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Results for “Dangerous Behavior”

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PubMed1989

Acceptability of behavioral interventions for self-injurious behavior.

Using a case description methodology, we examined the effects of behavior problem severity, intervention type (accelerative vs. reductive), client status (child vs. adult), and type of work setting (child vs. adult unit) on staff members' acceptability ratings of six behavioral interventions used to treat self-injurious behavior (SIB). Results indicated that (a) accelerative interventions were rated more acceptable than reductive treatments, (b) acceptability of treatments varied as a function of SIB severity, and (c) client status and type of work setting failed to significantly influence acceptability ratings. Findings were discussed in the context of the current controversy surrounding the use of aversive treatments. The implications of the results for the design of institutionally based behavioral intervention programs were examined.

Adult↗
PubMed1989

A descriptive study of seclusion: the unit environment, patient behavior, and nursing interventions.

The purpose of this descriptive study was to identify unit environmental factors at the initiation of seclusion, and patient behavior and nursing interventions throughout seclusion. The convenience sample of 56 seclusion incidents included 43 patients. A peak time for seclusion to be initiated was within 24 hours of admission. Before seclusion most behaviors were disturbed but nonviolent; during seclusion most behaviors were nondisturbed. Variables studied did not indicate that units were more disturbed when seclusions were initiated than at other times. Seclusion was generally used in conjunction with other interventions.

Adult↗
PubMed1995

Can experts agree when to hospitalize adolescents?

OBJECTIVE: Rates of psychiatric hospitalization and lengths of stay for adolescents have been a focus of recent controversy. With the advent of managed care, hospital systems and third-party payers are looking for ways to decide when hospitalization is indicated. The authors sought to determine whether experts could agree on the appropriateness of putative indicators for hospitalization of adolescents for conduct disorder or substance abuse. METHOD: Using a methodology developed at the Rand Corporation and previously applied to procedures in medicine and surgery, the authors developed a list of possible indications for hospitalization of adolescents with conduct disorder and/or substance abuse. A nine-member panel of experts in these areas, balanced by geography, academics/clinical practice, and whether the expert was in charge of a hospital unit, then rated the appropriateness of each indication twice under a modified Delphi procedure. RESULTS: Using prespecified definitions for agreement, after the initial rating the panel had low levels of disagreement (11%) and moderate levels of agreement (28%) on more than 1,900 possible indications for hospitalization. Despite an expanded number of indications, the panel reduced disagreement to less than 5% and increased agreement to more than 55% after the second round of ratings. CONCLUSIONS: The consensus achieved compared favorably with the results of similar panels judging the appropriateness of procedures in medicine and surgery. The methodology is applicable to studies of the appropriateness of pharmacological or psychotherapeutic interventions in both child and adult psychiatry. The results of such studies can form the basis for rational utilization review and treatment authorization decisions.

Adolescent↗
PubMedDate not supplied

Just say no! sounds right, but...

A review is provided of the results from the National Health Interview Survey of health-risk behavior among our nation's youth. The results indicate a high prevalence of risk taking among preteen and teenage girls and boys.

Adolescent↗
PubMed1994

Dangerousness: assessing the risk of violent behavior.

Results of discriminant analyses for identifying dangerous inpatients and prison inmates are presented. Analysis of a hospital sample (N = 100) yielded a discriminant function containing 5 variables, which was 85% accurate in classifying the sample. Analysis of a prison sample (N = 100) yielded a discriminant model with 6 variables, which was 72% accurate in classifying the sample. Stepwise discriminant analysis of the combined hospital and prison derivation sample (N = 200) yielded a discriminant function containing 8 variables, which was 75% accurate in classifying the sample as dangerous or nondangerous. It was concluded that the derived population-specific (i.e., hospital or prison) models constitute empirically valid measures of dangerousness for the populations studied.

Adult↗
PubMed1999

The dangerous nature of intimate relationship stalking: threats, violence, and associated risk factors.

Although previous studies of forensic and law enforcement stalking populations (Harmon, Rosner, & Owens, 1995; Meloy & Gothard, 1995; Zona, Sharma, & Lane, 1993) agree that the degree of intimacy of the victim-suspect relationship is an important factor in stalking cases, they have not conducted in-depth analyses of this variable. This study compared 223 intimate (n=135) and non-intimate (n=88) stalking cases managed by the Los Angeles Police Department's Threat Management Unit. A path analysis revealed a significant relationship between the stalkers' intimate versus non-intimate status and violence committed toward persons and property. This relationship was positively influenced by the suspect's level of proximity to the victim and threats toward the victim and property, but not influenced by suspect's criminal, psychiatric, and domestic violence histories. Overall, intimate relationship stalkers used more dangerous stalking behaviors than non-intimate relationship stalkers. Risk factors for assessing dangerousness of stalkers are discussed.

Adult↗
PubMed1977

Evaluation and management of suicidal behavior.

The danger of suicide is highest in depressed older people, especially men who have sustained a loss, who have an attitude of hopelessness, and who have not resolved feelings of grief. Factors associated with greater risk are chronic or serious illness, divorced, separated or widowed marital status, white race, drug abuse, excessive use of alcohol, unemployment, and poor living conditions. Commonly, those who commit suicide have made previous attempts and have directly or indirectly communicated their intention to others. The family physician is in the front line in the recognition and prevention of suicide. In the treatment of the suicidal, the physician should maintain a strong positive relationship to the patient and be consistently dedicated to his care including availability to see the patient frequently and to receive phone calls in the middle of the night. Those with the most serious risk should be referred to a psychiatrist and hospitalized to protect them from their suicidal impulses. Psychotherapy, antidepressant and tranquilizer drugs, and electric shcok treatment are the main therapeutic approaches. The physician's capacity for empathy and emotional commitment is of greater importance than his professional credentials.

Depression↗
PubMed1998

Hazards mean luck: counterfactual thinking in reports of dangerous situations and careless behavior.

It has been shown (Teigen, 1995) that experiences of "luck" in daily life are dependent upon the existence a worse and close hypothetical (counterfactual) outcome, rather than upon a positive evaluation of what actually happened. The present investigation focuses on the inverse relationship, namely whether a situation with a negative outcome close at hand will be perceived as lucky. To test this hypothesis, students were asked to describe dangerous situations (Experiment 1) and examples of careless behavior (Experiment 3) from their own lives, which subsequently were rated by the actors and by peer groups for good and bad luck, attractiveness, and for closeness and attractiveness of the counterfactual outcome. Dangerous situations and episodes involving careless behavior were generally regarded as more lucky than unlucky. Furthermore, degree of good luck was positively correlated with degree of dangerousness and with degree of carelessness. Luck was related to closeness, aversiveness, and (in Experiment 2) to estimated probability of the counterfactual outcome. It is concluded that luck is primarily determined by negative outcomes that did not happen, and thus a frequent by-product of risk taking and risk exposure.

Humans↗
PubMed1994

[Violent and intimidating behavior of psychiatric patients at admission].

The dangerousness of the mentally ill patient is still unknown. This study assesses the actual prevalence of violent and intimidating behaviours in psychiatric patients at the time of their admission, or in the days leading up to their admission to a Quebec hospital. These behaviours have been measured on a six-point scale whose reliability for this population is appropriate. The consecutive sample consists of 383 adult admissions, and the results show that 83.0 percent of the involuntary admissions and 40.7 percent of the voluntary admissions manifested violent or intimidating behaviours at the time of hospitalization. The results support the clinical experience that psychiatric patients often exhibit this type of behaviour on admission.

Adolescent↗