Proper assessment of aggressive behavior is essential for an understanding
of its causes. In 1987, Palmstierna and Wistedt [Acta Psychiatr Scand 76:65
7-663] introduced the Staff Observation Aggression Scale (SOAS), an instrum
ent for monitoring the frequency, nature, and severity of aggressive incide
nts. In the present study, the validity of the SOAS severity scoring system
was examined, and the severity scores were refined. The SOAS was used to r
ecord aggression on six closed wards of three psychiatric hospitals. The SO
AS severity scores of 556 aggressive incidents were compared with severity
estimates given on Visual Analogue Scales (VASs) by staff members. The orig
inal SOAS scores were found to be moderately correlated with the estimates
of severity given by staff on the VAS. The SOAS severity scoring system was
refined on the basis of the staff severity estimates. The revised scoring
method and other refinements in the contents of the instrument led to the c
onstruction of the SOAS-R. The SOAS-R seems to be a promising tool for moni
toring a wide range of (self-) destructive acts on psychiatric wards. (C) 1
999 Wiley-Liss, Inc.