Krakowski Menahem, Czobor Pal
Nathan Kline Institute for Psychiatric Research and the Department of Psychiatry, New York University School of Medicine, Orangeburg, NY 10962, USA.
Am J Psychiatry. 2004 Mar;161(3):459-65. doi: 10.1176/appi.ajp.161.3.459.
Men are more violent than women in the general population, but this has not been found to be the case among psychiatric inpatients. The reason for this exception is poorly understood. The present study investigated gender differences in violent behaviors among patients with major psychiatric disorders. It examined various clinical symptoms and psychosocial factors to determine their differential impact on violence in men and women.
Physical assaults and verbal assaults committed by psychiatric inpatients were recorded prospectively. Patients whose violent incident occurred during their first 2 months of hospitalization were eligible for the study. Patient history of community violence was also obtained. Psychiatric symptoms and ward behaviors were assessed upon entry into the study and after 4 weeks.
A similar percentage of women and men had an incident of physical assault in the hospital. Among the patients entered into the study, the women had a much higher level of verbal assaults throughout the evaluation period and a higher level of early physical assaults (i.e., within the first 10 days of the 4-week study period). Positive psychotic symptoms were more likely to result in assaults in women than in men. Physical assaults in the community, on the other hand, were more common in men and were associated with substance abuse, property crime, and a history of school truancy.
There are gender differences in the patterns of violent behavior among patients with major psychiatric disorders. Furthermore, psychiatric symptoms and psychosocial risk factors have a different impact on this behavior in men and women. This has important implications for the prediction and differential treatment of violent behavior.
在普通人群中,男性比女性更具暴力倾向,但在精神科住院患者中未发现这种情况。对此例外情况的原因了解甚少。本研究调查了患有主要精神疾病的患者暴力行为中的性别差异。研究考察了各种临床症状和社会心理因素,以确定它们对男性和女性暴力行为的不同影响。
前瞻性记录精神科住院患者实施的身体攻击和言语攻击行为。暴力事件发生在住院前两个月内的患者符合研究条件。还获取了患者在社区中的暴力史。在研究开始时和4周后评估精神症状和病房行为。
在医院发生身体攻击事件的女性和男性比例相似。在参与研究的患者中,在整个评估期间,女性的言语攻击水平高得多,早期身体攻击(即4周研究期的前10天内)水平也更高。与男性相比,阳性精神病性症状更有可能导致女性发生攻击行为。另一方面,社区中的身体攻击在男性中更为常见,并且与药物滥用、财产犯罪和逃学史有关。
患有主要精神疾病的患者在暴力行为模式上存在性别差异。此外,精神症状和社会心理风险因素对男性和女性的这种行为有不同影响。这对暴力行为的预测和差异治疗具有重要意义。