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Tijdschrift voor Psychiatrie 46 (2004) 9, 601 - 609

New research

Aggressive behaviour of prisoners with psychiatric disorders

H. Nijman, M. Geurkink

background Various sources indicate that acts of aggression against prison staff occur frequently. However, very little detailed information is available about the nature, causes and severity of aggressive behaviour in Dutch prisons.
aim To obtain insight into the nature and severity of the aggressive behaviour of prisoners with psychiatric disorders.
methods The aggressive behaviour of all the prisoners residing in one of the seven sections of the foba (Forensic Observation and Supervision Departement) (which has 66 cells) between 1 October 2001 and 31 July 2002 (10 months) was recorded by means of an adapted version of the Staff Observation Aggression Scale-Revised (adapted for prison conditions).
results Over the 10-month period 186 aggressive incidents were reported, which is equivalent to a frequency of about 3.4 incidents per cell per annum. About one in seven of the incidents reported had physical consequences for the victims and the aggression was generally directed against prison staff (79%). Patient-to-patient aggression, however, was rare in the foba (5%). The frequency of aggression was particularly high in the 'Very Intensive Care' ward where the most disturbed and mainly acutely psychotic patients are detained (on average 9 incidents per cell per annum). Among this category of patients aggression significantly often seems to stem from by the patient's psychopathy. In the seven sections of the foba aggression frequently occurs in cell doorways. conclusion In spite of the structure and rest that foba offers to patients, overstimulation still seems to play a role in eliciting aggression, particularly among the most disturbed psychotic prisoners in the Very Intensive Care ward. In the light of the ongoing discussion in the Netherlands about placing more than one prisoner in a cell, it is interesting to note that of all the incidents that occurred in the various sections more than a quarter took place in cell doorways. According to the prison staff a possible disadvantage of placing more than one prisoner in a cell is that dangerous situations often arise when cells are being locked or unlocked.

keywords aggression, imprisonment, psychiatric disorders, psychosis, violence