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The heterogeneity of violent behavior is often overlooked in risk assessment despite its importance in the management and treatment of psychiatric and forensic patients. In this study, items from the Personality Assessment Inventory (PAI) were first evaluated and rated by experts in terms of how well they assessed personality features associated with reactive and instrumental aggression. Exploratory principal component analyses (PCA) were then conducted on select items using a sample of psychiatric and forensic inpatients (η = 479) to examine the latent structure and construct validity of these reactive and instru- mental aggression factors. Finally, a confirmatory factor analysis (CFA) was conducted on a separate sample of psychiatric inpatients (η = 503) to evaluate whether these factors yielded acceptable model fit. Overall, the exploratory and confirmatory analyses supported the existence of two latent PAI factor structures, which delineate personality traits related to reactive and instrumental aggression.
Keywords: Personality Assessment Inventory; reactive aggression; instrumental aggression; violence; aggressive behavior; risk assessment
Assessing the risk for violence and aggressive behavior in psychiatric patients is important for management and treatment considerations across forensic and civil settings (Cawood & Corcoran, 2009). Violence risk assessment is also an integral part of discharge planning and may significantly influence a patient's length of institutional stay (Cawood & Corcoran, 2009). Despite the importance of violence risk assessment, often neglected is the heterogeneity of violence and the various pathways to aggressive behavior (Volavka, 2002). Instead, a unidimensional approach is used, in which the focus is simply on the presence of trait aggression, such as antisociality or psychopa- thy, or the history of any aggressive behavior. This approach may leave out etiopathophysi- ologically distinct ,v///;(ypes of violent behavior, which may be crucial in establishing more accurate risk profiles and determining more efficacious violence-preventive interventions and treatments (Antonius et al., 2010; Volavka & Citrome, 2008).
Reactive and Instrumental Aggression
One particularly important typological distinction is between reactive and instrumental aggression (Barratt, 1991; Cornell et al., 1996). Based in part on the "frustration-aggression model" (Berkowitz, 1962; Dollard, Doob, Miller, Mowrer, & Sears, 1939), reactive aggres- sion is emotion-based and typically in response to a provocation or a direct threat (Cornell et al., 1996; Stanford, Houston, Mathias, et al., 2003; Stanford, Houston, Villemarette, et al., 2003). Instrumental aggression,...