Deploying Mobile Technologies to Identify Predictors of Violence in Hospitalized Patients with Co-Occurring Substance Use and Psychiatric Disorders

A severe mental illness (SMI) does not necessarily increase one’s propensity for violence. However, individuals with SMI and co-occurring substance abuse and/or dependence (i.e. dual diagnosis) constitute a group that is at heightened risk for engaging in self–directed and other-directed violent behavior. The causes and predictors of violence among people with dual diagnosis are not well understood, in part, due to the limitations of clinical assessment strategies and research methodologies. The objective of the proposed study is to deploy mobile technologies that will facilitate the recording of internal and contextual factors that may contribute to the emergence of violent ideation in individuals with dual diagnosis.

We aim to:

(a) Develop a computerized Ecological Momentary Assessment (EMA) measure of potential predictors of self-directed and other- directed violent ideation; and (b) Conduct an EMA study with 30 high-risk inpatients with dual diagnosis at New Hampshire Hospital. The measure development, participant enrollment and retention, system deployment, and data analytic  procedures used in the proposed pilot study will enable us to develop a study protocol for  future extensions of this work, with the ultimate goal of detecting predictors of violence that may be most malleable with targeted time-sensitive interventions.