Staff survey results and characteristics that predict assault and injury to personnel working in mental health facilities

The purpose of this study was to complete a mental health staff opinion survey to identify patient and staff characteristics associated with staff assault and injury in psychiatric treatment settings and to develop a model of prediction for staff assault and injury utilizing these survey variables. The data consisted of opinion surveys sent to staff of 15 child, adolescent, and adult psychiatry inpatient units in the United States. Multivariate logistic regression was used to determine the level of assault and staff‐reported injury prediction that could be obtained from the staff‐completed opinion survey. Responses indicated a high prevalence of reported aggression, with 62.3% of staff endorsing verbal and physical aggression, property destruction, and self‐injurious behavior as being prevalent at their site, whereas only 4.1% rated none of these as prevalent. Staff working with children and adolescents in settings with high rates of psychiatric diagnoses reported increased frequency of assault and injury compared with those working with adults. Younger, less experienced staff reported higher rates of assault and injury. Staff working with female patients reported similar rates of assault and injury to those working with males. A logistic regression analysis using staff‐reported survey results of both staff and patient characteristics predicted assault correctly 73.7% of the time and injury 66.1% of the time. Resources for violence prevention and staff training programs in violence prevention are needed in child and adolescent psychiatry wards. Results are consistent with theories emphasizing the importance of negative emotions and affects, impulsivity, and frustration in goal‐directed activities in human aggression. Aggr. Behav. 29:31–40, 2003. © 2003 Wiley‐Liss, Inc.     

Do beliefs about aggression predict physical aggression to partners?

Three hypotheses concerning the association between instrumental (I) and expressive (E) beliefs about aggression and physical aggression were assessed among a sample comprising students (n=40), women from a domestic violence shelter (n=29), and male prisoners (n=46), all of whom had committed at least one act of physical aggression to a partner. Participants completed an adapted version of the EXPAGG [Archer and Haigh (1997a): British Journal of Social Psychology 35:1–23] to measure I and E beliefs about aggression, the Conflict Tactics Scale (CTS) [Straus (1979): Journal of Marriage and the Family 41:75–88] for themselves and their partner, and measures of fear and injuries resulting from partner violence. I beliefs predicted self‐reported physical aggression to the partner, most CTS acts of physical aggression, and injuries to the partner, with only minor and limited associations for E beliefs. Correlations for the student and prisoner samples, and for men and women, showed different strengths. The findings supported a general link between I beliefs and aggression but offered no support for the predictions that the link would be restricted to men or to men who showed a persistent pattern of violence to their partners. Aggr. Behav. 29:41–54, 2003. © 2003 Wiley‐Liss, Inc.     

Validation of the Multidimensional Blood/Injury Phobia Inventory: Evidence for a Unitary Construct

The Multidimensional Blood/Injury Phobia Inventory (MBPI) was developed from a theoretical framework to characterize a broad range of feared stimuli and phobic reactions associated with this pathology. The MBPI consists of 40 items that cross 4 types of stimulus content (injections, hospitals, blood, injury), 5 types of phobic responses (fear, avoidance, worry, fainting, disgust), and a self versus other focus. This study reports on administration of the MBPI to 558 undergraduates, 9 of whom had blood/injury phobia. The instrument had a Cronbach's alpha of .91 and demonstrated good concurrent validity, convergent validity, and discriminant validity. One large factor emerged in an unrotated principal components analysis, suggesting that blood/injury phobia is a unitary psychometric construct. Exploratory factor analyses revealed a 6-factor solution defined by stimulus content domains and fainting, each of which may be important to consider clinically when assessing the unique concerns of treatment-seeking individuals.     

Neurocognitive outcomes following pediatric brain injury: A developmental approach

Developmental neuropsychologists postulate that “immaturity” of the cerebral cortex should no longer be perceived as a protective factor. They argue that injury to the young brain may affect new learning by disrupting the skills in the midst of being acquired and skills that are yet to be developed. Cognitive deficits or weaknesses that are not detectable in the acute phase following a traumatic brain injury (TBI) may emerge over development as more complex skills are needed, thereby creating a developmental lag between children who sustained a pediatric TBI and typical age peers. This literature review was conducted to evaluate the developmental perspective on neurocognitive recovery/development following a TBI. Overall, the described findings support a developmental view and suggest that predictions of prognosis should be based on the child's remaining ability to learn.     

Psychological Variables Associated with Pain Perceptions Among Individuals with Chronic Spinal Cord Injury Pain

Structural equation modeling was used to examine the relationships between selected psychological variables and pain perceptions in 103 individuals experiencing chronic pain following traumatic spinal cord injury (SCI). Previous studies have suggested strong relationships between psychological variables and chronic SCI pain, but further delineation of such relationships is needed in order ultimately to develop more effective pain management strategies for individuals afflicted with such pain. Anger was found to be significantly related to perceptions of pain (p < .05), but neither guilt nor anger suppression was significantly associated with perceived pain. Internal health locus of control was associated with decreased pain perceptions (p < .05), but there was no significant relationship between internal health locus of control and anger. Punishing responses from significant others to pain complaints were related to feelings of guilt (p < .05) and perceived pain (p < .05), but this relationship was not mediated by guilt.     

Traumatic brain injury: Implications for practice

This article presents a brief overview of the prevalence and history of traumatic brain injury (TBI), discusses the multidimensional effects of TBI, describes the current focus of TBI rehabilitation, and summarizes outcomes from (re)habilitation work with individuals with traumatic brain injury. The importance of this critical area to rehabilitation personnel is discussed, along with suggestions for future research and evaluation studies.     

An examination of muscle force control in individuals with a functionally unstable ankle

Previous studies suggest that functional ankle instability (FAI) may be associated with deficits in the ability to sense muscle forces. We tested individuals with FAI to determine if they have reduced ability to control ankle muscle forces, which is a function of force sense. Our test was performed isometrically to minimize the involvement of joint position sense and kinesthesia. A FAI group and a control group were recruited to perform an ankle force control task using a platform-based ankle robot. They were asked to move a cursor to hit 24 targets as accurately and as fast as possible in a virtual maze. The cursor movement was based on the direction and magnitude of the forces applied to the robot. Participants underwent three conditions: pre-test (baseline), practice (skill acquisition), and post-test (post skill acquisition). The force control ability was quantified based on the accuracy performance during the task. The accuracy performance was negatively associated with the collision count of the cursor with the maze wall. The FAI group showed reduced ability to control ankle muscle forces compared to the control group in the pre-test condition, but the difference became non-significant in the post-test condition after practice. The change in performance before and after practice may be due to different degrees of reliance on force sense.     

Construct validity for the verbal associated pairs screen

The present study introduces the Verbal Associated Pairs Screen (VAPS) as a new measure for assessing performance validity in pediatric populations. This study presents initial data on psychometric properties and establishes construct validity for the VAPS in a sample of 30 adolescent healthy controls and 206 youths with traumatic brain injury (TBI: moderate/severe, N = 30; mild, N = 176). The control group’s age (M = 14.93, SD = 1.8) was significantly higher than the moderate/severe TBI (M = 13.9, SD = 2.8), t(68.508) = ?3.038, p = .003, and mild TBI (mTBI) groups (M = 14, SD = 2.8), t(54.147) = 2.038, p = .046. The TBI groups were administered the VAPS in accord with other established performance validity tests (PVTs) and well-established memory tests as part of routine clinical evaluations. The healthy control group was administered the VAPS only. VAPS score distributions for the control group were negatively skewed and highly kurtotic. VAPS scores from the moderate/severe TBI and control groups were indistinguishable for Trial 2 (U = 274, p < .01) and the Delay (U = 396, p = .218). In the mTBI group, convergent and divergent validity was established with other well-validated PVTs and memory tests, respectively. ROC curve analyses identified optimal cutoff scores for the VAPS Total Score, with acceptable sensitivity (55%) and excellent specificity (100%), as well as strong detectability (AUC = .829, 95% CI: 0.731 – 0.928, p < .001). Clinical applications, limitations, and directions for future research with the VAPS are discussed.