The objective was to evaluate the relative efficacy of dialectical behavior therapy modified for stalking offenders (DBT-S) versus a cognitive–behavioral anger management intervention for the treatment of stalking offenders. We expected DBT to result in significantly lower rates of renewed stalking behavior and significantly greater improvements in impulsivity, aggression, anger, and empathy. We randomly assigned individuals charged with stalking-related offences (N = 109) to one of two study interventions: DBT-S and anger management. Recidivism (renewed stalking, violence, and other offences) was monitored for 1 year following the baseline assessment, and participants completed a battery of self-report questionnaires before and after treatment and at a 1-year follow-up assessment. We found relatively low rates of reoffence when compared to past studies of untreated stalking offenders in the U.S., but type of treatment had no impact on the likelihood of reoffence, nor did completion of the treatment program. Likewise, there was no between-groups difference in rates of treatment completion, or on changes in self-report measures. Intensive treatment focused on reducing problematic behaviors in stalking offenders may be effective regardless of treatment modality, but the mechanism by which treatment impacts criminal behavior is not yet clear.

This study examined the internal validity and predictive accuracy of the Guidelines for Stalking Assessment and Management (SAM), a structured professional judgment risk assessment tool for stalking. Interviewers rated 89 stalking offenders on the Psychopathy Checklist: Screening Version (PCL:SV) and SAM Nature (N) and Perpetrator (P) subscales. Researchers obtained stalking and violence outcomes prospectively from several sources, for an average follow-up period of 2.5 years. Cox Proportional Hazard analyses including SAM and PCL:SV scores demonstrated a significant positive relationship between SAM total and subscale scores in predicting stalking recidivism, whereas PCL:SV scores were negatively associated with recidivism. However, the SAM clinical risk ratings did not significantly predict stalking reoffending. There were also no significant associations between SAM scores and violent outcomes. These findings provide mixed support for the use of the SAM as a risk assessment tool for stalking offenders.

Techniques to assess violence risk are increasingly common, but no systematic approach exists to help clinicians decide which psychiatric patients are most in need of a violence risk assessment. The Fordham Risk Screening Tool (FRST) was designed to fill this void, providing a structured, systematic approach to screening psychiatric patients and determining the need for further, more thorough violence risk assessment. The FRST was administered to a sample of 210 consecutive admissions to the civil psychiatric units of an urban medical center, 159 of whom were subsequently evaluated using the Historical Clinical Risk Management-20, version 3, to determine violence risk. The FRST showed a high degree of sensitivity (93%) in identifying patients subsequently deemed to be at high risk for violence (based on the Case Prioritization risk rating). The FRST also identified all of the patients (100%) rated high in potential for severe violence (based on the Serious Physical Harm Historical Clinical Risk Management-20, version 3, summary risk rating). Sensitivity was more modest when individuals rated as moderate risk were included as the criterion (rather than only those identified as high risk). Specificity was also moderate, screening out approximately half of all participants as not needing further risk assessment. A systematic approach to risk screening is clearly needed to prioritize psychiatric admissions for thorough risk assessment, and the FRST appears to be a potentially valuable step in that process. (PsycINFO Database Record

This study provides both a structural analysis of the Historical-Clinical-Risk Management–20 (HCR-20) Version 3 and an examination of the correspondence between the HCR-20 Versions 2 and 3. HCR-20 Versions 2 and 3 risk ratings were completed for 64 psychiatric inpatients. Moderate to good interrater reliability was observed for the Version 3 subscales and summary risk ratings. Subscale scores and summary risk ratings on the Version 2 were significantly correlated with the corresponding scales and indices on the Version 3, although correlations were stronger when ratings were completed by the same rater as opposed to different raters. Version 3 items corresponding to Violence, Violent Attitudes, Violent Ideation or Intent, and Insight were the strongest predictors of the summary risk ratings, although some differences emerged when risk factor presence ratings were weighted by relevance ratings. The implications of these findings for risk assessment practice are discussed.

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