Predicting inpatient aggression by self-reported impulsivity in forensic psychiatric patients

Area of Science:

• Forensic Psychiatry
• Clinical Psychology
• Behavioral Science

Background:

• Understanding predictors of inpatient aggression is crucial for developing effective prevention and management strategies.
• Physical aggression in inpatient settings poses significant risks to patients and staff.

Purpose of the Study:

• To evaluate the predictive utility of a self-reported impulsivity measure for identifying inpatient aggression.
• To investigate specific domains of impulsivity as predictors of violent behavior in forensic psychiatric inpatients.

Main Methods:

• Utilized the Urgency, Premeditation, Perseverance, Sensation seeking, Positive urgency (UPPS-P) scale to assess impulsivity domains in 74 forensic psychiatric inpatients.
• Measured aggressive incidents using the Social Dysfunction and Aggression Scale (SDAS).
• Employed Poisson regression to analyze the relationship between UPPS-P subscales and the duration of observed violent behavior.

Main Results:

• The 'negative urgency' (NU) domain of impulsivity, characterized by difficulty coping with negative emotions, significantly predicted the number of weeks with observed physical aggression.
• The presence of a personality disorder, in conjunction with negative urgency, further enhanced the prediction of physical aggression.
• Negative urgency also demonstrated predictive value for aggression occurring within the initial 12 weeks of hospitalization.

Conclusions:

• Negative urgency is strongly associated with an increased likelihood of inpatient violence, particularly in forensic settings.
• Targeting negative urgency, representing a deficit in coping with adverse feelings, may be a key therapeutic goal.
• Self-reported negative urgency can serve as a valuable tool in risk assessment and monitoring treatment progress for violence reduction.