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Violence and delusions: data from the MacArthur Violence Risk Assessment Study
P S Appelbaum1, P C Robbins, J Monahan
1Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA 01655, USA. appelbap@ummhc.org
The American Journal of Psychiatry
|March 30, 2000
Summary
Delusions, including threat/control override delusions, did not increase violence risk in psychiatric patients post-discharge. Self-reports may mislabel phenomena contributing to violence.
Area of Science:
- Psychiatry
- Criminology
- Mental Health Research
Background:
- Previous research indicated a link between delusions and increased violence risk.
- Threat/control override delusions were specifically implicated in prior studies.
Purpose of the Study:
- To investigate the association between delusions and violence in recently discharged psychiatric patients.
- To examine the role of threat/control override delusions in violent behavior.
Main Methods:
- Utilized data from the MacArthur Violence Risk Assessment Study.
- Followed 1,136 psychiatric patients for one year post-discharge.
- Gathered data via interviews and official records to assess delusions and violence.
Main Results:
- No significant association was found between delusions (general or threat/control override) and increased violence risk.
- Discrepancies with prior studies may stem from reliance on self-reported delusional symptoms.
Conclusions:
- Delusions do not appear to elevate the overall risk of violence in individuals with mental illness within a year of hospitalization.
- Clinical assessment of delusions and violence requires careful consideration of reporting methods.