Hostility During Admission Interview as a Short-Term Predictor of Aggression in Acute Psychiatric Male Inpatients
J Clin Psychiatry 2003;64(12):1460-1464
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: A critical step for improving the
prediction of on-ward violence is the identification of variables
that are not only consistently associated with an increased risk
of aggression but also easily evaluated during the admission
interview. The goal of this prospective study was to assess the
predictive utility of hostility during admission interview.
Method: The sample consisted of 80 newly
admitted male patients with heterogeneous DSM-IV psychiatric
diagnoses recruited from the psychiatric ward of an urban public
hospital. Psychiatric symptoms at admission were assessed with
the Brief Psychiatric Rating Scale (BPRS). Aggressive behavior
during the first week of hospitalization was measured with the
Modified Overt Aggression Scale. Data were collected between
January and June 1998.
Results: In a multiple regression model, BPRS
items hostility and tension-excitement emerged as significant
predictors of verbal aggression, whereas thinking disturbance
(high) and suspiciousness-uncooperativeness (low) emerged as
significant predictors of aggression against objects. In
contrast, when aggression was treated as a binary dependent
variable in a logistic model, hostility during the admission
interview had no utility in predicting on-ward aggressive
Conclusion: This study confirms the importance
of distinguishing between different types of aggression to
improve the accuracy of predictions of violence. The findings
suggest that the question whether hostility is a useful
short-term predictor of aggression in psychiatric inpatients
cannot be answered conclusively. The predictive utility of
hostility was relatively high for predicting verbal aggression
but was negligible for predicting other types of aggressive