Acute stress reactions to a patient threat

Abstract

We examined acute stress reactions following a threatening episode at an outpatient psychiatric clinic. After staff received threats by a patient, 63 of 83 (75.9%) non-faculty psychiatry staff completed a questionnaire on their acute stress and other reactions to this episode and experiences of this and previous threats. Clinic administrative staff reported greater acute stress reactions than did others (i.e., residents, interns or research staff). Greater acute stress symptoms were associated with objective event elements and with identifying the episode as threatening. Acute stress symptoms were strongly and positively related to both functional and dysfunctional behavioral change, including taking protective actions such as calling for help from security staff as well as experiencing interference in social and occupational functioning. Having been threatened or harassed previously was also related to both functional and dysfunctional behavioral change. Because clinic administrative staff and others who have direct contact with potentially threatening patients are more likely to experience acute stress reactions, training to cope with threatening patients should be directed particularly toward them.