Individual Rather Than Situational Characteristics Predict Violence in a Maximum Security Hospital

Abstract

Assaults on staff in a maximum security psychiatric hospital were analyzed over a 6.5-year period. During that time, 94 patients were admitted to the unit. Fifty-two (55%) of the patients engaged in assaultive behavior, generating 1,945 incident reports. A small number of patients was responsible for a large share of the incidents. Serious incidents were rare. Incidents were evenly distributed throughout the day, week, and year. Patients who attacked less often caused more serious harm, showed a decrease in assaults over time, and the preceding events suggested that the violence was functional. For assaultive patients, it was difficult to identify a preceding event, the preceding events that were identified seemed more unreasonable, and the frequency of assault was constant over time. Assaultive patients were more often women, had more positive and borderline symptoms, were younger, and scored lower on psychopathy and depressive symptoms.