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标题：In-patient aggression at a tertiary care child and adolescent psychiatry centre: psychosocial variables and caregiver perspectives
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作者：Preeti Jacob ; Shekhar Seshadri ; Shoba Srinath 等
期刊名称：Journal of Indian Association for Child and Adolescent Mental Health
电子版ISSN：0973-1342
出版年度：2014
卷号：10
期号：1
页码：31-46
出版社：Indian Association for Child and Adolescent Mental Health
摘要：Background: Few studies in India have focussed on psychosocial issues and caregiver perspectives on in-patient aggression, which can potentially impact the way aggression is understood and managed. Aims & Objectives: To study the psychosocial variables and caregiver perceptions on the nature, severity, precipitating, provoking factors and the methods employed to manage an aggressive episode in an in-patient tertiary care child and adolescent psychiatry centre. Materials and Methods: All consecutive episodes of aggression from February to April 2011 were recorded prospectively using MINI KID, Overt Aggression Scale (OAS), Children’s Global Assessment Scale (CGAS), and a Semi-structured interview regarding the aggressive episode. Results: 119 episodes of aggression were recorded in 31 in-patients amongst the 131 admissions during the study period. Marital discord and punitive parenting correlated positively with certain subscales on the Overt Aggression Scale (OAS). Psychopathology (24%) and the child/adolescent’s unmet demands (39%) were reported by care-givers asthe most common reasons for aggression; and the caregiver’s giving into those demands (24.4%) and starting/increasing medication (46.2%) were perceived as ways to help reduce the aggression. Family members were the most common targets. 44.5% of the caregivers were satisfied with the management of aggression. 27.7% did not report the incident to the nursing staff on duty. Conclusion: Important psychosocial factors that were associated with the severity of in-patient aggression on certain OAS sub-scales punitive parenting and marital discord. Caregivers were most often the target of aggression; they under-reported incidents of aggression, and perceived the need for staff help in managing aggression. Hence, psychosocial interventions need to be an important part of management. Genetic and environmental risk factors need to be studied in larger prospective studies.
关键词：aggression; in-patient; child; adolescent; caregiver; psychosocial.