Findings from the National Comorbidity Survey on the frequency of violent behavior in individuals with psychiatric disorders

Center for Psychiatric Rehabilitation at Evanston Northwestern Healthcare, 1033 University Place, Suite 450, Evanston, IL 60201, USA.
Psychiatry Research (Impact Factor: 2.47). 10/2005; 136(2-3):153-62. DOI: 10.1016/j.psychres.2005.06.005
Source: PubMed


Previous studies using probability samples have found a noticeable, but small association between violence and psychiatric disorder. In this article, we analyze data from the National Comorbidity Survey (NCS) to further examine this question. Psychiatric diagnosis of survey responses was based on a modified version of the Composite International Diagnostic Interview. The NCS study also included items that permitted self-report of violent behaviors in the past year. People with 12-month diagnoses of anxiety disorders, dysthymia and major depression were three to four times more likely to admit violent behaviors than those with no disorders. People with bipolar disorder or drug and alcohol abuse were eight times more likely to report violent behaviors. People with co-occurring non-substance and substance abuse disorders were more likely to report violence than those with only non-abuse disorders. Adjusting violence rates by population base rates shows demographics including ethnicity and gender to be a better predictor of violent behavior than psychiatric diagnosis. The NCS findings approximate those in other probability studies and echo the conclusions of the 1996 Consensus Statement by Advocates and Researchers on violence and mental illness; namely, mental illness is only a weak predictor of violent behavior.

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    • "Adults with mental illnesses are at heightened risk for violence, both perpetration (Corrigan & Watson, 2005; Van Dorn et al., 2012) and victimization (Goodman et al., 1999; Teplin et al., 2005); however, few studies have had the capability and/or objective to identify an overlap between the two violent outcomes. Thus, the present study's primary objective was to examine the victim–perpetrator overlap in a large, pooled sample of adults with mental illnesses. "
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    ABSTRACT: Objectives: In a large heterogeneous sample of adults with mental illnesses, we examined the 6-month prevalence and nature of community violence perpetration and victimization, as well as associations between these outcomes. Methods: Baseline data were pooled from 5 studies of adults with mental illnesses from across the United States (n = 4480); the studies took place from 1992 to 2007. The MacArthur Community Violence Screening Instrument was administered to all participants. Results: Prevalence of perpetration ranged from 11.0% to 43.4% across studies, with approximately one quarter (23.9%) of participants reporting violence. Prevalence of victimization was higher overall (30.9%), ranging from 17.0% to 56.6% across studies. Most violence (63.5%) was perpetrated in residential settings. The prevalence of violence-related physical injury was approximately 1 in 10 overall and 1 in 3 for those involved in violent incidents. There were strong associations between perpetration and victimization. Conclusions: Results provided further evidence that adults with mental illnesses experienced violent outcomes at high rates, and that they were more likely to be victims than perpetrators of community violence. There is a critical need for public health interventions designed to reduce violence in this vulnerable population.
    American Journal of Public Health 12/2014; 104(12):2342-2349. DOI:10.2105/AJPH.2013.301680 · 4.55 Impact Factor
    • "An increased risk was reported and adjusted odd ratio (OR) for risk of violent crimes was 2.3 (95% CI, 2.0–2.6) in patients with bipolar disorder when compared with general population [3]. With the exception of substance use disorder, the prevalence of violent behavior in patients with bipolar disorder was reported to be higher than in adults with major depression, posttraumatic stress or panic disorder [4]. Although there is growing awareness about neurocognitive impairments in euthymic bipolar disorder (BD), the paucity of knowledge about social cognitive ability in these patients is remarkable. "
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    ABSTRACT: It is well known that patients with bipolar disorder are more prone to violence and have more criminal behaviors than general population. A strong relationship between criminal behavior and inability to empathize and imperceptions to other person's feelings and facial expressions increases the risk of delinquent behaviors. In this study, we aimed to investigate the deficits of facial emotion recognition ability in euthymic bipolar patients who committed an offense and compare with non-delinquent euthymic patients with bipolar disorder. Fifty-five euthymic patients with delinquent behaviors and 54 non-delinquent euthymic bipolar patients as a control group were included in the study. Ekman's Facial Emotion Recognition Test, sociodemographic data, Hare Psychopathy Checklist, Hamilton Depression Rating Scale and Young Mania Rating Scale were applied to both groups. There were no significant differences between case and control groups in the meaning of average age, gender, level of education, mean age onset of disease and suicide attempt (p>0.05). The three types of most committed delinquent behaviors in patients with euthymic bipolar disorder were as follows: injury (30.8%), threat or insult (20%) and homicide (12.7%). The best accurate percentage of identified facial emotion was "happy" (>99%, for both) while the worst misidentified facial emotion was "fear" in both groups (<50%, for both). The total accuracy rate of recognition toward facial emotions was significantly impaired in patients with delinquent behaviors than non-delinquent ones (p<0.05). The accuracy rate of recognizing the fear expressions was significantly worse in the case group than in the control group (p<0.05). In addition, it tended to be worse toward angry facial expressions in criminal euthymic bipolar patients. The response times toward happy, fear, disgusted and angry expressions had been significantly longer in the case group than in the control group (p<0.05). This study is the first, searching the ability of facial emotion recognition in euthymic patients with bipolar disorder who had delinquent behaviors. We have shown that patients with bipolar disorder who had delinquent behaviors may have some social interaction problems i.e., misrecognizing fearful and modestly anger facial emotions and need some more time to response facial emotions even in remission.
    Comprehensive psychiatry 12/2013; 55(3). DOI:10.1016/j.comppsych.2013.11.022 · 2.25 Impact Factor
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    • "However, two more recent studies using robust data sources and more rigorous methodologies tell a different story. Unlike previous studies, Corrigan and Watson (2005) examined violence in all those in the US National Comorbidity Survey who met the criteria for mental illness but were not necessarily diagnosed or in treatment. "
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    ABSTRACT: We examined how different types of mental illness elicited varying levels of predicted criminality and compared this with factors which might also elicit a negative response, specifically, a criminal history and social disadvantage. A sample of 243 participants undertook an anonymous, online experiment. Each participant was exposed to one of six vignettes: three involved mental illness (schizophrenia, depression/anxiety, or alcohol dependency); two in which socio-economic background was manipulated; and a control. The impact of mental illness, history of criminality and social disadvantage on the likelihood that the character in the vignette would commit future crime, and levels of sympathy, trust and potential for rehabilitation in the character were measured. Age and personal experience of mental illness and/or criminal behaviour in the participants was also examined. The sample were significantly more likely to think that a character would 'possibly' commit future crime if he had mental illness in comparison to the control, but crimes were expected to be minor. Significantly more discriminatory behaviour was reported towards the character with no mental illness but a disadvantaged background. Familiarity ameliorated this effect. Prejudice towards those with a criminal past and a disadvantaged background may be stronger than prejudice against those with mental illnesses.
    03/2013; 209(3). DOI:10.1016/j.psychres.2013.02.013
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