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

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, trigge...

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Main Author: Whitwham, Stephanie
Format: Thesis (University of Nottingham only)
Language:English
Published: 2020
Subjects:
Online Access:https://eprints.nottingham.ac.uk/60746/
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author Whitwham, Stephanie
author_facet Whitwham, Stephanie
author_sort Whitwham, Stephanie
building Nottingham Research Data Repository
collection Online Access
description 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.
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spelling nottingham-607462025-02-28T14:56:12Z https://eprints.nottingham.ac.uk/60746/ Aggression following acquired brain injury in a forensic hospital: the assessment of triggers and management strategies Whitwham, Stephanie 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. 2020-07-24 Thesis (University of Nottingham only) NonPeerReviewed application/pdf en arr https://eprints.nottingham.ac.uk/60746/1/SW%20Thesis%20-%20Aggression%20following%20Acquired%20Brain%20Injury%20March%202020.pdf Whitwham, Stephanie (2020) Aggression following acquired brain injury in a forensic hospital: the assessment of triggers and management strategies. DForenPsy thesis, University of Nottingham. Acquired Brain Injury Forensic Aggression
spellingShingle Acquired Brain Injury
Forensic
Aggression
Whitwham, Stephanie
Aggression following acquired brain injury in a forensic hospital: the assessment of triggers and management strategies
title Aggression following acquired brain injury in a forensic hospital: the assessment of triggers and management strategies
title_full Aggression following acquired brain injury in a forensic hospital: the assessment of triggers and management strategies
title_fullStr Aggression following acquired brain injury in a forensic hospital: the assessment of triggers and management strategies
title_full_unstemmed Aggression following acquired brain injury in a forensic hospital: the assessment of triggers and management strategies
title_short Aggression following acquired brain injury in a forensic hospital: the assessment of triggers and management strategies
title_sort aggression following acquired brain injury in a forensic hospital: the assessment of triggers and management strategies
topic Acquired Brain Injury
Forensic
Aggression
url https://eprints.nottingham.ac.uk/60746/