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Flashcards in Violence Deck (11):

Predisposing Factors for Violence

Disorders and tumors of the limbic systems
Frontal lobe injury
Temporal lobe epilepsy
Low serotonin syndrome
Deliriums and Dementias
Alcohol/Drug Withdrawal


Environmental-Social Models of Violence

Gang involvement
Excessive TV
Child abuse
Low educational attainment


Managing Escalation

Depends on 3 skills:
Observation of changes from baseline
Assessment of the causes of behavioral change
Modification of communication based on the cause and degree of emotional arousal.
Voice should be low and slow


Addressing the escalating patient

Address pt with respect
Give pt opportunity to change behavior but do not provide more than 1 option
Maintain your ability to relax by deep breathing and centering yourself


Early Escalation

Changes in behavior: ascertain cause
First Technique:
-Offer self and use active listening techniques
-Discover the underlying emotion driving the behavior change
Second Technique:
-Supportive problem solving to alleviate distress
-Frustration: Identify source and practical ways to attain unmet needs
-Anger: Identify source and ways to reduce sense of threat or harm


Late Escalation

Engage in crisis communication rather than problem solving
Respond to the emotion driving the escalation
Reduce words to a minimum and offer simple choices
Set enforceable limits and offer simple choices


Escalated with fear and anxiety

Stand 5 to 8 feet away at an angle
Maintain a relaxed posture
Keep hands open and visible
Speak in a low but confident tone
Keep your facial expression neutral
Allow pt to determine eye contact
Offer help
Deny intent to harm
Ask pt what is needed to make him/her feel safe


Escalated frustration and anger

Stand directly in front of the pt but just out of reach
Use pointed gestures and maintain a ready, non-aggressive posture
Speak in a soft, firm tone
Give simple 1 or 2 word commands
Repeat until directions followed


Short-term goals when treating victims of abuse

A safe environment is established
Immediate injuries heal w/o complications
Client will be able to talk about abuse and feelings identified by abuse
Victims and/or abusers will be able to identify triggers for abuse and that the victim is not to blame


Long-term goals for victims of abuse

Current victim will have no further injuries and family will not create any new abuse/neglect situations
Abusers will receive adequate treatment of any significant mental illness and will be maintained in a safe level of remission
Victims and witnesses will not develop long term emotional problems and will suffer no further developmental delays as a consequence of abuse.



Criterion for involuntary treatment
Associated with anger, hostility, fear, manipulation, and intimidation
Aspect of aggression
Best predicted by a history of violence
Learned behavior that is reinforced by results and pleasurable arousal
Occurs in individuals in all diagnostic categories, and is not exclusively Manifested by individuals diagnosed with psychiatric disorders