Silver et al 2005

Silver et al 2005 - Mental Disorder and Violent...

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Mental Disorder and Violent Victimization in a Total Birth Cohort I Eric Silver, PhD, Louise Arseneault, PhD, John Langley, PhD, Avshalom Caspi, PhD, and Terrie E. Moffitt, PhD Mental disorder may be associated with vio- lent victimization. Unfortunately, few empiri- cal studies have investigated this relation,' and none has done so using general popula- tion data. Addressing this association is im- portant for two reasons. First, most previous studies of mental disorder and violence de- picted people with mental disorders as violent actors.^"'' These studies showed that people with mental disorders engaged in violence more often than people without mental disor- ders, particularly when their disorders in- volved alcohol or drug use. However, by ig- noring the victimization experiences of people with mental disorders, these studies inadver- tently reinforced the belief that people with mental disorders are dangerous^ when they also may be more vulnerable to harm from others than non-mentally disordered people. Second, understanding the association be- tween mental disorder and violent victimiza- tion is important for designing community- based mental health services. Studies of treated samples indicate that victims with mental disorders exhibit unique symptom patterns,^"'" require frequent use of emer- gency treatment services,'" and experience victimization in substantial numbers that do not appear in their medical charts.""''' Ignor- ing victimization may therefore undermine treatment success and contribute to the physi- cal and psychological harm experienced by people with mental disorders. Two hypotheses have been suggested for explaining the association between mental dis- order and violent victimization. One hypothe- sis, enhanced vulnerability to attack, suggests that people with mental disorders are often unable to engage in alert self-protection and self-defense.' The second hypothesis, victim- ization as an informal social control, suggests that people with mental disorders often be- have in ways that elicit grievances in others, which may lead to social control efforts that eventuate in victimization.'** Both hypotheses Objective. We examined the association between mental disorder and violent victimization in a general population sample. Methods. We performed a multivariate analysis of violent victimization in a 12- month period on a total birthcohortwithfollow-updata that assessed, during their 21st year, males and females born in Dunedin, New Zealand, in the early 1970s, Results. Compared with people with no mental disorder, (1) people with anxiety disorders experienced more sexual assaults, (2) people with schizophreniform dis- orders experienced more threatened and completed physical assaults, (3) people with alcohol dependence disorders experienced more completed physical assaults, and (4) people with marijuana dependence disorders experienced more attempted physical assaults. These results held after control for psychiatric comorbidity, de- mographic characteristics, and the study participants' own violent behavior.
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Silver et al 2005 - Mental Disorder and Violent...

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