Risk Of Violent Behavior Research Articles

Selecting an Instrument for Assessing the Risk of Patient Violence Across a Healthcare System.

Physical violence is one of the leading causes of nurse injury in the workplace. Studies indicate patients most often incite the violence and both patient and organization factors contribute to violent events. It has been suggested that an assessment be done upon admission to identify those patients at risk for violent behavior. To implement this intervention, organizations must objectively select a screening instrument that is accurate, easy to use, and appropriate for multiple patient populations.

A study of the relationships between rumination, anger rumination, aggressive script rehearsal, and aggressive behavior in a sample of incarcerated adult males.

ObjectiveThis study explored relationships between aggressive script rehearsal, rumination, and anger rumination with aggressive behavior.MethodOne hundred and twenty‐nine incarcerated males (M = 33.54, SD = 8.67) completed the Schedule of Imagined Violence, Preservative Thinking Questionnaire, Anger Rumination Scale, and the Life History of Aggression‐Aggression subscale. Correlations were run to examine associations between the variables and a four‐step sequential multiple regression was performed to assess for the unique contribution of rumination, anger rumination, and aggressive script rehearsal to aggressive behavior.ResultsResults revealed moderate‐strong positive associations between aggressive script rehearsal, rumination, and anger rumination. Moderate‐weak associations were found between these three constructs and aggressive behavior. Regression analyses revealed aggressive script rehearsal was uniquely related with aggressive behavior and path analysis demonstrated aggressive script rehearsal mediated the relationship between rumination/anger rumination and aggression.ConclusionThese results clarify the nature of the relationships between these conceptually connected constructs and suggest that the frequency with which someone rehearses aggressive scripts impacts on the likelihood of aggression more than anger rumination and general ruminative processes. The frequency with which a person rehearses aggressive scripts should be a critical consideration in violence risk assessment and treatment programs for people deemed to be at risk for violent behavior.

Use of Flashcard Games in the Application of Cognitive Behavior Therapy (CBT) in Schizophrenic Patients with Risk of Violent Behavior

The increase in maladaptive behavior of schizophrenic patients in recent times, such as violent behavior, hitting people, breaking things until they commit a murder, has been troubling for the community. This situation is a serious concern for all parties, especially health workers, to provide comprehensive and effective mental nursing care management in reducing the symptoms of maladaptive behavior. Group therapy based on Cognitive Behavior Therapy (CBT) with Flashcard media is one of the development and innovation models of psychotherapy that can be useful in overcoming violent behavior in schizophrenia patients. This study was aimed to determine the effectiveness of CBT with flashcards on changes in violent behavior in schizophrenic patients. The research design was used a quasi-experimental pre-posttest with a control group. A sample of 50 people includes 25 people in the intervention group and 25people in the control group. The results were showed that the reduction in signs and symptoms of schizophrenic patients was greater in the intervention group than in the control group, with a value of p=0,000. The CBT therapy with flashcards was effective 66.6% in reducing violent behavior. CBT therapy with flashcards is recommended to be applied as effective, efficient, and easy therapy for health professionals and families to reduce violent behavior.

Disasters and civilian victimization: Exploring the dynamic effect in Africa, 1997–2017

How do natural disasters affect the treatment of civilians by non-state actors? On the one hand, conflict literature argues that adverse shocks influence the strategic interplay between rebel groups and the government, potentially increasing the level of violence against civilians. On the other hand, sociological research on natural disasters argues that they increase social integration and cooperation and are thus expected to reduce the risk of violent behaviour. In this study, we contend that the dynamics of violence against civilians are different in the short term and long term after a disaster strikes. We argue that natural disasters lead to a decrease in violence against civilians perpetrated by rebel groups in the short run. However, over time this temporary improvement in social integration starts to decline, increasing the level of civilian victimization. To examine this potential temporal dynamic, we combine georeferenced information on one-sided violence (Armed Conflict Location & Event Data; ACLED) and data on disasters (Emergency Event Database; EM-DAT). Our results confirm the expected dynamic effects. This research has important implications for our understanding of how disasters can influence the relationship between civilians, rebel groups, and governments.

Asuhan Keperawatan Jiwa: Pasien Resiko Perilaku Kekerasan

Background: risk of Violent Behavior (RPK) is an angry response or vulnerable behavior carried out by someone where the behavior is at risk of endangering oneself, others, and the surrounding environment. There are two factors that influence the risk of violent behavior, namely predisposing factors and precipitation factors. Purpose : this study aims to describe how nursing care risks violent behavior. Methods : this study uses a qualitative method using a nursing process approach. The subjects in this study were 1 client at Risk for Violent Behavior. Results : the results of this study are the result of mental nursing care at the risk of social behavior through interventions to build a trusting relationship, help clients express their angry feelings, help clients reveal signs of violent behavior they experience, discuss with clients violent behavior committed, discuss with clients the consequences negative consequences of the act, discuss how to express healthy anger. Conclusion : the provision of nursing care to clients is adjusted to the client's problems and responses .

The Effects of Cognitive Behavior Therapy and Social Skill Training among Schizophrenia with Risk of Violent Behavior

BACKGROUND: Schizophrenia is a condition in which people suffer from impaired ability to think, perceive, and show emotional responses and interact socially. Patients with schizophrenia can experience the risk of violent behavior (RVB). Psychotherapy is needed to deal with the problem. AIM: This study aimed to investigate the effects of cognitive behavior therapy (CBT) and social skill training (SST) on signs and symptoms of risks of violent behavior (RVB). METHODOLOGY: This study employed a quasi-experimental without a control group. The research samples used purposive sampling were 30 patients with symptoms of risks of violent behavior. Meanwhile, the measurement used the sign and symptom questioners of risks of violent behavior (Z = 0.791). RESULT: This study revealed that signs and symptoms decreased significantly (p < 0.05) from 10.45 to 5.41 after the respondents had obtained the CBT. Moreover, after the respondents had received CBT and SST, the sign and symptoms decreased significantly (p < 0.05) from 5.41 to 0.52. CONCLUSION: This study recommends that the combination of CBT and SST be administered to patients with schizophrenia with risks of violent behavior.

YOGA PRANAYAMA LOWERS THE RISK OF VIOLENT BEHAVIOR IN SCHIZOPHRENIA PATIENTS

Introduction:The main problem that often occurs in schizophrenic patients is violent behavior. As a result of violent behavior can hurt or injure yourself or others. Handling violent behavior is done by a combination of psychopharmacology and psychotherapy intervention. One of the management of violent behavior through individual psychotherapy is physical activity in the form of pranayama yoga exercises. The purpose of this study is to determine the effect of Pranayama yoga on the risk of violent behavior in schizophrenic clients.Method :This type of pre-experimental research, using a One-group pre-post test design. The number of samples is 20 people with simple random sampling. Result : Data collection uses observation sheets. The mean symptom of the risk of violent behavior pre-test of 13.55 including the risk of moderate violent behavior. The average post-test of 5.50 included the risk of mild violent behavior. Paired t test statistic results obtained p value <0.05 means that there are significant differences in symptoms of risk of violent behavior in schizophrenic patients pre-test and post-test it shows there is an influence of pranayama yoga on symptoms of risk of violent behavior in schizophrenic patients. Physical exercise through pranayama yoga exercises in general can reduce physiological stimulation and tension so as to reduce patient anger.Discussion : Based on these results it is recommended that setting a routine schedule for schizophrenics in the Mental Hospital.Introduction:The main problem that often occurs in schizophrenic patients is violent behavior. As a result of violent behavior can hurt or injure yourself or others. Handling violent behavior is done by a combination of psychopharmacology and psychotherapy intervention. One of the management of violent behavior through individual psychotherapy is physical activity in the form of pranayama yoga exercises. The purpose of this study is to determine the effect of Pranayama yoga on the risk of violent behavior in schizophrenic clients.Method :This type of pre-experimental research, using a One-group pre-post test design. The number of samples is 20 people with simple random sampling. Result : Data collection uses observation sheets. The mean symptom of the risk of violent behavior pre-test of 13.55 including the risk of moderate violent behavior. The average post-test of 5.50 included the risk of mild violent behavior. Paired t test statistic results obtained p value <0.05 means that there are significant differences in symptoms of risk of violent behavior in schizophrenic patients pre-test and post-test it shows there is an influence of pranayama yoga on symptoms of risk of violent behavior in schizophrenic patients. Physical exercise through pranayama yoga exercises in general can reduce physiological stimulation and tension so as to reduce patient anger.Discussion : Based on these results it is recommended that setting a routine schedule for schizophrenics in the Mental Hospital.

Intergeneration Transmission of Violence in Forensic Patients With a Diagnosis of Schizophrenia and Psychosis: Was Parental Alcoholic Abuse a Significant Factor?

Background: Child abuse during childhood and the presence of parental alcohol abuse increase the risk of developing mental illness in children, as well as the risk of violent behavior in adulthood. The association of these factors has not been sufficiently investigated when it comes to forensic mental patients. In this study, we examined the impact of traumatic events in childhood and the presence of mental illness and alcohol abuse of parents in subjects with psychosis and schizophrenia who committed serious crimes.Methods: One-hundred and forty-three respondents were included in the current study. Information on childhood abuse was collected by Childhood Trauma Questionnaire (CTQ). The sample included participants diagnosed with psychotic disorders and schizophrenia with a history of violent behavior (PSCH-V, n = 20), patients diagnosed with psychotic disorders and schizophrenia without a history of violent behavior (Non-V-PSCH, n = 51), and healthy control patients (HC, n = 72). Participants were diagnosed according to the ICD 10 classification system. MINI and CAINS scales were used to confirm the diagnosis. Data on sociodemographic and clinical characteristics were collected. Differences between groups in terms of traumatic events in childhood as well as parental alcohol abuse are presented and analyzed, using descriptive statistical values and nonparametric techniques of inferential statistics.Results: Statistically significant differences were obtained for total scores (χ2 = 28.522, p < 0.001) as well as for (1) major upheaval between the parents (χ2 = 20.739, p < 0.001), (2) being victim of violence—other than sexual (χ2 = 12.701, p < 0.01), and (3) other major upheaval that may have shaped life or personality significantly (χ2 = 30.920, p < 0.001). PSCH-V, compared to HC, had greater exposure to all of the three domains of childhood trauma (U = 396.500, 436.500, and 376.000, respectively; p < 0.001). Similar results were obtained when Non V-PSCH were compared with HC (U = 1,223.000, 1,535.000, and 999.000, respectively; p < 0.001). The results indicated statistically insignificant differences between PSCH-V and Non-V-PSCH in having a family history of mental illness. On the other hand, family history of mental illness was less present in HC compared to PSCH-V (χ2 = 24.238, p < 0.001) and Non V-PSCH (χ2 = 14.456, p < 0.001). The presence of parental alcohol abuse was predominantly present in the PSCH-V group (60%) while a significantly lower presence was found in the Non-V PSCH group (35%) and HC (5.5%).Conclusion: Both PSCH-V and Non-V-PSCH groups had a high degree of exposure to traumatic events in childhood compared to the HC. In PSCH-V, the presence of parental alcohol abuse compared to Non-V-PSCH was dominant. Mental illness coupled with a history of violent behavior represents a factor of polyvictimization, which may increase the likelihood of violent behavior of offspring.

Young age and the risk of violent behaviour in people with severe mental disorders: prospective, multicentre study

BackgroundDuring adolescence and young adulthood people appear to be more prone to violent behaviour. A greater tendency to violent behaviour appears to be associated with hyperactivity, impulsivity and low tolerance for frustration and provocation in social settings.AimsThis prospective cohort study aimed to evaluate rates of violent behaviour among young people with mental disorders, compared with older age groups.MethodA total of 340 individuals with severe mental disorders (125 living in residential facilities and 215 out-patients) were evaluated at baseline with the SCID-I and II, Brief Psychiatric Rating Scale, Specific Level of Functioning scale, Brown–Goodwin Lifetime History of Aggression scale, Buss–Durkee Hostility Inventory, Barratt Impulsiveness Scale and State–Trait Anger Expression Inventory-2. Aggressive behaviour was rated every 15 days with the Modified Overt Aggression Scale (MOAS).ResultsThe sample comprised 28 individuals aged 18–29 years, 202 aged 30–49 and 110 aged 50 and over. Younger age was associated with a personality disorder diagnosis, substance use disorder, being single and employed. These results were confirmed even controlling for the gender effect. The patterns of the cumulative MOAS mean scores showed that younger (18–29 years old) individuals were significantly more aggressive than older (≥50) ones (P&lt; 0.001).ConclusionsThis study highlights how young age in people with severe mental disorders is correlated with higher levels of impulsivity, anger and hostility, confirming previous analyses. Our results may assist clinicians in implementing early interventions to improve anger and impulsivity control to reduce the risk of future aggressive behaviours.

THE RISK OF VIOLENT BEHAVIOR : A CASE STUDY

Background: Risk Violent behavior is an individual condition that will endanger oneself, others, family and society. Individuals at risk of violent behavior need psychiatric nursing care to overcome the nursing problems they experience. This study aims to discuss nursing care comprehensively from assessment to evaluation of clients at risk of violent behavior. Case report: The results of the client have a history of traffic accidents and experienced a collision in the head area but at the request of the family, surgery was carried out. After the accident, the family got changes in the client, namely irritability, tantrums, talking and smiling by themselves and seeing things that were not tangible. The implementation of nursing is given to clients in the form of physical exercises: deep breaths and hitting the pillow mattress, assertive exercises and spiritual exercises. The client's family is given nursing education about how to care for the client. The nursing evaluation found that the client was able to do physical exercise and assertive exercise. Families can recognize problems and motivate clients to do the exercises that have been taught by the nurse. Conclusion: The risk of violent behavior is one of the mental nursing problems that can be found in clients with mental disorders with a history of head trauma.

Identifying Predictors of Inpatient Verbal Aggression in a Forensic Psychiatric Setting Using a Tree-based Modeling Approach.

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.

Aplikasi Recovery Tidal Model dalam Pemberian Relaxation Therapy Pada Resiko Perilaku Kekerasan

Emotional problems are a symptom of violent behavior. Interaction of nerve activity between the hypothalamus, limbic structures (amygdala and hyppocampus), and the higher cortical centers which are psychophysiological events of emotion in the human system. The purpose of this case study is to see the application of Tidal Model recovery in mental health in the provision of relaxation therapy. The search method used is a case study, and literature review. The author selects the analyzed journals to find the effectiveness of relaxation therapy against the risk of violent behavior and a journal on recovery that links therapeutic communication between nurses and patients. In the discussion of this paper, the sub-theme of therapeutic relationship between nurses and patients is found and also the self-awareness of patients who are part of the Tidal Model. By implementing relaxation therapy with the Tidal Model approach, there is a reduction in signs and symptoms in patients. Recommendations for nurses are able to become more empathetic nurses in implementing therapy and can support and encourage patient awareness in carrying out therapies that will bring patients into recovery.

Levels of stress and coping strategies in family caregivers who treat schizophrenic patients with risk of violent behavior.

BackgroundViolent behavior is one of the most common symptoms of people who have schizophrenia. Caring for family members who have schizophrenia can be a stressor for other family members. The stressors can be stressful for the caregiver. Family caregivers require coping strategies to overcome the stressors. This study aims to determine the relationship between stress levels and coping strategies of family caregivers who treat schizophrenic patients with a risk of violent behavior.Design and MethodsThe research design engaged crosssectional with the purposive sampling technique by involving 87 caregiver families who who treat schizophrenic patients. The data was collected by using the Perceived Stress Scale (PSS) and Ways of Coping (WOC) questionnaires. This study was analyzed by employing the Chi-Square test to determine the relationship between stress levels and coping strategies in the caregiver family.ResultsThis study shows that stress levels are not significantly associated with coping strategies in family caregivers.ConclusionGood supports from health and social service professionals are required to help family caregivers cope with their stressors well.

Depressive Mood and Violent Behaviour among Teenagers: A Gender Dynamic Approach to the Study of Stressor Effects

Numerous studies have shown that the risk of depression in girls and the risk of violent behavior in boys progressively increase during adolescence. However, studies that clearly link the social mechanisms of gender to these results are relatively rare and studies that clearly delve into roots of these phenomena are even rarer still. The aim of this paper is to shed light on the genderization of spaces and life experiences during adolescence and its effect on adolescent mental and behavioral health. The recent scientific literature dedicated to this topic and the results of our own previous research have led us to define our hypotheses and analysis procedures. Concretely, we’ve tested the links between depression and violent behavior in both gender groups separately and we’ve investigated the potential role of gendered stressors and expectations influencing the developmental processes that lead to either depression or violent behaviour. The data used to perform our analysis of male and female pupils halfway through secondary education were drawn from the 2016 Belgian ISRD-3 study (International Study on Self-Reported Delinquency, third wave) we have conducted. Our findings confirm that the stressors adolescents have to face and the significance they assign to them reflect the genderization of symbolic and material spheres (private and emotional for girls, public and competitive for boys). In terms of reaction to these stressors, depressive mood and violent attitude appear interlinked. Male gender norms appear to encourage boys to seek recognition through violent behaviors and to avoid emotional demonstrations. In this gender group, a high score of depression reflects sensitivity to stressors comparable to the female group but also, perhaps, a fear of rejection by peers. Nevertheless, these results must be considered with caution given the rapidly changing nature of the social world as well as the fact that the instruments of measurement can themselves be governed by gender.

Psychiatric Patients with a Serious Mental Illness and a Recent History of Violent Behavior: An Exploration of Developmental, Clinical, Cognitive, and Demographic Characteristics

Background: Epidemiologic studies have shown that persons suffering from psychotic disorders are at increased risk of violent behavior. Several factors have been shown to predict violent behavior among persons with psychosis. However, prior research is limited in that these factors have not been explored simultaneously within the same study. Methods: The current study, therefore, aimed to determine which demographic, clinical, cognitive, and developmental characteristics were associated with an increased likelihood of violence among patients diagnosed with a psychotic disorder and which combination of these best predicted a history of violence. Participants (n=53) completed measures of demographics, violence risk, psychotic and personality symptoms, trauma, psychopathy and cognitive functioning. Results: Bivariate relationships were conducted to compare the history of violent behavior between all variables. Additionally, a binary logistic regression was run predicting participants’ history of violence. Several demographic, cognitive, clinical, and developmental factors were associated with increased odds of having a history of violence. The overall correct classification rate for the model was 92.2%, with 87.5% of participants without a history of violence and 91.4% with a history of violence being correctly classified. The model included antisocial personality traits, poor behavioral controls, head injury, not accepting responsibility, lacking goals, prior supervision failures, and HCR-20 total score. Conclusion: The binary logistic regression model showed good accuracy in predicting a history of violence in persons with psychosis. These findings are consistent with prior research and can inform efforts at risk assessment and identification of treatment targets for people with a psychotic disorder who are at highest risk of violence.

The Perspective of Forensic Inpatients With Psychotic Disorders on Protective Factors Against Risk of Violent Behavior.

Background: Little is known about the opinions of forensic inpatients with psychotic disorders like schizophrenia on factors likely to prevent or decrease future violent behavior.Aims: To understand the perspectives of forensic inpatients with psychotic disorders on protective factors against risk of violent behavior and compare them to factors identified by professional staff.Method: Using the Structured Assessment of Protective Factors (SAPROF) checklist for self-appraisal of violence risk, we conducted semi-structured interviews with 32 inpatients of the Medical Treatment and Supervision Act Ward and compared the results with those of professionals.Results: Inpatients scored higher in the SAPROF total score, the motivational factors of “life goals” and “motivation for treatment,” and the protective level in general. Inpatients scored themselves lower in risk level than professionals. The degree of agreement between service users' and professionals' evaluations was low for all categories except external factors. Inpatients prioritized “life goals,” “self-control,” and “medication” as the top three key strengths currently preventing violent behavior, whereas the professionals selected “life goals” less often. The top three important future goals for preventing future violence selected by inpatients were “work,” “intimate relationships,” and “life goals,” with the former two being selected significantly less often by the professionals.Conclusions: This is the first study to shed light on Japanese forensic inpatients' perspectives about preventing future violent behavior. Despite professionals' underestimation, inpatients viewed themselves as having high motivation for treatment and positive life goals. Inpatients prioritized personal values such as life goals, work, and intimate relationships, whereas professionals prioritized understanding, treating, and observing the disease. Our findings are consistent with past reports on patients' and clinicians' perspectives. Awareness of such gaps in perceptions can help build fruitful therapeutic alliances. We discuss the implications in terms of treatment, how to address the gap therapeutically, and how to design treatment accordingly. Directions for future research are also discussed.

Reducing the Violent Behavior in Schizophrenia Patient Through Online Clinical Practice During the Covid-19 Pandemic

Online clinical practice is an alternative in providing mental health services during the COVID-19 pandemic. Online clinical practice is useful in preventing relapse that is at risk of occurring during a pandemic in people with serious mental disorders such as schizophrenia. One of the schizophrenia relapse symptoms is a change in behavior that is distorted so that it creates a risk of violent behavior. Violence is a maladaptive response indicated by injuring oneself, others, or the environment. The patient’s ability to control violent behavior can be used as a means of preventing violent behavior. Nursing interventions based on mental health nursing care standards are carried out to prevent or control violent behavior in patient. The purpose of providing nursing care is to reduce symptoms and increase the patient’s ability to control violent behavior. The research method used case study analysis. The instrument used was an evaluation sheet of symptoms and the ability to control violent behavior. The final evaluation of the nursing care provided showed a decrease in symptoms and an increase in patient’s ability to control violent behavior. Promotion and prevention of health problems in patient with a risk of violent behavior can be done by implementing online nursing care based on mental health nursing care standards, as well as collaborating with clinical nurse specialist and related communities.

Association Analysis of Monoamine Oxidase-A Gene Promoter Polymorphism (MAOA uVNTR) for Antisocial Behavior: Absence of the Counting Number Repeats in Central Iran

Background: The MAOA gene is located on the X chromosome (Xp11.23). Several studies have established a VNTR (Variable Number Tandem Repeat) polymorphism in the upstream of the MAOA gene transcriptional initiation region named uVNTR which is correlated with the risk of antisocial behavior. Objectives: This study aimed to investigate the association between MAOA genotypes and the risk of violent behavior in a cohort of violent and age-matched non-violent individuals. Methods: In the current case-control study, MAOA uVNTR was genotyped in a cohort of 88 violent and 95 age-matched non-violent individuals. Individuals were genotyped for the MAOA uVNTR by performing PCR, gel electrophoresis, and sequencing. Furthermore, a chi-square test was performed using SPSS, and a p-value of less than 0.05 was considered statistically significant. Results: We identified three MAOA uVNTR allelic variants: They were harboring 3.5, 4.5, and 5.5 repeated sequences. Alleles with 2, 3, 4, 5, and 6 repeats were not observed in any of the two examined groups. Conclusions: We did not detect a statistically appreciable association between antisocial behavior and allele frequencies in the studied population in central Iran.

Nursing Care in Schizophrenia Clients With Focus Study Risk of Violent Behavior

There are around 20 million people worldwide suffering from schizophrenia. In Indonesia there is an increase in the number of schizophrenic clients, which were originally 1.7 per 1000 to 7 per 1000 population of Indonesia where Central Java is in the fifth position of mental disorders. The symptoms of schizophrenia are divided into 2 categories, positive and negative. Positive symptoms that can appear in schizophrenic clients, one of which is the risk of experiencing behavioral disorders, namely violent behavior. Violent behavior can result in loss of individual control so that it has the potential to hurt oneself, attack others and damage the environment. The purpose of this study is to describe nursing care from assessment to evaluation of schizophrenic clients with a focus on the study of the risk of violent behavior through interventions to control spiritual anger with murrotal ayat kursi. This research includes field research using descriptive analytic methods through case exposure with the nursing process approach. Research subjects are schizophrenic clients with risk of violent behavior. In this study using the instrument aggression questionnaire to measure the level of client aggression. The results showed the provision of nursing care to schizophrenic clients with the risk of violent behavior through intervention to control spiritual anger with murrotal ayat kursi showed improvement in the condition of the client which has a significant influence on mental status decline and aggression scores.

Applicability of two violence risk assessment tools in a psychiatric prison hospital population.

The risk of violent behavior is known to be higher for patients who suffer from a severe mental disorder. However, specific prediction tools for clinical work in prison psychiatry are lacking. In this single-center study, two violence risk assessment tools (Forensic Psychiatry and Violence Tool, "FoVOx," and Mental Illness and Violence Tool, "OxMIV") were applied to a prison hospital population with a primary psychotic or bipolar disorder and subsequently compared. The required information on all items of both tools was obtained retrospectively for a total of 339 patients by evaluation of available patient files. We obtained the median and inter-quartile range for both FoVOx and OxMIV, and their rank correlation coefficient along with 95% confidence intervals (CIs)-for the full cohort, as well as for cohort subgroups. The two risk assessment tools were strongly positively correlated (Spearman correlation = 0.83; 95% CI = 0.80-0.86). Such a high correlation was independent of nationality, country of origin, type of detention, schizophrenia-spectrum disorder, previous violent crime and alcohol use disorder, where correlations were above 0.8. A lower correlation was seen with patients who were 30 years old or more, married, with affective disorder and with self-harm behavior, and also in patients without aggressive behavior and without drug use disorder. Both risk assessment tools are applicable as an adjunct to clinical decision making in prison psychiatry.