Forensic nursing staff and aggressive challenging behaviour : the influence of psychiatric diagnosis on causal attributions, explanations and therapeutic optimism

Objectives: The aim of the current study was to investigate whether forensic nursing staff who worked with different patient groups (i.e. learning disability, mental illness, or personality disorder): made different causal attributions for an episode of aggressive challenging behaviour; drew on different causal models to explain the behaviour; reported different levels of optimism regarding the efficacy of therapeutic intervention for the behaviour; and reported different beliefs about the future risk of the behaviour.;Design and Method: A between-subjects design was employed. Eighty-eight nursing staff working within one of three Directorates in a high security hospital, read a vignette depicting an episode of aggressive challenging behaviour and completed a self-report questionnaire. Participants were required to make causal attributions along Weiner's (1980) dimensions of controllability, locus and stability and to provide causal explanations in accordance with five models of challenging behaviour (Hastings, 1997b). Participants also rated their therapeutic optimism and beliefs about future risk of the challenging behaviour occurring. Data were analysed using non-parametric tests of difference (Kruskal-Wallis test) and association (Spearman's Rank Order Correlation).;Results: Overall, the three participant groups did not make significantly different causal attributions, report different levels of therapeutic optimism, or different beliefs about future risk. Participants who worked with patients with a personality disorder were significantly more likely than participants who worked with patients with learning disabilities to consider an emotional causal model when seeking to explain the behaviour. All three participant groups held concurrent explanations for the behaviour. Participants cited psychological interventions as being useful in reducing the behaviour, but mainly referred to reactive physical strategies with commenting on their training.;Conclusions: Clinical implications of the current study are explored and suggestions made concerning the role of forensic nursing staff and clinical psychologists in addressing aggressive challenging behaviour. Directions for future research are suggested.