Psychosis Uncommonly and Inconsistently Precedes Violence Among High-Risk Individuals

Posted: 23 Sep 2015

See all articles by Jennifer L. Skeem

Jennifer L. Skeem

University of California, Berkeley

Patrick Kennealy

Government of the State of Texas - Travis County Community Justice Services (TCCJS)

John Monahan

University of Virginia School of Law

Jillian Peterson

Independent

Paul S. Appelbaum

Columbia University

Date Written: September 22, 2015

Abstract

A small group of individuals with mental illness is repeatedly involved in violence. Little is known about how often and how consistently these high-risk individuals experience delusions or hallucinations just before a violent incident. To address these questions, data from the MacArthur Violence Risk Assessment Study was used to identify 305 violent incidents associated with 100 former inpatients with repeated violence (representing 50% of incidents and 9% of participants), and test whether psychosis-preceded incidents cluster within individuals. Results indicated that (a) psychosis immediately preceded 12% of incidents, (b) individuals were “fairly” consistent in their violence type (ICC = .42), and (c) those with exclusively “non-psychosis-preceded” violence (80%) could be distinguished from a small group who also had some psychosis-preceded violence (20%). These findings suggest that psychosis sometimes foreshadows violence for a fraction of high-risk individuals, but violence prevention efforts should also target factors like anger control and social deviance.

Keywords: violence, psychosis, mental illness, crime

Suggested Citation

Skeem, Jennifer L. and Kennealy, Patrick and Monahan, John and Peterson, Jillian and Appelbaum, Paul S., Psychosis Uncommonly and Inconsistently Precedes Violence Among High-Risk Individuals (September 22, 2015). Available at SSRN: https://ssrn.com/abstract=2664063

Jennifer L. Skeem (Contact Author)

University of California, Berkeley ( email )

120 Haviland Hall
Berkeley, CA 94720-7400
United States

Patrick Kennealy

Government of the State of Texas - Travis County Community Justice Services (TCCJS) ( email )

P.O. Box 1748
Austin, TX 78767
United States

John Monahan

University of Virginia School of Law ( email )

580 Massie Road
Charlottesville, VA 22903
United States
434-924-3632 (Phone)

Jillian Peterson

Independent ( email )

No Address Available

Paul S. Appelbaum

Columbia University ( email )

NY State Psychiatric Institute
1051 Riverside Drive Unit 122
New York, NY 10032
United States
646-774-8630 (Phone)
646-774-8633 (Fax)

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