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Two scales for measuring patients’ perceptions for coercion during mental hospital admission
Abstract
Legal and extra-legal coercion are pervasive in mental hospital admission and there are sharp disputes about its appropriate role. This article presents two scales for measuring psychiatric patients' perceptions of coercion during hospital admission and reports data on these scales' internal consistency. We measure patients' perceptions of coercion by asking questions, in either an interview or questionnaire format, about their experience of lack of control, choice, influence, and freedom in hospital admission. Patients' responses to questions about their perceptions of coercion were highly internally consistent. The internal consistency of the scale was robust with respect to variation in site, instrument format, patient population, and interview procedure. Correspondence analysis was used to construct two numerical scales of perceived coercion.
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“Notably, most studies focused on inpatient settings and relied heavily on standardized tools, such as the MacArthur Admission Experience Survey [188] or the Coercion Ladder [189], to measure coercion.”
From Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review (2025) · cites this paper as [188]
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“First, in order to limit the burden on participants, only the Perceived Coercion subscale was administered to participants, resulting in the omission of the Procedural Justice and Voice subscales [18].”
MethodInfluentialDiCondina, J. (2016) · Digital Commons - PCOM (Philadelphia College of Osteopathic Medicine)
in-patientsand predictors of mental incapacity in psychiatric
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The Social Context of Mental Health and Illness: Introduction to Part II
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Mental Health Systems and Policy: Introduction to Part III
Scheid, T. L., & Wright, E. R. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316471289.023
Biological Approaches to Psychiatric Disorders: A Sociological Approach
Schwartz, S., & Corcoran, C. M. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316471289.009
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Đedović, J., Đurišić, T., Tomcuk, A., Miladinović, D., Vlahović, S., Mačić, A., Roganovic, V., & Wijnen, B. F. M. (2021) · Engrami · doi:10.5937/engrami43-35778
“In order to examine the subjective experience of coercion (perceived coercion)[26], a Mac Arthur Admission Experience Survey was used, although this scale has not been previously standardized for Montenegro population.”
MethodQuality of life after involuntary psychiatric admission
Finnegan, M., McLoughlin, J., Bainbridge, E. D., McGuinness, D., Hallahan, B. P., & McDonald, C. (2022) · International Journal of Law and Psychiatry · doi:10.1016/j.ijlp.2022.101810
Coercion experience of patients with mental illness in a tertiary care hospital in Kerala
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Perceptions of Youth Transport in Wilderness Therapy
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“Consistent with previous research, participant scores showed strong reliability with a Cronbach’s alpha = .87 and item-total correlations from .62 to .80 (Gardner et al., 1993; Hiday et al., 1997).”
InfluentialHahn, S., Hasler, M., Andersson, S. R., Bonner, Y. D. B., & Richter, D. (2024) · Springer eBooks · doi:10.1007/978-3-031-61224-4_3
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Perceived intrusiveness of coercive measures: a Danish survey of mental health service users
Lindekilde, C. R., Stokholm, L., Hvidhjelm, J., Baker, J. A., Gildberg, F. A., & Birkeland, S. (2026) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2026.2670367
“The most widely used surveys are the U.S. MacArthur Perceives Coercion Scales (MPCS) [22], the British Attitudes to Containment Method Questionnaire (ACMQ) [23] and the German Coercive Experience Scale (CES) [24].”
Cleary, H. M. D., & Guarnera, L. A. (2026) · Applied Cognitive Psychology · doi:10.1002/acp.70257
Wettstein, M. F. (2010) · Americanae (AECID Library)
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Vieira, R. W. (2010) · Americanae (AECID Library)
Metadata
- Authors
- Gardner, W., Hoge, S. K., Bennett, N., Roth, L. H., Lidz, C. W., Monahan, J., & Mulvey, E. P.
- Affiliations
- University of Pittsburgh (US)
- Corresponding author
- Gardner, William
- Venue
- Behavioral Sciences & the Law
- Publisher
- Wiley
- Published
- 1993-06
- Volume
- 11
- Issue
- 3
- Pages
- 307-321
- ISSN
- 0735-3936 (ISSN-L)
- 1099-0798
- OpenAlex
- W2155774656
- Cited by
- 342
- References
- 10
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 9 · 2023: 6 · 2022: 5 · 2021: 10 · 2020: 6 · 2019: 3 · 2018: 10 · 2017: 40 · 2016: 11 · 2015: 13 · 2014: 11 · 2013: 13 · 2012: 14
- FWCI
- 7.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behavioral Sciences & the Law (publishedVersion)
- PubMed (publishedVersion)
- The Journal of the American Medical Association (JAMA) Network (American Medical Association) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Keywords
- coercion, psychiatric hospital admissions, patient perspectives, internal consistency, involuntary psychiatric admission, patient autonomy, freedom of choice
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Mental Disorders, Coercion, Female, Hospitalization, Humans, Male, Middle Aged, Psychometrics, Surveys and Questionnaires, Observer Variation, Multivariate Analysis, Linear Models
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