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首页> 外文期刊>Harvard review of psychiatry >Violence by Persons with Serious Mental Illness Toward Family Caregivers and Other Relatives: A Review
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Violence by Persons with Serious Mental Illness Toward Family Caregivers and Other Relatives: A Review

机译：对家庭护理人员和其他亲属的严重精神疾病的暴力事件：审查

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摘要

Persons living with serious mental illness (SMI) are at a modestly increased risk of committing violence and are disproportionately likely to target family members when they do commit violence. In this article, we review available evidence regarding violence by persons with SMI toward family members, many of whom are caregivers. Evidence suggests that a sizable minority of family members with high levels of contact with persons with SMI have experienced violence, with most studies finding rates of past year victimization to be 20% or higher. Notable risk factors for family violence pertaining specifically to persons with SMI include substance use, nonadherence to medications and mental health treatment, history of violent behavior, and recent victimization. Notable risk factors pertaining specifically to the relationships between persons with SMI and family members include persons with SMI relying on family members for tangible and instrumental support, family members setting limits, and the presence of criticism, hostility, and verbal aggression. As described in qualitative studies, family members often perceive violence to be connected to psychiatric symptoms and inadequate treatment experiences. We argue that promising strategies for preventing violence by persons with SMI toward family members include (1) better engaging persons with SMI in treatment, through offering more recovery-oriented care, (2) strengthening support services for persons with SMI that could reduce reliance on family members, and (3) supporting the capabilities of family members to prevent and manage family conflict. The available interventions that may be effective in this context include McFarlane's Multifamily Group intervention and the Family-to-Family educational program.
机译：患有严重精神疾病（SMI）的人实施暴力的风险略有增加，而且在他们实施暴力时，以家庭成员为目标的可能性不成比例。在本文中，我们回顾了有关SMI患者对家庭成员施暴的现有证据，其中许多人是看护者。证据表明，与SMI患者有高度接触的家庭成员中有相当一部分人经历过暴力，大多数研究发现，过去一年的受害率为20%或更高。与SMI患者有关的家庭暴力的显著风险因素包括药物使用、不依从药物和心理健康治疗、暴力行为史和最近的受害。与SMI患者和家庭成员之间的关系相关的显著风险因素包括SMI患者依赖家庭成员提供有形和工具性支持、家庭成员设定限制，以及存在批评、敌意和言语攻击。如定性研究所述，家庭成员通常认为暴力与精神症状和治疗经验不足有关。我们认为，预防SMI患者对家庭成员的暴力行为的有希望的策略包括：（1）通过提供更多以康复为导向的护理，更好地让SMI患者参与治疗，（2）加强对SMI患者的支持服务，减少对家庭成员的依赖，（3）支持家庭成员预防和管理家庭冲突的能力。在这种情况下可能有效的现有干预措施包括McFarlane的多家庭小组干预和家庭对家庭教育计划。

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