Impulsivity Does Not Lead to Physical Aggression in All Patients With Schizophrenia: The Moderating Role of...

Aggressive behaviours are more frequent in schizophrenia patients compared to the general population. Impulsivity is a significant risk factor for aggressive behaviour. No previous studies have examined the role of metacognition in impulsivity that leads to physical aggression (PA) in schizophrenia patients. We hypothesised that impulsive schizophrenia patients with more maladaptive metacognitive beliefs may exhibit increased physical aggression. The aim of this study was to explore the moderating role of metacognition in the effects of impulsivity on PA in schizophrenia patients, as well as interventions for effectively managing PA.

This study included 83 schizophrenia patients and 83 healthy controls. Positive and Negative Syndrome Scale was used to assess symptomatology, and Buss-Perry Aggression Scale (BP) was used to measure physical aggression. Barratt Impulsivity Scale (BIS) was utilised to evaluate impulsivity, and Metacognitions Scale-30 (MCQ-30) assessed metacognition.

The BP total scores and BIS total scores were significantly higher in schizophrenia patients than healthy controls. Attentional Impulsivity (BIS-Att), negative beliefs about the uncontrollability and danger of worry (MCQ-UD), BIS-Att × MCQ-UD, and Motor Impulsivity (BIS-Motor) × Positive beliefs about worry (MCQ-PB) were especially strong predictors of BP-PA scores.

Our findings indicate that not all types of impulsivity lead to an increase in PA among schizophrenia patients. Metacognitions play a significant role in moderating impulsivity when predicting PA, which may either support or prevent its escalation into acts of PA.

It may be beneficial to explore the effectiveness of metacognitive therapies in preventing impulsive aggression among schizophrenia patients.