Violent Victimization Among People With Mental Illness: A Longitudinal Analysis of Time-Varying and Time-Stable Risk Factors Using Clinical and Justice-Involved Samples

Abstract

People with mental illness experience disproportionately high rates of violent victimization, yet findings on the predictors of such victimization remain inconsistent due to methodological limitations and sample differences. This study uses longitudinal data from two high-risk populations—a clinical sample of recently discharged psychiatric patients (MacArthur Risk Assessment Study) and a justice-involved sample of emerging adults with mental illness (Pathways to Desistance Study)—to examine both time-varying and time-stable predictors of violent victimization. Hierarchical linear modeling was used to distinguish within- and between-person effects. Across both samples, substance use, offending, and peer delinquency were robust time-varying predictors of victimization, while psychiatric symptom severity and threat/control-override symptoms were significant in the clinical sample only. Head injury emerged as a strong predictor in the justice-involved sample. Among time-stable predictors, psychopathy consistently increased victimization risk, while impulsivity and aggression had sample-specific effects. Diagnostic categories did not significantly predict victimization in either dataset. Findings highlight the value of integrating both dynamic and dispositional factors into victimization risk assessments and underscore the importance of contextualizing risk within specific populations. Implications for theory, assessment, and intervention are discussed.