Aggressive behavior and metacognitive functions: a longitudinal study on patients with mental disorders

Area of Science:

• Psychiatry
• Clinical Psychology
• Forensic Psychology

Background:

• Metacognitive functions are crucial for understanding psychological variables underlying personality and violence in severe mental disorders.
• Investigating metacognition's role can illuminate factors contributing to violent behavior in psychiatric patients.

Purpose of the Study:

• To compare patients with poor metacognitive functioning (PM group) and good metacognitive functioning (GM group) regarding history of violence.
• To assess differences in aggressive behavior between PM and GM groups during a 1-year follow-up.
• To identify predictors of aggressive behavior in patients with severe mental disorders.

Main Methods:

• A prospective cohort study of 180 patients with severe mental disorders, including outpatients and inpatients.
• Patients were categorized into poor metacognition (PM) and good metacognition (GM) groups based on MAI scores.
• Aggressive behavior was monitored bi-monthly using MOAS over a 1-year follow-up period.

Main Results:

• Patients in the PM group reported a history of violence more frequently than those in the GM group.
• No significant differences in aggressive or violent behavior were observed between the groups during follow-up.
• Borderline and passive-aggressive personality traits, history of violence, anger, and hostility were the strongest predictors of aggressive behavior.

Conclusions:

• Poor metacognition is associated with a history of violence, elevating the risk of aggressive behavior.
• Good metacognitive functioning appears to serve as a protective factor against violence.
• Metacognitive functions, while not direct predictors, interact with hostility and anger in predicting aggressive behavior.