Estroff S E, Zimmer C, Lachicotte W S, Benoit J
Department of Social Medicine, University of North Carolina at Chapel Hill 27599.
Hosp Community Psychiatry. 1994 Jul;45(7):669-79. doi: 10.1176/ps.45.7.669.
The authors examined the relationship between violent acts and threats by persons with serious mental illness, the size and composition of their social networks, and characteristics of the social support they received.
A group of 169 respondents with serious mental illness and 59 of their significant others were interviewed using structured and semi-structured protocols to elicit data on demographic characteristics, clinical characteristics, characteristics of respondents' social networks and of the social support they received, and perceptions of threat within the social network. Data on acts and threats of violence by respondents over an 18-month period were collected from self-reports by respondents and significant others and from hospital and court records.
Fifty-six respondents either threatened violence or committed a violent act during the study period. Respondents with a diagnosis of schizophrenia were more likely to commit violent acts but were not more likely to threaten violence than were respondents with other diagnoses. Respondents in larger networks, those with networks composed primarily of relatives, and those who lived with unrelated persons were more likely to threaten violence. Financial dependence on family was associated with more violent threats and acts. Respondents who perceived hostility from others were more likely to engage in violent threats and acts, and those with confused thinking were less likely to act or threaten violence. More than half of the targets of violence were respondents' relatives, particularly mothers living with a respondent. Respondents who were violent perceived their significant others as threatening but did not perceive themselves as being threatening in return.
The interpersonal and social contexts of respondents and their perceptions of these contexts are important considerations in assessing risk for violence by persons with mental illness. Mothers who live with an adult offspring with schizophrenia may be at increased risk for being a target of violence. Violence by persons with psychiatric disorders may be linked to their perceptions and experience of being threatened by others.
作者研究了患有严重精神疾病者的暴力行为和威胁、其社交网络的规模与构成，以及他们所获得的社会支持的特征之间的关系。
使用结构化和半结构化协议，对169名患有严重精神疾病的受访者及其59名重要他人进行访谈，以获取有关人口统计学特征、临床特征、受访者社交网络及其所获得社会支持的特征，以及社交网络中威胁感知的数据。通过受访者及其重要他人的自我报告以及医院和法庭记录，收集了受访者在18个月期间的暴力行为和威胁数据。
在研究期间，56名受访者要么威胁实施暴力，要么实施了暴力行为。被诊断为精神分裂症的受访者比其他诊断的受访者更有可能实施暴力行为，但在威胁实施暴力方面并无差异。社交网络较大、主要由亲属组成网络以及与非亲属同住的受访者更有可能威胁实施暴力。对家庭的经济依赖与更多的暴力威胁和行为相关。认为受到他人敌意的受访者更有可能实施暴力威胁和行为，而思维混乱的受访者实施暴力或威胁实施暴力的可能性较小。超过一半的暴力目标是受访者的亲属，尤其是与受访者同住的母亲。实施暴力的受访者认为其重要他人具有威胁性，但并不认为自己具有威胁性。
受访者的人际和社会背景以及他们对这些背景的认知，是评估精神疾病患者暴力风险时的重要考虑因素。与患有精神分裂症的成年子女同住的母亲可能成为暴力目标的风险增加。患有精神疾病者的暴力行为可能与其认为受到他人威胁的认知和经历有关。
