A model of aggression in psychiatric hospitals

• Published in: Acta psychiatrica Scandinavica Vol. 106; no. s412; pp. 142 - 143
• Main Author: Nijman, H. L. I.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Munksgaard International Publishers 01.06.2002
• Subjects: aggression; Aggression - psychology; Hospitalization; Hospitals, Psychiatric - statistics & numerical data; Humans; inpatients; Mental Disorders - epidemiology; Mental Disorders - psychology; Mental Disorders - rehabilitation; Social Behavior Disorders - epidemiology; violence
• ISSN: 0001-690X; 0065-1591; 1600-0447
• DOI: 10.1034/j.1600-0447.106.s412.30.x

Objective:  Research of the determinants of inpatient aggression indicates that certain environmental hospital variables play a role in triggering aggression in psychiatric hospitals. Yet, how patient, staff and ward variables interact in eliciting aggression is not well understood. Method:  On the basis of earlier findings, a model was proposed in which psychopathology and distorted cognitions of the patient are combined with environmental and communicational stressors that are specific for psychiatric wards. Results:  The proposed model elucidates how certain patient, staff and ward characteristics may interact in causing aggression. The model also emphasizes that repeated inpatient aggression may be the result of a vicious circle, i.e. inpatient violence is often followed by an increase in environmental and/or communication stress on the patient, thereby heightening the risk of a repeated outburst of violence. Conclusion: Although tentative, the model may shed light on the mechanisms that lead to (repeated) violence.