Abstract
Inpatient violence poses a great risk to the health and well-being of other patients and members of staff. Previous research has shown that prevalence rates of violent behavior are particularly high in forensic psychiatric settings. Thus, the reliable identification of forensic inpatients who are particularly at risk for violent behavior is an important aspect of risk management. In the present study, we analyzed clinicians' assessments of N = 504 male and female inpatients of German forensic mental health institutions in order to identify risk factors for verbal institutional violence. Using a tree-based modeling approach, we found the following variables to be predictors of verbal aggression: gender, insight into the illness, number of prior admissions to psychiatric hospitals, and insight into the iniquity of the offence. A high number of prior admissions to psychiatric hospitals seems to be a risk factor for verbal aggression amongst men whereas it showed the opposite effect amongst women. Our results highlight the importance of dynamic risk factors, such as poor insight into the own illness, in the prediction of violent incidents. With regard to future research, we argue for a stronger emphasis on nonparametric models as well as on potential interaction effects of risk and protective factors.
Highlights
The aim of the present study is to further investigate risk factors for institutional aggression within a forensic psychiatric setting based on previously established risk factors
58 (11.5%) of the 504 patients showed verbal aggression in the institution during the period of observation. 27.6% of the patients who were verbally aggressive engaged in physical violence
Using tree-based modeling, we were able to take into account nonlinear relationships and intricate interaction effects which cannot be detected using analyses like multiple regression
Summary
The aim of the present study is to further investigate risk factors for institutional aggression within a forensic psychiatric setting based on previously established risk factors
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