Aggression following acquired brain injury in a forensic hospital: the assessment of triggers and management strategies

Whitwham, Stephanie (2020) Aggression following acquired brain injury in a forensic hospital: the assessment of triggers and management strategies. DForenPsy thesis, University of Nottingham.

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Background: Aggression can often occur in people who have an Acquired Brain Injury (ABI), and the prevalence of ABI in forensic settings is high. This thesis aimed to explore aggression following ABI, how aggression is measured in various clinical settings, and then how aggression is defined, triggered and managed in a forensic hospital setting.

Method: A systematic review and meta-analysis was conducted, identifying and evaluating measures used to assess aggression in adults with ABI. One of these measures, the OAS-MNR was critically evaluated. A questionnaire was then developed based on the OAS-MNR to quantitatively assess triggers to aggression in patients with ABI in a forensic hospital from the staff’s perspective. Qualitative data was then collected through interviews with staff to provide deeper exploration of these triggers.

Results: The OAS-MNR was the only identified measure which assesses antecedents to aggression in people with ABI. Using a questionnaire based on this measure, staff frequently reported internal and external triggers that can lead to aggressive incidents, including restrictions in the secure environment. Frustration was identified as the main trigger, which they explained could lead to aggression if the patient is unable to control or effectively communicate their frustration. Impairment as a result of the brain injury can make this more difficult.

Discussion: Incidents of aggression in a forensic ABI setting are frequent, complex and include multiple triggers to aggression. Incidents can be better managed by awareness of individual patients’ triggers, and distraction techniques. This can be helpful when training new staff or managing incidents.

Item Type: Thesis (University of Nottingham only) (DForenPsy)
Supervisors: Jones, Katy
Keywords: Acquired Brain Injury, Forensic, Aggression
Subjects: W Medicine and related subjects (NLM Classification) > WL Nervous system
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Medicine
Item ID: 60746
Depositing User: Whitwham, Stephanie
Date Deposited: 28 Jul 2020 08:11
Last Modified: 28 Jul 2020 08:15

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