Journal of Biology, Agriculture and Healthcare www.iiste.org ISSN 2224-3208 (Paper) ISSN 2225-093X (Online) Vol.3, No.15, 2013 65 Impulsivity, Depression and Aggression among Psychiatric Patients Safaa Mohammed Zaki 1, Prof. Dr. Nefissa Mohamed Abd El- Kader 2 , Prof. Dr. Huda Diab Fahmy 3 , Dr. Azza Mohamed Abd El-Aziz 4 and Dr. Manal Hassan Abo EL-Magd 5 * 1. Psychiatric & Mental Health Nursing, Faculty of Nursing ,El Minia university ,Egypt 2. Psychiatric -Mental Health Nursing, Faculty of Nursing, Cairo University, Egypt 3. Community Health Nursing ,Faculty of Nursing , Assiut University, Egypt 4. Psychiatric Nursing, Faculty of Nursing, Assiut University, Egypt 5. *Psychiatric &Mental Health Nursing, Faculty of Nursing, El-Minia University, Egypt and Umm Al Qura University, KSA , * E-mail of the corresponding author: manalh2002@yahoo.com Abstract Aggression in inpatient facilities can generally be conceptualized as an interaction between an individual and the environment in which he or she finds themselves. The aim of this study was to assess impulsivity, depression and aggression among psychiatric patients. Descriptive correlational research design was used in this study. A convenient sample of 100 psychiatric patients from Beni-Ahmad psychiatric hospital in El-Minia, governorate, four tools were utilized to measure the study variables; Personal and clinical data Questionnaires, Barratt Impulsiveness Scale, Beck Depression Inventory and Aggression Questionnaire. Results of the study revealed that, 79% of the patients were in the age group from 20-35 years, 63% of the patients were males, and 52% of the patients were not working, 42% of the patients were schizophrenic, 56% of patients had moderate impulsivity, 58% of patients had extreme level of depression and 51% of the patients had severe level of aggression. In conclusion, more than half of psychiatric patients had moderate impulsivity level, extreme level of depression and severe level of aggression. There were positive correlations between impulsivity, depression and aggression. This study recommended developing and implementing psychosocial program to decrease impulsivity, depression and aggression among the psychiatric patients. Keywords: Impulsivity/ Depression /Aggression / psychiatric patients. 1. Introduction Aggression is a behavior performed by one person “the aggressor’’ with the intent of harming another person “the victim’’ who is believed by the aggressor to be motivated to avoid that harm. Harm may include direct physical harm e.g., a punch to the jaw, direct psychological harm e.g., verbal insults, and indirect harm e.g., destroying the victim’s property (Dupre & Barling 2006). There are many possible causes for aggressive behavior in patients with psychiatric disorders. Probably the most important causes are the presence of comorbid substance abuse, dependence, and intoxication. In addition, the disease process itself may produce hallucinations and delusions, which may provoke aggression. Often, poor impulse control related to neuropsychiatric deficits may also facilitate the discharge of aggressive tendencies. Finally, underlying personality characteristics, such as antisocial personality traits also may influence the use of violent acts as a means to achieve certain goals. Concerning environmental factors that are associated with aggressive behavior, such as chaotic or unstable home or hospital situation, which may encourage maladaptive aggressive behaviors (Volavka & Citrome 2008). A positive relationship between impulsivity and aggression was found by Vitacco et.al., (2002) and suggested that, high levels of impulsivity lead to poor problem solving, which then leads to aggression, they also added that, long-standing psychological abnormality and environmental stresses or cues may be necessary for the development of violent impulses. When such impulses occur, their control may relate to trait impulsivity. Depression refers to mental disorder characterized by low mood accompanied by low self-esteem, and loss of interest or pleasure in normally enjoyable activities. Depression and aggression are considered to belong to different classes of diagnoses according to psychiatric classification systems (DSM-IV) and to different factors in personality inventories. Yet, there is biochemical and clinical evidence for a relationship between the two constructs (Roberts etal., 2010). Indeed, both depression and aggression are characterized by low tolerance to frustration. The original frustration-aggression hypothesis claiming that frustration always leads to aggressive as well as depressive responses (Blair, 2010). Also, Fava (2002) found that, aggressive behavior was common among individuals experiencing depression. Similarly, Berkowitz (2002) suggested that, depression may contribute to aggression by bringing on unpleasant emotions or stimuli within the individual. Although for many individuals the reaction to depression may be to withdraw, for some individuals depressed emotions may increase sensations of anger, particularly toward perceived sources of the unpleasant emotions. This transference of depression to anger may result in impulsive