Date of Submission


Degree Type


Degree Name

Doctor of Psychology (PsyD)



Department Chair

Robert A DiTomasso, PhD, ABPP, Chair, Department of Psychology

First Advisor

Bruce S Zahn, EdD, ABPP, Chairperson

Second Advisor

Petra Kottsieper, PhD

Third Advisor

Jenna Tinker, PsyD


Aggression on inpatient psychiatric units poses a multitude of issues not only for patients, but also for staff. Thus, the identification of dynamic risk factors that may increase and also of protective factors that may decrease the likelihood of a patient becoming aggressive is important. The current study sought to expand on the current literature by examining if there is a difference between self-perceived strengths and risk factors between aggressive and nonaggressive patients. More specifically, it was hypothesized that self-reported strengths would moderate the relationship between self-reported risk factors and institutional aggression (IA) in forensic and in civil psychiatric units at a state hospital. It was also hypothesized that patients from the forensic unit, or those transferred from the forensic to civil unit, would be more likely to engage in IA. To test these hypotheses, archival data were examined in a final sample of 300 participants. Findings revealed that when someone had at least one aggressive act, he or she was more likely to have reported at least one severe symptom or poor coping skill. However, further analysis revealed that self-reported protective factors, namely activities of daily living and cultural and religious considerations, did not moderate the relationship between self-reported risk factors, namely severe symptoms and poor coping, and IA. Finally, forensic patients were not found to be more likely to engage in IA. Low base rates are inherent to this area of research, thus future researchers might benefit from addressing this issue. Other suggestions for future research include the consideration of environmental factors specific to inpatient units that may have a direct impact on IA. Finally, it may be useful to use a valid and reliable measure to obtain self-reported risk and protective factors, which may improve the quality of findings.