Psychiatric Quarterly, Vol. 76, No. 2, Summer 2005 (
PRECIPITANTS OF ELDERLY PSYCHIATRIC
PATIENT ASSAULTS ON STAFF:
PRELIMINARY EMPIRICAL INQUIRY
Raymond B. Flannery, Jr., Ph.D., Brenda
Peterson, M.H.W. IV, and Andrew P. Walker, B.A.
Although there have been several studies of the characteristics of psychiatric
patient assailants, there have been only six comprehensive, empirical assess-
ments of precipitants to these assaults and no precipitant study has focused
solely on elderly psychiatric patient assailants. This one and one-half year,
retrospective study continued the inquiry into the nature of patient assault
precipitants and focused only on elderly assailants. Older, male patients with
a diagnosis of schizophrenia and histories of violence toward others and sub-
stance use disorder physically assaulted primarily male, mental health work-
ers. These staff victims experienced disruptions in the domains of mastery,
attachment, and meaning as well as the symptomatology associated with psy-
chological trauma. The most common precipitants to these assaults were denial
of services and acute psychosis. The ﬁndings and implications for health care
Raymond B. Flannery, Jr., Ph.D., is Senior Psychologist, Worcester State Hospital,
Massachusetts Department of Mental Health, and Associate Clinical Professor of
Psychology, Harvard Medical School, at The Cambridge Health Alliance, Cambridge, MA.
Brenda Peterson, M.H.W. IV, is Training Coordinator, Westborough State Hospital,
Massachusetts Department of Mental Health, and ASAP Team Co-Leader at her facility,
Andrew P. Walker, B.A., is Information Technology Specialist, Massachusetts Depart-
ment of Mental Health, Boston, MA.
Address correspondence to Raymond B. Flannery, Jr., Ph.D., Department of Psychol-
ogy/6B, Worcester State Hospital, 305 Belmont Street, Worcester, MA 01604.
2005 Springer Science+Business Media, Inc.