Differential Factors Associated with Serious and Minor Family Violence By Persons with Psychiatric Disorders

Background and Purpose:  Due to the modestly increased risk of violence by persons with major psychiatric disorders (PD) such as schizophrenia, bipolar, and major depression and the large part family members have in the victimization by persons with PD, family violence (FV) by persons with PD is a startlingly common phenomenon.  Surprisingly, few studies have explored factors associated with the occurrence of FV by persons with PD, with even fewer studies differentiating between acts of serious and minor FV.  Aggregating acts of serious and minor FV in performing analyses can be argued to produce specific benefits, however, doing so surely obscures differences in factors associated with serious vs. minor FV.  Identifying such differences will enhance our ability to effectively prevent and treat such acts of violence. The objectives of the present analysis are to examine the extent to which proposed perpetrator, victim, and interaction factors are associated with the occurrence of 1) serious FV by persons with PD and 2) minor FV by persons with PD.

Methods: A cross-sectional survey design was employed. 573 adults, living in at least 42 states in the U.S., with an adult relative with PD completed an online survey between July 2014 and February 2015.  Respondents were recruited through advertisements made with a plethora of non-profit organizations across America pertaining to disability rights, aging services, food banks, and mental health advocacy/support groups.  Respondents provided information pertaining to themselves, their relative with PD, and the interactions they have with each other, including whether their relative with PD has committed acts of serious or minor violence against them, measured by the MacArthur Community Violence Instrument.  Multivariate logistic regression was conducted.

Results: Eight percent (n = 44) and 14% (n = 80) of respondents reported that their relative with PD had committed serious and minor acts of violence against them in the past 6 months, respectively.  After controlling for significant covariates, the following factors were significantly associated with serious FV: Perpetrator—income, use of illegal drugs; Victim—gender, presence of mental health diagnosis; Interaction—serving as a representative payee for relative with PD, level of financial assistance and limit-setting practices towards relative with PD.  The following factors were significantly associated with minor FV: Perpetrator—attendance of mental health treatment, psychiatric hospitalization; Victim—income; Interaction—level of in-person contact, level of limit-setting practices towards relative with PD

Conclusions and Implications:  Practitioners should assess the risk of FV and conflict and intervene when necessary.  While more research is needed, both serious and minor FV may be prevented by practitioners addressing with family members how to set limits with relatives with PD without escalating conflict.  Serious FV appears associated with financial dependency, money management, and illegal drug use, while minor FV appears related to treatment related factors and level of in-person contact.  Assisting persons with PD and their relatives avoid and resolve conflict related to finances may decrease the risk of serious FV.  Actively engaging persons with PD in mental health treatment may decrease the risk of minor FV.