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The Resident-intruder Paradigm: A Standardized Test for Aggression, Violence and Social Stress

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Severe non-lethal violence during psychotic illness.

Natalia Y L Yee¹, Matthew M Large, Richard I Kemp

¹University of New South Wales, Sydney, Australia.

The Australian and New Zealand Journal of Psychiatry

|May 14, 2011

Summary

Individuals with psychosis are disproportionately represented in severe non-lethal violent offenses. Addressing first-episode psychosis, treatment adherence, and substance abuse may decrease violence incidence in this population.

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Area of Science:

Forensic Psychiatry
Clinical Psychology
Criminology

Background:

Previous research on psychosis and violence primarily focused on homicide and inpatient violence.
This study investigates characteristics of offenders with psychotic illness who committed severe non-lethal violent offenses.

Purpose of the Study:

To characterize offenders with psychotic illness who committed severe non-lethal violent offenses.
To identify factors associated with severe non-lethal violence in individuals with psychosis.

Main Methods:

A review of court documents was conducted for cases of severe violent offenses resulting in significant injury.
Data were collected from the District Court of New South Wales, Australia, between 2006 and 2007.

Main Results:

11% of severe violent offenders had a diagnosed psychotic illness.
Many psychotic offenders had never received antipsychotic treatment, indicating first-episode psychosis.
Common characteristics included treatment non-adherence, co-morbid substance use, prior convictions, and active positive symptoms.

Conclusions:

Psychotic illness is over-represented in severe non-lethal violent offenses, confirming an association.
Earlier treatment of first-episode psychosis, improved adherence, and co-morbid substance abuse treatment are recommended to reduce violence.