Aggression

Question 1

Name 4 broad categories and 2 examples of each for risk factors for aggression

Answer 1

1. Historical: previous violent behavior, loss of control
2. Contextual: substance Use disorder! , high degree of intent to do harm, identifiable victim, frequent and open threats, access to instruments of violence, concrete plan
3. Clinical: chronic anger/hostility / resentment, paranoid ideation, hallucinations commanding aggression, antisocial traits with or without psychosis with or with out substance abuse
4. Dispositional: male, young

Question 2

Name 3 non-pharmacological interventions for aggression and what it’s indicated for

Answer 2

1. De-escalation techniques: for mild aggression to reduce level of arousal
2. Mechanical restraints : last resort. Give medication asap and don’t release until meds have had effect.
3. Seclusion : not as punishment.

Question 3

Name the 3 stages of aggression

Answer 3

1. Potential
2. Imminent (making threats)
3. Emergent

Question 4

Name 10 psychiatric disorders that may present with aggression

Answer 4

• Psychotic disorders
1. Schizophrenia
2. Substance induced psychotic disorder
3 general medical condition induced
(Delusional disorder)
• mood disorders
4. Bipolar
(Major depressive disorder with agitation)
5.adjustment disorder with disturbance of conduct
6. Intellectual disability
7.adhd
8. Conduct disorder
9. Neurocognitive disorders
(Delirium)
• Personality disorders
10. Borderline
11. Antisocial
12. Paranoid
13. Narcissistic

Question 5

Short term treatment for aggression? (5)

Answer 5

• Benzodiazepines

1. Lorazepam 2-4 mg sl, po, im . Max 16 mg /day
2. Diazepam 10 mg iv slowly over 5 min

• Antipsychotics

1. Haloperidol 5- 10 mg po, im, iv 4-6 hourly
2. olanzepine 2,5-10mg po, do not give im with benzos
3. Risperidone 1-2 mg po