Insight and Locus of Control as Related to Aggression in

1. Insight and Locus of Control as Related to Aggression in Individuals with Severe Mental Illness (SMI) Bethany L. Ridling Faculty Mentor: Dr. William Spaulding Department of Psychology, University of Nebraska-Lincoln Introduction Methods Data Analysis and Results • Individuals with severe mental illness (SMI) are often stereotyped as aggressive, although research has consistently shown that the majority of individuals with SMI are not aggressive. (7% to 35% depending on the study). • When aggression does occur, there is evidence that it is more intense than in normal populations, and it interferes with treatment and recovery. • Closer examination of factors that differentiate between high-aggressors and low-aggressors may predict which patients are more likely to become aggressive, thereby preventing aggressive instances. • Previous Findings • Many studies have examined the relationship between insight and locus of control and aggression. • Findings on insight are contradictory. Some studies have found that low insight is associated with aggression, while others have not. • Findings on locus of control have generally been that external locus of control is associated with aggression. • Participants • 44 psychiatric inpatients at a state hospital • 24 males, 20 females • 40 Caucasian, 3 African American, 1 Asian American • Average age at admission: 39.63 (Range from 22-66) • All had diagnoses in the schizophrenia spectrum • All met the administrative criteria for “severe and persistent mental illness” • History of aggression • 7 had history of verbal aggression • 27 had history of physical aggression • 10 had no history of aggression • Materials • Social History • History of aggression was extracted from Social History included in each patient’s medical record. Reliability was established through a preliminary interrater check requiring 100% agreement. • Birchwood Insight Scale • Evaluates 3 dimensions of insight • Perceived need for treatment • Awareness of illness • Relabeling symptoms as part of illness • Inventory of Competence and Control Beliefs (FKK) • Assesses locus of control • Each individual receives both an internal and an external score • Repeatable Battery for the Assessment of Neurocognitive Status (RBANS) • Assesses neurocognitive ability • Contains 5 scoring indices • Attention • Immediate Memory • Delayed Memory • Language • Visuospatial/Constructional tasks • Procedure • The Birchwood Insight Scale, FKK, and RBANS are administered by program staff as part of a routine battery that is given every 6 months. • Data Analysis • Linear discriminant function was used to determine the relationship between the Birchwood Insight Scale scores, the Externality subscale of the FKK scores, and aggression, while controlling for neurocognitive function. • Results • Multivariate analysis showed that the function did not reliably differentiate among the groups • λ=.855, X2(3)=2.123, p=.547, R2 canonical=.15 • A simple correlation between scores on the Birchwood Insight Scale and scores on the Externality subscale of the FKK scores showed that scores on the two assessments were not significantly related (r=.03, p=.84). Conclusions • Insight and locus of control measures are not related to aggression in this patient sample. • Why? • Historical aggression data was used in this study, instead of current data. • Much of the previously collected data on insight and locus of control in relation to aggression was collected with a more heterogeneous population, whereas the population for this study included individuals with especially severe and chronic mental illness. Purpose and Hypotheses • The purpose of this study was to examine the relationship between insight, locus of control, and aggression in individuals with SMI, while controlling for neurocognitive ability. This study enhanced the understanding of aggression in SMI. • Hypotheses: • Low insight is related to aggressive behavior • External locus of control is related to higher aggression • Low insight is related to external locus of control Acknowledgements Dr. William Spaulding, Faculty Mentor Melissa Tarasenko, Graduate Student Mentor Ashley Wynne, Graduate Student Felice Reddy, Graduate Student Severe Mental Illness (SMI) Research Group McNair Scholars Program