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生物心理社会模型在急性精神病学中的暴力风险评估中的预测有效性和性别差异。

Predictive validity and gender differences in a biopsychosocial model of violence risk assessment in acute psychiatry.

机构信息

Oslo University Hospital, Division of Mental Health and Addiction, Acute Psychiatric Department, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Oslo University Hospital, Division of Mental Health and Addiction, Acute Psychiatric Department, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway.

出版信息

Psychiatry Res. 2018 Jun;264:270-280. doi: 10.1016/j.psychres.2018.04.021. Epub 2018 Apr 9.

Abstract

Current violence risk assessment methods seem to have reached an upper limit of accuracy. More comprehensive biopsychosocial models may improve on existing methods. Research on gender differences concerning risk factors of violence is scarce and inconclusive. In this prospective study from an acute psychiatric ward, all patients admitted from March 2012 to March 2013 were included. Predictive validity and potential gender differences in a biopsychosocial model of violence risk assessment consisting of a psychosocial checklist (Violence risk screening-10, V-RISK-10), a patient's self-report risk scale (SRS), total cholesterol (TC) and high-density lipoprotein cholesterol (HDL) were examined in an inpatient (N = 348) and a 3-months follow-up (N = 101) sample. Overall increases in explained variances and predictive values were small and non-significant compared to V-RISK-10 alone. In the inpatient sample, HDL contributed significantly to the model for men but not for women. In the follow-up sample, SRS contributed significantly for the whole sample. Results indicated that the biopsychosocial model we tested partially improved accuracy of violence risk assessments in acute psychiatry and that gender differences may exist.

摘要

目前的暴力风险评估方法似乎已经达到了准确性的上限。更全面的生物心理社会模型可能会提高现有方法的准确性。关于暴力风险因素的性别差异研究很少且尚无定论。在这项来自急性精神病病房的前瞻性研究中,纳入了 2012 年 3 月至 2013 年 3 月期间入院的所有患者。在一个包括心理社会检查表(暴力风险筛查-10 项,V-RISK-10)、患者自我报告风险量表(SRS)、总胆固醇(TC)和高密度脂蛋白胆固醇(HDL)的生物心理社会暴力风险评估模型中,评估了其在住院患者(N=348)和 3 个月随访(N=101)样本中的预测有效性和潜在性别差异。与单独使用 V-RISK-10 相比,解释方差和预测值的总体增加很小且不显著。在住院患者样本中,HDL 对男性模型的贡献显著,但对女性模型的贡献不显著。在随访样本中,SRS 对整个样本的贡献显著。结果表明,我们测试的生物心理社会模型部分提高了急性精神病学中暴力风险评估的准确性,并且可能存在性别差异。

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