Structured risk assessment should guide clinical risk management, but it is uncertain which instrument has the highest predictive accuracy among men and women. In the present study, the authors compared the Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991, 2003); the Historical, Clinical, Risk Management-20 (HCR-20; C. D. Webster, K. S. Douglas, D. Eaves, & S. D. Hart, 1997); the Risk Matrix 2000-Violence (RM2000[V]; D. Thornton et al., 2003); the Violence Risk Appraisal Guide (VRAG; V. L. Quinsey, G. T. Harris, M. E. Rice, & C. A. Cormier, 1998); the Offenders Group Reconviction Scale (OGRS; J. B. Copas & P. Marshall, 1998; R. Taylor, 1999); and the total previous convictions among prisoners, prospectively assessed prerelease. The authors compared predischarge measures with subsequent offending and instruments ranked using multivariate regression. Most instruments demonstrated significant but moderate predictive ability. The OGRS ranked highest for violence among men, and the PCL-R and HCR-20 H subscale ranked highest for violence among women. The OGRS and total previous acquisitive convictions demonstrated greatest accuracy in predicting acquisitive offending among men and women. Actuarial instruments requiring no training to administer performed as well as personality assessment and structured risk assessment and were superior among men for violence.

Risks of reoffending remain for a subgroup of discharged patients. Future research should aim to improve their identification and risk management following discharge.

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Adverse childhood experiences and childhood temperamental features are known to contribute to the development of personality disorder. The aim of this study was to examine associations between personality disorder, childhood temperament, adverse childhood experiences, and victimisation. The Prisoner Cohort Study was carried out as part of the dangerous and severe personality disorder (DSPD) service development programme commissioned by the Home Office. The study comprised 1396 male offenders interviewed with the Structured Clinical Interview (SCID II) to diagnose personality disorders in addition to reveal selfreported experiences of childhood victimisation and disadvantage. Independent and joint relationships were examined between reported temperament and adverse childhood experiences and Axis II disorders measured at interview. Prisoners with personality disorder reported\ud adverse childhood experiences and victimisation more frequently than those with no personality disorder. Different childhood experiences were interrelated with specific personality disorder categories. Associations\ud between temperamental features and specific personality disorders were increased by the addition of adverse childhood experiences (joint effects). A difficult temperament and childhood adversity increase the likelihood of personality disorder in prisoners and may be risk factors to target for future early intervention

BackgroundUrban birth and urban living are associated with increased risk of schizophrenia but less is known about effects on more common psychotic experiences (PEs). China has undergone the most rapid urbanization of any country which may have affected the population-level expression of psychosis. We therefore investigated effects of urbanicity, work migrancy, and residential stability on prevalence and severity of PEs.MethodsPopulation-based, 2-wave household survey of psychiatric morbidity and health-related behavior among 4132 men, 18–34 years of age living in urban and rural Greater Chengdu, Sichuan Province, China. PEs were measured using the Psychosis Screening Questionnaire.Results1261 (31%) of young men experienced at least 1 PE. Lower levels of PEs were not associated with urbanicity, work migrancy or residential stability. Urban birth was associated with reporting 3 or more PEs (OR: 1.63; 95% CI: 1.25–2.11), after multivariable adjustment, with further evidence (P = .01) this effect was restricted to those currently living in urban environments (OR: 1.78; 95% CI: 1.16–2.72). Men experiencing a maximum of 5 PEs were over 8 times more likely to have been born in an urban area (adjusted odds ratio [AOR] 8.81; 95% CI 1.50–51.79).ConclusionsMen in Chengdu, China, experience a high prevalence of PEs. This may be explained by rapid urbanization and residential instability. Urban birth was specifically associated with high, but not lower, severity levels of PEs, particularly amongst those currently living in urban environments. This suggests that early and sustained environmental exposures may be associated with more severe phenotypes.