Georgina J. Flannery

Sense of coherence, life stress, and psychological distress: A prospective methodological inquiry

Antonovsky (1987) has proposed the Sense of Coherence (SOC) as a global perceptual predisposition in responding to life stress. Composed of comprehensibility, manageability, and meaningfulness, this construct has been associated with more adaptive coping in previous cross-sectional studies. This prospective study (N = 95) investigated the association of SOC (assessed by Antonovskys measure) with life stress and symptoms. SOC was correlated negatively with life stress and symptoms and appeared to mitigate the impact of life stress. SOC was not found to be a buffer variable. Implications of these findings are presented, as are methodological issues that concern Antonovskys measure.

Validating Antonovsky's Sense of Coherence Scale.

This study empirically supported Antonovskys predictions that a persons Sense of Coherence is implicated in coping with life stresses and psychological distress. Sense of Coherence scales accounted for as much variance in criterion measures of Life Events stressors, Depression, and Anxiety as did traditional locus of control and social support predictor measures. Sense of Coherence scales emerged as useful additions for studies of personality characteristics implicated in personal reactions to distressing life events.

Hospital Downsizing and Patients' Assaults on Staff

Although the downsizing and closing of state mental hospitals is occurring with increasing frequency nationwide, there appears to be only one case study of the clinical impacts of downsizing state hospitals. In this study, Snyder7 reported a four-fold increase in frequency of assaults on staff as the hospital census decreased. The present paper is a second case study of state hospital downsizing and closing in which the frequency of assaults on staff decreased by 63%. Possible explanations for the two differing outcomes are considered, and some general guidelines for the downsizing and closing of state hospitals are proposed.

Violence and the lax milieu?: preliminary data

Recently, Rosenbaum noted a rise in the number of patient assaults on staff. He attributed this increase to a lax milieu of impaired structures, boundaries, and leadership. This case study reports on a sharp decline in violence on three lax units in one state mental hospital, when new management fielded initiatives to strengthen the structures and boundaries on these three units. The implications of the findings are discussed.

Violence against women: psychiatric patient assaults on female staff

Violence against women is increasing in the community and the workplace, and health care is not exempt from this trend. Women represent an unacceptably high percentage of victims, yet gender has remained a neglected variable for systematic inquiry. This article reports on gender differences among caregivers assaulted by their clients in two settings: a psychiatric inpatient facility and community residential house settings.

Characteristics of International Assaultive Psychiatric Patients: Review of Published Findings, 2000–2012

Abstract In international reviews of psychiatric inpatient violence, one study of all types of patient violence found hostility, involuntary admission, and longer hospital stays associated with violence. A second study of comparison-group papers of patient assaults found younger males with schizophrenia, past violence, and substance abuse assaultive. The present review of raw assault data studies assessed characteristics of assaultive patients worldwide. It was hypothesized that patients with schizophrenia would present greatest assault risk. There were three analyses: International/no American studies (reviewed earlier), European studies, and merged International/American studies. Results revealed that male and female patients with schizophrenia, affective disorders, personality disorders, and other diagnoses presented greatest worldwide risk. Results partially support earlier findings. Given that individual institutional studies in this review reported significant assailant characteristics, a second finding is the absence of most of these institutional characteristics in this international review. Possible explanations for findings and a detailed methodological review are presented.

Characteristics of international staff victims of psychiatric patient assaults: review of published findings, 2000-2012

Abstract Psychiatric patient assaults on staff are a worldwide occupational hazard that results in human suffering and dollar cost expense. International research in the 1990s documented the frequent occurrence of these assaults. This present paper reviewed the published, international literature on staff victim assaults during the first decade of the new century. The findings indicate assaults on staff remain a serious worldwide issue as it was in the 1990s, even with new policy initiatives in place meant to reduce such violence. The findings by continents and a detailed methodological inquiry are presented.

International Review of Precipitants to Patient Assaults on Staff, 2013–2017

In studying psychiatric patient assaults, assessing the person x event x environment interaction is important in enhancing safety and ensuring quality care. Precipitants to patient assaults have traditionally received less attention than the patient characteristics of such assaults. Reviews of inpatient precipitants from 1960 to 2012 noted acute psychosis, denial of services, and substance abuse as commonly occurring precipitants. The present study reviewed the literature on precipitants from 2013 to 2017. A variety of precipitants, including acute psychosis, substance abuse, and denial of services were observed. The literature in this review broke new ground in subjects, methodologies, and precipitants. These new findings and a detailed methodological inquiry are presented.