Disruptive office behaviors in the medical setting: associations with other clinical phenomena

Aggression and violence in the medical setting appear to be on the increase. In support of this impression, a number of studies have documented surprising rates of such behavior toward trainees as well as physicians-in-practice. However, to date, these studies have focused on the experiences and reports of professionals, not patient offenders. In a series of investigations, we examined aggressive and disruptive office behaviors from the perspective of the perpetrators-the patients. Findings from these studies indicate that disruptive office behaviors by patients appear to be related to borderline personality symptomatology, alcohol/drug misuse, prescription medication abuse, and higher rates of past mental healthcare utilization. The results of these studies suggest a rudimentary psychological profile for the aggressive patient in the primary care setting.