Effects of Integrated Moral Reasoning Development Intervention for Management of Violence in Schizophrenia

NCT05207319 | Completed

• 1 other identifier: IShouU
• Study Type: interventional
• Target: 43
• Locations: 1 country
• Sites: 1

Brief Summary

Moral cognition is an important and multidimensional, but often overlooked, determinant of violence. Very few interventions have systematically examined the role of moral reasoning, anger management and problem-solving together in violence. A randomized controlled trial was conducted to comprehensively evaluate the sustained effects of an integrated Moral Reasoning Development Intervention (MRDI) on management of repetitive violence in schizophrenia. This study placed special emphasis on essential components related to moral reasoning and violence in patients with schizophrenia. Evaluations including measures of violence, moral reasoning, ethical valuation and judgement, decision-making, conflict management style, and personality traits, were performed at baseline, end of intervention, and 1-month follow-up after intervention. MRDI was superior to treatment-as-usual in improving moral reasoning and related variables and violence outcomes. In comparison with the treatment-as-usual group, patients in the MRDI group showed improved levels of moral reasoning whereas decreased levels of violent behaviors. The MRDI participants also experienced significantly greater improvements or changes in their ethical valuation and judgement, decision-making style and preferences, and conflict management style. Our findings provide important implications for risk assessment and violence management and prevention.

Conditions

Schizophrenia; Moral Status; Violence

Outcome Measures

Primary Outcomes (7)

• The Adapted Version of the Sociomoral Reflection Measure

  Moral reasoning (The score 1 which corresponds with the first stage of Kohlberg's moral development, indicates the patient did not understand the moral content of the proposition. )

  Change of status of moral reasoning from Baseline (T1), immediately after the intervention (T2), to 1-month follow-up after intervention (T3)

• Multidimensional Ethics Scale

  Ethical valuation (The patients are required to rate the questionable actions of a hypothetical auditor on several 7-point Likert scales, anchored on such as unjust/just, unfair/fair, unethical/ethical, not morally right/morally right, culturally unacceptable/culturally acceptable.)

  Change of ethical valuation from Baseline (T1), immediately after the intervention (T2), to 1-month follow-up after intervention (T3)

• Rational Experiential Inventory

  Reasoning and thinking styles (A higher score indicates a more rational/experiential thinking style.)

  Change of reasoning and thinking styles from Baseline (T1), immediately after the intervention (T2), to 1-month follow-up after intervention (T3)

• Rahim Organizational Conflict Inventory-II

  Conflict management style (The higher the score is, the greater a particular conflict management style is used.)

  Change of conflict management style from Baseline (T1), immediately after the intervention (T2), to 1-month follow-up after intervention (T3)

• Modified Overt Aggression Scale

  Aggression Frequency

  Aggression frequency at Baseline

• Buss-Perry Aggression Questionnaire

  Violence/Aggression (The higher the score is, the higher the patient has the violent behavior.)

  Change of violence/aggression from Baseline (T1), immediately after the intervention (T2), to 1-month follow-up after intervention (T3)

• Ten Item Personality Inventory

  Personality traits (A greater change from the baseline in this scale (with higher score) on each of personality traits represents more the expression of each personality trait was calculated.)

  Change of personality traits from Baseline (T1), immediately after the intervention (T2), to 1-month follow-up after intervention (T3)

Study Arms (2)

the MRDI group (Moral Reasoning Development Intervention)

EXPERIMENTAL

The MRDI is comprised of 4 components that are run concurrently: moral reasoning, strategies of anger management and problem-solving and social skills.

Other: integrated Moral Reasoning Development Intervention (MRDI)

the control group

NO INTERVENTION

The control group is the Treatment as Usual (TAU).

Interventions

integrated Moral Reasoning Development Intervention (MRDI) OTHER

The MRDI is comprised of 4 components that are run concurrently: moral reasoning, strategies of anger management and problem-solving and social skills.

the MRDI group (Moral Reasoning Development Intervention)

Eligibility Criteria

• Age: 20 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Clinical diagnosis of schizophrenia for more than 2 years
• Psychiatrically hospitalized
• Repetitive violence within one year
• Having basic literacy
• More than 20 years old
• Less than 65 years old

You may not qualify if:

• Clinical diagnosis of catatonic schizophrenia and schizophreniform disorder.

Sponsors & Collaborators

• I-Shou University: lead

Study Sites (1)

I-Shou University

Kaohsiung City, Taiwan

Location

MeSH Terms

Conditions

Schizophrenia

Condition Hierarchy (Ancestors)

Schizophrenia Spectrum and Other Psychotic Disorders; Mental Disorders

Study Officials

• Mei-Chi Hsu, Ph.D

  I-Shou University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: December 27, 2021
• First Posted: January 26, 2022
• Study Start: September 1, 2019
• Primary Completion: December 31, 2020
• Study Completion: December 31, 2020
• Last Updated: January 26, 2022

Record last verified: 2022-01

Data Sharing

• IPD Sharing: Will not share

Locations

TW (1)