Contagion of violence and self-harm behaviors on a psychiatric ward

Abstract

ABSTRACTMental health care personnel have one of the highest rates of workplace violence of any occupational class in the United States, with psychiatric aides having a rate that is 69 times higher than the national mean; furthermore, aggression on the part of psychiatric patients that targets other patients is a substantial component of morbidity and even mortality rates in inpatient psychiatric institutions. Much research has focused on such topics as the demographic characteristics of staff most likely to be victimized and the identification of patients most likely to become aggressive, but very little attention has been devoted to the temporal architecture of aggressive behavior. This study examined the temporal patterning of violent and aggressive behavior on an inpatient psychiatric ward over a one-year period. A statistical analysis of these data indicated that events occurred in a nonrandom fashion, with evidence to support the contention that periodic ‘bursts’ of aggression occurred in a manner that could be labeled a ‘contagion’ effect. Additional analyses indicated that (1) certain types of aggressive behaviors were more likely to kindle or trigger contagion events, and; (2) certain patients were more likely to kindle others to behave violently.