Description
The association between violence and mental illness is well studied, yet remains highly
controversial. Currently, there does appear to be a trend of increasing violence in hospital
settings, including both civilly and forensically committed populations. In fact, physical
aggression is the primary reason for admission to many hospitals. Given that violence
is now often both a reason for admission and a barrier to discharge, there is a pressing
need for violence to be re-conceptualized as a primary medical condition, not as the byproduct
of one. Furthermore, treatment settings need to be enhanced to address the new
types of violence exhibited in inpatient environments and this modification needs to be
geared toward balancing safety with treatment. This book focuses on violence from assessment, through underlying neurobiology,
to treatment and other recommendations for practice. This will be of interest to forensic psychiatrists, general adult psychiatrists,
psychiatric residents, psychologists, psychiatric social workers and rehabilitation therapists.
Key Features
Focuses on violence from assessment, through underlying neurobiology, to treatment and other recommendations for practice
Reconceptualizes violence as a primary medical condition, not as the by-product of one
Addresses new types of violence exhibited in inpatient environments to enhance a balance between safety and hospital treatment

Contents
List of contributors;
Part I. Statement of the Problem:
1. Deinstitutionalization and the rise of violence;
2. The new mission of forensic mental health
systems: managing violence as a medical syndrome
in an environment that balances treatment and
safety;
Part II. Assessment:
3. The evolution of violence risk assessment;
4. Assessment of aggression in inpatient settings;
5. Clinical assessment of psychotic and mood
disorder symptoms for risk of future violence;
6. Inpatient aggression in community hospitals;
7. Prevalence of physical violence in a forensic
psychiatric hospital system during 2011 2013:
patient assaults, staff assaults, and repeatedly violent
patients;
8. The psychiatrist's duty to protect;
Part III. Neurobiology:
9. Deconstructing violence as a medical syndrome:
mapping psychotic, impulsive, and predatory
subtypes to malfunctioning brain circuits;
10. Aggression, DRD1 polymorphism, and lesion
location in penetrating traumatic brain injury;
11. Is impulsive violence an addiction? The habit
hypothesis;
12. The neurobiology of psychopathy: recent
developments and new directions in research and
treatment;
13. The neurobiology of violence;
14. Impulsivity and aggression in schizophrenia:
a neural circuitry perspective with implications for
treatment;
15. Serotonin and impulsive aggression;
Part IV. Guidelines:
16. California State-Hospital Violence Assessment
and Treatment (Cal-VAT) guidelines;
Part V. Psychopharmacology:
17. Effectiveness of antipsychotic drugs against
hostility in patients with schizophrenia in the
Clinical Antipsychotic Trials of Intervention
Effectiveness (CATIE) study;
18. Clozapine: an effective treatment for seriously
violent and psychotic men with antisocial
personality disorder in a UK high-security hospital;
19. Augmentation of clozapine with amisulpride:
an effective therapeutic strategy for violent
treatment-resistant schizophrenia patients in a UK
high-security hospital;
20. The psychopharmacology of violence: making
sensible decisions;
21. Treating the violent patient with psychosis or
impulsivity utilizing antipsychotic polypharmacy
and high-dose monotherapy;
22. A rational approach to employing high plasma
levels of antipsychotics for violence associated with
schizophrenia: case vignettes;
23. Illustrative cases to support Cal-VAT guidelines;
Part VI. Treatment Interventions:
24. A new standard of care for forensic mental
health: prioritizing forensic intervention;
25. Forensic focused treatment planning: a new
standard for forensic mental health systems;
26. Implementing an ecological approach to
violence reduction at a forensic psychiatric hospital:
approaches and lessons learned;
27. The appropriateness of treating psychopathic
disorders;
28. Psychosocial approaches to violence and
aggression: contextually anchored and traumainformed
interventions;
29. Co-morbid mental illness and criminalness:
implications for housing and treatment;
30. Crime, violence and behavioral health:
collaborative community strategies for risk
mitigation;
31. New technologies in the management of risk and
violence in forensic settings;
32. Risk reduction treatment of psychopathy and
applications to mentally disordered offenders;
Index.