Elbogen Eric B, Tomkins Alan J, Pothuloori Antara P, Scalora Mario J
Department of Psychiatry, Duke University Medical Center, Durham, NC 27710, USA.
J Am Acad Psychiatry Law. 2003;31(1):58-64.
Studies have identified risk factors that show a strong association with violent behavior in psychiatric populations. Yet, little research has been conducted on the documentation of violence risk information in actual clinical practice, despite the relevance of such documentation to risk assessment liability and to conducting effective risk management. In this study, the documentation of cues of risk for violence were examined in psychiatric settings. Patient charts (n = 283) in four psychiatric settings were reviewed for documentation of violence risk information summarized in the MacArthur Violence Risk Assessment Study. The results revealed that particular patient and institutional variables influenced documentation practices. The presence of personality disorder, for example, predicted greater documentation of cues of violence risk, regardless of clinical setting. These findings have medicolegal implications for risk assessment liability and clinical implications for optimizing risk management in psychiatric practice.
研究已经确定了一些风险因素，这些因素与精神科人群的暴力行为有着密切关联。然而，尽管此类记录对于风险评估责任和进行有效的风险管理具有相关性，但在实际临床实践中，关于暴力风险信息记录的研究却很少。在本研究中，我们对精神科环境中暴力风险线索的记录情况进行了检查。我们查阅了四个精神科环境中的患者病历（n = 283），以获取麦克阿瑟暴力风险评估研究中总结的暴力风险信息记录。结果显示，特定的患者和机构变量会影响记录行为。例如，人格障碍的存在预示着会有更多关于暴力风险线索的记录，无论临床环境如何。这些发现对于风险评估责任具有法医学意义，对于优化精神科实践中的风险管理具有临床意义。
