Kasinathan John, Marsland Christopher, Batterham Philip, Gaskin Claire, Adams Jonathon, Daffern Michael
Consultant Forensic Psychiatrist, Adolescent Unit, The Forensic Hospital, Justice Health, New South Wales Health, Sydney, NSWConjoint Lecturer, Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSWForensic Mental Health Service Australian Capital Territory Health, Canberra, ACTVisiting Fellow, Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
Clinical Nurse Consultant, Adolescent Unit and Justice Health, The Forensic Hospital, New South Wales Health, Sydney, NSW, Australia.
Australas Psychiatry. 2015 Feb;23(1):44-8. doi: 10.1177/1039856214563845. Epub 2014 Dec 15.
Aggression in adolescents presents a significant problem for psychiatric units. The Dynamic Appraisal of Situational Aggression (DASA) is an empirically validated measure designed to appraise the risk of imminent aggression (within the next 24 hours) in adult patients. Our aim was to examine the predictive validity of the DASA: Youth Version (DASA:YV) with youth-specific items, in young offenders hospitalised with a mental illness.
This prospective validation study involved 4440 DASA:YV ratings of mentally ill adolescents in a secure hospital. At 24 hours post-assessment, the nursing staff documented whether patients had behaved aggressively: physically, verbally or towards property. Predictive accuracy was assessed using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.
The DASA:YV significantly predicted any imminent aggression (AUC = 0.754). Additional youth-specific items conferred a greater predictive yield, as compared to adult-derived items (p = 0.014).
It is possible to monitor the risk state of hospitalised mentally ill youth, so that heightened states can be detected early, thus facilitating interventions to reduce the risk of violence.
青少年攻击行为对精神科病房来说是一个重大问题。情境性攻击动态评估（DASA）是一项经过实证验证的测量工具，旨在评估成年患者即将发生攻击行为（在接下来24小时内）的风险。我们的目的是检验具有青少年特定项目的DASA青少年版（DASA:YV）在患有精神疾病的青少年罪犯中的预测效度。
这项前瞻性验证研究对一家安全医院中4440名患有精神疾病的青少年进行了DASA:YV评分。在评估后24小时，护理人员记录患者是否有攻击行为：身体攻击、言语攻击或对财产的攻击。使用受试者操作特征（ROC）曲线的曲线下面积（AUC）评估预测准确性。
DASA:YV显著预测了任何即将发生的攻击行为（AUC = 0.754）。与源自成人的项目相比，额外的青少年特定项目具有更高的预测效能（p = 0.014）。
监测住院患有精神疾病青少年的风险状态是可能的，以便早期发现高度风险状态，从而促进采取干预措施降低暴力风险。
