{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:47:14Z","timestamp":1791996434447,"version":"4.4.0"},"reference-count":76,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Industrial Med"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Workplace violence (WPV) in hospitals worldwide has been on the rise for the last decade, marked by increased verbal and physical aggression. From a biopsychosocial perspective, we conceptualize aggressors' mental states as their control (or lack of) of an impulse across their life course. To contribute to violence prevention, our study synthesizes theoretical assumptions and organizational analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An exploratory sequential mixed\u2010methods design analyzed 2634 WPV narratives from two hospitals in a large city in the Northeastern United States of America (2019\u20132023). Narratives were coded for \u201cinvoluntary mental states\u201d (e.g., dementia, delirium, lack of inhibition) and \u201cunremorseful attitudes\u201d (denial, minimization, justification without medical causation). Quantitative analysis identified patterns within these categories, types of violence, and safety responses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>WPV incidents increased by 212.4% from 2020 to 2021 and did not decrease in incidence in subsequent years. Patient\/visitor workplace violence (Type 2) accounted for 93%. Physical violence was most prevalent (76%), followed by verbal (48%) and sexual (6%). \u201cInvoluntary mental states\u201d comprised 28% of narratives, while \u201cunremorseful attitudes\u201d represented 29%. Workers often showed compassion, omitting emotional details for involuntary aggression, but reported significant distress from unremorseful acts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our novel middle\u2010range theory and mixed\u2010methods approach reveal the complexity of WPV beyond simple dichotomies. Differentiating between involuntary and unremorseful aggression provides actionable insights for tailoring prevention strategies, de\u2010escalation training, and aftermath support. Integrating mental health professionals and addressing the profound impact of remorseless acts is crucial for worker morale and retention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ajim.70047","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T10:59:48Z","timestamp":1766746788000},"page":"132-143","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Mental States of Aggressors: A Biopsychosocial Analysis of Workplace Violence Reports in Hospitals"],"prefix":"10.1002","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0781-5662","authenticated-orcid":false,"given":"Ricardo Diego","family":"Su\u00e1rez Rojas","sequence":"first","affiliation":[{"name":"Boston College School of Social Work Chestnut Hill Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Boston College Law School Chestnut Hill Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika L.","family":"Sabbath","sequence":"additional","affiliation":[{"name":"Boston College School of Social Work Chestnut Hill Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2020.570459"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2022.09.010"},{"issue":"1","key":"e_1_2_10_4_1","first-page":"14","article-title":"Workplace Violence Against Healthcare Workers During the COVID\u201019 Pandemic: A Systematic Review","volume":"7","author":"Chirico F.","year":"2022","journal-title":"Journal of Health Social Sciences"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-046620"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2019-105849"},{"key":"e_1_2_10_7_1","unstructured":"World Health Organization. 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