Group climate, aggressive incidents and coercion in a secure forensic setting for individuals with mild intellectual disability or borderline intellectual functioning: A multilevel study.
Elien G Neimeijer, Monique J Delforterie, Jesse J Roest and 2 others
PMID 33305516WHAT IT FOUND
In a secure forensic setting for people with mild intellectual disability, residents who perceived a more therapeutic group climate had fewer aggressive incidents.
Aggressive incidents were strongly linked to higher use of coercive measures. Improving the social environment may reduce both aggression and coercion.
Key findings
01A positive group climate was associated with lower levels of aggression at both the individual and group level.
02Aggressive incidents were significantly related to coercive measures, and aggression mediated the link between group climate and coercion.
03Coercive measures were more frequently used on female clients, those in involuntary treatment, and those in higher care intensity or smaller groups.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study was conducted in a single facility, which limits generalizability to other settings or countries. The cross-sectional design prevents establishing causality; it is unclear whether a poor climate causes aggression or if aggression leads to a perception of poor climate. Two extreme outliers with very high coercive measure scores were removed from the analysis, which may affect the robustness of findings regarding coercion. The sample size restricted the number of variables that could be included in the complex multilevel models, potentially overlooking other relevant factors.
Declared interests
The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
The easy way to misread this
Do not assume that improving group climate directly reduces coercive measures. The study found no direct link; the reduction in coercion was indirect, mediated by a decrease in aggressive incidents. Additionally, the cross-sectional nature means we cannot say that a better climate causes less aggression, only that they are associated.