Study On Aggression And Related Factors Of Inpatients With Schizophrenia

Objective: To study the reliability and validity of the Chinese version of Buss & Perry aggression questionnaire(AQ-CV)in schizophrenia patients.The questionnaire was used to explore the aggressive status of patients and its influencing factors to provide a theoretical reference for prevention and management.Methods: 125 schizophrenic inpatients who met inclusion criteria in Wuhu Fourth People’s Hospital and 101 healthy controls who worked and studied in this hospital during October 2019-November 2020 participated the study.The general condition questionnaire,modified overt aggression scales(MOAS),positive and negative symptom scale(PANSS),Chinese version of Buss & Perry aggression questionnaire(AQ-CV),insight and treatment attitude questionnaire(ITAQ)and social support rating scale(SSRS)were used to investigate and evaluate the patients.60 patients were retested with Chinese version of Buss & Perry aggression questionnaire(AQ-CV)at the first week.The positive and negative symptom scale(PANSS)and Chinese version of Buss & Perry aggression questionnaire(AQ-CV)were retested at the sixth week.The general condition questionnaire,Chinese version of Buss & Perry aggression questionnaire(AQ-CV),were used to investigate and evaluate the healthy controls.Results:(1)Among 226 subjects,there were 69(30.5%)schizophrenic inpatients with aggressive behavior,56(24.8%)inpatients without aggressive behavior and 101(44.7%)healthy controls.There were significant differences among the three groups in the composition of general demographic characteristics,such as education level,marital status,average income per person in family(P < 0.05).(2)The Cronbach’s α reliability coefficient of Chinese version of Buss & Perry aggression questionnaire(AQ-CV)was 0.959 in schizophrenic inpatients,and the Cronbach’s αreliability coefficient of each subscale ranged from 0.687 to 0.901.The split-half reliability was 0.917,and the split-half reliability of each subscale ranged from 0.488 to0.829.The test-retest reliability was 0.866,and the test-retest reliability of each subscale ranged from 0.662 to 0.895.The results of confirmatory factor analysis showed that the fitting indexes were: X~2 /df = 1.897、SRMR = 0.016、RMSEA = 0.038、GFI = 0.960、CFI = 0.934、NFI = 0.976、IFI = 0.942.The average variance extracted(AVE)of each latent variable was between 0.502-0.629,and the combined reliability CR was from 0.777 to 0.904.There was a significant correlation between each factor of Chinese version of Buss & Perry aggression questionnaire(AQ-CV)(P < 0.01),and the absolute value of the correlation coefficient all was less than 0.5,and was less than the square root of the corresponding AVE.The criterion related validity analysis showed that results of Chinese version of Buss & Perry aggression questionnaire(AQ-CV)were correlated with scores of modified overt aggression scales(MOAS)(P < 0.05 or P < 0.01).(3)The difference of the aggressive scores of schizophrenic inpatients was statistically significant(P < 0.05)in age,gender,education level,occupation,residence,family monthly income,family management mode,living condition,the course of disease,physical disease,history of attack behavior and self-knowledge level.The analysis results of influencing factors of each dimension of aggression were as follows :(1)the most influential factor on the total aggressiveness of patients was the utilization of social support(B =-17.146);(2)the most influential factors on the physical aggressiveness of patients was the utilization of social support(B=-2.145);(3)the most influential factors on the verbal aggressiveness of patients were the understandings of disease recurrence and ways of seeking help(B =-1.336);(4)the most influential on anger aggression factors of patients the understanding of disease recurrence and ways of seeking help(B =-43.726);(5)the most influential factors on hostility aggression of patients was the awareness of hospitalization(B =-1.116);(6)the most influential factors on of selfaggression the utilization of social support(B =-1.153)。(4)The treatment effect of schizophrenic inpatients was significant in the positive symptoms curative effect,and the treatment of negative symptoms and general mental symptoms were effective.There was no significant difference on curative effect between the aggressive and non-aggressive groups(P > 0.05).After treatment,the total score of Chinese version of Buss & Perry aggression questionnaire(AQ-CV)and each subscale score of the two groups were significantly lower than those before treatment(P < 0.01).Conclusion: The Chinese version of Buss & Perry aggression questionnaire(AQ-CV)could be used to predict the aggressive behavior of schizophrenic inpatients in the early stage.The mental symptoms,utilization of social support,subjective support,awareness of hospitalization and the understandings of disease recurrence and ways of seeking help were the mainly influencing factors of aggressive behavior in schizophrenic inpatients.And improving the utilization of social support and increasing the activity of inpatient medication could significantly reduce the aggressiveness in schizophrenic inpatients.