[Emotional reactions of staff-members managing highly aggressive mentally ill patients]

Highly aggressive behaviour of psychiatric in-patients often provokes intense emotional reactions and countertransference-feelings in staff especially when it is necessary to control aggression in psychiatric emergency units. We investigated the emotional reactions immediately after the manifestation of a patient's aggressive behaviour in a group of 53 staff members. The amount of aggression was measured with the help of the "Modified Overt Aggression Scale" (MOAS). The type and intensity of the staff-emotions can be adequately described by using a special self-rating questionnaire: "Eigenschaftswörterliste" (EWL 60 S). Using principal component analysis, three factors were differentiated: experience of stress, experience of sovereignty and experience of calmness. Several independent variables were identified as selectively increasing the probability of priority of each emotional factor mentioned above. In addition, a subgroup of staff members who have a raised risk of stress experience compared to the other staff members was compiled by cluster analysis. Based on an aggressiveness sequence model, useful strategies were discussed which directly aim to improve the coping abilities of staff members dealing with their emotional over involvement.