Background: Epidemiologic studies have shown that persons suffering from psychotic
disorders are at increased risk of violent behavior. Several factors have been shown to predict violent
behavior among persons with psychosis. However, prior research is limited in that these factors
have not been explored simultaneously within the same study.
Methods: The current study, therefore, aimed to determine which demographic, clinical, cognitive,
and developmental characteristics were associated with an increased likelihood of violence among
patients diagnosed with a psychotic disorder and which combination of these best predicted a history
of violence. Participants (n=53) completed measures of demographics, violence risk, psychotic
and personality symptoms, trauma, psychopathy and cognitive functioning.
Results: Bivariate relationships were conducted to compare the history of violent behavior between
all variables. Additionally, a binary logistic regression was run predicting participants’ history of
violence. Several demographic, cognitive, clinical, and developmental factors were associated with
increased odds of having a history of violence. The overall correct classification rate for the model
was 92.2%, with 87.5% of participants without a history of violence and 91.4% with a history of
violence being correctly classified. The model included antisocial personality traits, poor behavioral
controls, head injury, not accepting responsibility, lacking goals, prior supervision failures, and
HCR-20 total score.
Conclusion: The binary logistic regression model showed good accuracy in predicting a history of
violence in persons with psychosis. These findings are consistent with prior research and can inform
efforts at risk assessment and identification of treatment targets for people with a psychotic disorder
who are at highest risk of violence.