title: A model of aggression in psychiatric hospitals.
abstract: OBJECTIVE
  Research of the determinants of inpatient aggression indicates that certain environmental hospital variables play a role in triggering aggression in psychiatric hospitals. Yet, how patient, staff and ward variables interact in eliciting aggression is not well understood.
  
  
  METHODS
  On the basis of earlier findings, a model was proposed in which psychopathology and distorted cognitions of the patient are combined with environmental and communicational stressors that are specific for psychiatric wards.
  
  
  RESULTS
  The proposed model elucidates how certain patient, staff and ward characteristics may interact in causing aggression. The model also emphasizes that repeated inpatient aggression may be the result of a vicious circle, i.e. inpatient violence is often followed by an increase in environmental and/or communication stress on the patient, thereby heightening the risk of a repeated outburst of violence.
  
  
  CONCLUSIONS
  Although tentative, the model may shed light on the mechanisms that lead to (repeated) violence.
authors.affiliation: Forensic Psychiatric Hospital De Kijvelanden, Poortugaal, the Netherlands.
authors.forename: H L I
authors.initials: HL
authors.lastname: Nijman
mesh_terms: D000374:Aggression / Q000523:psychology*; D006760:Hospitalization; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D012920:Social Behavior Disorders / Q000453:epidemiology*