Self- and Other-Directed Aggressive Behavior and Safety Measures in an Acute Psychiatric Ward
5 affiliations
- 1Department of Mental Health and Drug Abuse, Azienda USL-Modena, 41121 Modena, Italy
- 2Department of Mental Health and Drug Abuse, Azienda USL-Romagna, 48121 Ravenna, Italy
- 3School of Specialization in Psychiatry, University of Modena and Reggio Emilia, 42122 Reggio Emilia, Italy
- 4Nursing Programme, University of Modena and Reggio Emilia, 41124 Modena, Italy
- 5Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
Abstract
Background: Aggression in hospital settings, particularly in acute psychiatric wards, is a significant and frequent phenomenon. Objectives: This study analyzes self- and other-directed aggressive behavior and highlights risk factors, prevention and management actions. Methods: We divided hospitalizations in the Service for Psychiatric Diagnosis and Care (SPDC) of AUSL-Modena over a year based on the presence or absence of aggressive behavior. Socio-demographic and clinical variables, aggression risk assessment, modality of aggression management, Incident Reports, and harmful consequences were analyzed. The data were statistically analyzed. Results: The sample consisted of 411 hospitalizations and 370 inpatients, of whom 29.2% (n = 108) exhibited aggression: 3.0% (n = 11) self-directed, 23.2% (n = 86) other-directed, and 3.0% (n = 11) both types of aggression. Risk levels were found to be highly predictive of aggressive behavior. Males engaged in other-directed aggressive behavior more frequently than females, who presented more prevalent self-directed aggression (Pearson Chi2 = 13.73; p = 0.003). Adolescents more frequently engaged in both self- and other-directed aggression. Other-directed aggressive behavior occurred more frequently in unmarried people (p = 0.014), with no children (p = 0.019), in involuntary hospitalizations (p = 0.000), in longer hospitalizations (p = 0.0001), and in acute psychosis (p < 0.001), during the first days of hospitalization. The Brøset Violence Checklist showed good discrimination with high sensitivity and negative predictive value. Conclusions: Assessing the level of self- and other-directed aggression risk at admission is essential for adopting appropriate preventive and management measures for patient and staff safety in a ward, avoiding coercive measures to contain aggression.
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BibTeX
@article{lorenzo2026self,
title = {{Self- and Other-Directed Aggressive Behavior and Safety Measures in an Acute Psychiatric Ward}},
author = {Rosaria Di Lorenzo and Federico Mordenti and Ilaria Rubini and Lisa Capitani and Chiara Biral and Sergio Rovesti and Paola Ferri},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15208187},
url = {https://www.mdpi.com/2077-0383/15/20/8187},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Self- and Other-Directed Aggressive Behavior and Safety Measures in an Acute Psychiatric Ward
AU - Rosaria Di Lorenzo
AU - Federico Mordenti
AU - Ilaria Rubini
AU - Lisa Capitani
AU - Chiara Biral
AU - Sergio Rovesti
AU - Paola Ferri
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15208187
UR - https://www.mdpi.com/2077-0383/15/20/8187
AB - Background: Aggression in hospital settings, particularly in acute psychiatric wards, is a significant and frequent phenomenon. Objectives: This study analyzes self- and other-directed aggressive behavior and highlights risk factors, prevention and management actions. Methods: We divided hospitalizations in the Service for Psychiatric Diagnosis and Care (SPDC) of AUSL-Modena over a year based on the presence or absence of aggressive behavior. Socio-demographic and clinical variables, aggression risk assessment, modality of aggression management, Incident Reports, and harmful consequences were analyzed. The data were statistically analyzed. Results: The sample consisted of 411 hospitalizations and 370 inpatients, of whom 29.2% (n = 108) exhibited aggression: 3.0% (n = 11) self-directed, 23.2% (n = 86) other-directed, and 3.0% (n = 11) both types of aggression. Risk levels were found to be highly predictive of aggressive behavior. Males engaged in other-directed aggressive behavior more frequently than females, who presented more prevalent self-directed aggression (Pearson Chi2 = 13.73; p = 0.003). Adolescents more frequently engaged in both self- and other-directed aggression. Other-directed aggressive behavior occurred more frequently in unmarried people (p = 0.014), with no children (p = 0.019), in involuntary hospitalizations (p = 0.000), in longer hospitalizations (p = 0.0001), and in acute psychosis (p < 0.001), during the first days of hospitalization. The Brøset Violence Checklist showed good discrimination with high sensitivity and negative predictive value. Conclusions: Assessing the level of self- and other-directed aggression risk at admission is essential for adopting appropriate preventive and management measures for patient and staff safety in a ward, avoiding coercive measures to contain aggression.
SN - 2077-0383
ER -