History Of Physical Aggression Research Articles

The influence of impulsivity and the Dark Triad on self-reported aggressive driving behaviours

The present study tested the role of Dark Triad traits (DT; narcissism, psychopathy, and Machiavellianism) as potential contributors to self-reported aggressive driving alongside driving anger, general aggression, impulsiveness, and attributions of malign driving intent. Members of the general community (N = 168) completed an online survey battery measuring these characteristics, and a proxy measure of aggressive driving. Regression analyses revealed that psychopathy, a history of physical aggression towards others, and the “progress impeded” aspect of driving anger, accounted for 50.8% of the variance in self-reported aggressive driving behaviours. The remaining variables were not significant. A structural equation model found all measures fitted into a single model in which impulsivity and the DT predicted general aggression, general aggression fully mediated the effect of the DT on driving anger, and general aggression and progress impedance predicted self-reported aggressive driving (GFI = 0.925). These results indicate tendencies toward expressing aggression physically, frustration at goals being impeded, and a callous, impulsive nature can predispose an individual to aggressive driving behaviours. Implications of these findings and recommendations for research are discussed.

Identifying factors associated with the discharge of male State patients from Weskoppies Hospital.

BackgroundDesignated psychiatric facilities are responsible for the care, treatment and reintegration of State patients. The necessary long-term care places a considerable strain on health-care resources. Resource use should be optimised while managing the risks that patients pose to themselves and the community. Identifying unique factors associated with earlier discharge may decrease the length of stay. Factors associated with protracted inpatient care without discharge could identify patients who require early and urgent intervention.AimWe identify socio-economic, demographic, psychiatric and charge-related factors associated with the discharge of male State patients.MethodsWe reviewed the files of discharged and admitted forensic State patients at Weskoppies Psychiatric Hospital. Data were captured in an electronic recording sheet. The association between factors and the outcome measure (discharged vs. admitted) was determined using chi-squared tests and Fischer’s exact tests.ResultsDischarged State patients were associated with being a primary caregiver (p = 0.031) having good insight into illness (p = 0.025) or offence (p = 0.005) and having had multiple successful leaves of absences. A lack of substance abuse during admission (p = 0.027), an absence of a diagnosis of substance use disorder (p = 0.013) and the absence of verbal and physical aggression (p = 0.002 and p = 0.016) were associated with being discharged. Prolonged total length of stay (9–12 years, p = 0.031) and prolonged length of stay in open wards (6–9 years, p = 0.000) were associated with being discharged. A history of previous offences (p = 0.022), a diagnosis of substance use disorder (p = 0.023), recent substance abuse (p = 0.018) and a history of physical aggression since admission (p = 0.017) were associated with continued admission.ConclusionDischarge of State patients is associated with an absence of substance abuse, lack of aggression, multiple successful leave of absences and length of stay in hospital.

Aggressive Behaviour Risk Assessment Tool for newly admitted residents of long-term care homes.

The aim of this study was to revise the 10-item Aggressive Behaviour Risk Assessment Tool for predicting aggressive events among residents newly admitted to long-term care homes. The original tool had acceptable sensitivity and specificity for identifying potentially aggressive patients in acute care medical-surgical units, but its usefulness in long-term care homes is unknown. A retrospective cohort study design was used. All residents admitted to 25 long-term care homes in western Canada were assessed for the risk of aggression using the original tool within 24hours of admission from January 2014 - December 2014 (n=724). Incident reports of aggressive events occurring within 30days of admission were collected. Multiple logistic regression and receiver operating characteristics analyses were performed. Fifty-three residents of 724 exhibited aggressive behaviours. The demographic variable of age less than 85years was found to be a positive predictor of aggressive events in multivariate logistic regression model and was added to the tool. The revised six-item Aggressive Behaviour Risk Assessment Tool for Long-Term Care consists of one new item, age less than 85years and five items from the original tool: History of physical aggression, physically aggressive/threatening, anxiety, confusion/cognitive impairment and threatening to leave. The receiver operating characteristics of the revised tool with weighted scoring showed a good discriminant ability with satisfactory sensitivity and specificity at the recommended cut-off score of 4. The revised six-item tool may be useful in identifying potentially aggressive residents newly admitted to long-term care homes.

Physical aggression, compromised social support, and 10-year marital outcomes: Testing a relational spillover model.

The purpose of the present study was to test a relational spillover model of physical aggression whereby physical aggression affects marital outcomes due to its effects on how spouses ask for and provide support to one another. Newlywed couples (n = 172) reported levels of physical aggression over the past year and engaged in interactions designed to elicit social support; marital adjustment, and stability were assessed periodically over the first 10 years of marriage. Multilevel modeling revealed that negative support behavior mediated the relationship between physical aggression and 10-year marital adjustment levels whereas positive support behavior mediated the relationship between physical aggression and divorce status. These findings emphasize the need to look beyond conflict when explaining how aggression affects relationships and when working with couples with a history of physical aggression who are seeking to improve their relationships.

Differential Diagnosis of Psychosis in a Deaf Inpatient with Language Dysfluency

This case report demonstrates challenges diagnosing psychosis in language dysfluent deaf patients. Treatment of a 34-year-old deaf man on an inpatient psychiatric unit is described. He had a history of physical aggression and possible symptoms of paranoia and thought disorganization, in addition to learning difficulties and minimal language skills. The patient was placed on a combined hearing/deaf inpatient unit, received specialized programming for deaf patients and was prescribed risperidone and divalproex sodium to treat his aggressive behavior and possible psychosis. Uncertainty if the patient were having psychotic symptoms remained throughout his hospitalization, although he improved behaviorally and was discharged after 13 months of treatment. The patient's pre-existing language deficits made accurate diagnosis and appropriate treatment challenging. It is important for clinicians to be aware of the frequency of language dysfluency in the deaf inpatient population and have a strategy for evaluating and treating this complex subgroup of deaf people.

A randomized clinical trial of the effectiveness of premarital intervention: Moderators of divorce outcomes.

This study examined the effects of premarital relationship intervention on divorce during the first 8 years of first marriage. Religious organizations were randomly assigned to have couples marrying through them complete the Prevention and Relationship Education Program (PREP) or their naturally occurring premarital services. Results indicated no differences in overall divorce rates between naturally occurring services (n = 44), PREP delivered by clergy at religious organizations (n = 66), or PREP delivered by professionals at a university (n = 83). Three moderators were also tested. Measured premaritally and before intervention, the level of negativity of couples' interactions moderated effects. Specifically, couples observed to have higher levels of negative communication in a video task were more likely to divorce if they received PREP than if they received naturally occurring services; couples with lower levels of premarital negative communication were more likely to remain married if they received PREP. A history of physical aggression in the current relationship before marriage and before intervention showed a similar pattern as a moderator, but the effect was only marginally significant. Family-of-origin background (parental divorce and/or aggression) was not a significant moderator of prevention effects across the two kinds of services. Implications for defining risk, considering divorce as a positive versus negative outcome, the practice of premarital relationship education, and social policy are discussed.

Risk assessment of self- and other-directed aggression in adolescent psychiatric inpatient units

To examine the predictive validity of unstructured clinical risk assessment and associated risk factors for aggression in predicting self- and other-directed aggression in the first 4 weeks of admission for patients admitted to an Australian adolescent psychiatric inpatient facility. A retrospective review of patient records was conducted at the Marian Drummond Adolescent Unit during late 2009 for the period of September 2006 to July 2009. Information collected included admission risk assessment ratings, aggressive incident reports, patient diagnoses, sex and history of aggression and self-harming behaviour. A total of 193 adolescents (aged 13-18 years old) were included in retrospective analyses. The hypothesis that unstructured clinical risk assessment would be predictive of self- and other-directed aggression was partially supported. High risk assessment scores were predictive of engagement in other-directed aggression. A history of physical aggression was also found to be predictive of engagement in other-directed aggression; however, it was not as predictive as the risk assessment rating. High risk assessment scores were not predictive of self-directed aggression. A history of engaging in one or more acts of self-harm or suicide was the most predictive of engagement in self-directed aggression during inpatient stay. Female sex also predicted engagement in self-directed aggression. Based on professional expertise, prior experience and intuition, clinicians are relatively good predictors of other-directed aggression in adolescent inpatient units; however, they are less successful at predicting self-directed aggression in this population. It is possible that, unlike other-directed aggression, self-harming behaviour is heavily dependent on environmental factors and that admission to the inpatient unit removes these triggers from the individual's environment.

Risk Assessment: Predicting Physical Aggression in Child Psychiatric Inpatient Units

The aim of this study was to examine the predictive validity of unstructured clinical risk assessment and associated risk factors for aggression in predicting physical aggression in children admitted to an Australian psychiatric inpatient facility. A retrospective review of patient records was conducted at the State Wide Child Inpatient Unit during late 2009 for the period September 2006-July 2009. Children between the ages of 8 and 13 were included in analyses. Information collected included admission risk assessment ratings, critical incident reports, patient diagnoses and history of aggression and trauma. A total of 127 children (aged 8-13 years) were included in retrospective analyses. Higher aggression risk rankings were predictive of the frequency but not the severity of aggression. A diagnosis of a disruptive behaviour disorder and a history of being a victim of trauma were also predictive of engagement in aggression; however, were not as predictive as the risk assessment. A high risk assessment rating for aggression was better able to predict engagement in aggressive behaviour than a history of physical aggression alone. Based on professional expertise, prior experience and intuition, clinicians were able to successfully predict engagement in aggressive behaviour during patient admission to a child psychiatric inpatient units.

Physical aggression in unmarried relationships: The roles of commitment and constraints.

Using commitment theory, the present study explored longitudinal associations between physical aggression and various aspects of commitment and relationship stability. Participants (N = 1,278) were unmarried adults between the ages of 18 and 35 who were in a heterosexual romantic relationship at the time of the initial assessment. Of these, 51.6% reported never experiencing physical aggression in their current relationship, 12.8% reported experiencing physical aggression in the past, but not in the last year, and 35.6% reported experiencing physical aggression in the last year. As hypothesized, those who had experienced aggression in the last year were more likely to have broken up 1 year later. They also generally reported lower levels of dedication and higher levels of constraint commitment compared with those with no history of physical aggression. Among those who had experienced aggression in the last year, constraints and other commitment-related variables explained more about who broke up over time than did relationship adjustment alone, indicating the importance of measuring commitment constructs in future research about which aggressive couples are most likely to end their relationships. Clinical implications of these results are discussed, particularly in regard to preventive relationship education programs.

Neurological soft signs in homicidal men with antisocial personality disorder

Neurological soft signs (NSS) are characterized by abnormalities in motor, sensory, and integrative functions. NSS have been regarded as a result of neurodevelopmental dysfunction, and as evidence of a central nervous system defect, resulting in considerable sociopsychological dysfunction. During the last decade there has been growing evidence of brain dysfunction in severe aggressive behavior. As a symptom, aggression overlaps a number of psychiatric disorders, but it is commonly associated with antisocial personality disorder. The aim of the present study was to examine NSS in an adult criminal population using the scale by Rossi et al. [29]. Subjects comprised 14 homicidal men with antisocial personality disorder recruited from a forensic psychiatric examination. Ten age- and gender-matched healthy volunteers as well as eight patients with schizophrenia, but no history of physical aggression, served as controls. The NSS scores of antisocial offenders were significantly increased compared with those of the healthy controls, whereas no significant differences were observed between the scores of offenders and those of patients with schizophrenia. It can be speculated that NSS indicate a nonspecific vulnerability factor in several psychiatric syndromes, which are further influenced by a variety of genetic and environmental components. One of these syndromes may be antisocial personality disorder with severe aggression.

Executive Functions and Physical Aggression after Controlling for Attention Deficit Hyperactivity Disorder, General Memory, and IQ

This study examined the role of ADHD in the association between physical aggression and two types of executive functions. Boys received a cognitive-neuropsychological test battery over the ages of 13, 14, and 15 years. Diagnostic Interview Schedule for Children (DISC 2.25) data were collected from the boys and one parent between ages 14 and 16, and an IQ estimate was obtained at age 15. Three groups, differing in stability and level of physical aggression since kindergarten, were formed: Stable Aggressive, Unstable Aggressive, and Non-aggressive. Composite scores of validated executive function tests of working memory representing subjective ordering and conditional association learning were formed. A MANCOVA (N = 149) using ADHD status, teacher-rated negative emotionality, general memory abilities, and IQ as covariates was performed on the two composite scores. ADHD and teacher-rated emotionality did not provide significant adjustment to the dependent variables. Number of ADHD symptoms was negatively associated only with general memory and IQ. General memory contributed significantly to adjusting for conditional association test scores. Group differences indicated lower conditional association scores for Unstable Aggressive boys relative to the other groups. Both IQ and general memory abilities interacted with subjective ordering within the groups. Specifically, Stable Aggressive boys performed poorly on this measure and did not benefit from increases in IQ whereas Nonaggressive boys performed best and were not disadvantaged by lower general memory abilities. This suggests a relationship exists between aspects of working memory and a history of physical aggression regardless of ADHD and IQ.

Executive Functions and Physical Aggression after Controlling for Attention Deficit Hyperactivity Disorder, General Memory, and IQ

This study examined the role of ADHD in the association between physical aggression and two types of executive functions. Boys received a cognitive-neuropsychological test battery over the ages of 13, 14, and 15 years. Diagnostic Interview Schedule for Children (DISC 2.25) data were collected from the boys and one parent between ages 14 and 16, and an IQ estimate was obtained at age 15. Three groups, differing in stability and level of physical aggression since kindergarten, were formed: Stable Aggressive, Unstable Aggressive, and Nonaggressive. Composite scores of validated executive function tests of working memory representing subjective ordering and conditional association learning were formed. A MANCOVA (N= 149) using ADHD status, teacher-rated negative emotionality, general memory abilities, and IQ as covariates was performed on the two composite scores. ADHD and teacher-rated emotionality did not provide significant adjustment to the dependent variables. Number of ADHD symptoms was negatively associated only with general memory and IQ. General memory contributed significantly to adjusting for conditional association test scores. Group differences indicated lower conditional association scores for Unstable Aggressive boys relative to the other groups. Both IQ and general memory abilities interacted with subjective ordering within the groups. Specifically, Stable Aggressive boys performed poorly on this measure and did not benefit from increases in IQ whereas Nonaggressive boys performed best and were not disadvantaged by lower general memory abilities. This suggests a relationship exists between aspects of working memory and a history of physical aggression regardless of ADHD and IQ.