SCL‐90‐R profiles in a sample of severely violent psychiatric inpatients

A sample of 39 patients who had committed serious violent acts toward others were assessed with the revised Symptom Checklist (SCL‐90‐R). The SCL‐90‐R is a self‐report symptom inventory for the measurement of psychopathology in psychiatric and medical patients. In addition to the patients' self‐report, an observer‐rated SCL‐90‐R was obtained. This was accomplished by letting one pair of nurses complete SCL‐90‐R ratings for each patient. The first aim of the study was to compare the SCL‐90‐R self‐report scores of the patient sample with the psychiatric inpatient norms [Derogatis LR (1992): Clinical Psychometric Research Inc]. Another purpose of this study was to explore possible trends of discordance between the observer ratings and the self‐reports of the study group. Always considering the limitations of the small sample, it was nevertheless also of interest to look for possible sex differences and differences between violent subgroups and between diagnostic groups in the self‐reported scores as well as in the observer ratings. The most striking findings of the present study were that the self‐reported scores were lower than the inpatient norms for SCL‐90‐R and that the patients' self‐reported levels of distress were significantly lower than those found in the observer ratings. Underreporting of psychopathology as a marker of violence risk is discussed in light of these findings. In this study, women reported higher distress levels than men in the Interpersonal Sensitivity symptom dimension. There were no significant differences concerning SCL‐90‐R ratings between patients who had committed homicide, attempted homicide, or physically assaulted another person in a serious but not life‐threatening way. Aggr. Behav. 28:446–457, 2002. © 2002 Wiley‐Liss, Inc.