Hostility and violent ideation: Physical rehabilitation patient and community samples

Objectives. To assess the relative frequency of violent ideation [VI] in ph ysical rehabilitation and community samples, and to identify associated fac tors. Design. Analysis of variables horn the Battery for Heath Improvement using MANOVA, ANOVA and XL analyses. Setting. Medical sites in 30 US states, and community sites in 16 US states , overall representing 36 US states. Participants. 527 physical rehabilitation patients suffering from both acut e and chronic pain conditions, and 725 community members. Subjects from bot h groups were drawn from a larger pool of 2,262 subjects. Interventions. No ne. Outcome Measures. The Hostility scale and a VI critical item from the Batte ry for Heath Improvement (BHI). Results. The patient group reported significantly more violent ideation tha n did the community group. VI was also significantly associated with involv ement in workers' compensation or personal injury insurance systems, work c onditioning programs, the BHI Hostility scale, and a number of other psycho social factors. Conclusions. Recent research supports the contention that there is a relati onship between ideation, angry affect, aggressive behavior and delayed reco very. Thus the presence of VI in the patient should be a cause for concern, and has clear ramifications for those working in the clinical setting. Pri mary prevention should involve not only the identification of hostile patie nts at risk for VI and aggression, it should also involve identifying progr ams or systems where a higher incidence of VI is likely to be observed. As VI was found to be associated with a range of variables, including characte rological disorders, mood and social conflict, a further evaluation of fact ors contributing to VI would be recommended prior to intervention.