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Scales for measuring aggressive cognitions and behaviour have mainly been administered by nursing-staff or been self-ratings. During recent years we have made an attempt to construct an observer-scale for aggression analogous to the Hamilton scale for depression. The Social Dysfunction and Aggression Scale (SDAS) consists of 9 items (SDAS-9) covering outward aggression and 2 items (SDAS-2) covering inward aggression. The inter-observer reliability of the SDAS has been found adequate in terms of intra-class coefficients. In a pilot study on 82 inpatients from different centres in Denmark and Sweden the SDAS was compared to three-item scales for outward and inward aggression and to a global scale for outward aggression. The results showed that the SDAS-9 correlated positively with the other outward observer-scales, and the SDAS-2 with the other inward scale. A divergent validity was seen between the outward and inward scales, indicating that it is necessary to measure both dimensions. Preliminary ranks-according-to-frequency scores showed the following order of the nine outward items: irritability, dysphoric mood, social disturbances, nondirected verbal aggressiveness, negativism, directed verbal aggressiveness, physical violence towards staff, physical violence towards things, and physical violence towards persons other than staff.
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PMID:The development of an observer-scale for measuring social dysfunction and aggression. 228 25

Past research on the relationship between mood disorders and violent behavior has been inconsistent, sometimes finding a relationship between the two and sometimes finding no relationship. Any relationship is arguably complex, and this area of research would benefit from attempts to clarify the relationship. This paper addresses the issue of complexity by examining the relationship between specific mood disorder categories and symptoms and six conceptually different indicators of violent behavior. Relationships are analyzed in logistic regression models where demographic and problem drinking variables are included to control variation that may be accounted for by these factors. The study uses a sample of 1140 recently incarcerated male felons. Psychiatric disorder diagnoses are based on the Diagnostic Interview Schedule. There is evidence of a direct relationship between a lifetime diagnosis of dysthymia and an arrest or incarceration history for robbery as well as with multiple incidents of fighting since age 18. Recurrent depression was significantly associated with a robbery incarceration history. Depression symptoms (regardless of whether a disorder diagnosis was made) were associated with multiple incidents of fighting since age 18. Manic symptoms were inconsistently associated with "expressive" violence and a number of mood disorder/violence models showed no significant relationship between the two.
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PMID:Relationship of mood disorders to violence. 229 89

Violent incidents were assessed as part of a prospective study of 1,243 pregnant women. Participants were predominantly poor, urban, minority group women. Seven percent (n = 92) of women reported physical or sexual violence during pregnancy. Most of the women (94 percent) knew their assailant. Victims of violence were at greater risk of having a history of depression and attempted suicide, having more current depressive symptoms, reporting less happiness about being pregnant, and receiving less emotional support from others for the current pregnancy. Comparisons of victims and non-victims showed that victims were more likely to be users of alcohol and drugs. In addition, partners of victims were more likely to use marijuana and cocaine. When possible confounders were controlled using multivariable analyses, a woman's alcohol use during pregnancy and her partner's drug use were independently associated with an increased risk of being a victim of violence during pregnancy. Results of this study highlight the importance of assessing exposure to violence during prenatal care, especially among women who are heavy users of alcohol or drugs or whose partners use these substances.
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PMID:Violence during pregnancy and substance use. 232 35

Two hundred fifty four adolescents with psychiatric illnesses were evaluated in relation to alcoholism in their parents. All cases concerned underwent evaluation in Kurihama National Hospital by a psychiatrist. Those evaluated ranged from 11 to 25 years of age. The characteristic symptoms were as follows. 1. Thirty one had alcoholic parents, 48% of them came from broken families before reaching the age of 15, and 19% had mothers suffering from psychiatric illness. Many had serious family problems besides their father's alcoholism. In many cases, the psychotic symptoms started in early adolescence. 2. In an examination of psychiatric illnesses in adolescents with alcoholic parents, 36% were found to have borderline personality disorders, and 19% violence in the family. 3. Significant symptoms of psychiatric illness in adolescents with alcoholic parents were signs of aggression, violence, troubles in school, regression and convulsions. The average number of symptoms per patient was higher than in cases with non-alcoholic families. Other symptoms prevalent in adolescents with alcoholic parents were depression, anxiety, fear, delinquency and self-destructive behavior. It was apparent that severe symptoms were diverse in such adolescents. 4. Based on the above results, alcoholism in the family and borderline personality disorders in adolescents were discussed.
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PMID:[Psychiatric illnesses in adolescents of alcoholic parents]. 235 74

Corroborating a typology of rape proposed 10 years earlier, a recent demographic study of 1,000 incidents of rape concluded that the two predominant types of assault were blitz and confidence rape. Blitz rape is characterized by sudden surprise attack by an unknown assailant using force or the threat of violence to gain control over the victim. In confidence rape, the assailant is known to some degree, however slight, and gains control over his victim by winning her trust. The characteristic details that differentiate one type of rape from the other suggest that the psychological impact on the victim will differ according to the type of rape. Specific clinical approaches for the mental health care of each victim group need to be provided. The immediate concerns of blitz rape victims center around their sense of safety, their fear that the rapist may return, and their dismay at having failed to ward off their attacker. They may respond like typical trauma victims with nightmares, flashbacks, sleep and appetite disturbances, heightened startle responses, anxiety, and depression. Treatment--usually sought soon after the rape--may include psychotherapy, medication, and behavioral desensitization. The confidence rape victims' chief concerns are guilt and self-blame. The rape may be revealed only years later. There is often significant delay between the rape and the victims' request for help. The victims need to be assured that they are deserving of help and need the meaning and definition of rape clarified. Providing services may require active and sustained involvement on the part of clinicians. Confidence rape victims will have strong doubts about their ability to discern who is truly trustworthy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Blitz rape and confidence rape: implications for clinical intervention. 236 37

Research on the relationship of diagnosis, genetics, violence, and psychological factors to suicide has changed dramatically during the past 20 years. Within this changing framework the author reviews current research, which focuses on understanding why some patients within one diagnostic category such as depression or schizophrenia commit suicide while others do not; separating genetic factors responsible for suicide from those responsible for depression; clarifying the biological correlates of suicide and aggression; and examining the psychosocial and demographic factors affecting suicide among the young and old, men and women, and various cultures and subcultures.
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PMID:Suicide: a review of new directions in research. 241 33

Standardized measures of depression, anxiety, and behavioral deviancy were administered to a nonclinical sample of 67 high school girls (M age = 16.3; SD = 1.28). In addition, an adolescent version of the Sexual Experiences Survey was administered to assess the history of peer sexual victimization. In this sample, 55.0% of the girls had experienced at least one sexual victimization, including 7.5% of them who had experienced completed forcible rape. Data were analyzed via multivariate analysis of variance and multiple regression. Sexually victimized girls scored significantly higher than nonvictimized girls on the Trait Anxiety Index and the Beck Depression Inventory, but not on the Antisocial Index of the Jesness Inventory. The extent of victimization contributed significantly to the prediction of both the depression score and the anxiety score. The clinical significance of the reported symptoms is discussed. Although the study was not based on a probability sample, the prevalence of rape was consistent with existing literature. Because the sample was limited to girls who have remained involved in social systems, the measured symptoms probably are a conservative estimate of retrospectively measured postassault standardized test scores among sexually victimized adolescents.
Violence Vict 1989
PMID:The impact of adolescent sexual victimization: standardized measures of anxiety, depression, and behavioral deviancy. 248 30

A study was conducted at New York State's Harlem Valley Psychiatric Center of the effects of physical changes in the ward environment on severely regressed psychotic inpatients and on the hospital staff who treat them. Two standard wards were remodeled according to principles in the scientific literature, preferences of those involved, and attempts to facilitate treatment goals. Within 8 months of the inauguration of the redesigned setting, there were selective behavior and attitude changes in both staff (N = 27) and patients (N = 37) as compared to four matched control wards (staff N = 44; patient N = 44): (1) staff mood level was raised significantly on a standard scale; (2) staff unscheduled absence rate was cut in half; (3) staff did not report significant improvement on scales of ward atmosphere and patient functioning; (4) patients themselves reported improvement in their self-images, but not in irritability, isolation, or depression; (5) patients reported significantly more satisfaction with the ward dayroom; (6) rate of patient violence decreased almost 50%.
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PMID:How physical settings affect chronic mental patients. 264 80

Questionnaires and self-report scales were administered to 100 psychiatric inpatients. The scales measured such variables as depression, hopelessness, impulsivity, mental and life problems, family violence, personality characteristics, and dyscontrol tendencies. These were correlated with indices of suicide risk and violence risk. Most variables were found to correlate significantly with both suicide and violence risk. Partial correlation analyses revealed that 10 variables correlated significantly with suicide risk but not violence risk, while four variables correlated significantly with violence risk but not suicide risk. A two-stage model of countervailing forces, incorporating concepts from both psychoanalysis and ethology, is presented as a way of interpreting the results.
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PMID:Correlates of suicide and violence risk: III. A two-stage model of countervailing forces. 274 72

A support group was organized for women who sought help to cope with physical and emotional abuse from their male partners. Women who have lived through the cycle of violence may experience a stress response that includes fear, depression, anxiety, and low self-esteem. High anxiety can interfere with problem solving and with developing new coping patterns. Low self-esteem can accompany depression and intensify the sense of helplessness and powerlessness abused women feel. A descriptive study was conducted to determine to what extent women in the group experienced high anxiety and low self-esteem. Results indicated that high levels of anxiety and low self-esteem were present in the group. Anxiety reduction strategies and techniques to enhance self-esteem were developed.
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PMID:Self-esteem and anxiety: key issues in an abused women's support group. 279 28


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