Self-directed and overt aggression among forensic psychiatric patients

Background

Forensic psychiatric patients exhibit an increased tendency to be aggressive towards others as well as towards themselves. Both types of aggression is considered to be a global health issue. They imply great psychological suffering, can have long-term and profound effects on a person’s quality of life, and challenge the health care system. Therefore, there is a great need of knowledge that can guide future interventions. The knowledge on what drives these behaviors among forensic psychiatric patients and the function of these behaviors, is still scarce.

Aim

The overall aim of this explorative study is to describe and investigate deliberate self-harm behavior among Swedish forensic psychiatric patients by investigating the prevalence of self-harm behavior and identifying clinical, neurocognitive, psychosocial and criminological characteristics associated with the behavior.

Methods

A cohort of 100 forensic psychiatric patients will participate in the study, based on free, informed consent. Participation entails file reviews, self-report questionnaires, and additional interviews. Data collection will be complete in the end of 2019 and further analyses will be performed during the spring of 2020.

Results

Preliminary results show that the prevalence of deliberate self-harm and suicidal behavior is elevated in this forensic population. The results also show that the majority of the participants have grown up with adverse childhood experiences for example witnessing violence between parents, substance abuse and bullying victimization in school.

Clinical relevance

The results of this study will be used to guide which areas of intervention that are needed to focus on, or consider, in interventions within forensic psychiatric care. Thus, the study will contribute to the continued development of evidence-based practice in Swedish, forensic psychiatry.

Time plan
2015 Planning research project
2016 Starting data collection
2020 Finishing data collection
2020 Composing manuscripts

Principal Investigator
Märta Wallinius, lic. psychologist, associate professor, The Regional Forensic Psychiatric Clinic in Växjö, Institution of Clinical Sciences in Lund, Lund University.

Research group
Natalie Laporte, Behavioral Scientist, PhD Candidate, The Regional Forensic Psychiatric Clinic in Växjö, Institution of Clinical Sciences in Lund, Lund University.

Johan Berlin, lic. psychologist, PhD Student, The Regional Forensic Psychiatric Clinic in Växjö, Institution of Clinical Sciences in Lund, Lund University.

Supervisors
Sofie Westling, MD, PhD, Region Skåne, Institution of Clinical Sciences in Lund, Lund University.

Professor Åsa Westrin, MD, Professor, Region Skåne, Institution of Clinical Sciences in Lund, Lund University.

Andrejs Ozolins, lic. psychologist, associate professor, Institution of Psychology, Linnaeus University.

Financing
This project is a part of a larger project financed by FORTE. It is also partly financed by the Regional Forensic Psychiatric Clinic in Växjö, by the Center of Ethic, Law and Mental Health (CELAM) in Gothenburg, and by external funds through FoU Kronoberg and Södra Sjukvårdsregionen.