Incremental validity of patients’ self-reported anger beyond structured professional judgment tools in the prediction of inpatient aggression

Rahul Jalil*, Jorg Huber, Judith Sixsmith, Geoffrey L. Dickens

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Mental health inpatients’ self-reported violence risk predicts actual aggressive outcomes. Anger, for which there are well-evidenced interventions, commonly precedes inpatient aggression. We aimed to determine whether patients’ self-reported anger added incremental validity to violence prediction beyond routinely completed violence risk assessments. A correlational, pseudo-prospective study design was employed. N = 76 inpatients in secure hospitals completed self-report validated anger measures; routinely collected clinicians' ratings on structured professional judgment tools, and aggressive incident data for a 3-month follow-up period were extracted from clinical records. Thirty four (45%) participants were violent; self-reported anger and clinician-risk ratings were significantly positively correlated. Self-reported anger predicted aggressive outcomes but not incrementally beyond relevant risk assessment subscale and item scores. It may not be beneficial for all patients to self-report anger as part of continuous violence risk assessments, but those who score highly on anger-relevant items of risk assessment tools could be considered for further assessment to support risk-management interventions.
Original languageEnglish
Pages (from-to)365-375
Number of pages11
JournalInternational Journal of Forensic Mental Health
Volume18
Issue number4
Early online date26 Mar 2019
DOIs
Publication statusPublished - 2 Oct 2019

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Anger
Aggression
Inpatients
Violence
Self Report
Risk Management
Mental Health
Prospective Studies

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title = "Incremental validity of patients’ self-reported anger beyond structured professional judgment tools in the prediction of inpatient aggression",
abstract = "Mental health inpatients’ self-reported violence risk predicts actual aggressive outcomes. Anger, for which there are well-evidenced interventions, commonly precedes inpatient aggression. We aimed to determine whether patients’ self-reported anger added incremental validity to violence prediction beyond routinely completed violence risk assessments. A correlational, pseudo-prospective study design was employed. N = 76 inpatients in secure hospitals completed self-report validated anger measures; routinely collected clinicians' ratings on structured professional judgment tools, and aggressive incident data for a 3-month follow-up period were extracted from clinical records. Thirty four (45{\%}) participants were violent; self-reported anger and clinician-risk ratings were significantly positively correlated. Self-reported anger predicted aggressive outcomes but not incrementally beyond relevant risk assessment subscale and item scores. It may not be beneficial for all patients to self-report anger as part of continuous violence risk assessments, but those who score highly on anger-relevant items of risk assessment tools could be considered for further assessment to support risk-management interventions.",
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Incremental validity of patients’ self-reported anger beyond structured professional judgment tools in the prediction of inpatient aggression. / Jalil, Rahul; Huber, Jorg; Sixsmith, Judith; Dickens, Geoffrey L.

In: International Journal of Forensic Mental Health, Vol. 18, No. 4, 02.10.2019, p. 365-375.

Research output: Contribution to journalArticle

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AB - Mental health inpatients’ self-reported violence risk predicts actual aggressive outcomes. Anger, for which there are well-evidenced interventions, commonly precedes inpatient aggression. We aimed to determine whether patients’ self-reported anger added incremental validity to violence prediction beyond routinely completed violence risk assessments. A correlational, pseudo-prospective study design was employed. N = 76 inpatients in secure hospitals completed self-report validated anger measures; routinely collected clinicians' ratings on structured professional judgment tools, and aggressive incident data for a 3-month follow-up period were extracted from clinical records. Thirty four (45%) participants were violent; self-reported anger and clinician-risk ratings were significantly positively correlated. Self-reported anger predicted aggressive outcomes but not incrementally beyond relevant risk assessment subscale and item scores. It may not be beneficial for all patients to self-report anger as part of continuous violence risk assessments, but those who score highly on anger-relevant items of risk assessment tools could be considered for further assessment to support risk-management interventions.

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