| Violence and psychosis in relationship to insight into illness and medication compliance. (2002) | |||||||||||||
Abstract | |||||||||||||
| Source: Dissertation Abstracts International, Volume: 63-10, Section: B, page: 4887.. Sponsor: Leah Blumberg Lapidus.. Thesis (Ph.D.)--Columbia University, 2002.. The present study tested predicted relationships between the severity of outpatient other directed violence and two influences of outcome and prognosis in persons with psychotic disorders: insight into illness and compliance with medication. No studies in the U.S. were found to have published measures of insight of violent individuals with psychotic disorders in forensic settings. Participants were 60 legally detained male inpatients at the forensic unit of Kings County Hospital Center in Brooklyn, New York, who suffer from psychotic disorders. The following measures were administered: demographic and diagnosis questionnaire, four subscales of insight into illness, and a Violence Assessment Scale (VAS; Alia-Klein et al., 2000) that was developed for this project to measure severity of violence. To complement and validate self-report data, hospital records were reviewed as well as interview data from family and other informants. The following results are found: (1) Increase in the severity of violence outside of the hospital is associated with low medication compliance, all dimensions of poor insight, and several demographic and clinical variables. (2) Of the insight dimensions, externally judged affective indifference, awareness of illness, and self-reported affective indifference are the strongest predictors respectively. (3) The relative contribution of medication compliance to severity of violence was larger than that of awareness of illness. (4) Awareness and compliance together contribute 17% to the prediction of severity of violence after controlling for covariates. (5) Seventy-seven percent of severity of violent behavior is accounted for by the covariates together with compliance and the select insight variables. Implications for future research and clinical applications are presented. | |||||||||||||
Publication details | |||||||||||||
| |||||||||||||