Mental health care has continued to shift away from extensive inpatient treatment and toward providing more services in community settings. This has led to many calls for managing violence in the community. To do this, however, we must know not only who is at risk for violence, but when these individuals are most likely to be violent. This study proposes to intensively follow a selected group of 125 patients for six months in the community and to provide a detailed picture of the types and patterns of violence in the lives of these patients. Using a recently developed screen, the investigators will identify patients coming into a hospital who are highly likely to be repetitively violent. They will gather information about violent incidents, threats, symptoms, drinking and drug use, treatment involvement, and social relationships through weekly interviews with the patient and a collateral (a person whom the patient has named as knowing about the patient's life). Official records such as arrest records and hospital records will also be obtained. Extensive data about subject selection bias, attrition, and the effects of repeated interviewing will be kept throughout the project, providing valuable information for future investigations of this sort. This study is designed to a) describe the degree to which risk of violence varies over time within patients, and b) test whether changes over time in the risk of violence are predictable from changes in the other measured variables. This study will provide the first data analyses regarding short term changes in risk state for violence.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH040030-11
Application #
2674835
Study Section
Violence and Traumatic Stress Review Committee (VTS)
Project Start
1985-06-01
Project End
2001-03-31
Budget Start
1998-05-01
Budget End
1999-03-31
Support Year
11
Fiscal Year
1998
Total Cost
Indirect Cost
Name
University of Pittsburgh
Department
Psychiatry
Type
Schools of Medicine
DUNS #
053785812
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
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Lidz, Charles W; Banks, Steven; Simon, Lorna et al. (2007) Violence and mental illness: a new analytic approach. Law Hum Behav 31:23-31
Skeem, Jennifer L; Schubert, Carol; Odgers, Candice et al. (2006) Psychiatric symptoms and community violence among high-risk patients: A test of the relationship at the weekly level. J Consult Clin Psychol 74:967-79
Mulvey, Edward P; Odgers, Candice; Skeem, Jennifer et al. (2006) Substance use and community violence: a test of the relation at the daily level. J Consult Clin Psychol 74:743-54
Lidz, C W; Coontz, P D; Mulvey, E P (2000) The ""pass-through"" model of psychiatric emergency room assessment. Int J Law Psychiatry 23:43-51
Mulvey, E P; Lidz, C W (1998) Clinical prediction of violence as a conditional judgment. Soc Psychiatry Psychiatr Epidemiol 33 Suppl 1:S107-13
Newhill, C E; Mulvey, E P; Lidz, C W (1995) Characteristics of violence in the community by female patients seen in a psychiatric emergency service. Psychiatr Serv 46:785-9
Mulvey, E P; Lidz, C W (1995) Conditional prediction: a model for research on dangerousness to others in a new era. Int J Law Psychiatry 18:129-43
Mulvey, E P (1994) Assessing the evidence of a link between mental illness and violence. Hosp Community Psychiatry 45:663-8
Monahan, J; Appelbaum, P S; Mulvey, E P et al. (1993) Ethical and legal duties in conducting research on violence: lessons from the MacArthur Risk Assessment Study. Violence Vict 8:387-96

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