A Tentative Model of Aggression on Inpatient Psychiatric Wards

Violence in psychiatric hospitals threatens the safety and well-being of patients and staff members. The determinants and correlates of inpatient aggression are not well understood. The authors present an explanatory model of aggressive behavior that attempts to integrate patient, staff, and ward variables. In the proposed model, the patient's psychopathology and distorted cognitions are exacerbated by environmental and communication stressors found on psychiatric wards. The model emphasizes that repeated inpatient aggression may be the result of a vicious circle, whereby a patient's violent behavior is often followed by an increase in stress on the patient caused by environmental or communication factors, heightening the risk of another outburst of violence.