title: Precipitants of elderly psychiatric patient assaults on staff: preliminary empirical inquiry.
abstract: Although there have been several studies of the characteristics of psychiatric patient assailants, there have been only six comprehensive, empirical assessments of precipitants to these assaults and no precipitant study has focused solely on elderly psychiatric patient assailants. This one and one-half year, retrospective study continued the inquiry into the nature of patient assault precipitants and focused only on elderly assailants. Older, male patients with a diagnosis of schizophrenia and histories of violence toward others and substance use disorder physically assaulted primarily male, mental health workers. These staff victims experienced disruptions in the domains of mastery, attachment, and meaning as well as the symptomatology associated with psychological trauma. The most common precipitants to these assaults were denial of services and acute psychosis. The findings and implications for health care providers in long-term care settings where elderly psychiatric patients reside are discussed.
authors.affiliation: Department of Psychology/6B, Worcester State Hospital, Massachusetts Department of Mental Health, 305 Belmont Street, Worcester, MA 01604, USA.
authors.forename: Raymond B
authors.initials: RB
authors.lastname: Flannery
authors.forename: Brenda
authors.initials: B
authors.lastname: Peterson
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Walker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression / Q000523:psychology*; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D015984:Causality; D015897:Comorbidity; D003419:Crisis Intervention / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008134:Long-Term Care / Q000706:statistics & numerical data; D008297:Male; D008404:Massachusetts; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation; D010348:Patient Care Team; D011369:Professional-Patient Relations; D012307:Risk Factors; D012308:Risk Management / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation; D012565:Schizophrenic Psychology; D055502:Secondary Prevention; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data