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Anger as a Risk Factor for Violence Among the Mentally Disordered (From Violence and Mental Disorder: Developments in Risk Assessment, P 21-59, 1994, John Monahan and Henry J Steadman, eds. -- See NCJ-165556)

NCJ Number
165558
Author(s)
R W Novaco
Date Published
1994
Length
39 pages
Annotation
This chapter describes the development and testing of an instrument designed to measure anger that is likely to lead to violent behavior, followed by a discussion of its implications for risk assessment.
Abstract
The assessment of anger performed by the developed Novaco Anger Scale (NAS) is derived from a general conception of cognitive, arousal, and behavioral domains linked by feedback mechanisms. Each of these domains is construed as having component dimensions that are relevant to anger as a clinical problem. The NAS separately assesses these dimensions and then sums the results to generate aggregate scores for each domain. The NAS is constructed in two parts. Part A contains the clinically oriented scales. Part B is an abbreviated improvement of the Novaco Provocation Inventory (NPI); it is designed to provide an index of anger intensity and generality across a range of potentially provocative situations (five subscales); the five- point scaling used by the NPI and other anger intensity measures is reduced to four points to simplify responses for mentally disordered persons. Because the scale is intended for use with mentally disordered persons, item construct gives particular attention to statement clarity. After the author describes the development and characteristics of the scale, reliability and concurrent validity testing with patients are described. In discussing the implications of the use of the scale for risk assessment, the author notes that the degree to which anger constitutes a risk factor for violence hinges on its operation as a mediator of the relationship between aversive events and harm- doing behavior; however, since it is expected that anger is neither necessary nor sufficient for aggression, violence can occur in the absence of anger, and it takes more than anger to produce violent behavior. Because the occurrence of harm-doing behavior is also regulated by inhibitory mechanisms, the determination of violence risk can be gauged only partly from the assessment of anger. Nevertheless, the role of anger as a potent activator of aggressive behavior and its involvement in a wide range of clinical disorders have encouraged refinements in its measurement. 6 tables and 97 references

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