Biomedical subjects

H L Nijman

Publications and source records attributed to H L Nijman.

5 recordsLinked to original sources

PubMed1999

Self-mutilating behaviour of psychiatric inpatients.

In the present study two broad hypotheses about the origins of self-mutilation in psychiatric patients were evaluated. The first hypothesis states that self-mutilation originates from child abuse and experiences of neglect and is connected to dissociation in later life. The second hypothesis views self-mutilation as the consequence of impulse control problems. To test these two hypotheses, data concerning traumatic childhood experiences and dissociative symptoms (hypothesis 1), as well as data concerning aggressiveness, obsessive-compulsiveness and sensation seeking (hypothesis 2) were collected in a sample of 54 psychiatric inpatients. Twenty-four out of 54 patients (44%) reported having engaged in self-mutilation. Mean age of onset of this behaviour was 23 years. Self-report measures of self-mutilators were more in line with the first than with the second hypothesis. That is, patients who engaged in self-mutilation reported more traumatic childhood experiences and dissociative symptoms than did control patients. The two groups did not differ in terms of aggressiveness, obsessive-compulsiveness, and sensation seeking. In line with earlier studies, the current results indicate that self-mutilating behaviour is linked to a history of abuse and neglect.

Adult↗

PubMed1999

Crowding and aggression on inpatient psychiatric wards.

The association between crowding and aggressive behavior among psychiatric inpatients was investigated. Aggressive incidents were documented on two closed psychiatric wards between February 1 and December 15, 1996. A modest correlation between number of patients on the ward and number of aggressive incidents per patient was found. Enlargement of the physical space by the addition of a courtyard to one of the wards midway through the study did not lead to a significant decline in incidents. Possibly, a lack of psychological space-having no privacy or not being able to get sufficient rest-may be more important in triggering aggression than a lack of physical space.

Adolescent↗

PubMed1999

A tentative model of aggression on inpatient psychiatric wards.

Violence in psychiatric hospitals threatens the safety and well-being of patients and staff members. The determinants and correlates of inpatient aggression are not well understood. The authors present an explanatory model of aggressive behavior that attempts to integrate patient, staff, and ward variables. In the proposed model, the patient's psychopathology and distorted cognitions are exacerbated by environmental and communication stressors found on psychiatric wards. The model emphasizes that repeated inpatient aggression may be the result of a vicious circle, whereby a patient's violent behavior is often followed by an increase in stress on the patient caused by environmental or communication factors, heightening the risk of another outburst of violence.

Aggression↗

PubMed1997

Prevention of aggressive incidents on a closed psychiatric ward.

OBJECTIVE: This study examined whether staff members' use of interventions for preventing patients' aggression reduced the number of incidents of aggression on a closed acute admissions ward of a psychiatric hospital in the Netherlands. METHODS: The number and severity of incidents of aggression on three closed wards were measured using the Dutch version of the Staff Observation Aggression Scale (SOAS). Measurements were made for three months before and after staff implemented interventions for preventing aggression on one of the wards. Interventions included a protocol for talking to patients who exhibited aggressive behavior, discussing treatment goals with the patient shortly after admission, explaining why the ward's door was locked and the exit rules, providing a schedule of staff meetings to explain staff members' absence from the ward, and clarifying the procedure for making an appointment with the psychiatrists. RESULTS: The frequency of aggressive incidents was reduced on all three wards, with no significant difference between the ward where the interventions were implemented and the two control wards. A marginally significant difference in the severity of aggressive incidents was found between experimental and control wards after the introduction of the preventive measures, with incidents in the experimental ward tending to be less severe. CONCLUSIONS: This study failed to find a robust effect of specific intervention measures on aggressive incidents. However, it did find evidence suggesting that standardized reporting by staff of aggressive incidents on closed psychiatric wards may in itself result in straightforward reduction of violent incidents.

Aggression↗

PubMed1997

[Aggression and psychiatry--does training have any effect?].

This study with a quasi-experimental design was conducted into the effects of an aggression management training on the perception of safety and self-confidence of the participants. Also it was studied whether the participants of the training were less likely to be involved in aggressive incidents. It was found that the perception of safety of the participants had significantly increased compared to the control subjects. No significant differences in perceived self-confidence were found between the two groups. In both the experimental and the control group the frequency of aggressive incidents was lower during the posttest period. This reduction had taken place regardless of the aggression management training. Possibly, the systematic registration of aggression by means of the Staff Observation Aggression Scale (SOAS) initiates a learning process in the staff.

Adult↗