Silver and Teasdale

Silver and Teasdale - Mental Disorder and Violence: An...

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Social Problems , Vol. 52, Issue 1, pp. 62–78, ISSN 0037-7791, electronic ISSN 1533-8533. © 2005 by Society for the Study of Social Problems, Inc. All rights reserved. Please direct all requests for permission to photo- copy or reproduce article content through the University of California Press’s Rights and Permissions website, at http://www. ucpress.edu/journals/rights.htm. Mental Disorder and Violence: An Examination of Stressful Life Events and Impaired Social Support ERIC SILVER, Penn State Univeristy BRENT TEASDALE, University of Akron Research on the relationship between mental disorder and violence has focused largely on the effects of clin- ical characteristics, such as treatment adherence and psychotic symptoms, with little attention to the potentially important role of stressful life events and impaired social support. Yet, stressful life events and impaired social support have been found to be signiFcantly associated with the onset and course of mental disorder and with the occurrence of violence. This raises the question: Do stressful life events and impaired social support contribute to the association between mental disorder and violence? The current study addresses this question using general population data from the Durham site of the National Institute of Mental Health’s Epidemiological Catchment Area Surveys ( N 5 3,438). Results indicate that when stressful life events and impaired social support are con- trolled, the association between mental disorder and violence is substantially reduced. Implications for future research on the relationship between mental disorder and violence are discussed. After over a decade of research, considerable evidence has accrued suggesting that people with mental disorders are signiFcantly more likely to engage in violence than people without mental disorders (Arseneault et al. 2000; Monahan 1992; Swanson et al. 1990), particularly when their disorders involve paranoid psychotic symptoms (Link, Andrews, and Cullen 1992; Link, Monahan, Stueve, and Cullen 1999; Swanson et al. 1996) or when they co-occur with substance abuse (Steadman et al. 1998). The link between mental disorder and violence has been observed across a variety of sampling strategies, outcome measures, and mental dis- order measures, and with controls for a wide range of sociodemographic characteristics (for reviews, see Link and Stueve 1995; Monahan et al. 2002; Mulvey 1994). However, despite the robustness of this association, little is understood about why mental disorder and violence are linked (Hiday 1995, 1997; Mulvey 1994; Silver 2000). Most prior explanations of the relationship between mental disorder and violence empha- size clinical characteristics, such as paranoid psychotic symptoms (Link, Monahan, Stueve, and Cullen 1999; Link and Stueve 1994), substance abuse disorders (Steadman et al. 1998), and treatment nonadherence (Swanson et al. 1996; Swartz et al. 1998). These explanations are rooted in the assumption that the causes of violence by mentally disordered people are linked fundamentally to the mental disorder itself (Monahan 1992). The most prominent
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Silver and Teasdale - Mental Disorder and Violence: An...

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