Jacqueline M. T. Becker

Inpatient Evaluation of Aggression in Psychiatric Patients

The authors rated violent and violence-related behavior of patients on a psychiatric intensive care unit, and found that despite the restricted environment such behavior was manifested to a considerable degree. The amount of violent behavior was significantly correlated with admission Brief Psychiatric Rating Scale ratings on measures of thought disorder and schizophrenic thinking, but not with ratings of hostility.

Hostile words and assaultive behavior on an acute inpatient psychiatric unit

This report analyzes the relationship of hostile verbalizations to assaultive acts committed by 110 male schizophrenic patients on an acute psychiatric unit. It was found that patients who were verbally assaultive and threatening also tended to be physically assaultive. Assaults rarely occurred in the absence of verbal threats or abuse, and 32 per cent of violent patients could be identified on the basis of the occurrence of hostile verbalizations.

Family conflict, psychopathology, and dangerous behavior by schizophrenic inpatients

Data supporting the hypothesis that history of severe discipline and parental conflict in childhood is related to current violence were obtained in a study of 100 schizophrenic inpatients. In addition to a relation between inpatient violence and degree of schizophrenic symptoms, inpatient assaults and other dangerousness measures were positively and significantly correlated with severity of parental discipline, especially involving the father, and with degree of family conflict, particularly fights between parents and others outside the home.

Quantitative CT scan studies in aphasia II. Comparison of the right and left hemispheres.

Abstract Quantitative information about the right and left hemispheres (RH and LH) on CT scans of 32 aphasic stroke patients (As) and 10 nonaphasic controls (NCs) within a similar age range was obtained with a semiautomated computer program written to analyze CT scans. There was significant increase in the RH %LoPix (pixels related primarily to ventricular areas) for the As (especially global aphasics) as compared to the NCs. This was not related to midline shift, but may have been related to age, diaschisis (postlesion shock), or transsynaptic degeneration. Distinctive tissue-loss profiles were generated which reflected LH %LoPix (pixels related to infarct plus ventricular area) minus RH %LoPix at each CT slice for six aphasia types. These quantitative profiles (L - R %LoPix) were used with 89–100% accuracy in discriminant-analysis classification of aphasia groups when anterior/posterior lesion locus was controlled for. Significant correlations were obtained between severity of aphasia and L - R %LoPix. The overall percentage midline shift (right to left) for the As was 2.4% (NCs, 0.8%). The globals showed the least amount of shift, and the transcortical motor and Brocas showed the most at the lower slices (B and B W ), while the Wernickes showed the most at the higher slices (W and SM). The CT numbers in the remaining tissue (nonlesioned areas) were also studied. This right- and left-hemisphere analysis provided insight into the dynamics of the gross morphological reaction of both hemispheres to the presence of a unilateral infarct.

The context of involuntary commitment on the basis of danger to others: a study of the use of the California 14-day certificate.

This study examines the application of civil commitment criteria for prolonged (14-day) involuntary hospitalization of individuals judged to be dangerous to others by reason of mental illness. The California Civil Commitment Statute (Lanterman-Petris-Short, LPS) provides for such commitment, after a 72-hour period of observation. For a sample of 71 males on an acute inpatient unit, we examined the relationship between 14-day certification by reason of dangerousness to others (DO) under the LPS and measures of prehospitalization dangerousness, prior legal status, assaultive behavior in hospital, and mental status. The 31 per cent of subjects who were certified as DO were found to have been significantly more often held initially for 72-hour observation on the DO grounds than were patients who were certified for other reasons. However, subjects in the DO group were no different from the contrast groups on ratings of assaultiveness of preadmission behavior and of violent acts while in hospital. The implications of these results for the evaluation of civil commitment proceedings are discussed.

CONCURRENT VALIDITY OF THE OVERCONTROLLED HOSTILITY SCALE FOR PSYCHOTICS

MMPI Overcontrolled Hostility scores of 31 male psychotic inpatients correlated negligibly with scores on measures of expressed hostility and assaultiveness. The scale does not appear useful as an index of potential for violence by acute inpatients.

Analysis of responses to the Personal Opinion Survey by a sample of inpatients.

The utility of employing the Personal Opinion Survey as a measure of experienced control with psychiatric inpatients was examined for a sample of 71 patients in a psychiatric acute-care setting. Retest correlations suggested that 5 of the 7 scales were relatively stable over a 1- to 2-wk. interval. Correlations between scores on the survey and ratings of patients on the Brief Psychiatric Rating Scale were presented and discussed, as were relationships to involuntary legal detention on grounds of Grave Disability.