Overt Aggression Scale-Modified (OAS-M)

Overt Aggression Scale-Modified (OAS-M)

Explanation of the Critical Components of the OAS-M Psychiatric Interview and Why They Are Essential

OAS-M, or the Modified Overt Aggression Scale, refers to a psychiatric interview scale that utilizes four critical elements to rate and assess the behavior of patients, particularly the severity and frequency of aggressive incidences (Harris, Oakley, & Picchioni, 2013). The rating scale consists of four crucial components: autoaggression (or aggression against the self), aggression against objects/property, verbal aggression, and aggression against others. This scale is important during a psychiatric interview because clinicians can use it to determine how severe and frequently a patient behaves aggressively towards the self, property, and others, whether verbally or physically.

The Psychometric Properties of the Rating Scale

One psychometric property of the OAS-M scale includes the ability to measure the verbal aggression of the patient with aggressive behavior from a scale of 0 (no verbal aggression) to 4 (threatens violent behavior towards others deliberately and repeatedly). The scale also measures ‘aggression against property’ from a range of 0 (no aggression) to 4 (patient hurls objects perilously or sets fire). Besides, it evaluates autoaggression properties, including no autoaggression (rating 0), hits self, pulls hair out, or scratches skin (1), hits walls with fist or bangs head (2), and burns, bruises, and inflicts minor injuries on self (3). Finally, the scale evaluates physical aggression property, with 0 representing the absence of physical aggression and 4 representing ‘attacks’ on others, often resulting in serious injury (Mattes, 2010).

When It Is Appropriate and Helpful

The application of this tool is appropriate when a patient displays impulsive aggression, a disorder identified by the DSM-5 as IED (Intermittent Explosive Disorder). The symptoms of impulsive aggressive behavior range include tingling, racing thoughts, increased energy, irritability, temper tantrums, and rage. Patients often exhibit overblown or exaggerated explosive behavioral and verbal outbursts. This tool is suitable for conducting mental interviews to evaluate the severity and intensity of aggression among patients in open settings (outpatients or those not hospitalized). For a nurse practitioner’s mental assessment, this scale presents the most reliable and valid diagnostic and quantification tool for evaluating prolonged aggression and IED (Coccaro, 2020).

References

Coccaro, E. F. (2020). The Overt Aggression Scale Modified (OAS-M) for clinical trials targeting impulsive aggression and intermittent explosive disorder: Validity, reliability, and correlates. Journal of Psychiatric Research, 124, 50-57. doi.org/10.1016/j.jpsychires.2020.01.007

Harris, S. T., Oakley, C., & Picchioni, M. (2013). Quantifying violence in mental health research. Aggression and Violent Behavior, 18(6), 695-701. doi:10.1016/j.avb.2013.07.022

Mattes, J. A. (2010). Suggested Improvements to the Overt Aggression Scale-Modified. The Journal of Neuropsychiatry and Clinical Neurosciences, 22(1), 123-123. doi:10.1176/jnp.2010.22.1.123.e1

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Overt Aggression Scale-Modified (OAS-M)

Overt Aggression Scale—Modified (OAS-M)

1. A brief explanation of three important components of the psychiatric interview and why you consider these elements important.
2. Explain the psychometric properties of this rating scale.
3. Explain when it is appropriate to use this rating scale with clients during the psychiatric interview and how the scale is helpful to a nurse practitioner’s psychiatric assessment. Support your approach with evidence-based literature.