The prediction of violence in a health care setting

  • Richard Whittington
  • Til Wykes


One of the most important ways of tackling the problem of violence to health service staff is to improve our ability to predict when such violence is likely to occur. The health care professional is faced with a continuous stream of new patients or clients and staff need to know with some degree of accuracy which, if any, of these patients is likely to assault them during their period of contact. Currently such judgements are often based on clinical intuition and may be more or less accurate but there is growing evidence that more objective information could aid our predictions of violent behaviour.


Violent Behaviour Health Care Setting Verbal Aggression Community Psychiatry Health Care Staff 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Aiken, G.J.M. (1984) Assaults on staff in a locked ward: prediction and consequences. Medicine, Science and the Law, 24, 199–207.Google Scholar
  2. Archer, J. and Browne, K. (eds) (1989) Human Aggression. Naturalistic Approaches, Routledge, London.Google Scholar
  3. Armond, A.D. (1982) Violence in the semi-secure ward of a psychiatric hospital. Medicine, Science and the Law, 22, 203–209.Google Scholar
  4. Baron, R. (1977) Human Aggression, Plenum Press, New York.Google Scholar
  5. Blomhoff, S., Seim, S. and Friis, S. (1990) Can prediction of violence among psychiatric inpatients be improved? Hospital and Community Psychiatry, 41, 771–75.PubMedGoogle Scholar
  6. Breakwell, G.M. and Rowett, C. (1989). Violence and social work, in Human Aggression. Naturalistic Approaches, (eds J. Archer and K. Browne), Routledge, London.Google Scholar
  7. Carmel, H. and Hunter, M. (1989) Staff injuries from inpatient violence. Hospital and Community Psychiatry, 40, 41–46.PubMedGoogle Scholar
  8. Colenda, C.C. and Hamer, R.M. (1991) Antecedents and interventions for aggressive behavior of patients in a geriopsychiatric state hospital. Hospital and Community Psychiatry, 42, 287–92.PubMedGoogle Scholar
  9. Convey, J. (1986). A record of violence. Nursing Times, 82(46), 36–38.PubMedGoogle Scholar
  10. Cooper, A.J. and Medonca, J.D. (1991) A prospective study of patient assault on nurses in a provincial psychiatric hospital in Canada. Acta Psychiatrica Scandinavica, 84, 163–66.PubMedCrossRefGoogle Scholar
  11. Cooper, S.J., Browne, F.W.A., McClean, K.J. (1983) Aggressive behaviour in a psychiatric observation ward. Acta Psychiatrica Scandinavica, 68, 386–93.PubMedCrossRefGoogle Scholar
  12. Depp, F.C. (1976) Violent behavior patterns on psychiatric wards. Aggressive Behavior, 2, 295–306.CrossRefGoogle Scholar
  13. DHSS (1988) Violence to Staff. Report of the DHSS Advisory Committee on Violence to Staff, HMSO, London.Google Scholar
  14. Dietz, P.E. and Rada, R.T. (1983) Battery incidents and batterers in a maximum security hospital. Archives of General Psychiatry, 39, 31–34.CrossRefGoogle Scholar
  15. Edwards, J.G., Jones, D., Reid, W.H. et al. (1988) Physical assaults in a psychiatric unit in a general hospital. American Journal of Psychiatry, 145, 1568–71.PubMedGoogle Scholar
  16. Geen, R.G. (1990) Human Aggression. Open University Press, Milton Keynes.Google Scholar
  17. Haffke, E.A. and Reid, W.H. (1983) Violence against mental health personnel in Nebraska, in Violence Within Psychiatric Facilities, (eds J.R. Lion and W.H. Reid), Grune and Stratton, New York, pp. 91–102.Google Scholar
  18. Haller, R.M. and Deluty, R.H. (1988) Assaults on staff by psychiatric inpatients. A critical review. British Journal of Psychiatry, 152, 174–79.PubMedCrossRefGoogle Scholar
  19. Hodgkinson, P.E., Mclvor, L. and Phillips, M. (1985) Patient assaults on staff in a psychiatric hospital: a 2-year retrospective study. Medicine, Science and the Law, 25, 288–94.Google Scholar
  20. HSAC (1987) Violence to Staff in the Health Services, HMSO, London.Google Scholar
  21. Janofsky, J.S., Spears, S. and Neubauer, D.N. (1988) Psychiatrists’ accuracy in predicting violent behaviour on an inpatient unit. Hospital and Community Psychiatry, 39, 1090–1094.PubMedGoogle Scholar
  22. Krakowski, M., Jaeger, J. and Volavka, J. (1988) Violence and psychopathology: a longitudinal study. Comprehensive Psychiatry, 29, 174–81.PubMedCrossRefGoogle Scholar
  23. Kronberg, M.E. (1983) Nursing intervention in the management of the assaultive patient, in Assaults within Psychiatric Facilities, (eds J.R. Lion and W.H. Reid), Grune and Stratton, New York, pp. 225–40.Google Scholar
  24. Lanza, M.L., Kayne, H.L., Hicks, C. et al. (1991) Nursing staff characteristics related to patient assault. Issues in Mental Health Nursing, 12, 253–65.PubMedCrossRefGoogle Scholar
  25. Larkin, E., Murtagh, S. and Jones, S. (1988). A preliminary study of violent incidents in a Special Hospital (Rampton). British Journal of Psychiatry, 153, 226–31.PubMedCrossRefGoogle Scholar
  26. Lazarus, R. and Folkman, S. (1984) Stress, Appraisal and Coping, Springer, New York.Google Scholar
  27. Lee, H.K., Villar, O., Juthani, N. et al. (1989) Characteristics and behavior of patients involved in psychiatric ward incidents. Hospital and Community Psychiatry, 40, 1295–97.PubMedGoogle Scholar
  28. Long, G.T. (1984) Psychological tension and closeness to others: stress and interpersonal distance preference. Journal of Psychology, 117, 143–46.PubMedCrossRefGoogle Scholar
  29. Lorenz, K. (1966) On Aggression, Methuen, London.Google Scholar
  30. Lowenstein, M., Binder, R.L. and McNiel, D.E. (1990) The relationship between admission symptoms and hospital assaults. Hospital and Community Psychiatry, 41, 311–13.PubMedGoogle Scholar
  31. Martin, J.P. (1984) Hospitals in Trouble, Blackwell, London.Google Scholar
  32. Maslach, C. and Jackson, S.E. (1986) Maslach Burnout Inventory Manual, 2nd edn, Consulting Psychologists Press, Palo Alto, California.Google Scholar
  33. McNiel, D.E. and Binder, R.L. (1991) Clinical assessment of the risk of violence amongst psychiatric inpatients. American Journal of Psychiatry, 148, 1317–21.PubMedGoogle Scholar
  34. McNiel, D.E., Binder, R.L. and Greenfield, T.K. (1988) Predictors of violence in civilly committed acute psychiatric patients. American Journal of Psychiatry, 145, 965–70.PubMedGoogle Scholar
  35. Noble, P. and Rodger, S. (1989) Violence by psychiatric in-patients. British Journal of Psychiatry, 155, 384–90.PubMedGoogle Scholar
  36. Ochitill, H.N. (1983) Violence in a general hospital, in Violence Within Psychiatric Facilities, (eds J.R. Lion and W.H. Reid), Grune and Stratton, New York, pp. 103–18.Google Scholar
  37. Olweus, D. (1984) Development of stable aggressive reaction patterns in males, in Advances in the Study of Aggression, Vol. 1, (eds R.J. Blanchard and D.C. Blanchard), Academic Press, London.Google Scholar
  38. Owens, R.G. and Bagshaw, M. (1985) First steps in the functional analysis of aggression, Current Issues in Clinical Psychology, vol. 1 (ed. E. Karas), Gower, Aldershot.Google Scholar
  39. Palmstierna, T., Lassenius, R. and Wistedt, B. (1989) Evaluation of the Brief Psychopathological Rating Scale in relation to aggressive behaviour by acute involuntarily admitted patients. Acta Psychiatrica Scandinavica, 79, 313–16.PubMedCrossRefGoogle Scholar
  40. Perkins, R. (1991). Clinical Psychologist’s Experience of Violence at Work. Paper presented at the Annual Conference of the British Psychological Society, Bournemouth, April 1991.Google Scholar
  41. Poyner, B. and Warne, C. (1986) Violence to Staff: A Basis for Assessment and Prevention, HMSO, London.Google Scholar
  42. Poyner, B. and Warne, C. (1988) Preventing Violence to Staff, HMSO, London.Google Scholar
  43. Roscoe, J. (1987) Survey on the Incidence and Nature of Violence Occurring in the Joint Hospitals. Report to the Working Party on Violence, Bethlem Royal and Maudsley Hospitals Special Health Authority.Google Scholar
  44. Sheridan, M., Henrion, R., Robinson, L. et al. (1990) Precipitants of violence in a psychiatric inpatient setting. Hospital and Community Psychiatry, 41, 776–80.PubMedGoogle Scholar
  45. Smith, B.J. and Cantrell, P.J. (1988). Distance in nurse-patient encounters. Journal of Psychosocial Nursing and Mental Health Services, 26(2), 22–26.PubMedGoogle Scholar
  46. Tanke, E.D. and Yesavage, J.A. (1984) Characteristics of assaultive patients who do and do not provide visible cues of potential violence. American Journal of Psychiatry, 142, 1409–13.Google Scholar
  47. Werner, P.D., Rose, T.L. and Yesavage, J.A. (1983a) Reliability, accuracy and decision-making strategy in clinical predictions of imminent dangerousness. Journal of Consulting and Clinical Psychology, 51, 815–25.PubMedCrossRefGoogle Scholar
  48. Werner, P.D., Yesavage, J. A., Becker, J.M.T. et al. (1983b) Hostile words and assaultive behaviour on an acute inpatient psychiatric unit. Journal of Nervous and Mental Disease, 171, 385–87.PubMedCrossRefGoogle Scholar
  49. Whittington, R. (1992) Assaults on Nurses by Patients in Psychiatric Hospitals. Unpublished PhD thesis, Department of Psychology, Institute of Psychiatry, University of London.Google Scholar
  50. Whittington, R. and Wykes, T. (1991) Psychiatric Nurses’ Experience of Violence at Work. Paper presented at the Annual Conference of the British Psychological Society, Bournemouth, April 1991.Google Scholar
  51. Whittington, R. and Wykes, T. (1992) Violence to Nurses: Do Interaction Rates Explain Why Some Grades of Nurses are More at Risk of Assault than Others? Paper presented at the Advances in Nursing Practice and Research Conference, Institute of Psychiatry, London, May 1992.Google Scholar
  52. Yesavage, J.A. (1984) Correlates of dangerous behaviour by schizophrenics in hospital. Journal of Psychiatric Research, 18, 225–31.PubMedCrossRefGoogle Scholar
  53. Yesavage, J.A., Werner, P.D., Becker, J. et al. (1981) Inpatient evaluation of aggression in psychiatric patients. Journal of Nervous and Mental Disease, 169, 299–302.PubMedCrossRefGoogle Scholar

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© Springer Science+Business Media Dordrecht 1994

Authors and Affiliations

  • Richard Whittington
  • Til Wykes

There are no affiliations available

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