Situational variables and institutional violence: A systematic review of the literature

Department of Psychology, Centre for the Study of Violence, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G41 0BA, Scotland, United Kingdom.
Clinical Psychology Review (Impact Factor: 7.18). 10/2006; 26(5):515-34. DOI: 10.1016/j.cpr.2006.02.002
Source: PubMed


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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    • "The financial cost of patient assault is significant in terms of consequent staff illness or injury (Carmel & Hunter, 1993; Hillbrand et al., 1996; Lanza & Milner, 1989) and in terms of the implementation of managerial measures (Flood et al., 2007). There has been considerable research into inpatient aggression, much of it aimed at identifying individual demographic and clinical risk factors, and at determining its situational and environmental antecedents (Bowers et al., 2011; Gadon et al., 2006; Papadopoulos et al., 2012). There has also been some examination of the perceptions held by psychiatric care staff about managing patient violence (Bilgin & Buzlu, 2006; Bock, 2011; Chen et al., 2007; Cutcliffe, 1999; Gordon et al., 1996; Kealeboga, 2009; Martin & Daffern, 2006; Poster & Ryan, 1994; Poster & Ryan, 1989; Spokes et al., 2002; Zuzelo et al., 2012). "
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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 · 1.95 Impact Factor
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    • "Levels, patterns and sources of workplace violence have been investigated in most healthcare settings and among most health professions [11,14,16,23,25-31]. However, little is known about workplace violence as it is experienced by nurses and other health professionals who deliver care to prisoners and other people who come into contact with the criminal justice system, although a few studies have explored workplace violence among mental health professionals who were practising in forensic psychiatric facilities [32,33]. A recent cross-sectional survey undertaken by the same research team found a three-month period prevalence of physical abuse among correctional health professionals of 16% [23], which, although unacceptably high, was lower than comparable studies set in the community (proportions of 50% [22] and 30% [11] were found in two Australian studies). "
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    ABSTRACT: Background Little is known about workplace violence among correctional health professionals. This study aimed to describe the patterns, severity and outcomes of incidents of workplace violence among employees of a large correctional health service, and to explore the help-seeking behaviours of staff following an incident. Methods The study setting was Justice Health, a statutory health corporation established to provide health care to people who come into contact with the criminal justice system in New South Wales, Australia. We reviewed incident management records describing workplace violence among Justice Health staff. The three-year study period was 1/7/2007-30/6/2010. Results During the period under review, 208 incidents of workplace violence were recorded. Verbal abuse (71%) was more common than physical abuse (29%). The most (44%) incidents of workplace violence (including both verbal and physical abuse) occurred in adult male prisons, although the most (50%) incidents of physical abuse occurred in a forensic hospital. Most (90%) of the victims were nurses and two-thirds were females. Younger employees and males were most likely to be a victim of physical abuse. Preparing or dispensing medication and attempting to calm and/or restrain an aggressive patient were identified as ‘high risk’ work duties for verbal abuse and physical abuse, respectively. Most (93%) of the incidents of workplace violence were initiated by a prisoner/patient. Almost all of the incidents received either a medium (46%) or low (52%) Severity Assessment Code. Few victims of workplace violence incurred a serious physical injury – there were no workplace deaths during the study period. However, mental stress was common, especially among the victims of verbal abuse (85%). Few (6%) victims of verbal abuse sought help from a health professional. Conclusions Among employees of a large correctional health service, verbal abuse in the workplace was substantially more common than physical abuse. The most incidents of workplace violence occurred in adult male prisons. Review of the types of adverse health outcomes experienced by the victims of workplace violence and the assessments of severity assigned to violent incidents suggests that, compared with health care settings in the community, correctional settings are fairly safe places in which to practice.
    BMC Health Services Research 08/2012; 12(1):245. DOI:10.1186/1472-6963-12-245 · 1.71 Impact Factor
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    • "The Journal of Forensic Psychiatry & Psychology Vol. 23, No. 2, April 2012, 168–183 (Gadon, Johnstone, & Cooke, 2006). Aggression within these institutions is common (Daffern & Howells, 2002), and frequently occurs consequent to the anger that is aroused by the restrictions and demands that are placed on individuals to maintain the regime and to facilitate treatment adherence (Daffern, Howells, & Ogloff, 2007). "
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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 · 0.88 Impact Factor
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