Risk Assessment for Violence Lecture Flashcards
The incidence of violence is highest in:
A) schizophrenia
B) mania
C) depression
D) Drug dependence
D) Drug dependence
Which of the following is associated with the likelihood of obeying command hallucinations?
A) repetition of the voice
B) instructions from God
C) hallucination-related delusions
D) affective symptoms
C) hallucination-related delusions
Also, if it is a familiar voice, associated with personal superiority, or benefits the hallucinator.
Good or evil has no correlation
Which of the following is not a component of dangerousness:
A) magnitude
B) Intensity
C) likelihood
D) imminence
E) frequency
B) Intensity
Which item about persons with paranoid schizophrenia is false?
A) They are more violent in the community than in hospitals
B) Their violence is usually well planned
C) Their violence is toward random persons
D) They retain more reality testing than disorganized schizophrenics
C) Their violence is toward random persons
Which of these demographic statements about violence is false?
A) Violence peaks in the late 20s
B) Males commit more violence than females
C) The lower the social class, the more street violence
D) The lower the intelligence, the more violence
A) Violence peaks in the late 20s
Which of the following factors is not a childhood antecedent of adult violence?
A) Brutality from a parent
B) dyslexia
C) Parental seduction
D) Hyperactivity
B) dyslexia
Under Tarasoff, reasonable steps to protect a victim do not include?
A) Warning the intended victim.
B) Notifying the police.
C) Hospitalizing the patient.
D) Admonishing the patient
D) Admonishing the patient
Risk factors for violence include:
A) Frequent changes in employment
B) Frequent changes of residence
C) Lower level of education
D) All of the above
D) All of the above
Which delusional symptom is not associated with an increased risk of aggression by the patient?
A) Feeling that external forces dominate his or her mind
B) Feeling that thoughts are being put into his or her head
C) Feeling that his or her thoughts are being broadcast.
D) Feeling that other people wish him or her harm
C) Feeling that his or her thoughts are being broadcast.
When is the rate of homicide greatest in psychosis?
Homicide is 15 times greater during the first episode of psychosis compared to the annual rate following treatment.
A building crescendo of paranoid fear creates a high risk of violence.
What are the demographics of violence?
1) Crescendos in late teens or early 20s
2) males more than females in the general population (equal in mental illness)
3) lower IQ is more violent
4) The lower the social class, the more risk of street violence.
What are the clinical judgment errors by clinicians?
1) Underestimation of female violence
2) overestimate minority violence
3) Underestimation of violence in attractive patients
4) Overestimate if you see crime details
What is the blameworthiness attribution?
Judges see women as less blameworth and more mentally ill, leading to shorter sentences and more NGRI.
What does “substantial risk” in risk assessments mean?
A strong possibility (51%)
The greater the severity/magnitude of the crime, the less the likelihood is required.
What characteristics of hallucinations increase the risk of violence
Negative emotions, less successful strategies to deal with voices, and command hallucinations.
What is the most common command hallucination?
Suicide - to kill one’s self
The more violent the command, the less likely they are to carry it out.
Which delusional symptoms are more associated with violence?
Threat and Control- override delusions - mind controlled, thought insertion, people wish you harm
Which delusional symptoms are not associated with violence?
Feeling dead or not existing, though broadcasting, thoughts are removed
What delusions are more associated with violence?
Persecutory, systematized, fearful or angry, of being poisoned.
What is the risk of violence with mania?
More assaults, impulsive behavior, frequently commit parricide (kill parents)
Twice as violent with substance use,
High blood zinc levels also have a higher risk of aggression
What is the risk of violence with depression?
more homicides, higher risk of filicide (killing children)
Who is most at risk of harm from SMI and violence?
Parents 68%
Family caregiver (20%)
Often because of limit setting or due to criticism or hostility by family
What personality traits are most associated with violence?
Impulsivity, low frustration tolerance, inability to tolerate criticism, egocentric and entitled, projects blame
What personality disorders have the highest incidence of violence?
Borderline and antisocial
What are the two types of violence?
1) Affective violence - limbic response, threatening vocalizations, and postures.
2) Predatory violence - cortex-driven, planned
What are the childhood factors correlated with later violence?
1) brutality, particularly a brutal father
2) Prental seduction
3) Truancy, school failures, lower IQ
4) Being a bully
5) delinquency
6) h/o assault
7) ADHD
Which are the two emotions that often precede violence?
Fear and anger
What are the static risk factors of dangerousness?
Demographic data
History of violence
Childhood abuse history
Antisocial personality traits
What are the dynamic risk factors of dangerousness?
living setting
access to weapons
psychotic symptoms
probationary supervision
What are the highest recent (last 6 months) risk factors associated with violence?
Current alcohol use
Recent violence
Recent victimization
