Digieffects Delirium Serial Macro4/20/2021
Violence risk prediction schemes such as the Historical-Clinical-Risk-20 (HCR-20) 10, 11 take advantage of this and assess violence proneness by including a large number of equally weighted items 12 that are not specific to schizophrenia or mental disorder but are associated with suboptimal functioning.Copyright OReilly et al.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated. Abstract Background There is a broad literature suggesting that cognitive difficulties are associated with violence across a variety of groups. Methods We prospectively examined whether neurocognition and social cognition predicted inpatient violence amongst patients with schizophrenia and schizoaffective disorder ( n 89; 10 violent) over a 12 month period. Neurocognition and social cognition were assessed using the MATRICS Consensus Cognitive Battery (MCCB). Results Using multivariate analysis neurocognition and social cognition variables could account for 34 of the variance in violent incidents after controlling for age and gender. Scores on a social cognitive reasoning task (MSCEIT) were significantly lower for the violent compared to nonviolent group and produced the largest effect size. Mediation analysis showed that the relationship between neurocognition and violence was completely mediated by each of the following variables independently: social cognition (MSCEIT), symptoms (PANSS Total Score), social functioning (SOFAS) and violence proneness (HCR-20 Total Score). Digieffects Delirium Serial Ro Serial Pathway BetweenThere was no evidence of a serial pathway between neurocognition and multiple mediators and violence, and only social cognition and violence proneness operated in parallel as significant mediators accounting for 46 of the variance in violent incidents. There was also no evidence that neurocogniton mediated the relationship between any of these variables and violence. Conclusions Of all the predictors examined, neurocognition was the only variable whose effects on violence consistently showed evidence of mediation. ![]() Social cognition in contrast has a direct effect on violence independent of neurocognition, violence proneness and symptom severity. The neurocognitive impairment experienced by patients with schizophrenia spectrum disorders may create the foundation for the emergence of a range of risk factors for violence including deficits in social reasoning, symptoms, social functioning, and HCR-20 risk items, which in turn are causally related to violence. Electronic supplementary material The online version of this article (doi:10.1186s12888-015-0548-0) contains supplementary material, which is available to authorized users. ![]() However there is a small but significant association between schizophrenia and violence and with homicide in particular 1 3. The relationship between violence and schizophrenia is thought to arise primarily from active symptoms such as delusions and co-morbid problems particularly substance misuse 1, 4. But there is a link between schizophrenia and vulnerability to substance misuse and an increased risk of violence remains even when substance misuse is taken into account 4, 5. Also violent acts carried out by people with schizophrenia are complex and cannot always be explained by psychotic symptoms alone. Some people with schizophrenia can become violent at a young age prior to the onset of psychosis, whereas others become chronically violent after the first psychotic episode even when receiving medication, and there are those who commit only a single act of violence during their lifetime 1, 3, 6. Furthermore the violent acts carried out by people with schizophrenia appear to be driven by some of the same risk factors as violence in general 6 9.
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