Understanding anger and aggression: A questionnaire study
Research type
Research Study
Full title
Understanding anger and aggression: A questionnaire study
IRAS ID
320010
Contact name
Sinéad Lambe
Contact email
Sponsor organisation
RGEA
Duration of Study in the UK
1 years, 1 months, 29 days
Research summary
Summary of Research
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.This is the second study in a three year fellowship funded by the NIHR to develop a new psychological treatment to reduce aggression by forensic patients with psychosis. This study aims to (a) create a new questionnaire measureing the beliefs and thinking that leads to aggression in people with psychosis (b) examine what psychological factors ‘drive’ aggression (i.e. keeps it going).
This study will recruit 1000 patients with psychosis from adult mental health services (approximately half coming from forensic mental health teams and half from community mental teams). We will include participants with and without a history of aggression so we can see how the things that contribute to the presence or absence of aggression. Participants will be asked to complete questionnaires (~45minutes), and provide some brief demographic information. The majority of participants will only answer the questions on a single occasion. However, a small subgroup of around 100 participants will be asked to repeat some of the measures again one week to see how much scores change over time (test retest reliability).
Summary of Results
Background and Aim Some people with psychosis experience thoughts that make violence seem acceptable or necessary. These kinds of thoughts are not well understood but may play an important role in explaining why violence happens, especially when combined with other difficulties such as anger or drug use. This study looked at what types of thoughts about violence are most important, and how they connect with other risk factors, to help design better treatments in the future.What We Did
We worked with 860 men over the age of 16 who had a diagnosis of psychosis and were using mental health services in England and Wales. We checked whether they had been violent in the past six months, and how serious the violence was. Each person also completed assessments about their thoughts on violence, experiences of paranoia and hearing voices, difficulties with emotions and anger, past traumatic experiences, and substance use. We then used statistical methods to look at patterns in these results and how they linked to violent behaviour.What We Found
We found six main types of thoughts that encouraged violence and two types of thoughts that discouraged it. The five things were most strongly linked to violence: thoughts that encouraged violence; anger; current drug use; distress from hearing voices and younger age.
Conclusion
Violence in psychosis seems most likely when people have strong violence-encouraging thoughts particularly when this is combined with anger, psychotic experiences, and drug use. Treatments that directly address these thoughts, as well as the factors that reduce self-control, could open up new ways of preventing violence.REC name
North West - Preston Research Ethics Committee
REC reference
23/NW/0012
Date of REC Opinion
1 Feb 2023
REC opinion
Favourable Opinion