Risk assessment for aggressive behaviour in schizophrenia.

BACKGROUND: Aggressive or violent behaviour is often associated with people with schizophrenia in common perceptions of the disease. Risk assessment methods have been used to identify and evaluate the behaviour of those individuals who are at the greatest risk of perpetrating aggression or violence or characterise the likelihood to commit acts. Although many different interventions have been developed to decrease aggressive or violent incidences in inpatient care, staff working in inpatient settings seek easy-to-use methods to decrease patient aggressive events. However, many of these are time-consuming, and they require intensive training for staff and patient monitoring. It has also been recognised in clinical practice that if staff monitor patients' behaviour in a structured manner, the monitoring itself may result in a reduction of aggressive/violent behaviour and incidents in psychiatric settings. OBJECTIVES: To assess the effects of structured aggression or violence risk assessment methods for people with schizophrenia or schizophrenia-like illnesses. SEARCH METHODS: We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials, which is based on CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, PubMed, ISRCTN registry, ClinicalTrials.gov, and WHO ICTRP, on 10 February 2021. We also inspected references of all identified studies. SELECTION CRITERIA: We included all randomised controlled trials (RCTs) comparing structured risk assessment methods added to standard professional care with standard professional care for the evaluation of aggressive or violent behaviour among people with schizophrenia. DATA COLLECTION AND ANALYSIS: At least two review authors independently inspected citations, selected studies, extracted data, and appraised study quality. For binary outcomes, we calculated a standard estimation of the risk ratio (RR) and its 95% confidence interval (CI). For continuous outcomes, we calculated the mean difference (MD) and its 95% CI. We assessed risk of bias in the included studies and created a summary of findings table using the GRADE approach. MAIN RESULTS: We included four studies in the review. The total number of participants was not identifiable, as some studies provided number of participants included, and some only patient days. The studies compared a package of structured assessment methods with a control group that included routine nursing care and drug therapy or unstructured psychiatric observations/treatment based on clinical judgement. In two studies, information about treatment in control care was not available. One study reported results for our primary outcome, clinically important change in aggressive/violent behaviour, measured by the rate of severe aggression events. There was likely a positive effect favouring structured risk assessment over standard professional care (RR 0.59, 95% CI 0.41 to 0.85; 1 RCT; 1852 participants; corrected for cluster design: RR 0.59, 95% CI 0.37 to 0.93; moderate-certainty evidence). One trial reported data for the use of coercive measures (seclusion room). Compared to standard professional care, structured risk assessment may have little or no effect on use of seclusion room as days (corrected for cluster design: RR 0.92, 95% CI 0.27 to 3.07; N = 20; low-certainty evidence) or use of seclusion room as secluded participants (RR 1.83, 95% CI 0.39 to 8.7; 1 RCT; N = 20; low-certainty evidence). However, seclusion room may be used less frequently in the standard professional care group compared to the structured risk assessment group (incidence) (corrected for cluster design: RR 1.63, 95% CI 0.49 to 5.47; 1 RCT; N = 20; substantial heterogeneity, Chi2 = 0.0; df = 0.0; P = 0.0; I2 = 100%; low-certainty evidence). There was no evidence of a clear effect on adverse events of escape (RR 0.2, 95% CI 0.01 to 4.11; 1 RCT; n = 200; very low-certainty evidence); fall down (RR 0.33, 95% CI 0.04 to 3.15; 1 RCT; n = 200; very low-certainty evidence); or choking (RR 0.2, 95% CI 0.01 to 4.11; 1 RCT; n = 200; very low-certainty evidence) when comparing structured risk assessment to standard professional care. There were no useable data for patient-related outcomes such as global state, acceptance of treatment, satisfaction with treatment, quality of life, service use, or costs. AUTHORS' CONCLUSIONS: Based on the available evidence, it is not possible to conclude that structured aggression or violence risk assessment methods are effective for people with schizophrenia or schizophrenia-like illnesses. Future work should combine the use of interventions and structured risk assessment methods to prevent aggressive incidents in psychiatric inpatient settings.

The Affective Side of Disruptive Behavior: Toward Better Understanding, Assessment, and Treatment.

Historically, much of the progress made in youth mental health research can be classified as focusing on externalizing problems, characterized by disruptive behavior (e.g. aggression, defiance), or internalizing problems, characterized by intense negative affect (e.g. depression, anxiety). Until recently, however, less attention has been given to topics that lie somewhere in between these domains, topics that we collectively refer to as the affective side of disruptive behavior. Like the far side of the moon, the affective side of disruptive behavior captures facets of the phenomenon that may be less obvious or commonly overlooked, but are nonetheless critical to understand. This affective side clarifies socially disruptive aspects of traditionally "externalizing" behavior by elucidating proximal causation via intense negative affect (traditionally "internalizing"). Such problems include irritability, frustration, anger, temper loss, emotional outbursts, and reactive aggression. Given a recent explosion of research in these areas, efforts toward integration are now needed. This special issue was developed to help address this need. Beyond the present introductory article, this collection includes 4 empirical articles on developmental psychopathology topics, 4 empirical articles on applied treatment/assessment topics, 1 evidence base update review article on measurement, and 2 future directions review articles concerning outbursts, mood, dispositions, and youth psychopathology more broadly. By deliberatively investigating the affective side of disruptive behavior, we hope these articles will help bring about better understanding, assessment, and treatment of these challenging problems, for the benefit of youth and families.

Evidence Base Update on the Assessment of Irritability, Anger, and Aggression in Youth.

OBJECTIVE: Irritability, anger, and aggression have garnered significant attention from youth mental health researchers and clinicians; however, fundamental challenges of conceptualization and measurement persist. This article reviews the evidence base for assessing these transdiagnostic constructs in children and adolescents. METHOD: We conducted a preregistered systematic review of the evidence behind instruments used to measure irritability, anger, aggression, and related problems in youth. Searches were conducted in PsycINFO and PubMed, identifying 4,664 unique articles. Eligibility criteria focused on self- and proxy-report measures with peer-reviewed psychometric evidence from studies in English with youths ages 3-18. Additional measures were found through ancillary search strategies (e.g. book chapters, review articles, test publishers). Measures were screened and coded by multiple raters with acceptable reliability. RESULTS: Overall, 68 instruments met criteria for inclusion, with scales covering irritability (n = 15), anger (n = 19), aggression (n = 45), and/or general overt externalizing problems (n = 27). Regarding overall psychometric support, 6 measures (8.8%) were classified as Excellent, 46 (67.6%) were Good, and 16 (23.5%) were Adequate. Descriptive information (e.g. informants, scales, availability, translations) and psychometric properties (e.g. reliability, validity, norms) are summarized. CONCLUSIONS: Numerous instruments for youth irritability, anger, and aggression exist with varying degrees of empirical support for specific applications. Although some measures were especially strong, none had uniformly excellent properties across all dimensions, signaling the need for further research in particular areas. Findings promote conceptual clarity while also producing a well-characterized toolkit for researchers and clinicians addressing transdiagnostic problems affecting youth.

Characterizing the role of impulsivity in costly, reactive aggression using a novel paradigm.

A lack of self-control has long been theorized to predict an individual's likelihood to engage in antisocial behaviors. However, existing definitions of self-control encompass multiple psychological constructs and lab-based measures of aggression have not allowed for the examination of aggression upon provocation where self-control is needed most. We introduce two versions of a novel paradigm, the Retaliate or Carry-on: Reactive AGgression Experiment (RC-RAGE) to fill this methodological gap. Using large online samples of US adults (N = 354 and N = 366), we evaluate to what extent dispositional impulsivity, self-control, aggression, and state anger contribute to aggression upon provocation when there is a financial cost involved. Results showed that costly retaliation on this task was related to trait aggression and being in an angry emotional state, but not related to social desirability. Importantly, we show that the tendency to act impulsively is a better predictor of costly retaliation than other forms of self-control, such as the ability to delay gratification, resist temptation, or plan ahead. As a browser-based task, the RC-RAGE provides a tool for the future investigation of reactive aggression in a variety of experimental settings.

Momentary assessment of the relations between narcissistic traits, interpersonal behaviors, and aggression.

INTRODUCTION: This study explores the associations among narcissistic traits, interpersonal behaviors, and aggression using repeated, situation-based measurement. We examine narcissism's relations with aggression across three levels of its theorized hierarchy (level 1: narcissism; level 2: grandiose vs. vulnerable narcissism; level 3: antagonism, agentic extraversion, and narcissistic neuroticism). METHODS: Using an experience-sampling approach, the current study examined the effects of narcissism and its finer-grained components on daily affective experiences and aggressive behaviors in the context of interpersonal interactions. Data were collected from 477 undergraduate students who were instructed to complete four prompts a day for ten consecutive days. RESULTS: Narcissism at the global construct level positively predicted multiple indices of episodic aggression (i.e., aggressive temper, aggressive urge, verbal aggression). At the dual-dimension level, grandiose narcissism specifically predicted aggression, and then at the trifurcated level, interpersonal antagonism predicted aggression by itself and in interaction with event-level negative affect. Negative affect consistently exhibited both within- and between-person effects on aggression. CONCLUSION: In real-life social interactions, narcissism dimensions differentially affect the way individuals experience social interactions and process negative affect, and thus in both research and clinical practice, narcissism is best assessed as a heterogeneous, multidimensional construct.

Disdainful Hookups: a Powerful Social Determinant of Health.

The health consequences of gender violence, a global health and social problem, are increasingly studied. Among its roots, research has identified a coercive dominant discourse imposing the idea that masculinities and relationships marked by abuse and domination are more attractive than egalitarian ones. To prevent the health consequences of gender violence, it is necessary to understand the factors that lead many adolescents to fall into it. This study aims to identify the specific mechanisms by which the coercive dominant discourse manifests in the peer group and its consequences for adolescents. Forty-one 15- and 16-year-old female adolescents from three high schools in Barcelona participated in the study. Eight communicative discussion groups were conducted to deepen on participants' perceptions regarding how peer interactions promote the learning of attraction to violence in sexual-affective relationships. The results show that the participants perceived and experienced different types of coercion to have violent relationships in their peer group interactions. Those interactions fostered the reproduction of the association between sexual-affective attraction and males with aggressive attitudes and behaviors. Many peers coerce others to have disdainful hookups which have very negative health consequences for the victims, including suicidal ideation and committing suicide. Some peer groups become a risk developmental context for female adolescents as far as they foster the coercive dominant discourse, push some young women to engage in violent sporadic relationships, and even harass some others afterwards. This clarifies the importance of peer group-level interventions when addressing the health consequences of gender violence in adolescence.

Violence Risk Assessment in the Emergency Department.

INTRODUCTION: Workplace violence is a prevalent problem in health care, with mental health and emergency departments being the most at-risk settings. The aim of this evidence-based practice project was to pilot use of a violence risk assessment tool, the Broset Violence Checklist, to assess for risk of type II violence and record the interventions that nurses chose to implement to mitigate the situation. Additionally, reports made to the hospital reporting system were tracked and compared to previous reporting frequency. METHODS: Following staff education, nurses were instructed to complete checklists for all patients who have a score of 1 or higher, which indicates the presence of at least 1 high-risk behavior, and continue hourly scoring until the score returned to 0 or the patient was dispositioned. The number of incidents recorded, time of day, scores, interventions applied to mitigate violence, and change in scores after interventions were evaluated. The number of Broset Violence Checklist scoring sheets submitted and reports made via the hospital reporting system were compared. RESULTS: Incidents were most frequent from 11 am until 3 am. The highest scores occurred in the late evening and early morning hours. There were significantly more incidents captured with the use of the Broset Violence Checklist as compared to the hospital reporting system. Incidents significantly associated with higher scores included providing comfort measures, addressing concerns, and applying restraints. DISCUSSION: The Broset Violence Checklist was used successfully in the emergency department setting to identify behaviors associated with violence. Under-reporting to the hospital report system was identified in this project, consistent with reports in the literature. Specific interventions were not associated with a decrease in Broset Violence Checklist scores.

Predictive care: a protocol for a computational ethnographic approach to building fair models of inpatient violence in emergency psychiatry.

INTRODUCTION: Managing violence or aggression is an ongoing challenge in emergency psychiatry. Many patients identified as being at risk do not go on to become violent or aggressive. Efforts to automate the assessment of risk involve training machine learning (ML) models on data from electronic health records (EHRs) to predict these behaviours. However, no studies to date have examined which patient groups may be over-represented in false positive predictions, despite evidence of social and clinical biases that may lead to higher perceptions of risk in patients defined by intersecting features (eg, race, gender). Because risk assessment can impact psychiatric care (eg, via coercive measures, such as restraints), it is unclear which patients might be underserved or harmed by the application of ML. METHODS AND ANALYSIS: We pilot a computational ethnography to study how the integration of ML into risk assessment might impact acute psychiatric care, with a focus on how EHR data is compiled and used to predict a risk of violence or aggression. Our objectives include: (1) evaluating an ML model trained on psychiatric EHRs to predict violent or aggressive incidents for intersectional bias; and (2) completing participant observation and qualitative interviews in an emergency psychiatric setting to explore how social, clinical and structural biases are encoded in the training data. Our overall aim is to study the impact of ML applications in acute psychiatry on marginalised and underserved patient groups. ETHICS AND DISSEMINATION: The project was approved by the research ethics board at The Centre for Addiction and Mental Health (053/2021). Study findings will be presented in peer-reviewed journals, conferences and shared with service users and providers.

Aggressive behavior in adolescent: The importance of biopsychosocial predictors among secondary school students.

Introduction: Overt aggression is a common type of aggression observed among adolescents, which is apparent and outward confrontational acts manifested physically and verbally, such as fighting and shouting. It has become a major public health concern, as it results in detrimental health impacts like injury, mental health, and social problems. Methods: An observational study was conducted among 16-year-old school students to determine their biopsychosocial predictors, using stratified proportionate population sampling. Pre-tested surveys were distributed to measure students' aggression, biological, psychological, and social factors. Results: A total of 463 students from four public secondary schools participated in the study, with a median aggression score was 23.00 (IQR=12.00). The significant predictors of aggression from multivariate analysis were Malay race, frequent dessert intakes, attitude towards aggression, low family income, and peer deviant affiliation (F [8, 244] = 15.980, p < 0.001, adjusted R 2 = 0.290). Discussion: Adolescent aggression determinants are collectively impacted as a result of biological, psychological, and social predictors and need to be focused on in interventional strategies.

Using the Dynamic Appraisal of Situational Aggression (DASA) to assess the impact of unit atmosphere on violence risk assessment.

WHAT IS KNOWN ON THE SUBJECT: Research suggests that the Dynamic Appraisal of Situational Aggression (DASA) is a useful risk assessment instrument to identify individuals who might be at risk of aggression in mental health inpatient units. Although, risk assessment research has typically focused on an individual's risk of aggression, recent research has begun exploring whether the DASA could be used to assess the likelihood that a group of patients would be aggressive. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE: While the DASA was useful for assessing whether an individual was likely to be aggressive, the group average score was not a useful indicator for the likelihood of aggression once the individual DASA score was taken into consideration. Unexpectedly, patients who were assessed as high risk on the DASA were more likely to be aggressive on settled units compared to unsettled units, which included other individuals whose risk was elevated. WHAT ARE THE IMPLICATIONS FOR PRACTICE: There is not enough evidence to suggest that the group DASA average improves the identification of aggression above the individual DASA score. ABSTRACT: INTRODUCTION: The Dynamic Appraisal of Situational Aggression (DASA) is an inpatient aggression risk assessment instrument. Recently, research explored whether the unit atmosphere, as indicated by a unit's average DASA score, was related to inpatient aggression risk, but failed to control for individual risk. AIM: Investigate whether the DASA unit average score or an interaction between the unit average and an individual patient's DASA score was related to the likelihood that an individual would act aggressively. METHOD: Cox regression with repeated assessments and recurrent events was used to analyse 11,243 DASA risk assessments of 113 inpatients collected via retrospective file review. RESULTS: The unit DASA average score was not related to aggression towards staff. There was a negative interaction between the individual and the unit DASA average scores when identifying patient-to-patient aggression; high-risk patients engaged in less aggression when the unit average was heightened relative to units with lower DASA average scores. DISCUSSION: It is possible that there were more nursing interventions and/or patients engaged in greater self-regulation on unsettled units, thus reducing aggression. IMPLICATIONS FOR PRACTICE: Currently, there is insufficient evidence to suggest that the unit average score should be used to supplement individual DASA scores to identify aggression risk.

Socio-economic and psychosocial determinants of violent discipline among parents in Asia Pacific countries during COVID-19: Focus on disadvantaged populations.

BACKGROUND: Mobility restrictions and economic downfall as a result of the COVID-19 pandemic may increase the risk of child maltreatment, including increased risk for violent discipline use by parents. OBJECTIVE: We examined the socio-economic and psychosocial determinants of violent discipline among parents against children in Asia Pacific countries. PARTICIPANTS & SETTINGS: This secondary data analysis included 7765 parents with children 6-18 years old in eight Asia Pacific countries. METHODS: 24 potential determinants were identified, including household demographic factors, parents' psychosocial status, and livelihood changes. The dependent variable was parental use of violent discipline (physical, severe physical, psycho-social aggression, and any violent discipline). Univariate and multivariable logistic regression analysis was conducted. RESULTS: A total of 41 % of households reported violent discipline. Parental demographic characteristics that were positively related to use of violent discipline were living in rural areas, not being a household head, female sex, age younger than 35 years, and large family size. Poor parental mental health status, loss of job or reduced income due to COVID-19, lack of food at household level, parent engagement in petty trade, and owning a business also predicted violent discipline. Mandatory curfew and receiving pandemic-related education materials were also positive predictors. CONCLUSION: Some socio-demographic factors, economic hardship due to COVID-19, and poor mental health status of parents are associated with the use of violent discipline against children in the Asia Pacific region. These results highlight several potential target areas for child protection interventions by governmental and non-profit organizations, including economic, social, and mental health interventions.

[Introduction of a risk assessment tool to evaluate the risk of aggressive behavior during acute psychiatric admission]. / Az agresszív magatartás rizikóját felméro skála alkalmazása akut pszichiátriai felvételre kerülo betegeken.

INTRODUCTION: Aggressive behavior among psychiatric patients occurs the most frequently during acute inpatient treatment causing significant safety risk for patients and staff. OBJECTIVE: As part of a risk-reducing project targeting the reduction of the frequency of physical aggression, a daily routine use of a risk evaluation tool was introduced in the acute psychiatric unit of the Jahn Ferenc South Pest Hospital. METHODS: Selection of the appropriate risk evaluation tool was based on a thorough search of the literature. After preparing the Hungarian translation of V-RISK-10, all acutely admitted patients were assessed with this rating scale completed by the duty psychiatrist. To evaluate the predictive validity of the scale, the authors retrospectively surveyed the number and length of necessary physical restraints due to aggressive behavior in the first week after admission. RESULTS: The mean score on V-RISK-10 was 6.78 ± 3.36 points and the time patients spent under restraints was 6.96 ± 17.21 hours. The sum score of the V-RISK-10 showed a moderate strength, and significant correlation with the time spent under restraint (r = 0.447; p = 0.001). DISCUSSION: The results confirmed that V-RISK-10 is an appropriate tool for predicting physical aggression necessitating restraints in the first days following an acute psychiatric admission. History of violent behavior, drug use, and a psychiatric diagnosis and suspiciousness among current symptoms had the strongest predictive value. CONCLUSION: The V-RISK-10 is a risk assessment tool that is user-friendly in the context of acute psychiatric inpatient care and has a moderate power for predicting aggressive behavior. Patients with high risk of aggression can be identified with this tool at the time of admission. With careful monitoring and timely initiation of aggression prevention strategies, the occurrence of aggressive behavior can be minimized. Orv Hetil. 2023; 164(8): 293-299.

Similarities and Differences between Psychosocial Determinants of Bullying and Cyberbullying Perpetration among Polish Adolescents.

Despite the extensive literature on the psychosocial determinants of bullying and cyberbullying among adolescents, there is not sufficient comprehensive analysis of the differences between perpetrators. This study aims to assess the psychosocial similarities and differences between bullies and cyberbullies. Data of 3650 students from two grades, K9 and K11 (47% females, mean age = 16.53), were used from a survey conducted in Poland in 2018 as part of the Health Behaviour in School-aged Children study. Perpetration was measured by questions adapted from the Olweus Bully/Victim Questionnaire. The following predictors were analyzed: demographic, socioeconomic status measured with the Family Affluence Scale-III (FAS), and individual and social factors. Multiple binary logistic regression was applied. The random sampling design was based on stratification according to the local deprivation index of the region where the school was located. Male gender, younger age, and non-intact family were associated with a higher risk of bullying and cyberbullying. Family support, empathy, school performance, and school attachment had a protective effect against both aggressive behaviors. Life dissatisfaction and high FAS were revealed as determinants of cyberbullying and local deprivation of bullying only. Bullying and cyberbullying school prevention programs should take into account these psychosocial differences and consider the economic deprivation of the region.

Short-term risk assessment in the long term: A scoping review and meta-analysis of the Brøset Violence Checklist.

WHAT IS KNOWN ON THE SUBJECT?: The Brøset Violence Checklist (BVC) has been widely translated and implemented in diverse mental healthcare settings to improve prevention of violence. It is valued as a brief but effective tool in clinical practice. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This review is the largest and most comprehensive international review of the BVC conducted in the 25+ years since the inception of the instrument in 1995. It integrates findings from existing studies and establishes that the tool has many impressive strengths considering the brief time investment required for completion. The review reveals that the tool has been used in more than 20 different countries around the world in a variety of mental health and other settings as both a risk assessment tool to guide clinical practice and as a formally structured intervention to minimize violence. There is much variation in how the tool is implemented and scored in different services. This variation questions its applicability as a resource and consistency and its use needs attention. This variation in use also limits the conclusions regarding best practices. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The review supports the use of the BVC as one part of the package for mental health services committed to preventive action aimed at reducing violence and coercion. The review identified that the patient perspective was often absent when completing the BVC, and so this should be considered as an option by services as part of a collaborative philosophy of care. ABSTRACT: INTRODUCTION: Existing literature on the Brøset Violence Checklist (BVC) is examined in the context of usability, implementation and validity to provide evidence-based recommendations on its application and identify opportunities for future development. AIM/QUESTION: To identify current knowledge on the BVC and guide clinicians and researchers toward the next steps in using this tool in clinical practice to prevent violence in healthcare settings. METHOD: A scoping review approach with a meta-analysis supplement was adopted to broadly identify and map available evidence on the BVC and provide specific estimates of predictive validity in different contexts. RESULTS: Sixty-two studies conducted in 23 countries addressed the implementation of the BVC across various settings. Many studies adapted the original BVC, and the clinical utility was noted as an important feature. A meta-analysis of the original BVC format estimated a pooled area under the curve at 0.83 (95% CI 0.78-0.87) in a subset of 15 studies. DISCUSSION: The BVC combines high predictive validity and good clinical utility across a wide range of settings and cultures. It should continue to be incorporated into routine practice in mental health services focused on preventing violence and coercion. IMPLICATIONS FOR PRACTICE: Development of collaborative approaches with service users involved in assessing their own risk of future violence.

Effects of economic regional differences and family on adolescents' aggressive behaviors: Perspective of ecosystem integration.

INTRODUCTION: Based on the ecological systems theory and cumulative risk model, the current study aimed to determine the mediating effects of parenting styles, peer relationship, and psychological capital on family socioeconomic status and adolescents' aggressive behaviors, as well as the moderating effects of economic regional differences. METHODS: In a cross-sectional design, 1271 Chinese adolescents were recruited to complete the MacArthur Scale, the short-form Egna Minnen av Barndoms Uppfostran, the Positive PsyCap Questionnaire, the peer support subscale in the Student Personal Perception of Classroom Climate, and the Aggression Questionnaire. RESULTS: After controlling for gender and age, parenting style, peer relationship, and psychological capital not only mediated, but also constituted multiple chains mediation between family socioeconomic status and aggressive behaviors. Moreover, economic regional differences moderated the multiple chains mediation model between family socioeconomic status and aggressive behaviors. CONCLUSION: The accumulation of multiple adverse factors increases the probability of inducing aggressive behaviors, and the development of psychological capital helps reduce the occurrence of aggressive behaviors in adolescents.

Investigating the dynamic nature of multiple risk assessment instruments in a forensic mental health hospital.

Readministration of multiple risk assessment instruments to determine the risk of aggression over the short, medium, and long term is common practice in many forensic mental health settings. Justification for the repeated administration and use of multiple instruments is based on purported differences in discriminative validity of risk factors according to whether they are characterized as static, stable, or acute, and the composition of these tools, in terms of the relative balance of different types of risk factors, which can impact the discriminative validity of these instruments over different follow-up periods. However, research has yet to determine whether the use of multiple and repeated administration of risk assessment instruments improves identification of risk, and it may be the case that the heavy burden on service providers to administer multiple instruments is unwarranted. In this study, time-dependent cox regression with repeated assessments and recurrent events was used to investigate the dynamic nature and incremental validity of the dynamic appraisal of situational aggression (DASA), short-term assessment of risk and treatability (START), and HCR-20v3, which were repeatedly rated on a sample of forensic mental health inpatients (N = 240) over a 2-year period. Results suggest that using the rolling mean or the most recent risk assessment yielded the most accurate characterization of change in aggression risk. Repeated administration of dynamic risk instrument instruments improved the identification of aggression beyond the initial risk assessment. Although static, stable, and acute factors were significantly related to aggression, the combination of data from multiple risk assessment instruments may not result in clinically meaningful improvements in risk identification. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Revised Assessment of Sadistic Personality (ASP-8): Evidence for Validity across Four Countries.

Subclinical sadism, characterized by infliction of cruelty, aggression, or humiliation on another for subjugation or pleasure, provides important information in the prediction of aversive behaviors that have implications for individuals' and society's well-being worldwide. Given sadism's universal relevance, it is imperative that researchers ensure valid and reliable trait measurement not only among English-speaking individuals, but also cross-nationally among countries in which sadism remains relatively understudied. The objective of the current research was to validate the revised version of the Assessment of Sadistic Personality (ASP-8) (Plouffe et al., 2017) across samples of Russian (n = 1087, Mage = 37.36, SD = 10.36), Greek (n = 1195, Mage = 35.64, SDage = 13.08), Serbian (n = 443, Mage = 28.10, SDage = 6.60), and British (n = 511, Mage = 28.50, SDage = 11.62) adults. Overall, results supported the reliability, dimensionality, and scalar/partial scalar measurement invariance of the ASP-8 across cross-national samples. Convergent and discriminant validity were mostly supported through correlations with general personality traits, the Dark Triad, emotional intelligence, mental toughness, depression, anxiety, stress, satisfaction with life, aggression, and attitudes toward social groups. Based on our findings, we recommend the use of the ASP-8 in future investigations of aversive traits.

When thriving requires effortful surviving: Delineating manifestations and resource expenditure outcomes of microaggressions for Black employees.

Although overt racism is condemned by many organizations, insidious forms of racism persist. Drawing on the conservation of resources framework (Hobfoll, 1989), this article identifies forms and outcomes of racial microaggressions-daily verbal, behavioral, and environmental indignities that denigrate individuals from racially minoritized groups (Sue, Capodilupo, et al., 2007). Leveraging survey data from 345 Black employees, open-ended question qualitative insights delineate three overarching themes of workplace microaggression toward Black employees: anti-Black stereotype expression, racialized role assignment, and interactional injustice. We also detail how these themes manifest in nine distinct ways. Then, we model the cognitive and emotional resource recovery and protection processes that Black employees engage in to overcome workplace microaggressions. Quantitative results demonstrated that workplace microaggressions related to subsequent resource replenishment (i.e., co-rumination, or discussing feelings and venting about problems with coworkers; Rose, 2002) and protection (i.e., racism-related vigilance, or mentally preparing for anticipated racism; Clark et al., 2006) efforts. Further, results suggested undesirable effects of microaggressions on burnout and job satisfaction. Finally, we found a positive relationship between resourcing efforts and job satisfaction but found no support for trait resiliency or organizational support as buffers of microaggression effects. Implications for future research and direct interventions are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Physical and Psychological Maltreatment of Deaf and Hard of Hearing Children: Frequency and Associated Factors in a Low Socioeconomic Setting.

Few studies have assessed frequency of maltreatment and other factors associated with maltreatment of deaf and hard of hearing children. The present study's objective was to verify the frequency of physical and psychological maltreatment and associated factors experienced by DHH children. DHH children from low-income families in Maceió, Brazil, were studied (N = 265). The Parent-Child Conflict Tactics Scales (Straus et al., 1998) were used to identify nonviolent discipline, psychological aggression, and physical assault (minor, severe, very severe). The study found that 221 children (83.4%) experienced physical assault; 238 (89.8%) experienced psychological aggression. Both physical and psychological aggression was reported for 94.3%. Most mothers (98.1%) reported using nonviolent discipline. Maltreatment was associated with male children, mothers' job dissatisfaction, religiously nonobservant families, and children born of unintended pregnancy. In conclusion, high frequencies of physical and psychological maltreatment of DHH children of low-income families were found.

Life history of experienced and witnessed aggression: Development of a new assessment instrument.

A Lifetime History of Experienced Aggression and a Lifetime History of Witnessed Aggression assessment was developed and its psychometric properties examined in a modest sample of individuals with and without history of psychopathology. Following this, the two assessments were administered to 400 subjects with or without histories of major psychiatric and personality disorders. These studies demonstrated good to excellent psychometric properties as well as evidence of convergent and divergent validity. Since both assessments quantify the occurrence of aggressive behaviors directed at a person and the occurrence of aggressive behaviors witnessed, the researchers propose that these assessments represents a needed modular assessment of aggression in the environment for behavioral science research.