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Psychotic Symptoms and the Violent/Illegal Behavior of Mental Patients Compared to Community Controls (From Violence and Mental Disorder: Developments in Risk Assessment, P 137-159, 1994, John Monahan and Henry J Steadman, eds. -- See NCJ-165556)

NCJ Number
165562
Author(s)
B G Link; A Stueve
Date Published
1994
Length
23 pages
Annotation
This study investigated which psychotic symptoms, if any, explain the elevated rates of violent behavior previously observed among current and former mental patients compared to community controls.
Abstract
Data for this investigation were drawn from a methods study conducted by Dohrenwend and colleagues to compare 1-month and 1- year versions of the Psychiatric Epidemiology Research Interview (PERI). Samples of psychiatric patients and community residents, randomly assigned to either a 1-month or a 1-year time frame for questions, were interviewed in person using the PERI schedule between 1979 and 1982. To obtain a community sample of individuals between 19 and 59 years of age, households in the Washington Heights section of New York City were enumerated and contacted to determine whether an eligible respondent lived there. Psychiatric patients used in the analysis were recruited from the outpatient clinic and an inpatient community service at Columbia-Presbyterian Medical Center, both of which are centrally located in the Washington Heights community. A total of 375 patients from these two settings were interviewed. The study found that only a subset of psychotic symptoms -- called by the researchers "threat/control-override" symptoms -- are related to violence. Further, these symptoms are associated with violence not only among former mental patients, but also among members of the general population who have never been treated for a mental disorder. The authors advise that the symptoms should be viewed only as an "internal opportunity structure" that makes violence more or less likely, not as an accurate predictor of individual behavior. Most mental patients do not experience the specific psychotic symptoms that were identified as risks for violent behavior. 7 tables and 25 references