Hearing about helpful and unhelpful reactions when feeling irritable
Research type
Research Study
Full title
Hearing about helpful and unhelpful reactions when feeling angry or irritable
IRAS ID
303976
Contact name
Sinead Lambe
Contact email
Sponsor organisation
RGEA
Duration of Study in the UK
0 years, 6 months, 1 days
Research summary
Although most people with psychosis are never violent, for a proportion of patients aggression is an important clinical issue. Forensic hospitals provide mental health care to offenders with a psychiatric diagnosis who pose a risk to others. These patients often react aggressively to other people. Forensic hospitals reduce risk to the public by taking patients out of provoking situations and providing treatment. This works in the short term. But when discharged, patients go back into provoking situations and most reoffend. Recent improvements in our understanding of learning and behaviour change could be used to improve treatments aimed at reducing aggression by forensic patients with psychosis.
However to date no studies have looked at how this new understanding fits with the experience of patients. To do this between fifteen and twenty-five forensic patients with psychosis will be interviewed about their experiences of aggression, including the main triggers, unhelpful thoughts that lead to aggression, and any helpful thoughts that reduce aggression. This will also be an opportunity to hear from patients about any other neglected factors important to consider in the development of future treatments.
This is the first study in a three year fellowship funded by the NIHR to develop a new psychological treatment to reduce aggression by forensic patients with psychosis.
Lay summary of study results: The aim of the study was to understand the reasons behind violence so we can create better support and treatments.
We interviewed twenty men who were using forensic mental health services in the UK. Interviews were very detailed and participants shared their experiences with violence and the reasons for sometimes using violence. We looked for common patterns across the different interviews to identify the key drivers of violence.
The interviews gave us lots of very rich information about violence. Different people had different experiences and reasons for using violence so not all of these will be relevant to everyone. The main points are summarised here but the full paper is available through this link: https://eur03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fu2790089.ct.sendgrid.net%2Fls%2Fclick%3Fupn%3DXv3JSvJ-2B3M71ppf7N9agbQ4nARpWB7mrkq5w4EGO2ot7im8GhdULkkBU769zqXlvd5F-_E1aO2-2BZlVOSJJV-2FajQqskegTd6IRomHYTi-2Fbt8SH3YJZKv-2BAZOBniWqJ-2BA0UShPd1FiEMWyQO6NYz5KACObQXnekzhAPZNpSAQLoJ-2Fstc8hiVqF-2Fn7pLyWjxXP5u1hKOp0DqVKTILAVFYLYwB-2FzEo7EDgKC2onK56sE-2Byv-2FkMy-2B3p0ATuTVAfqJAjg5OGBQkKcTvhQEdlDuINYejU-2Bc62A-3D-3D&data=05%7C02%7Criverside.rec%40hra.nhs.uk%7C0adaa86ffa614fc1f93f08dc485e0ae9%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638464816822352868%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=eGYD%2F6G572lxzdpn5IgPTxmN8HXxTe3xJHbs9%2FMbvNM%3D&reserved=0
* For some people, violence feels like a normal way of managing difficult situations. They have been exposed to violence from a young age and it has been encouraged, and sometimes even required, by those around them.
* There can be rules that guide and justify the use of violence e.g. 'if your friend is in a fight you have to jump in', 'If you are in trouble, you don't go to the police, you sort it out yourself'.
* For some people violence is triggered by feeling physically threatened, disrespected socially, or treated unfairly. Violence is seen as a way of protecting oneself, gaining respect and getting justice/fair treatment.
* Aggression was also a way to cope with intense emotions. Some people spoke about getting anxious or angry very quickly and feeling it very intensely. Kicking off or getting aggressive provided a release of these difficult feelings.
* Some people spoke about struggling with voices or other psychosis experiences which were overwhelming and intense. Sometimes violence was an attempt to escape these experiences or to make them stop.REC name
London - Riverside Research Ethics Committee
REC reference
21/LO/0892
Date of REC Opinion
17 Dec 2021
REC opinion
Favourable Opinion