The role of psychopathic traits and substance abuse in predicting violent victimization in patients with schizophrenia spectrum disorders

Serious physical assault and subsequent risk for rehospitalization in individuals with severe mental illness: a nationwide, register-based retrospective cohort study

BACKGROUND

Victimization is associated with worse social and clinical outcomes of individuals with severe mental illness (SMI). A relapse of SMI may be one of the clinical consequences of assaultive trauma. As far as we know, there is no published study that analyzes nationwide health registers to assess the risk of SMI rehospitalization following assault.

AIM

We aimed to assess whether exposure to assault is associated with an increased risk of psychiatric hospitalization in those with SMI.

METHODS

We utilized data from the Czech nationwide registers of all-cause hospitalizations and all-cause deaths. We defined exposed individuals as those discharged from a hospitalization for SMI between 2002 and 2007, and hospitalized for serious injuries sustained in an assault in the subsequent 7 years. For each assaulted individual, we randomly selected five counterparts, matched on SMI diagnosis, age and sex, who were not assaulted in the examined time period. We used mixed effect logistic regression to assess the effect of assault on the risk of SMI rehospitalization within the following 6 months. We fitted unadjusted models and models adjusted for the number of previous SMI hospitalizations and drug use disorders.

RESULTS

The sample consisted of 248 exposed and 1 240 unexposed individuals. In the unadjusted model, assaulted individuals were almost four times more likely to be rehospitalized than their non-assaulted counterparts (odds ratio (OR) = 3.96; 95% CI 2.75; 5.71). After adjusting for all covariates, the OR remained threefold higher (OR = 3.07; 95% CI 2.10; 4.49).

CONCLUSION

People with a history of SMI hospitalization were approximately three times more likely to be rehospitalized for SMI within 6 months after an assault than their non-assaulted SMI counterparts. Soon after a person with SMI is physically assaulted, there should be a psychiatric evaluation and a close follow-up.

Psychopathic Personality Traits and the Risk for Personal Victimization

Previous research links psychopathic traits with involvement in criminal behavior and numerous negative life outcomes. To date, however, a relatively limited amount of research has examined whether psychopathic traits confer an increased risk of victimization. This area of research is of interest as some scholars contend that psychopathic traits may confer several advantages for life outcomes including outcomes related to criminal conduct. As a result, psychopaths may be at a decreased risk of victimization. On the contrary, research examining the victim-offender overlap indicates that as psychopaths are likely to be involved in criminal behavior they would be more likely to be victimized. This article addresses this gap in the literature by examining whether psychopathic personality traits are associated with odds of victimization in a large nationally representative sample of Americans from adolescence to adulthood. Specifically, our study employs logistic regression and Poisson regression to test associations between psychopathic personality traits and victimization in data drawn from the National Longitudinal Study of Adolescent to Adult Health (Add Health). Our findings reveal that psychopathic personality traits are positively associated with odds of victimization in adolescence and adulthood. In addition, our findings indicate that psychopathic personality traits interact with criminal involvement to predict odds of victimization. The findings of our study have implications for the literatures concerning successful psychopathy and the victim-offender overlap.

The Association Between Psychopathic Personality Traits and Victimization and Exposure to Violence in a Sample of Saudi Arabian Youth

Psychopathic personality traits have been shown to increase the odds of a wide range of antisocial outcomes. Very little research, however, has examined the association between psychopathy and the risk of personal victimization. The current study address this gap in the literature by examining the association between scores on the Levenson Self-Report Psychopathy scale and a self-reported measure of victimization by using cross-sectional data drawn from a sample of youth residing in Jeddah, Saudi Arabia (N = 311). The results revealed a positive and statistically significant association between LSPR scores and the odds of being victimized. Additional analyses revealed that two mediators-arrest history and exposure to delinquent peers-were related to personal victimization, but neither of these measures mediated the effects of LSPR scores on victimization. Whether these findings would generalize to other nations remains an issue awaiting future research.

Violent victimization of adult patients with severe mental illness: a systematic review

The aims of this paper are to review data on the prevalence and correlates of violent victimization of persons with severe mental illness, to critically evaluate the literature, and to explore possible approaches for future research. PubMed/MEDLINE and PsycINFO databases were searched using several terms related to severe mental illness in successive combinations with terms describing victimization. The searches identified 34 studies. Nine epidemiological studies indicate that patients with severe mental illness are more likely to be violently victimized than other community members. Young age, comorbid substance use, and homelessness are risk factors for victimization. Victimized patients are more likely to engage in violent behavior than other members of the community. Violent victimization of persons with severe mental illness has long-term adverse consequences for the course of their illness, and further impairs the quality of lives of patients and their families. Victimization of persons with severe mental illness is a serious medical and social problem. Prevention and management of victimization should become a part of routine clinical care for patients with severe mental illness.