Citation

Johnson KL, Desmarais SL, Grimm KJ, Tueller SJ, Swartz MS, Van Dorn RA. Psychiatr. Serv. 2016; 67(7): 771-778.

Affiliation

Mrs. Johnson and Dr. Desmarais are with the Department of Psychology, North Carolina State University, Raleigh, North Carolina (e-mail: kljeske@ncsu.edu ). Dr. Grimm is with the Department of Psychology, Arizona State University, Tempe. Dr. Tueller is with Research Triangle Institute, Providence, Utah. Dr. Swartz is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Dr. Van Dorn is with Research Triangle Institute, Durham, North Carolina.

Copyright

(Copyright © 2016, American Psychiatric Association)

DOI

10.1176/appi.ps.201500259

PMID

26927580

Abstract

OBJECTIVE: This study examined the role of static indicators and proximal, clinically relevant indicators in the prediction of short-term community violence in a large, heterogeneous sample of adults with mental illnesses.

METHODS: Data were pooled from five studies of adults with mental illnesses (N=4,484). Follow-up data were available for 2,579 participants. A hierarchical linear regression assessed the incremental validity of a series of variable clusters in the prediction of violence risk at six months: static characteristics (age, sex, race-ethnicity, and primary diagnosis), substance use (alcohol use and drug use at baseline), clinical functioning (psychiatric symptoms at baseline and recent hospitalization), recent violence, and recent victimization.

RESULTS: Results demonstrated improved prediction with each step of the model, indicating that proximal indicators contributed to the prediction of short-term community violence above and beyond static characteristics. When all variables were entered, current alcohol use, recent violence, and recent victimization were positive predictors of subsequent violence, even after the analysis controlled for participant characteristics.

CONCLUSIONS: This study provides empirical evidence for three proximal, clinically relevant indicators in the assessment and management of short-term violence risk among adults with mental illnesses: current alcohol use, recent violence, and recent victimization. Consideration of these indicators in clinical practice may assist in the identification of adults with mental illnesses who are at heightened risk of short-term community violence.

Language: en