Violent behavior in schizophrenic patients: relationship with clinical symptoms

Considerable evidence suggests that violent behavior observed in schizophrenic patients is motivated by psychotic symptomatology. The understanding of violence in schizophrenic patients requires consideration of psychiatric symptomatology. Objective: This study investigated the relationship between violent behavior and psychiatric symptomatology in schizophrenic patients. Method: One hundred and thirteen patients were recruited. Thirteen patients were excluded due to concomitant substance abuse six months prior to the assessment. Diagnoses were based on the SCID‐I. Psychotic symptom severity was assessed with the PANSS. Violent behaviors were assessed with the OAS. Results: Violent behaviors were associated with more severe psychotic symptomatology including hallucinations, delusions, excitement, poor impulse control, and thinking disturbances. Conclusions: Patients with exacerbation of psychotic symptomatology have an increased risk of violent behavior. It is necessary to determine which subtypes of hallucinations and delusions are implicated in the association of schizophrenia and violent behavior. Violent behavior in schizophrenic patients is a heterogeneous phenomenon best explained in the context of specific symptoms associated with violence and course of illness. The retrospective assessment of the variables raises methodological questions concerning the reliability of measurement of the impact of psychotic symptoms on violence. Aggr. Behav. 00:1–10, 2005. © 2005 Wiley‐Liss, Inc.     

Violent versus nonviolent methods for suicide.

Violent and nonviolent suicide rates in the American states in 1980 showed different social correlates, but both patterns were different from those for homicide rates.     

Violent and nonviolent video games produce opposing effects on aggressive and prosocial outcomes

Experimental studies routinely show that participants who play a violent game are more aggressive immediately following game play than participants who play a nonviolent game. The underlying assumption is that nonviolent games have no effect on aggression, whereas violent games increase it. The current studies demonstrate that, although violent game exposure increases aggression, nonviolent video game exposure decreases aggressive thoughts and feelings (Exp 1) and aggressive behavior (Exp 2). When participants assessed after a delay were compared to those measured immediately following game play, violent game players showed decreased aggressive thoughts, feelings and behavior, whereas nonviolent game players showed increases in these outcomes. Experiment 3 extended these findings by showing that exposure to nonviolent puzzle-solving games with no expressly prosocial content increases prosocial thoughts, relative to both violent game exposure and, on some measures, a no-game control condition. Implications of these findings for models of media effects are discussed.     

Violent and nonviolent video games differentially affect physical aggression for individuals high vs. low in dispositional anger

Although numerous experiments have shown that exposure to violent video games (VVG) causes increases in aggression, relatively few studies have investigated the extent to which this effect differs as a function of theoretically relevant individual difference factors. This study investigated whether video game content differentially influences aggression as a function of individual differences in trait anger. Participants were randomly assigned to play a violent or nonviolent video game before completing a task in which they could behave aggressively. Results showed that participants high in trait anger were the most aggressive, but only if they first played a VVG. This relationship held while statistically controlling for dimensions other than violent content on which game conditions differed (e.g. frustration, arousal). Implications of these findings for models explaining the effects of video games on behavior are discussed.     

Violent, nonviolent, and substance-related offending over the life course in a cohort of males and females treated for substance misuse as youths

Most studies on adolescent offending heterogeneity are based on general population samples, and few include individuals with substance misuse or look specifically at substance-related offending. It is also unclear how offender subtypes develop after young adulthood or how offending heterogeneity varies between genders. This study aimed to identify subgroups of offending among adolescents with misuse problems and to examine associations with offending in adulthood. The study included 1,992 females and males that consulted a clinic for adolescents with misuse problems between 1968 and 1971. Latent Class Analyses were conducted to identify subgroups based on violent and nonviolent offending before age 20. Participants were then followed until age 50 and reexamined regarding violent, nonviolent, and substance-related crimes. Associations between subgroups before age 20 and subgroups age 21-50 were examined. Before age 20, three subgroups were identified among the females and six among the males. Males were more specialized in their offending and demonstrated higher levels of offending. Results pointed to both stability and decrease of violent and nonviolent offending, and to the emergence of substance-related offending in adulthood in both genders. The connection between substance-related crimes and general delinquency in adulthood among individuals treated for substance misuse suggests that interventions should also address substance misuse for reducing the overall volume of crime. This study also highlights the importance of including females in research on offending heterogeneity.     

Depression and suicide in schizophrenic patients

This study supports the idea that schizophrenic patients represent a distinctive subgroup of patients who can suffer from a major depressive illness and also can commit suicide. The study showed that 22.4% of the schizophrenic population in a medium-sized psychiatric facility showed severe depressive symptoms that met the criteria for the diagnosis of a major depressive episode according to the DSM-III classification. Seven patients committed suicide during the acute phase of the illness--five during hospitalization, and two within a year of discharge. Nine patients attempted suicide during the hospitalization period, and 10 attempted suicide within a year of discharge. Nearly one-third (215) of the patients were readmitted during that year because of a recurrence of acute schizophrenic symptoms; of these, 84 were having severe depressive symptoms. The study also provides indications of the causes of suicide in these patients.     

Risk factors in violent and nonviolent offenders

Factors leading to risk for violence were evaluated in an offender population of 36 male offenders including 18 Violent, e.g., assault, threatening and 17 nonviolent (break and enter, theft), and 17 nonoffenders. Their scores on the Psychopathy Checklist Revised, Violence Risk Scale-Experimental Version 1, Minnesota Multiphasic Personality Inventory-168, and the Porteus Maze tests showed scores for the inmates with violent offenses were elevated on Psychopathic Deviate, Paranoia, Schizophrenia scales of the Minnesota Multiphasic Personality Inventory, violence risk of the Violence Risk Scale, showed psychopathic orientation on the Psychopathy Checklist Revised, and had a lower test age quotient score on the Porteus Maze test.     

Increased semantic and repetition priming in schizophrenic patients

Positive and negative priming (PP and NP) in schizophrenia were studied with a lexical-decision task. Probe words, presented 800 ms after the response to the prime (containing a word and a nonword), were either identical to, semantically related to, or unrelated to the prime target word (PP) or to the prime distractor word (NP). Schizophrenic patients displayed stronger semantic and repetition PP than controls after controlling for their slower responses. Significant NP was observed in both groups for word repetition only. The PP findings contrast with results from studies with similar prime-probe intervals but without prime responses. It is proposed that schizophrenic patients, because of impaired (controlled) processes of response selection, strongly benefit from (or rely on) the automatic retrieval of processing episodes containing response information. Related findings indicating automatic response facilitation in schizophrenia are discussed.     

Reported childhood trauma and suicide attempts in schizophrenic patients

Childhood traumas are associated with suicidal behavior but this aspect has not been examined in relation to schizophrenia. In this study, 50 chronic schizophrenic patients who had attempted suicide were compared with 50 chronic schizophrenic patients who had never attempted suicide for their scores on the 34-item Childhood Trauma Questionnaire (CTQ). It was found that schizophrenics who had attempted suicide reported significantly higher CTQ scores for emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect than schizophrenics who had never attempted suicide. Therefore, childhood trauma may be a risk factor predisposing schizophrenic patients to attempt suicide.     

Attentional network task performance in schizophrenic patients

Several studies have researched the attentional functioning of schizophrenic patients by means of the Attentional Network Test. The present work reviews these studies and assesses the clinical relevance of their results. Both the reviewed data and our own results suggest that the Attentional Network Test does not provide a clear-cut discrimination of the attentional profile of schizophrenic patients from a clinical point of view. However, after classifying patients according to their psychotic symptoms, it became evident that positive syndrome patients are less efficient at tasks that tap the orientation network.