Situational variables and institutional violence: A systematic review of the literature
ABSTRACT The impact of violence on institutions is not hard to discern: staff and patients are physically injured and may become psychologically disturbed, property is destroyed, and regimes and programs are disrupted and thereby impoverished. Furthermore, violent individuals are not only incarcerated for longer but are held in more expensive and more restrictive conditions. In order to manage institutional violence, risk factors need to be identified. Research directed at understanding institutional violence has tended to focus on person-centered explanations. However, human behavior does not occur in a vacuum of internal drives and motivations; situational factors are also relevant. A focus on situational risk factors may provide an additional means for managing institutional violence. The primary aim of this systematic review was to examine research that measured the impact of situational factors on institutional violence. The relationships among physical, verbal and/or sexual face-to-face violence and situational factors in prisons and closed psychiatric settings were reviewed. A descriptive and in-depth analysis of previous research findings was carried out. Findings indicated that a range of situational factors may impact on institutional violence. Methodological issues that influence the confidence that can be placed on these findings are considered. The implications of the findings are outlined.
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ABSTRACT: Primary and secondary violence prevention can reduce conflict in inpatient psychiatric settings. We aimed to review the empirical literature about how patients and staff in these settings perceive violence prevention. We conducted a systematic review using comprehensive terms to search multiple electronic databases. Thirty-seven studies were identified; all used either qualitative methods, quantitative cross-sectional surveys, or mixed method combinations. There are currently no adequate psychometric tools that can measure the perception of violence prevention in the inpatient setting. No studies have established a link between perceptions about inpatient violence prevention and violence preventive behaviors. The results from included studies were synthesized into a narrative review guided by thematic analysis. Important themes related to patient factors, care staff factors, and organizational and environmental factors. The narrative review can provide the basis for an empirically-based, descriptive, middle range theory of attitudes to violence prevention. However, further theoretical and empirical development is required to link conceptual developments from the current review to models that explain the role of perception in behavior in general and violence prevention behavior specifically. Future work should develop methods to measure the violence prevention climate in psychiatric settings and interventions to increase preventive behaviors.Aggression and Violent Behavior 08/2014; 19(5):502-514. DOI:10.1016/j.avb.2014.07.009
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ABSTRACT: Aggressive behavior in incarcerated youth presents a significant problem for staff, co-residents and the functioning of the institution. This study aimed to examine the predictive validity of an empirically validated measure, designed to appraise the risk of imminent aggression within institutionalized adult psychiatric patients (Dynamic Appraisal of Situational Aggression; DASA), in adolescent male and female offenders. The supervising staff members on the residential units rated the DASA daily for 49 youth (29 males and 20 females) over two months. The results showed that DASA total scores significantly predicted institutional aggression in the following 24 and 48 hrs; however, the predictive validity of the DASA for institutional aggression was, at best, modest. Further analyses on male and female subsamples revealed that the DASA total scores only predicted imminent institutional aggression in the male subsample. Item analyses showed that negative attitudes, anger when requests are denied, and unwillingness to follow instructions predicted institutional aggression more strongly as compared with other behavioral manifestations of an irritable and unstable mental state as assessed by the DASA.Journal of Forensic Psychiatry and Psychology 04/2012; 23(2):1-16. DOI:10.1080/14789949.2012.668207
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ABSTRACT: There has been an increased interest among researchers and clinicians to understand the violence risk factors that are important in inpatient psychiatric settings, as well as to improve the accuracy of inpatient violence risk assessments. The Short-Term Assessment of Risk and Treatability (START) is a structured violence risk assessment instrument designed to assess multiple risk domains and protective factors that are pertinent to inpatient psychiatric care and treatment. Unlike many structured risk assessment instruments, the START is comprised solely of dynamic factors. Using a sample of 50 inpatients, the present study sought to examine the predictive validity of the START Risk and Strength scales for inpatient aggression in a high-security forensic psychiatric hospital during a 1-month follow-up period. The Risk scale predicted interpersonal violence, verbal threats, and any inpatient aggression, whereas the Strength scale predicted interpersonal violence and any inpatient aggression. The results suggest that short-term inpatient violence risk appraisals using the START are significantly predictive whether risk factors or strengths are considered.10/2011; 10(4):337-345. DOI:10.1080/14999013.2011.629715