical and research reflections relating to the thesis. Three main themes are considered: the philosophical underpinnings of research; the impact of the process of research; clinical and ethical implications of research.