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- Title
Aggressive behavior and metacognitive functions: a longitudinal study on patients with mental disorders.
- Authors
Candini, Valentina; Ghisi, Marta; Bianconi, Giorgio; Bulgari, Viola; Carcione, Antonino; Cavalera, Cesare; Conte, Giovanni; Cricelli, Marta; Ferla, Maria Teresa; Ferrari, Clarissa; Iozzino, Laura; Macis, Ambra; Nicolò, Giuseppe; Stefana, Alberto; de Girolamo, Giovanni; for the VIORMED-2 Group; Barlati, Stefano; Martinazzoli, Assunta; Mina, Giuliana; Paleari, Roberta
- Abstract
Background: Metacognitive functions play a key role in understanding which psychological variables underlying the personality might lead a person with a severe mental disorder to commit violent acts against others. The aims of this study were to: (a) investigate the differences between patients with poor metacognitive functioning (PM group) and patients with good metacognitive functioning (GM group) in relation to a history of violence; (b) investigate the differences between the two groups in relation to aggressive behavior during a 1-year follow-up; and (c) analyze the predictors of aggressive behavior. Methods: In a prospective cohort study, patients with severe mental disorders with and without a lifetime history of serious violence were assessed with a large set of standardized instruments and were evaluated bi-monthly with MOAS in order to monitor any aggressive behavior. The total sample included 180 patients: 56% outpatients and 44% inpatients, and the majority were male (75%) with a mean age of 44 (± 9.8) years, and half of them had a history of violence. The sample was split into two groups: poor metacognition (PM) group and good metacognition (GM) group, according to MAI evaluation scores. Results: The PM patients reported a history of violence more frequently than GM patients, during the 1-year follow-up, but no differences between groups in aggressive and violent behavior were found. The strongest predictors of aggressive behavior were: borderline and passive–aggressive personality traits and a history of violence, anger, and hostility. The metacognitive functions alone did not predict aggressive behavior, but metacognitive functions interacted with hostility and angry reactions in predicting aggressive behavior. Conclusions: This study led to some important conclusions: (a) some aspects closely related to violence are predictive of aggressive behavior only in patients with poor metacognition, thus good metacognition is a protective factor; (b) poor metacognition is associated with a history of violence, which in turn increases the risk of committing aggressive behavior.
- Subjects
RISK factors of aggression; RISK of violence; COGNITION; COGNITION disorders; LONGITUDINAL method; MENTAL illness; RISK assessment; PATIENTS' attitudes; DESCRIPTIVE statistics
- Publication
Annals of General Psychiatry, 2020, Vol 19, Issue 1, p1
- ISSN
1744-859X
- Publication type
Article
- DOI
10.1186/s12991-020-00286-3