Individual characteristics predisposing patients to aggression in a forensic psychiatric hospital

The assessment and management of aggression have become crucial components of psychiatric inpatient care and the focus of considerable research attention. This study examined the relationships between characteristics of psychiatric inpatients with aggressive behaviour in a forensic psychiatric hospital. Demographic and clinical characteristics, patients' social behaviour, and histories of aggression and substance use were obtained for every patient admitted to the Thomas Embling Hospital, a secure forensic psychiatric hospital, during 2002. Of these patients, 110 completed an additional assessment of psychotic symptoms and a battery of psychological tests measuring anger expression and control, assertiveness, and impulsivity. Results indicated that a recent history of substance use, an entrenched history of aggression, recent antisocial behaviour, and symptoms of psychosis including thought disturbance, auditory hallucinations, and conceptual disorganisation contributed to aggression.