Mental Illness and Violence_unit Present Ion
Post on 30-May-2018
219 Views
Preview:
Transcript
8/9/2019 Mental Illness and Violence_unit Present Ion
1/26
Mental illness and
violence
Brief overview
By
Dr Adeyemis unit, FNPH Kaduna
03/03/10
8/9/2019 Mental Illness and Violence_unit Present Ion
2/26
2
Definition of Violence
The intentional use of physical force or
power, threatened or actual, against oneself,
another person, or against a group orcommunity, that either results in or has a
high likelihood of resulting in injury, death,
psychological harm, maldevelopment or
deprivation (WHO).
8/9/2019 Mental Illness and Violence_unit Present Ion
3/26
3
Types of violence
Self-directed
1. Suicidal behaviour : attempted suicide,suicide
2. Self abuse e.g. self mutilation
Interpersonal
1. Family & intimate partner violence e.g.child abuse, elder abuse, spouse/intimate
partner violence2. Community violence: b/w unrelated
individuals
8/9/2019 Mental Illness and Violence_unit Present Ion
4/26
4
Types of violence
Collective violence
Violence committed by larger groups
of people or state:
1. To advance a particular socialagenda e.g.
Crimes of hate by large groups Terrorist acts
Mob violence
8/9/2019 Mental Illness and Violence_unit Present Ion
5/26
5
Types of violence
2. Political violence
War and related violent conflicts
State violence
3. Economic violence
Attacks by larger groups motivated by
economic gain
purpose is to disrupt economic activity, denyaccess to essential services, or create
economic division and fragmentation
8/9/2019 Mental Illness and Violence_unit Present Ion
6/26
6
Nature of violent acts
Physical
Sexual
Psychological
Involving deprivation or neglect
8/9/2019 Mental Illness and Violence_unit Present Ion
7/26
7
8/9/2019 Mental Illness and Violence_unit Present Ion
8/26
8
Demographic variables
Sex:
In general population: M>F
Among psychiatric population: lessclear
Male sex significant predictor:community based epid studies of self
reported violence & studies ofviolence among psych patients (Bontaet al. 1998, Lovell et al 2002).
8/9/2019 Mental Illness and Violence_unit Present Ion
9/26
9
Demographic variables
Males not more likely than Females:
retrospective & prospective studies
utilizing samples psychiatric patientsrecently admitted or discharged
(Hiday et al. 1998; Robbins et al
2003).
8/9/2019 Mental Illness and Violence_unit Present Ion
10/26
10
Demographic variables
mental disorder have more of an
effect on the criminal potential of
females than of males.Among people with a major mental
illness, the risk of criminality is
increased M:F =2x:5x Hodgins (1992)
8/9/2019 Mental Illness and Violence_unit Present Ion
11/26
11
Demographic variables
Sex differences have also been found
in the severity and consequences of
violence perpetrated by persons withmental disorder
males more likely to commit serious
injury and to be arrested (Hiday et al.,
1998; Robbins et al., 2003).
8/9/2019 Mental Illness and Violence_unit Present Ion
12/26
12
Demographic variables
Age:
incidence and prevalence of violent
behaviour and offending is highest in thelate teens and early twenties among
persons with mental disorders as with the
general population
a significant number of males with majormental illness began their criminal behaviour
across all age groups (Hodgins 1992).
8/9/2019 Mental Illness and Violence_unit Present Ion
13/26
13
Demographic variables
Race:
Higher rates of violence & crime amongAfrican-American mentally ill
Neighbourhood disadvantage eliminated thisassociation (Silver2000b).
African-Americans were at greater risk for
perpetrating violence but only when theythemselves have previously been the victimsof violence (Swartz et al. 1998b).
8/9/2019 Mental Illness and Violence_unit Present Ion
14/26
14
Demographic variables
Socioeconomic status
The relationship btw SES & violence
among mentally ill people is complex& less clear than in general population
Some studies showed an associationbtw SES & violence among mentally ill
offenders while others did not
8/9/2019 Mental Illness and Violence_unit Present Ion
15/26
15
Historical factors
Prior violence and criminality have
been found to be the best predictors
of future violence and criminality
Prior arrests,
Prior convictions, and self-reported prior violence
8/9/2019 Mental Illness and Violence_unit Present Ion
16/26
16
Historical factors
A violent incidence increase the odds of
violence occurring in the following week by
1.4 times (Skeem et al. 2006).
Violence on any given day increase theodds of violence occurring the next day by
5.4 times (Mulvey et al. 2006).
8/9/2019 Mental Illness and Violence_unit Present Ion
17/26
17
Historical factors
History of delinquencyprior to adulthood
Early arrests
Young age at indexoffence
Parental crime
Parental substanceabuse
Separation fromparents before age16yrs
Childhood abuse
Victim of violence asan adult
8/9/2019 Mental Illness and Violence_unit Present Ion
18/26
18
Clinical factors
Significant association has been found btw
violence & certain psychiatric disorders:
Antisocial personality disorder
Substance use disorders
Comorbid substance use disorder
BAD Schizophrenia
Major depressive disorder
8/9/2019 Mental Illness and Violence_unit Present Ion
19/26
19
Clinical factors
Though several studies support this
association, others do not
This led to studies that have tried to
find the link btw specific
psychopathology and violence
8/9/2019 Mental Illness and Violence_unit Present Ion
20/26
20
Clinical factors
positive psychotic symptoms
significantly increased the risk of
violence among individuals diagnosed
with schizophrenia but only when
negative psychotic symptoms were
minimal or absent (Swanson et al.
2006) .
8/9/2019 Mental Illness and Violence_unit Present Ion
21/26
21
Clinical factors
Commanding auditory hallucinations
Persecutory delusions
Assigning an identity to a hallucinatedvoice was also found to be related tocompliance with commandhallucinations
Hallucination-related delusions Non-adherence to medication
8/9/2019 Mental Illness and Violence_unit Present Ion
22/26
22
Clinical factors
the most common feelings
experienced at the time of the
commission of a violent act are:
Feelings of rage,
anxiety, and fear of harm
8/9/2019 Mental Illness and Violence_unit Present Ion
23/26
23
Contextual factors
Contextual factors may exacerbate or
restrain the expression of violence.
family illness, change in financial status,
Change in employment status,
significant change in family situation
Residential instability
concentrated neighbourhood
poverty
8/9/2019 Mental Illness and Violence_unit Present Ion
24/26
24
Contextual factors
the risk of violence among psychiatric
patients with serious mental illness
toward a family member increased
fourfold when subjects were
financially dependent on the family
member ( Estroff et al.1998) .
8/9/2019 Mental Illness and Violence_unit Present Ion
25/26
25
Contextual factors
individuals at highest risk of violence
are
family members: >50%,( most werethe mother )
Friends
Males are more likely to targetstrangers in public
8/9/2019 Mental Illness and Violence_unit Present Ion
26/26
26
THANK YOU.
top related