Assailant and victim behaviors immediately preceding inpatient assault

The goals of this study were to detect and define victim and assailant behaviors immediately before inpatient assault and to determine their specificity to assault, to assailants, and to more serious assaults. Assault was defined as physical contact such as hitting and slapping and detected using video-cameras installed on a specialized ward for violent patients. Antecedent behaviors, or cues, were identified in victim and assailant in the five minutes preceding assault and in control periods, five minute segments in which both patients were present but no assault occurred. Fifty-five assaults between 59 patients were detected. Threatening and intrusive behaviors in assailant and victim preceded 60% of assaults and 10% of control periods. They were more than ten times more numerous before assaults. Assault was often the end of a set of overt, recognizable interactions between patients. In a chronically ill inpatient population these behaviors can be useful predictors of assault.