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California State Hospital Violence Assessment and Treatment (Cal-VAT) guidelines

Published online by Cambridge University Press:  14 August 2014

Stephen M. Stahl
Department of Psychiatry, University of California–San Diego, San Diego, California, USA Department of Psychiatry, University of Cambridge, Cambridge, UK Neuroscience Education Institute, Carlsbad, California, USA California Department of State Hospitals, California, USA
Debbi A. Morrissette
Neuroscience Education Institute, Carlsbad, California, USA Department of Biology, California State University, San Marcos, California, USA Department of Biology, Palomar College, San Marcos, California, USA
Michael Cummings
California Department of State Hospitals, California, USA Department of Psychiatry, Patton State Hospital, California, USA
Allen Azizian
California Department of State Hospitals, California, USA Department of Psychology, Coalinga State Hospital, California, USA Department of Criminology, California State University, Fresno, California, USA
Shannon Bader
California Department of State Hospitals, California, USA Department of Psychiatry, Patton State Hospital, California, USA
Charles Broderick
California Department of State Hospitals, California, USA Department of Psychology, Atascadero State Hospital, California, USA
Laura Dardashti
California Department of State Hospitals, California, USA Department of Psychology, Metropolitan State Hospital, California, USA
Darci Delgado
California Department of State Hospitals, California, USA Department of Psychology, Vacaville Psychiatric Program, California, USA
Jonathan Meyer
Department of Psychiatry, University of California–San Diego, San Diego, California, USA California Department of State Hospitals, California, USA Department of Psychiatry, Patton State Hospital, California, USA
Jennifer O’Day
California Department of State Hospitals, California, USA Department of Psychology, Metropolitan State Hospital, California, USA
George Proctor
California Department of State Hospitals, California, USA Department of Psychiatry, Patton State Hospital, California, USA
Benjamin Rose
California Department of State Hospitals, California, USA Department of Psychology, Napa State Hospital, California, USA
Marie Schur
California Department of State Hospitals, California, USA Department of Psychology, Atascadero State Hospital, California, USA
Eric Schwartz
California Department of State Hospitals, California, USA Department of Psychology, Vacaville Psychiatric Program, California, USA
Susan Velasquez
California Department of State Hospitals, California, USA Department of Psychiatry, Patton State Hospital, California, USA
Katherine Warburton
California Department of State Hospitals, California, USA Department of Psychiatry, Forensic Division, University of California–Davis, Davis, California, USA


Here we provide comprehensive guidelines for the assessment and treatment of violence and aggression of various etiologies, including psychotic aggression and impulsive aggression due to schizophrenia, mood disorders, ADHD, or trauma, and predatory aggression due to psychopathy and other personality disorders. These guidelines have been developed from a collection of prescribing recommendations, clinical trial results, and years of clinical experience in treating patients who are persistently violent or aggressive in the California Department of State Hospital System. Many of the recommendations provided in these guidelines employ off-label prescribing practices; thus, sound clinical judgment based on individual patient needs and according to institution formularies must be considered when applying these guidelines in clinical practice.

© Cambridge University Press 2014 

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1. Diaz-Marsa, M, Gonzalez Bardanca, S, Tajima, K, Garcia-Albea, J, Navas, M, Carrasco, JL. Psychopharmacological treatment in borderline personality disorder. Actas Esp Psiquiatr. 2008; 36(1): 3949.Google Scholar
2. Buscema, CA, Abbasi, QA, Barry, DJ, Lauve, TH. An algorithm for the treatment of schizophrenia in the correctional setting: the Forensic Algorithm Project. J Clin Psychiatry. 2000; 61(10): 767783.CrossRefGoogle ScholarPubMed
3. Castle, D, Daniel, J, Knott, J, Fielding, J, Goh, J, Singh, B. Development of clinical guidelines for the pharmacological management of behavioural disturbance and aggression in people with psychosis. Australas Psychiatry. 2005; 13(3): 247252.Google Scholar
4. Herrmann, N, Lanctôt, KL, Hogan, DB. Pharmacological recommendations for the symptomatic treatment of dementia: the Canadian Consensus Conference on the Diagnosis and Treatment of Dementia 2012. Alzheimers Res Ther. 2013; 5(Suppl 1): S5.CrossRefGoogle ScholarPubMed
5. List, BA, Barzman, DH. Evidence-based recommendations for the treatment of aggression in pediatric patients with attention deficit hyperactivity disorder. Psychiatr Q. 2011; 82(1): 3342.Google Scholar
6. Morana, HC, Camara, FP. International guidelines for the management of personality disorders. Curr Opin Psychiatry. 2006; 19(5): 539543.Google Scholar
7. Oliver-Africano, P, Murphy, D, Tyrer, P. Aggressive behaviour in adults with intellectual disability: defining the role of drug treatment. CNS Drugs. 2009; 23(11): 903913.Google Scholar
8. Taft, CT, Creech, SK, Kachadourian, L. Assessment and treatment of posttraumatic anger and aggression: a review. J Rehabil Res Dev. 2012; 49(5): 777788.CrossRefGoogle ScholarPubMed
9. Tyrer, P, Seivewright, N. Pharmacological treatment of personality disorders. Clin Neuropharmacol. 1988; 11(6): 493499.CrossRefGoogle ScholarPubMed
10. Vickland, V, Chilko, N, Draper, B, Low, LF, O’Connor, D, Brodaty, H. Individualized guidelines for the management of aggression in dementia—Part 2: appraisal of current guidelines. Int Psychogeriatr. 2012; 24(7): 11251132.Google Scholar
11. Vickland, V, Chilko, N, Draper, B, Low, LF, O’Connor, D, Brodaty, H. Individualized guidelines for the management of aggression in dementia—Part 1: key concepts. Int Psychogeriatr. 2012; 24(7): 11121124.CrossRefGoogle Scholar
12. Warden, DL, Gordon, B, McAllister, TW, et al. Guidelines for the pharmacologic treatment of neurobehavioral sequelae of traumatic brain injury. J Neurotrauma. 2006; 23(10): 14681501.Google Scholar
13. Allen, MH. Currier GW, Hughes DH, Docherty JP, Carpenter D, Ross R. Treatment of behavioral emergencies: a summary of the expert consensus guidelines. J Psychiatr Pract. 2003; 9(1): 1638.CrossRefGoogle ScholarPubMed
14. Fava, M. Psychopharmacologic treatment of pathologic aggression. Psychiatr Clin North Am. 1997; 20(2): 427451.CrossRefGoogle ScholarPubMed
15. Sheard, MH. Clinical pharmacology of aggressive behavior. Clin Neuropharmacol. 1988; 11(6): 483492.CrossRefGoogle ScholarPubMed
16. Tardiff, K. The current state of psychiatry in the treatment of violent patients. Arch Gen Psychiatry. 1992; 49(6): 493499.Google Scholar
17. Wong, SC, Gordon, A, Gu, D. Assessment and treatment of violence-prone forensic clients: an integrated approach. Br J Psychiatry Suppl. 2007; 49: s66s74.Google Scholar
18. Dack, C, Ross, J, Papadopoulos, C, Stewart, D, Bowers, L. A review and meta-analysis of the patient factors associated with psychiatric in-patient aggression. Acta Psychiatr Scand. 2013; 127(4): 255268.Google Scholar
19. Howland, RH. Limitations of evidence in the practice of evidence-based medicine. J Psychosoc Nurs Ment Health Serv. 2007; 45(11): 1316.Google Scholar
20. Kennedy, HG. Therapeutic uses of security: mapping forensic mental health services by stratifying risk. Advances in Psychiatric Treatment. 2002; 8(6): 433443.Google Scholar
21. Vaaler, AE, Iversen, VC, Morken, G, Flovig, JC, Palmstierna, T, Linaker, OM. Short-term prediction of threatening and violent behaviour in an acute psychiatric intensive care unit based on patient and environment characteristics. BMC Psychiatry. 2011; 11: 44.Google Scholar
22. Bandura, A. Psychological mechanisms of aggression. In: Geen RG, Donnerstein EI, eds. Aggression: Theoretical and Empirical Reviews—Vol 1, Theoretical and Methodological Issues. New York: Academic Press; 1983: 140.Google Scholar
23. Berkowitz, L. Aggression: Its Causes, Consequences, and Control. New York: McGraw-Hill Higher Education; 1993.Google Scholar
24. Hemphill, JF, Hare, RD, Wong, S. Psychopathy and recidivism: a review. Legal and Criminological Psychology. 1998; 3(1): 139170.Google Scholar
25. Volavka, J, Citrome, L. Pathways to aggression in schizophrenia affect results of treatment. Schizophr Bull. 2011; 37(5): 921929.Google Scholar
26. Hare, RD, Neumann, CS. Psychopathy as a clinical and empirical construct. Annu Rev Clin Psychol. 2008; 4: 217246.Google Scholar
27. Hankin, CS, Bronstone, A, Koran, LM. Agitation in the inpatient psychiatric setting: a review of clinical presentation, burden, and treatment. J Psychiatr Pract. 2011; 17(3): 170185.CrossRefGoogle ScholarPubMed
28. Joshi, A, Krishnamurthy, VB, Purichia, H, Hollar-Wilt, L, Bixler, E, Rapp, M. “What’s in a name?” Delirium by any other name would be as deadly: a review of the nature of delirium consultations. J Psychiatr Pract. 2012; 18(6): 413418.Google Scholar
29. Wortley, R. Situational Prison Control: Crime Prevention in Correctional Institutions. Cambridge, UK: Cambridge University Press; 2002.Google Scholar
30. Gadon, L, Johnstone, L, Cooke, D. Situational variables and institutional violence: a systematic review of the literature. Clin Psychol Rev. 2006; 26(5): 515534.Google Scholar
31. Baldwin, S. Effects of furniture rearrangement on the atmosphere of wards in a maximum-security hospital. Hosp Community Psychiatry. 1985; 36(5): 525528.Google Scholar
32. Zaslove, MO, Beal, M, McKinney, RE. Changes in behaviors of inpatients after a ban on the sale of caffeinated drinks. Hosp Community Psychiatry. 1991; 42(1): 8485.Google Scholar
33. Ekland-Olson, S, Barrick, DM, Cohen, LE. Prison overcrowding and disciplinary problems: an analysis of the Texas prison system. Journal of Applied Behavioral Science. 1983; 19(2): 163192.Google Scholar
34. Mabli, J, Holley, C, Patrick, J, Walls, J. Age and prison violence: increasing age heterogeneity as a violence-reducing strategy in prisons. Criminal Justice and Behavior. 1979; 6(2): 175186.CrossRefGoogle Scholar
35. Cooke, DJ, Wozniak, E. PRISM applied to a critical incident review: a case study of the Glendairy prison riot and its aftermath in Barbados. International Journal of Forensic Mental Health. 2010; 9(3): 159172.CrossRefGoogle Scholar
36. Ekland-Olson, S. Crowding, social control, and prison violence: evidence from the post-Ruiz years in Texas. Law & Society Review. 1986; 20(3): 389421.Google Scholar
37. Lester, D. Overcrowding in prisons and rates of suicide and homicide. Percept Mot Skills. 1990; 71(1): 274.Google Scholar
38. Palmstierna, T, Huitfeldt, B, Wistedt, B. The relationship of crowding and aggressive behavior on a psychiatric intensive care unit. Hosp Community Psychiatry. 1991; 42(12): 12371240.Google Scholar
39. Flannery, RB Jr, Hanson, MA, Penk, WE, Flannery, GJ. Violence and the lax milieu? Preliminary data. Psychiatr Q. 1996; 67(1): 4750.CrossRefGoogle ScholarPubMed
40. Morrison, E, Morman, G, Bonner, G, Taylor, C, Abraham, I, Lathan, L. Reducing staff injuries and violence in a forensic psychiatric setting. Arch Psychiatr Nurs. 2002; 16(3): 108117.Google Scholar
41. Katz, P, Kirkland, FR. Violence and social structure on mental hospital wards. Psychiatry. 1990; 53(3): 262277.CrossRefGoogle ScholarPubMed
42. Flannery, RB Jr. Precipitants to psychiatric patient assaults on staff: review of empirical findings, 1990–2003, and risk management implications. Psychiatr Q. 2005; 76(4): 317326.Google Scholar
43. Flannery, RB Jr, Hanson, MA, Penk, WE. Risk factors for psychiatric inpatient assaults on staff. Journal of Mental Health Administration. 1994; 21(1): 2431.Google Scholar
44. Flannery, RB, Staffieri, A, Hildum, S, Walker, AP. The violence triad and common single precipitants to psychiatric patient assaults on staff: 16-year analysis of the Assaulted Staff Action Program. Psychiatr Q. 2011; 82(2): 8593.Google Scholar
45. Mistral, W, Hall, A, McKee, P. Using therapeutic community principles to improve the functioning of a high care psychiatric ward in the UK. Int J Ment Health Nurs. 2002; 11(1): 1017.CrossRefGoogle ScholarPubMed
46. Flannery, RB Jr, White, DL, Flannery, GJ, Walker, AP. Time of psychiatric patient assaults: fifteen-year analysis of the Assaulted Staff Action Program (ASAP). Int J Emerg Ment Health. 2007; 9(2): 8995.Google Scholar
47. Davies, W, Burgess, PW. Prison officers’ experience as a predictor of risk of attack: an analysis within the British prison system. Medicine, Science and the Law. 1988; 28(2): 135138.Google Scholar
48. Hamadeh, RR, Al Alaiwat, B, Al Ansari, A. Assaults and nonpatient-induced injuries among psychiatric nursing staff in Bahrain. Issues Ment Health Nurs. 2003; 24(4): 409417.Google Scholar
49. Webster, CD, Nicholls, TD, Martin, ML, Desmarais, SL, Brink, J. Short-Term Assessment of Risk and Treatability (START): the case for a new structured professional judgment scheme. Behav Sci Law. 2006; 24(6): 747766.Google Scholar
50. Stewart, D, Van der Merwe, M, Bowers, L, Simpson, A, Jones, J. A review of interventions to reduce mechanical restraint and seclusion among adult psychiatric inpatients. Issues Ment Health Nurs. 2010; 31(6): 413424.CrossRefGoogle ScholarPubMed
51. Bowers, L, Stewart, D, Papadopoulos, C, et al. Inpatient Violence and Aggression: A Literature Review. Report from the Conflict and Containment Reduction Research Programme London: Institute of Psychiatry, King’s College London; 2011.Google Scholar
52. Reisig, MD. Administrative control and inmate homicide. Homicide Studies. 2002; 6(1): 84103.Google Scholar
53. Templeton, L, Gray, S, Topping, J. Seclusion: changes in policy and practice on an acute psychiatric unit. Journal of Mental Health. 1998; 7(2): 199202.Google Scholar
54. Jayewardene, CH, Doherty, P. Individual violence in Canadian penitentiaries. Canadian Journal of Criminology. 1985; 27(4): 429439.Google Scholar
55. Porporino, FJ, Doherty, PD, Sawatsky, T. Characteristics of homicide victims and victimizations in prisons: a Canadian historical perspective. International Journal of Offender Therapy and Comparative Criminology. 1987; 31(2): 125136.CrossRefGoogle Scholar
56. Bader, S, Evans, SE, Welsh, E. Aggression among psychiatric inpatients: the relationship between time, place, victims, and severity ratings. J Am Psychiatr Nurses Assoc. 2014; 20(3): 179186.Google Scholar
57. Grainger, C, Whiteford, H. Assault on staff in psychiatric hospitals: a safety issue. Aust N Z J Psychiatry. 1993; 27(2): 324328.Google Scholar
58. Hodgkinson, PE, McIvor, L, Phillips, M. Patient assaults on staff in a psychiatric hospital: a two-year retrospective study. Medicine, Science, and the Law. 1985; 25(4): 288294.Google Scholar
59. Weizmann-Henelius, G. Suutala HJO. Violence in a Finnish forensic psychiatric hospital. Nord J Psychiatry. 2000; 54(4): 269273.CrossRefGoogle Scholar
60. Hunter, ME, Love, CC. Total quality management and the reduction of inpatient violence and costs in a forensic psychiatric hospital. Psychiatr Serv. 1996; 47(7): 751754.Google Scholar
61. Harris, GT, Varney, G. A ten-year study of assaults and assaulters on a maximum security psychiatric unit. Journal of Interpersonal Violence. 1986; 1(2): 173191.CrossRefGoogle Scholar
62. Heilbrun, K, Lander, T. Forensic mental heath assessment. In: Spielberger C, ed. Encyclopedia of Applied Psychology, Vol 2. New York: Elsevier Academic Press; 2004: 2942.Google Scholar
63. Maden, A. Treating Violence: A Guide to Risk Management in Mental Health. New York: Oxford University Press; 2007.Google Scholar
64. Lopez, LV, Kane, JM. Plasma levels of second-generation antipsychotics and clinical response in acute psychosis: a review of the literature. Schizophr Res. 2013; 147(2–3): 368374.CrossRefGoogle ScholarPubMed
65. Douglas, KS, Hart, SD, Webster, CD, Belfrage, H. HCR-20V3: Assessing risk of violence—User guide. Burnaby, Canada: Mental Health, Law, and Policy Institute, Simon Fraser University; 2013.Google Scholar
66. Webster, CD, Martin, ML, Brink, J, Nicholls, TD, Desmarais, SL. Manual for the Short-Term Assessment of Risk and Treatability (START) (Version 1.1). Port Coquitlam, BC, Canada: Forensic Psychiatric Services Commission and St. Joseph’s Healthcare; 2009.Google Scholar
67. Bjørkly, S, Hartvig, P, Heggen, FA, Brauer, H, Moger, TA. Development of a brief screen for violence risk (V-RISK-10) in acute and general psychiatry: an introduction with emphasis on findings from a naturalistic test of interrater reliability. Eur Psychiatry. 2009; 24(6): 388394.Google Scholar
68. Hare, RD. Manual for the Revised Psychopathy Checklist, 2nd ed. Toronto: Multi-Health Systems; 2003.Google Scholar
69. Monahan, J, Steadman, HJ, Robbins, PC, et al. An actuarial model of violence risk assessment for persons with mental disorders. Psychiatr Serv. 2005; 56(7): 810815.Google Scholar
70. Dolan, M, Fullam, R, Logan, C, Davies, G. The Violence Risk Scale Second Edition (VRS-2) as a predictor of institutional violence in a British forensic inpatient sample. Psychiatry Res. 2008; 158(1): 5565.Google Scholar
71. Quinsey, VL, Harris, GT, Rice, ME, Cormier, CA. Violent Offenders: Appraising and Managing Risk. Washington, DC: American Psychological Association; 1998.Google Scholar
72. Wong, S, Gordon, A. The Violence Risk Scale. Saskatchewan, Canada: Research Unit, Regional Psychiatric Centre, Saskatoon; 2000.Google Scholar
73. Ogloff, JRP, Daffern, M. The Dynamic Appraisal of Situational Aggression: an instrument to assess risk for imminent aggression in psychiatric inpatients. Behav Sci Law. 2006; 24(6): 799813.Google Scholar
74. Nijman, HLI, Muris, P, Merckelbach, HLGJ, et al. The staff observation aggression scale–revised (SOAS-R). Aggressive Behavior. 1999; 25(3): 197209.Google Scholar
75. Marder, SR. A review of agitation in mental illness: treatment guidelines and current therapies. J Clin Psychiatry. 2006; 67(Suppl 10): 1321.Google Scholar
76. National Institute for Health and Clinical Excellence. Violence: The Short-Term Management of Disturbed/Violent Behaviour in In-Patient Psychiatric Settings and Emergency Departments. London: Royal College of Nursing; 2005.Google Scholar
77. Huf, G, Alexander, J, Allen, MH, Raveendran, NS. Haloperidol plus promethazine for psychosis-induced aggression. Cochrane Database Syst Rev. 2009; (3): CD005146.Google Scholar
78. Huf, G, Coutinho, ES, Adams, CE. Rapid tranquillisation in psychiatric emergency settings in Brazil: pragmatic randomised controlled trial of intramuscular haloperidol versus intramuscular haloperidol plus promethazine. BMJ. 2007; 335(7625): 869.Google Scholar
79. Raveendran, NS, Tharyan, P, Alexander, J, Adams, CE. Rapid tranquillisation in psychiatric emergency settings in India: pragmatic randomised controlled trial of intramuscular olanzapine versus intramuscular haloperidol plus promethazine. BMJ. 2007; 335(7625): 865.Google Scholar
80. Nobay, F, Simon, BC, Levitt, MA, Dresden, GM. A prospective, double-blind, randomized trial of midazolam versus haloperidol versus lorazepam in the chemical restraint of violent and severely agitated patients. Acad Emerg Med. 2004; 11(7): 744749.Google Scholar
81. Silver, JM, Yudofsky, SC, Slater, JA, et al. Propranolol treatment of chronically hospitalized aggressive patients. J Neuropsychiatry Clin Neurosci. 1999; 11(3): 328335.Google Scholar
82. Stanford, MS, Anderson, NE, Lake, SL, Baldridge, RM. Pharmacologic treatment of impulsive aggression with antiepileptic drugs. Curr Treat Options Neurol. 2009; 11(5): 383390.Google Scholar
83. Stanford, MS, Mathias, CW, Dougherty, DM, Lake, SL, Anderson, NE, Patton, JH. Fifty years of the Barratt Impulsiveness Scale: an update and review. Personality and Individual Differences. 2009; 47(5): 385395.Google Scholar
84. Azermai, M, Petrovic, M, Elseviers, MM, Bourgeois, J, Van Bortel, LM, Vander Stichele, RH. Systematic appraisal of dementia guidelines for the management of behavioural and psychological symptoms. Ageing Res Rev. 2012; 11(1): 7886.Google Scholar
85. Langballe, EM, Engdahl, B, Nordeng, H, Ballard, C, Aarsland, D, Selbæk, G. Short- and long-term mortality risk associated with the use of antipsychotics among 26,940 dementia outpatients: a population-based study. Am J Geriatr Psychiatry. 2014; 22(4): 321331.Google Scholar
86. Ballard, C, Corbett, A. Agitation and aggression in people with Alzheimer’s disease. Curr Opin Psychiatry. 2013; 26(3): 252259.Google Scholar
87. Ruberg, SJ, Chen, L, Stauffer, V, et al. Identification of early changes in specific symptoms that predict longer-term response to atypical antipsychotics in the treatment of patients with schizophrenia. BMC Psychiatry. 2011; 11: 23.Google Scholar
88. Tombaugh, TN. Trail Making Test A and B: normative data stratified by age and education. Arch Clin Neuropsychol. 2004; 19(2): 203214.Google Scholar
89. Erhardt, D, Epstein, JN, Conners, CK, Parker, JDA, Sitarenios, G. Self-ratings of ADHD symptoms in adults II: reliability, validity, and diagnostic sensitivity. Journal of Attention Disorders. 1999; 3(3): 153158.Google Scholar
90. Ketter, TA. Monotherapy versus combined treatment with second-generation antipsychotics in bipolar disorder. J Clin Psychiatry. 2008; 69(Suppl 5): 915.CrossRefGoogle ScholarPubMed
91. Yatham, LN, Grossman, F, Augustyns, I, Vieta, E, Ravindran, A. Mood stabilisers plus risperidone or placebo in the treatment of acute mania: international, double-blind, randomised controlled trial. [Erratum appears in Br J Psychiatry. 2003;182:369]. Br J Psychiatry. 2003; 182(2): 141147.Google Scholar
92. Keck, PE Jr. The role of second-generation antipsychotic monotherapy in the rapid control of acute bipolar mania. J Clin Psychiatry.. 2005; 66(Suppl 3): 511.Google Scholar
93. Swann, AC, Bowden, CL, Calabrese, JR, Dilsaver, SC, Morris, DD. Differential effect of number of previous episodes of affective disorder on response to lithium or divalproex in acute mania. Am J Psychiatry. 1999; 156(8): 12641266.Google Scholar
94. Bauer, M, Berghofer, A, Bschor, T, et al. Supraphysiological doses of L-thyroxine in the maintenance treatment of prophylaxis-resistant affective disorders. Neuropsychopharmacology. 2002; 27(4): 620628.Google Scholar
95. Kupka, RW. Treatment options for rapid cycling bipolar disorder. Clinical Approaches in Bipolar Disorders. 2006; 5(1): 2229.Google Scholar
96. Calabrese, JR, Kimmel, SE, Woyshville, MJ, et al. Clozapine for treatment-refractory mania. Am J Psychiatry. 1996; 153(6): 759764.Google Scholar
97. Green, AI, Tohen, M, Patel, JK, et al. Clozapine in the treatment of refractory psychotic mania. Am J Psychiatry. 2000; 157(6): 982986.Google Scholar
98. Suppes, T, Ozcan, ME, Carmody, T. Response to clozapine of rapid cycling versus non-cycling patients with a history of mania. Bipolar Disord. 2004; 6(4): 329332.Google Scholar
99. Suppes, T, Webb, A, Paul, B, Carmody, T, Kraemer, H, Rush, AJ. Clinical outcome in a randomized 1-year trial of clozapine versus treatment as usual for patients with treatment-resistant illness and a history of mania. Am J Psychiatry. 1999; 156(8): 11641169.Google Scholar
100. Grunze, H, Vieta, E, Goodwin, GM, et al. The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 2009 on the treatment of acute mania. [Erratum appears in World J Biol Psychiatry. 2009;10(3):255. Note: Dosage error in article text]. World J Biol Psychiatry. 2009; 10(2): 85116.Google Scholar
101. Osterberg, L, Blaschke, T. Adherence to medication. N Engl J Med. 2005; 353(5): 487497.Google Scholar
102. Bauer, M, Adli, M, Bschor, T, et al. Lithium’s emerging role in the treatment of refractory major depressive episodes: augmentation of antidepressants. Neuropsychobiology. 2010; 62(1): 3642.Google Scholar
103. Bauer, M, Forsthoff, A, Baethge, C, et al. Lithium augmentation therapy in refractory depression—update 2002. Eur Arch Psychiatry Clin Neurosci. 2003; 253(3): 132139.CrossRefGoogle ScholarPubMed
104. Crossley, NA, Bauer, M. Acceleration and augmentation of antidepressants with lithium for depressive disorders: two meta-analyses of randomized, placebo-controlled trials. J Clin Psychiatry. 2007; 68(6): 935940.Google Scholar
105. Joffe, RT, Singer, W, Levitt, AJ, MacDonald, C. A placebo-controlled comparison of lithium and triiodothyronine augmentation of tricyclic antidepressants in unipolar refractory depression. Arch Gen Psychiatry. 1993; 50(5): 387393.Google Scholar
106. Nierenberg, AA, Fava, M, Trivedi, MH, et al. A comparison of lithium and T(3) augmentation following two failed medication treatments for depression: a STAR*D report. Am J Psychiatry. 2006; 163(9): 15191530; quiz 1665.Google Scholar
107. Komossa, K, Depping, AM, Gaudchau, A, Kissling, W, Leucht, S. Second-generation antipsychotics for major depressive disorder and dysthymia. Cochrane Database Syst Rev. 2010: 12, CD008121.Google Scholar
108. Nelson, JC, Papakostas, GI. Atypical antipsychotic augmentation in major depressive disorder: a meta-analysis of placebo-controlled randomized trials. Am J Psychiatry. 2009; 166(9): 980991.Google Scholar
109. Lam, RW, Kennedy, SH, Grigoriadis, S, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. III. Pharmacotherapy. J Affect Disord. 2009; 117(Suppl 1): S26S43.Google Scholar
110. Kho, KH, van Vreeswijk, MF, Simpson, S, Zwinderman, AH. A meta-analysis of electroconvulsive therapy efficacy in depression. J ECT. 2003; 19(3): 139147.Google Scholar
111. National Collaborating Centre for Mental Health. The Treatment and Management of Depression in Adults. Updated ed. London: The British Psychological Society and The Royal College of Psychiatrists; 2010.Google Scholar
112. Pagnin, D, de Queiroz, V, Pini, S, Cassano, GB. Efficacy of ECT in depression: a meta-analytic review. J ECT. 2004; 20(1): 1320.CrossRefGoogle ScholarPubMed
113. Spijker, J, Nolen, WA. An algorithm for the pharmacological treatment of depression. Acta Psychiatr Scand. 2010; 121(3): 180189.Google Scholar
114. UK ECT Review Group. Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet. 2003; 361(9360): 799808.Google Scholar
115. Jones, RM, Arlidge, J, Gillham, R, Reagu, S, van den Bree, M, Taylor, PJ. Efficacy of mood stabilisers in the treatment of impulsive or repetitive aggression: systematic review and meta-analysis. Br J Psychiatry. 2011; 198(2): 9398.Google Scholar
116. Frogley, C, Anagnostakis, K, Mitchell, S, et al. A case series of clozapine for borderline personality disorder. Ann Clin Psychiatry. 2013; 25(2): 125134.Google Scholar
117. Butler, T, Schofield, PW, Greenberg, D, et al. Reducing impulsivity in repeat violent offenders: an open label trial of a selective serotonin reuptake inhibitor. Aust N Z J Psychiatry. 2010; 44(12): 11371143.Google Scholar
118. Huband, N, Ferriter, M, Nathan, R, Jones, H. Antiepileptics for aggression and associated impulsivity. Cochrane Database Syst Rev. 2010; 17(2): CD003499.Google Scholar
119. Mattes, JA. Medications for aggressiveness in prison: focus on oxcarbazepine. J Am Acad Psychiatry Law. 2012; 40(2): 234238.Google Scholar
120. Takahashi, A, Quadros, IM, de Almeida, RM, Miczek, KA. Brain serotonin receptors and transporters: initiation vs. termination of escalated aggression. Psychopharmacology (Berl). 2011; 213(2–3): 183212.Google Scholar
121. Young, RC, Biggs, JT, Ziegler, VE, Meyer, DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978; 133(5): 429435.Google Scholar
122. Hart, SD, Cox, DN, Hare, RD. The Hare Psychopathy Checklist: Screening Version. Toronto: Multi-Health Systems; 1995.Google Scholar
123. Hare, RD. Psychopathy: a clinical and forensic overview. Psychiatr Clin North Am. 2006; 29(3): 709724.Google Scholar
124. Ross, RR, Ross, RD. Programme development through research. In: Ross RR, Ross RD, eds. Thinking Straight: The Reasoning and Rehabilitation Program for Delinquency Prevention and Offender Rehabilitation. Ottawa: Air Training and Publications; 1995.Google Scholar
125. Brown, D, Larkin, F, Sengupta, S, et al. Clozapine: an effective treatment for seriously violent and psychopathic men with antisocial personality disorder in a UK high-security hospital. CNS Spectr. In press, DOI: 10.1017/S1092852914000157.Google Scholar
126. Bonta, J, Andrews, DA. Risk–need–responsivity model for offender assessment and rehabilitation 2007–06. Ottawa: Her Majesty the Queen in Right of Canada; 2007.Google Scholar
127. Dvoskin, JA, Skeem, JL, Novaco, RW, Douglas, KS, eds. Using Social Science to Reduce Violent Offending. New York: Oxford University Press; 2012.Google Scholar
128. Hanson, RK, Bourgon, G, Helmus, L, Hodgson, S. The principles of effective correctional treatment also apply to sexual offenders: a meta-analysis. Criminal Justice and Behavior. 2009; 36(9): 865891.CrossRefGoogle Scholar
129. Douglas, KS, Nicholls, TD, Brink, J. Reducing the risk of violence among people with serious mental illness: a critical analysis of treatment approaches. In: Kleespies PM, ed. Behavioral Emergencies: An Evidence-Based Resource for Evaluating and Managing Risk of Suicide, Violence, and Victimization. Washington, DC: American Psychological Association; 2009: 351376.Google Scholar
130. Beck, NC, Menditto, AA, Baldwin, L, Angelone, E, Maddox, M. Reduced frequency of aggressive behavior in forensic patients in a social learning program. Hospital Community Psychiatry. 1991; 42(7): 750752.Google Scholar
131. Becker, M, Love, CC, Hunter, ME. Intractability is relative: behaviour therapy in the elimination of violence in psychotic forensic patients. Legal and Criminological Psychology. 1997; 2(1): 89101.Google Scholar
132. Stermac, LE. Anger control treatment for forensic patients. Journal of Interpersonal Violence. 1986; 1(4): 446457.Google Scholar
133. Evershed, S, Tennant, A, Boomer, D, Rees, A, Barkham, M, Watsons, A. Practice-based outcomes of dialectical behaviour therapy (DBT) targeting anger and violence, with male forensic patients: a pragmatic and non-contemporaneous comparison. Crim Behav Ment Health. 2003; 13(3): 198213.Google Scholar
134. Drummond, DJ, Sparr, LF, Gordon, GH. Hospital violence reduction among high-risk patients. JAMA. 1989; 261(17): 25312534.Google Scholar
135. Carroll, E, Tyson, K. Therapeutic management of violence in residential care for severely mentally ill clients: an application for intrapsychic humanism. Smith College Studies in Social Work. 2004; 74(3): 539561.CrossRefGoogle Scholar
136. Shelton, D, Sampl, S, Kesten, KL, Zhang, W, Trestman, RL. Treatment of impulsive aggression in correctional settings. Behav Sci Law. 2009; 27(5): 787800.Google Scholar
137. Rizvi, SL, Linehan, MM. Dialectical behavior therapy for personality disorders. Curr Psychiatry Rep. 2001; 3(1): 6469.Google Scholar
138. Berzins, LG, Trestman, RL. The development and implementation of dialectical behavior therapy in forensic settings. International Journal of Forensic Mental Health. 2004; 3(1): 93103.Google Scholar
139. Flannery, DJ, Singer, MI, Van Dulmen, M, Kretschmar, J, Belliston, L. Exposure to violence, mental health and violent behavior. In: Flannery DJ, Vazsonyi AT, Waldman I, eds. The Cambridge Handbook of Violent Behavior. Cambridge, UK: Cambridge University Press; 2007: 306319.Google Scholar
140. Sullivan, CP, Elbogen, EB. PTSD symptoms and family versus stranger violence in Iraq and Afghanistan veterans. Law Hum Behav. 2014; 38(1): 19.Google Scholar
141. Management of Post-Traumatic Stress Working Group. VA/DoD Clinical Practice Guideline for Management of Post-Traumatic Stress. Washington, DC: Department of Defense; 2010.Google Scholar
142. Cauffman, E, Feldman, SS, Waterman, J, Steiner, H. Posttraumatic stress disorder among female juvenile offenders. J Am Acad Child Adolesc Psychiatry. 1998; 37(11): 12091216.Google Scholar
143. Steiner, H, Garcia, IG, Matthews, Z. Posttraumatic stress disorder in incarcerated juvenile delinquents. J Am Acad Child Adolesc Psychiatry. 1997; 36(3): 357365.Google Scholar
144. Ford, JD, Chapman, J, Connor, DF, Cruise, KR. Complex trauma and aggression in secure juvenile justice settings. Criminal Justice and Behavior. 2012; 39(6): 694724.Google Scholar
145. Physicians for Human Rights—Health and Justice for Youth Campaign. Unique needs of girls in the juvenile justice system., 2009. Accessed January 13, 2014.Google Scholar
146. Flannery, DJ, Singer, MI, Wester, KL. Violence exposure, psychological trauma, and suicide risk in a community sample of dangerously violent adolescents. J Am Acad Child Adolesc Psychiatry. 2001; 40(4): 435442.Google Scholar
147. Najavits, LM, Schmitz, M, Gotthardt, S, Weiss, RD. Seeking safety plus exposure therapy: an outcome study on dual diagnosis men. J Psychoactive Drugs. 2005; 37(4): 425435.Google Scholar
148. Zlotnick, C, Najavits, LM, Rohsenow, DJ, Johnson, DM. A cognitive-behavioral treatment for incarcerated women with substance abuse disorder and posttraumatic stress disorder: findings from a pilot study. J Subst Abuse Treat. 2003; 25(2): 99105.Google Scholar
149. Heinrichs, RW, Zakzanis, KK. Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology. 1998; 12(3): 426445.Google Scholar
150. Keefe, RS, Bilder, RM, Harvey, PD, et al. Baseline neurocognitive deficits in the CATIE schizophrenia trial. Neuropsychopharmacology. 2006; 31(9): 20332046.Google Scholar
151. Keefe, RS, Fenton, WS. How should DSM-V criteria for schizophrenia include cognitive impairment? Schizophr Bull. 2007; 33(4): 912920.Google Scholar
152. Harris, GT, Rice, ME, Quinsey, VL. Violent recidivism of mentally disordered offenders: the development of a statistical prediction instrument. Criminal Justice and Behavior. 1993; 20(4): 315335.Google Scholar
153. D’Silva, K, Duggan, C, McCarthy, L. Does treatment really make psychopaths worse? A review of the evidence. J Personal Disord. 2004; 18(2): 163177.Google Scholar
154. Polaschek, DLL, Daly, TE. Treatment and psychopathy in forensic settings. Aggression and Violent Behavior. 2013; 18(5): 592603.Google Scholar
155. Salekin, RT. Psychopathy and therapeutic pessimism: clinical lore or clinical reality? Clin Psychol Rev. 2002; 22(1): 79112.Google Scholar
156. McGuire, J. General offending behaviour programmes: concept, theory, and practice. In: Hollin CR, Palmer EJ, eds. Offending Behaviour Programmes: Development, Application, and Controversies. Chichester, UK: John Wiley & Sons, Ltd; 2008; 69111.Google Scholar
157. Ross, R, Fabiano, E. Reasoning and Rehabilitation: Manual. Ottawa: Air Training and Publications; 1985.Google Scholar
158. Tong, LSJ, Farrington, DP. How effective is the “Reasoning and Rehabilitation” programme in reducing reoffending? A meta-analysis of evaluations in four countries. Psychology, Crime & Law. 2006; 12(1): 324.Google Scholar
159. Clarke, DA. Theory Manual for Enhanced Thinking Skills—Prepared for the Joint Prison Accreditation Panel. London: Home Office; 2000.Google Scholar
160. Renner, F, van Goor, M, Huibers, M, Arntz, A, Butz, B, Bernstein, D. Short-term group schema cognitive-behavioral therapy for young adults with personality disorders and personality disorder features: associations with changes in symptomatic distress, schemas, schema modes and coping styles. Behav Res Ther. 2013; 51(8): 487492.Google Scholar
161. Bernstein, DP, Arntz, A. Vos Md. Schema focused therapy in forensic settings: theoretical model and recommendations for best clinical practice. International Journal of Forensic Mental Health. 2007; 6(2): 169183.Google Scholar
162. Livesley, WJ. Practical Management of Personality Disorder. New York: Guilford Press; 2003.Google Scholar
163. The President’s Commission on Mental Health. Report to the President from The President’s Commission on Mental Health. Vol 1. Washington, DC: U.S. Government Printing Office; 1978.Google Scholar
164. Coombs, T, Taylor, M, Pirkis, J. Benchmarking forensic mental health organizations. Australas Psychiatry. 2011; 19(2): 133142.Google Scholar
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