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Cited by 870Psychopathy, Forensic Psychiatry, Sexual OffendingCrime Patterns and InterventionsMental Health Treatment and Access

The Intricate Link Between Violence and Mental Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions

Elbogen, Eric B., Johnson, Sally C.·2009·Archives of General Psychiatry
DOI 10.1001/archgenpsychiatry.2008.537
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Abstract

CONTEXT: The relationship between mental illness and violence has a significant effect on mental health policy, clinical practice, and public opinion about the dangerousness of people with psychiatric disorders. OBJECTIVE: To use a longitudinal data set representative of the US population to clarify whether or how severe mental illnesses such as schizophrenia, bipolar disorder, and major depression lead to violent behavior. DESIGN: Data on mental disorder and violence were collected as part of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a 2-wave face-to-face survey conducted by the National Institute on Alcohol Abuse and Alcoholism. PARTICIPANTS: A total of 34 653 subjects completed NESARC waves 1 (2001-2003) and 2 (2004-2005) interviews. Wave 1 data on severe mental illness and risk factors were analyzed to predict wave 2 data on violent behavior. MAIN OUTCOME MEASURES: Reported violent acts committed between waves 1 and 2. RESULTS: Bivariate analyses showed that the incidence of violence was higher for people with severe mental illness, but only significantly so for those with co-occurring substance abuse and/or dependence. Multivariate analyses revealed that severe mental illness alone did not predict future violence; it was associated instead with historical (past violence, juvenile detention, physical abuse, parental arrest record), clinical (substance abuse, perceived threats), dispositional (age, sex, income), and contextual (recent divorce, unemployment, victimization) factors. Most of these factors were endorsed more often by subjects with severe mental illness. CONCLUSIONS: Because severe mental illness did not independently predict future violent behavior, these findings challenge perceptions that mental illness is a leading cause of violence in the general population. Still, people with mental illness did report violence more often, largely because they showed other factors associated with violence. Consequently, understanding the link between violent acts and mental disorder requires consideration of its association with other variables such as substance abuse, environmental stressors, and history of violence.

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  • The best replicated of early findings - frontal hypometabolism and hippocampal atrophy - remain foundational to current models of depression, although they are not pathognomonic.

    “The best replicated of early findings - frontal hypometabolism and hippocampal atrophy 313,314 - remain foundational to current models of depression, although they are not pathognomonic.”

    From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [314]

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Authors
Elbogen, E. B., & Johnson, S. C.
Affiliations
University of North Carolina at Chapel Hill (US)
ORCID
Elbogen, Eric B.
Venue
Archives of General Psychiatry
Publisher
American Medical Association (AMA)
Published
2009-02-01
Volume
66
Issue
2
Pages
152
ISSN
0003-990X (ISSN-L)
DOI
10.1001/archgenpsychiatry.2008.537
OpenAlex
W2095751856
Cited by
868
References
58
Citations by year
2026: 15 · 2025: 24 · 2024: 23 · 2023: 28 · 2022: 28 · 2021: 53 · 2020: 47 · 2019: 52 · 2018: 38 · 2017: 88 · 2016: 45 · 2015: 102 · 2014: 66 · 2013: 72 · 2012: 53
FWCI
66.64
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of General Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
  • Social Sciences › Sociology and Political Science › Crime Patterns and Interventions
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
severe mental illness, violent behavior, schizophrenia, bipolar disorder, major depressive disorder, substance abuse, co-occurring disorders, risk factors for violence, juvenile detention, physical abuse, threat perception, victimization, unemployment, divorce, environmental stressors, mental health policy
MeSH terms
Adolescent, Adult, Alcoholism, Bipolar Disorder, Cross-Sectional Studies, Dangerous Behavior, Major Depressive Disorder, Depressive Disorder, Major, Female, Health Surveys, Humans, Longitudinal Studies, Male, Middle Aged, Risk Factors, Schizophrenia, Schizophrenic Psychology, Social Environment, Illicit Drugs, United States, Violence, Comorbidity, Incidence, Substance-Related Disorders, Young Adult

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