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    edited by Dr. Michael A. Cummings, Dr. Stephen M. Stahl.
    "In community settings, the most common barriers to independent living, employment, and stable interpersonal relationships for patients suffering from schizophrenia-spectrum disorders or other psychotic disorders are negative symptoms and cognitive deficits. In contrast, severely mentally ill individuals, often incarcerated or chronically institutionalized, more frequently experience substantial barriers related to positive psychotic symptoms leading to problematic behaviors such as aggression or violence. This is not to say that among the chronically institutionalized severely mentally ill population that positive psychotic symptoms are the only, or even majority, source of problematic behaviors. A survey conducted within the California Department of State Hospitals, a circa 7000-bed system dedicated to the treatment of conserved and forensically committed patients, reviewed 839 episodes of aggression or violence by 88 persistently aggressive inpatients and found that 54% of such episodes were impulsive, 39% were predatory or instrumental, and 17% were psychotically driven. Nevertheless, amelioration or control of positive psychotic symptoms commonly forms the initial treatment focus among the severely mentally ill."-- Provided by publisher.
    Digital Access  Cambridge 2021