assault (violence)

Etiology

• motives: fear, anger, frustration
• predisposing factors
  • alcoholism, drug abuse
  • coexisting illness or pain
  • mental illness
    • dementia, depression, schizophrenia, personality disorder
  • lack of support system
  • stress: hostile work environment, high-risk occupation
• precipitating factors
  • environmental stimuli
  • financial stress
  • invasion of personal space
  • lack of privacy
  • lack of respect
  • long waiting times
• axis 1 disorders associated with violent outbursts
  • episodic dyscontrol syndrome
  • antisocial personality disorder
  • borderline personality disorder
  • attention deficit hyperactivity disorder

Clinical manifestations

• warning signs
  • confusion, fear or altered state of consciousness
  • perceived threat
  • excessive psychomotor activity
    • restlessness, intensified facial features, fist or jaw clenching
  • use of profanity
• axis 1 disorders may not be associated with warning signs prior to a violent outburst

Management

• see anger
• reporting:
  • if a provider is treating an injury suspected to be a result of violence (gunshot, knife, assault), he/she is mandated to report this to the police
  • if a patient is a threat others or another person, a provider is mandated to report this to the police
• screening veterans
  • financial instability
  • combat experience
  • alcohol misuse
  • history of lifetime noncombat violence or arrest for crime
  • probable post-traumatic stress disorder plus past-week irritability or angry outbursts

More general terms

• aggression

More specific terms

• domestic violence (includes intimate partner violence)
• gun violence
• workplace violence

Additional terms

• anger
• fear
• firearm (gun, rifle, handgun)
• trauma