History Of Previous Violence Research Articles

Intimate partner violence among pregnant women attending a low-resource primary care facility in Ghana.

Intimate partner violence in pregnancy is a significant public health issue that has several detrimental effects. Pregnant women subjected to intimate partner violence (IPV) have a higher risk for adverse pregnancy outcomes. The aim of the study was to determine the prevalence, patterns and factors associated with intimate partner violence among pregnant women attending a primary care antenatal clinic. A quantitative cross-sectional study design was employed to study intimate partner violence among 269 pregnant women in Accra, Ghana between July and October 2021. Participants were selected by systematic sampling technique. The self-reported Composite Abuse Scale was used to assess and classify intimate partner violence. Socio-demographic, clinical (obstetric) and behavioural characteristics were obtained with a structured questionnaire. Associations were determined between independent and dependent variables using the chi-squared test, and logistic regression with adjusted odds ratio (AOR). The statistical significance level was set at a p-value ≤ 0.05. The prevalence of IPV was 11.2%. The prevalence of emotional/psychological abuse, harassment/controlling behaviour, physical abuse, sexual abuse and severe combined abuse were 12.3%, 13.0%, 8.2%, 3.3% and 8.9% respectively. Pregnant women who were employed had reduced odds of experiencing IPV [AOR = 0.16 (95%CI: 0.05-0.47), p = 0.001], however, the past experience of violence [AOR = 4.9 (95%CI: 1.06-22.96), p = 0.042], alcohol use by women [AOR = 7.8 (95%CI: 1.63-37.42), p = 0.01], and partners' alcohol consumption [AOR = 10.0 (95%CI: 3.22-31.26), p<0.001] were associated with increased odds of IPV. There is a high prevalence of IPV among pregnant women in this study from a resource-limited setting. The factors found to be associated with IPV in pregnancy were the employment status of women, alcohol consumption by women or their partners and a previous history of violence. Healthcare providers in primary care need to recognize IPV as a medical condition that can occur in pregnancy and be ready to assist and manage the victims when it is detected.

Study on clinical characteristics of event-related potential P300 in elderly schizophrenics and associated risk factors.

To investigate the clinical characteristics of event-related potential P300 in elderly schizophrenics with different levels of violence and the risk factors of severe violence. A total of 138 elderly schizophrenic patients from January 2020 to December 2021 in the First Hospital of Hebei Medical University were enrolled in this retrospective analysis. Based on the violence risk assessment, 61, 102, and 145 patients were divided into high-risk, medium-risk, and low-risk groups, respectively. Clinical characteristics, P300 latency, and P300 amplitude were compared among the three groups followed by a logistic regression analysis of elderly schizophrenics with severe violence. The latency of P300 in the high-risk group was higher than that in the low-risk group (p<.05). The P300 amplitude of patients in the high-risk group was significantly lower than that in the low-risk group (p<.05). Univariate logistic regression analysis showed that previous history of violence, delusion of persecution, P300 latency, and amplitude were independent influencing factors of severe violence in elderly schizophrenics (odds ratio [OR]: 0.022, 95% confidence interval [CI]: 0.007-0.067, p<.001; OR: 0.118, 95% CI: 0.043-1.763, p=.037; OR: 1.289, 95% CI: 1.142-1.673, p<.001; and OR: 0.049, 95% CI: 0.021-0.067, p<0.001, respectively). After adjusting gender, age, and other confounding factors, multivariate logistic regression analysis showed that delusion of persecution, P300 latency, and P300 amplitude were associated with severe violence in elderly schizophrenics (OR: 2.211, 95% CI: 0.061-4.067, p<.001; OR: 2.006, 95% CI: 1.421-2.721, p=.017; and OR: 0.067, 95% CI: 0.037-0.276; p<.001; respectively). The latency and amplitude of P300 can be used as effective neuroelectrophysiological indicators to evaluate the violence level of elderly schizophrenics. Delusion of persecution, P300 latency, and P300 amplitude were independent influencing factors of severe violence in elderly schizophrenics.

Self-esteem in women experienced intimate partner violence : a tunisian cross-sectional study

IntroductionIntimate partner violence (IPV) and psychological distress are major public health concerns among emerging adult women.ObjectivesTo study the self-esteem of women victims of domestic violence and to determine its associated factors .MethodsThis was a cross-sectional descriptive study carried out at the National Health Fund of Sfax among women who consulted during the months of October and November 2019. The sociodemographic and clinical characteristics of the consultants were collected using a pre-established form. Women’s Experience with Battering Scale” (WEBS) was used to screen (IPV). The Rosenberg Self-Esteem Scale (RSE), was used for evaluating individual self-esteem. It uses a scale of 0–4 where a score less than 25 may indicate a problematic very low self esteem.ResultsThe sample comprised 110 women. More than half (66.7%) of women had a primary school level and 69% had a median socioeconomic level. (IPV) was estimated at 57.3% in our population. The mean (WEBS) score was 30.92(SD=9.8) and the mean (RSE) score was 31.26 (SD=3.5) among abused women self-esteem was very low in15.5% and low in 42.7% Abused women were more likely to have a low self-esteem (r= -0.528 ;p=0.012) The score of self-esteem decreased with age (r=-0.685 p=0.0001) and previous history of violence(p=0.04).ConclusionsThe findings suggests that Women who experienced (IPV) were more likely to have a low self-esteem. Therefore, the role of the physician is essential not only in the care of the victims but also in the detection of psychological repercussions.DisclosureNo significant relationships.

Influence of Intergroup Contact, Ethnicity and Education on Social Distance in Kosovo

Reducing social distance between communities with a previous history of violence is one of the crucial challenges in post-conflict societies. Social distance refers to the degree of understanding and intimacy between members of different groups. In this respect, this study examined the influence of direct intergroup contact, extended intergroup contact (i.e., knowing that a member of the ingroup has a positive relationship with a member of the outgroup), education and ethnicity on social distance in Kosovo. The sample of this study consisted of Kosovo Albanian (N = 125) and Serbian participants (N = 103) from ethnically mixed and non-mixed areas in Kosovo. Using hierarchical multiple regression analysis, the results show that direct intergroup contact, extended intergroup contact, ethnicity and education are significant predictors of social distance in Kosovo. Among the variables studied, ethnicity was found as the best predictor of social distance in Kosovo. Consistent with the previous findings, the study results show that increased frequency of direct intergroup contact and extended intergroup contact reduced social distance in Kosovo. Similarly, the results show that an increased level of education reduced social distance only among Albanian participants.

Suicidal Ideation in Victims of Sexual Abuse in Khyber Pakhtunkhwa, Pakistan

This study focuses on suicidal ideation in victims of sexual abuse. Drawing upon semi-structured interviews of thirty victims of sexual abuse in Khyber Pukhtunkhwah, Pakistan, this paper discusses the theme, i.e. domestic violence, including indiscriminate sexual abuse and the abhorring crime of incest, which remains hidden due to aggressively upheld patriarchal norms of women exploitation. The interviews conducted at six different locations, present women's narratives of their untold plight for the first time. The findings of this research show that among the respondents, only those women had strong suicidal ideations who were the victims of incest. Irritation, aggression and self-deprecating behaviour were strong symptoms of their suicidal temptations. Pain, physical and emotional, caused by overwhelming stress in the form of familial and social hatred, social disconnectedness, burdensomeness and the previous history of violence were the main factors that highly escalated their risk factor in committing suicide

Patterns of Substance Abuse in Offenders With Schizophrenia- Illness-Related or Criminal Life-Style?

Objective: The impact of substance abuse on violent behavior in patients suffering from schizophrenia is well-known. However, the association between the pattern of substance abuse and certain aspects of criminal behavior like the severity of offense, the previous history of violence and the age at onset of the criminal career is still unclear.Method: To assess the relationship between substance abuse, schizophrenia and violent behavior we examined healthy non-offenders; healthy offenders; non-offenders suffering from schizophrenia; and offenders suffering from schizophrenia, with respect to different patterns of substance abuse (none, alcohol only, illicit drugs only, and multiple substances).Results: Healthy offenders as well as offenders and non-offenders suffering from schizophrenia are characterized by increased rates of alcohol and illicit drug abuse. Especially multiple substance abuse appears to lower the threshold of aggression and illegal behavior. This effect is more pronounced in subjects suffering from schizophrenia. In both offender groups the abuse of psychoactive substances is associated with an earlier onset of the criminal career, but has no impact on the severity of the offenses.Conclusion: Our results point to the need for a differentiated view on the contribution of substance abuse to the criminality of subjects suffering from schizophrenia.

Facteurs de risque de passage à l’acte d’homicide chez des patients marocains atteints de schizophrénie

BackgroundPersons with schizophrenia are thought to be at increased risk of committing violent crime – 4 to 6 times the level of general population individuals without this disorder. The relationship between schizophrenia and homicide is complex and cannot be reduced to a simple causal link. ObjectivesThe objectives of this study were to describe the characteristics of homicide in Moroccan patients suffering from schizophrenia and to determine the correlated sociodemographic, clinical and toxic variables. MethodsThe study included two groups of patients with a DSM IV diagnosis of schizophrenia who attended the “Ibn Nafis” university psychiatric hospital of Marrakech in Morocco. The first group was composed of 30 patients hospitalized for homicide in the forensic unit between 1 January 2005 and 31 August 2015. The second group included 90 patients without any criminal record. These two groups have been matched according to age and gender. Demographic, clinical and therapeutic variables were analyzed and compared between the two groups. ResultsData analysis has objectified the following results: the mean of age in the first group was 37.03 (±9.09) and in the second group was 31.4 (±8.76). No significant differences were found between the two groups regarding the different sociodemographic variables and the age of onset of disease. Significant differences were found between the two groups regarding: personal antecedents of attempt of homicide (P=0.003), personal antecedents of attempt of suicide (P<0.001), a history of previous violence (P=0.005), untreated psychosis before the act (P<0.001), poor medication compliance and a low familial support (P<0.001), antisocial behavior (P<0.001) and addictive behavior (P=0.005). DiscussionSeveral studies identified some possible predictor factors for violent behavior: poor compliance, lack of insight impulsivity and paranoid–hallucinatory symptoms, systematized delusions and addictive behavior seem to considerably increase the risk of turning to violence. Demographic variables as suggested by other studies are less valuable predictors of homicide in patients with schizophrenia. ConclusionAwareness of these factors will allow us to provide improved prevention of violence within schizophrenic subjects. Interventions for reducing such behavior should focus on clinical variables and integrate an early diagnosis of the disease and an improvement of medication compliance.

Detección y seguimiento de malos tratos en personas mayores en un hospital terciario: experiencia de 3 años

ObjectivesThe Hospital Clínico San Carlos Committee against violence established a protocol in 2012 in order to detect and follow-up violence against elderly persons. This article presents the experience after 3years of its introduction, as well as an analysis comparing the differences between those younger and older than 65years of age. Material and methodsAll cases were collected during years 2013, 2014, and 2015, and were divided into two groups, A and B, according to age, younger or older than 65years. Parameters studied were: gender, place of detection (emergency department, during hospital admission, or outpatient clinics), type of professional worker who detected each case (social workers, nurses, or physicians), previous history of violence, type of aggression (physical, psychological, financial), institutional procedures once aggression was confirmed, and deaths after one year of follow-up. The SPPS v.18.0 package was used for the statistical analysis. ResultsA total of 172 cases were detected, of which 140 of them were included in groupA (<65years), and 32 in groupB (>65 years, 22.8%). Gender: GroupA: women: 93.5%. GroupB: women: 78.1% (P=.014). Registration site: GroupA: emergency department: 90.7%, hospital wards: 6.4%, outpatient wards: 3.0. GroupB: emergency department: 65.6%, hospital wards: 31.6%, outpatient wards: 2.8% (P=.001). Notification: GroupA: social worker: 25%, physician: 67.8%, nurse: 6.4%. GroupB: social worker: 65.2%, physician: 28.1%, nurse: 6.2% (P<.001). Previous violence history: GroupA: 62.1%. GroupB: 68.7%. Type of abuse: GroupA: physical: 56.4%, psychological: 2.8%, physical +psychological: 30.4%, physical +psychological +economic: 10.1%. GroupB: physical: 31.1%, psychological: 5.1%, neglect: 18.7%, physical +psychological: 10.1, physical +psychological +economic: 9.8, economic: 25.1 (P<.0001). Resources employed and follow-up: Injuries: Group A: 63.5%. Group B: 31.2% (P=.001). Judicial protection measures: GroupA: 12.8. GroupB: 15.6 (P=.773). Removal order: GroupA: 2.1. GroupB: 6.25 (P=.235). More than one-third of patients in groupB, and none of the patients in groupA, died in the year of follow-up. ConclusionsThere are more problems detected in the Emergency Department. There is a history of previous violence in more than half of the cases in both age groups. The profile of the victim is an elderly woman with significant physical and cognitive impairment. Economic abuse and neglect are more frequent in the elderly population. In our series, more than one-third of elderly patients who are victims of ill-treatment die each year. The hospital registry is fundamental for the detection and follow-up of abuse in the elderly.

Risk factors related to homicide in Moroccan patients with schizophrenia

BackgroundThe relationship between schizophrenia and homicide is complex and cannot be reduced to a simple causal link.ObjectivesThe objectives of this study were to describe the characteristics of homicide in Moroccan patients suffering from schizophrenia and to determine the correlated socio-demographic, clinical and toxic variables.MethodsThe study included two groups of patients with a DSM-IV diagnosis of schizophrenia who attended the “Ibn Nafis” university psychiatric hospital of Marrakech in Morocco. The first group was composed of 30 patients hospitalized for homicide in the forensic unit between the first January 2005 and the 31st of August 2015. The second group included 90 patients without any criminal record. These two groups have been matched according to age and gender. Demographic, clinical and therapeutic variables were analyzed and compared between the two groups.ResultsThe mean of age in the first group was 37.03 and in the second group was 31.4. No significant difference was found between the two groups regarding the different socio-demographic variables and the age of onset of disease. Significant difference was found between the two groups regarding: personal antecedents of attempt of homicide a (P &lt; 0.003), personal antecedents of attempt of suicide (P &lt; 0.001), a history of previous violence (P = 0.005), untreated psychosis before the act (P &lt; 0.001) poor medication compliance and a low familial support (P &lt; 0.001), antisocial behavior (P &lt; 0.001), addictive behavior (P = 0.007).ConclusionAwareness of these factors will allow us to provide improved prevention of violence within schizophrenic subjects.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Historical and clinical items of the HCR-20 as predictors of risk within an intellectual disability population

Purpose – The use of violence risk assessment measures within intellectual disabilities (ID) services is now the norm and a growing target for research. The purpose of this paper is to examine the clinical utility of the historical and clinical factors of the HCR-20 in predicting violence. Design/methodology/approach – The study took place within a national low secure service for adults with ID examining all completed admissions over a six-year period, (N=22). Clinical records covering the first three months of admission were examined along with historical reports and incident data recorded at three, six, nine and 12 months admission using the Modified Overt Aggression Scale (MOAS). Findings – Significant positive relationship between Historical score and total number of incidents was established. Patients with challenging behaviour less likely to have a previous history of violence, and more likely to be older at first violent incident than patients without challenging behaviour. Incidents involving patients with autism were less severe and those with no additional psychiatric diagnosis were significantly more likely to have substance misuse problems than those with a diagnosis. Originality/value – The study found the Historical section was predictive of violent incidents and whilst the study is too small to draw any firm conclusions, the significant positive relationship between the Historical Score and number of incidents for those without additional diagnosis needs to be investigated further as well as the potential positive clinical impact of using the HCR-20 in routine clinical practice.

Violent behavior of patients living in psychiatric residential facilities: A comparison of male patients with different violence histories

People with severe mental disorders and a history of violence are often seen as a difficult-to-manage segment of the population. In addition, this group is usually characterized by a high risk of crime recidivism, and poor compliance with community and aftercare programs.To investigate a sample of male patients living in Residential Facilities (RFs) with a history of violent behavior against people and to compare their characteristics with those of never-violent residents; to analyze the associations between aggressive behaviors in the last two years and a history of previous violence; and, to assess the predictors of aggressive behaviors.This study is part of a prospective observational cohort study which involved 23 RFs in Northern Italy. A comprehensive set of sociodemographic, clinical, and treatment-related information was gathered, and standardized assessments were administered to each participant. Also a detailed assessment of aggressive behaviors in the past two years was carried out.The study involved 268 males: 81 violent and 187 never-violent. Compared to never-violent patients, violent patients were younger, with a higher proportion of personality disorders, and have displayed an increased number of aggressive behaviors in the last two years. The presence of a history of violent behavior in the past significantly increases the probability of committing aggressive acts in the future.

Demographics, clinical characteristics, and treatment of aggressive patients admitted to the acute behavioral unit of a community general hospital: a prospective observational study.

Aggressive patients are not uncommon in acute inpatient behavioral health units of general hospitals. Prior research identifies various predictors associated with aggressive inpatient behavior. This prospective observational study examines the demographic and clinical characteristics of aggressive inpatients and the routine medications these patients were receiving at discharge. Thirty-six adults diagnosed with a DSM-IV mental disorder who met 2 of 6 established inclusion criteria for high violence risk and a Clinical Global Impressions-Severity of Illness (CGI-S) scale score ≥ 4 were observed for a maximum of 28 days on the 23-bed case mix acute behavioral health unit of St Luke's University Hospital, Bethlehem, Pennsylvania, from January 2012 to May 2013. Primary outcome measures were the Modified Overt Aggression Scale (MOAS) and CGI-S; secondary measures were symptom outcome measures and demographic and clinical characteristics data. Analysis was conducted using repeated measures methodology. Younger males with a history of previous violence, psychiatric admissions, and symptoms of severe agitation were more at risk for aggressive behavior. Positive psychotic symptoms, a diagnosis of bipolar disorder, substance use, and comorbid personality disorders also increased risk. Significant improvements from baseline to last visit were observed for the CGI-S and MOAS (P < .001 for both), with a significant correlation between the MOAS and CGI-S at last visit (P < .001). Only the symptom of agitation was significantly correlated to MOAS scores at both baseline and last visit (P < .001). Patients significantly improved over time in both severity of illness and level of aggression.

Novel psychoactive substance intoxication resulting in attempted murder

A man in his twenties who had no previous history of violence, snorted large quantities of two substances he identified as 3-methoxyphencyclidine (3-MeO-PCP), and methylenedioxypyrovalerone (MDPV); both are recognised as novel psychoactive substances, or commonly described in the media as “legal highs”. He also inhaled butane gas. He experienced vivid hallucinations and developed bizarre ideas. During this state of mind he stabbed his father multiple times and was arrested and charged with attempted murder. He had a previous history of drug induced psychosis and although he had some slight residual symptoms before he consumed the substances, these were not considered relevant to his criminal liability at the time of the offence. The hallucinations caused by the use of these substances took six weeks to completely recede. He was convicted of attempted murder and sentenced to four years in prison.

Criminally violent victimisation in schizophrenia spectrum disorders: the relationship to symptoms and substance abuse

BackgroundViolent victimisation among people with major mental illness is well-documented but the risk factors for criminal violent victimisation are not well understood.MethodsWe examined the relationship between illness-related variables, indices of substance abuse and previous history of violence in a sample of 23 male criminally violently victimized and 69 non-criminally violently victimized male patients with DSM-IV-TR diagnoses of schizophrenia and schizoaffective disorder that were resident in the community and in contact with public mental health services in Victoria Australia. Data on criminal victimisation was acquired from the police database.ResultsDemographic, a history of violence or illness-related variables did not distinguish between those had been the victim of a violent crime and those who had not. Our data indicated that drug abuse was a key factor in distinguishing between the groups, but the age of onset of substance abuse was not a significant factor. Scores on measures of drug abuse were modest predictors of criminal victimisation status in our Receiver Operator Characteristic analyses.ConclusionOverall, our findings suggest that substance abuse (particularly drug abuse) is a key predictor of violent victimisation based on criminal statistics. The latter has implications for mental health professions involved in the care planning and community management of patients with major mental illness and work points to the importance of substance abuse treatment in the prevention of victimisation as well as violence perpetration.

Schizophrenia with and without homicide: a clinical comparative study

This is a cross-sectional controlled study aimed to examine the social and clinical differences between a sample of patients with schizophrenia who were convicted of homicide (128 patients), those who did not (118 patients). The studied groups were examined using to DSM-IV TR criteria for schizophrenia, PANSS, Calgary Depression Scale for Schizophrenia, and The Aggression Questionnaire. The results showed that, substance use, auditory hallucination, delusional beliefs, history of previous violence, and positive family history of crime were found to be more prevalent among patients with schizophrenia who committed homicide than who did not.

V-RISK-10: Validation of a screen for risk of violence after discharge from acute psychiatry

BackgroundCurrent violence risk assessment instruments are time-consuming and mainly developed for forensic psychiatry. A paucity of violence screens for acute psychiatry instigated the development and validation of the V-RISK-10. The aim of this prospective naturalistic study was to test the predictive validity of the V-RISK-10 as a screen of violence risk after discharge from two acute psychiatric wards. MethodsPatients were screened with V-RISK-10 before discharge, and incidents of violence were recorded 3, 6, 9 and 12 months after discharge. A total of 381 of the 1017 patients that were screened completed the follow up. ResultsThe ROC-AUC values for any violent behaviour were 0.80 and 0.75 (p<0.001) for the 3 and 12 months follow-up periods, respectively, and significant for both genders. The most accurate risk estimates were obtained for severe violence. For persons without a known history of violence prior to the screening, AUCs were 0.74 (p=0.004) and 0.68 (p=0.002). ConclusionsResults indicate that the V-RISK-10 is a valid and clinically useful screen for violence risk after discharge from acute psychiatry, and even significant for patients without a known previous history of violence.

Preventing the Unpredicted: Managing Violence Risk in Mental Health Care

Preventing the Unpredicted: Managing Violence Risk in Mental Health Care

Aggressive behaviour in an acute general adult psychiatric unit

Aims and MethodThe study aimed to identify the correlates of aggressive behaviour in an adult acute psychiatric ward. Over a period of 9 months, all incidents of verbal and physical aggressive behaviour exhibited by in-patients were routinely assessed using the Overt Aggression Scale.ResultsOf the 535 patients admitted during the study period, 80 (15%) were involved in a total of 124 aggressive incidents. Of these 80, 44 (55%) had a history of previous violence and 54 (68%) had a history of substance misuse. The majority of events occurred early in the hospital stay and in most cases aggression was against staff. There were significant differences between aggressive and non-aggressive patients in terms of gender and ethnicity, with the lowest rate occurring in European females.Clinical ImplicationsThese results reinforce clinical impressions, and empirical evidence, and allow risk assessment to be performed with greater confidence. The relevance of ethnicity (or more likely culture) highlights the difficulties of a ‘one size fits all’ approach to risk assessment.

Risque de violence et troubles mentaux graves

In opposition to a widespread belief in psychiatry, mental disorders per se, without alcohol or drug abuse, represent a risk for violence against others, including homicide, that is significantly higher than that of the general population. The present paper extensively reviews the scientific literature during the past 15 years and present their findings in a summary table. The contradictory results of the notorious McArthur study are also presented and critically discussed. Elevated risks of assaults are more closely associated with a subgroup of patients showing one or more of the following characteristics: a history of previous violence; non compliance with antipsychotic medication and follow-up; alcohol and/or illegal drug abuse; violent fantasies; acute psychotic symptoms; and cerebral damage. Although violence associated with mental disorders is significantly higher than that observed among the general population, the absolute number of assaults committed by patients is still low. Between 85 and 97% of violent offenders are not mentally ill. Certain aspects of the deinstitutionalization, such as lack of outpatient resources and a modification of the law reflecting more concerns for the rights of the patients might provoke health care interruptions. However, a clinical commitment relayed by legal interventions in case of danger generate significant reduction of the risks for violence.

Separated Women's Risk for Violence

It is well known that women are at an increased risk for violence during separation. Existing research does not provide an understanding of why separated women are more at risk. The following study helps to fill this gap through an empirical examination of indicators derived from potential explanations for the relationship between separation and violence. Using Statistics Canada's 1999 General Social Survey (GSS), the study employs both descriptive and multivariate statistical analyses to examine the following variables: continuation of previous violence; immigrant status; youth; power; jealousy; and Aboriginal status. These risk factors accounted for over half of the variance in separation violence. This was largely due to the impact of age and Aboriginal status. The findings also showed that women without a previous history of violence were not protected from experiencing separation violence. The article concludes with a discussion of the findings.