Assessment and management of acute risk of violence in adult patients.

McNiel, Dale E.

doi:10.1037/11865-006

Behavioral Emergencies: An Evidence-Based Resource for Evaluating and Managing Risk of Suicide, Violence, and Victimization. 2009

DOI: 10.1037/11865-006

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Assessment and management of acute risk of violence in adult patients.

Dale E. McNiel

Abstract: risk of violence in adult patients. On the basis of analysis of how these variables influence a patient's risk, the clinician may select from an array of interventions for managing the risk of violence.

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Cited by 3 publications

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References 41 publications

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“…Similarly, Kraemer recommended that static or stable risk factors should be called risk markers . Nonetheless, there is general consensus that dynamic factors should be more useful than static factors in clinical and correctional settings as they provide a target for treatment or intervention (e.g., Douglas & Skeem, 2005; Dvoskin & Heilbrun, 2001; McNiel, 2009). Accordingly, many risk assessment tools, such as the HCR–20 (Webster et al, 1997), START (Webster et al, 2009), the Brøset Violence Checklist (Almvik & Woods, 1999), and the Level of Service/Case Management Inventory (Andrews et al, 2004), include dynamic risk factors in addition to static risk factors.…”

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confidence: 99%

Predictive validity of dynamic factors: Assessing violence risk in forensic psychiatric inpatients.

Wilson¹,

Desmarais²,

Nicholls³

et al. 2013

Law and Human Behavior

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There is general consensus that dynamic factors ought to be considered in the assessment of violence risk, but little direct evidence exists to demonstrate that within-individual fluctuations in putative dynamic factors are associated with changes in risk. We examined these issues in a sample of 30 male forensic psychiatric inpatients using a pseudoprospective design. Static and dynamic factors were coded on the basis of chart review using 2 structured measures of violence risk: Version 2 of the Historical-Clinical-Risk Management-20 (HCR-20; C. D. Webster, K. S. Douglas, D. Eaves, & S. D. Hart, 1997, HCR-20: Assessing risk for violence, Version 2, Vancouver, BC, Canada: Mental Health, Law, and Policy Institute, Simon Fraser University) and the Short-Term Assessment of Risk and Treatability (START; C. D. Webster, M. L. Martin, J. Brink, T. L. Nicholls, & S. L. Desmarais, 2009, Short-Term Assessment of Risk and Treatability [START], Version 1.1, Coquitlam, BC, Canada: British Columbia Mental Health and Addiction Services). HCR-20 and START assessments were repeated every 3 months for a period of 1 year. Institutional violence in the 3 months following each assessment was coded using a modified version of the Overt Aggression Scale (S. C. Yudofsky, J. M. Silver, W. Jackson, J. Endicott, & D. W. Williams, 1986, The Overt Aggression Scale for the objective rating of verbal and physical aggression, The American Journal of Psychiatry, Vol. 143, pp. 35-39). Dynamic risk and strength factors showed predictive validity for institutional aggression. Results of event history analyses demonstrated that changes in dynamic risk factors significantly predicted institutional violence, even after controlling for static risk factors. This is one of the first studies to provide clear and direct support for the utility of dynamic factors in the assessment of violence risk.

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confidence: 99%

Predictive validity of dynamic factors: Assessing violence risk in forensic psychiatric inpatients.

Wilson¹,

Desmarais²,

Nicholls³

et al. 2013

Law and Human Behavior

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A qualitative analysis of suicide risk factors, preferred means, and means restriction feasibility within a homeless shelter environment

Poon

Holleran

Chu

et al. 2017

Journal of Social Distress and the Homeless

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Protective Factors in Forensic Mental Health: A New Frontier

Ruiter

Nicholls

2011

International Journal of Forensic Mental Health

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Assessment and management of acute risk of violence in adult patients.

Abstract: risk of violence in adult patients. On the basis of analysis of how these variables influence a patient's risk, the clinician may select from an array of interventions for managing the risk of violence.

Cited by 3 publications

References 41 publications

Predictive validity of dynamic factors: Assessing violence risk in forensic psychiatric inpatients.

Predictive validity of dynamic factors: Assessing violence risk in forensic psychiatric inpatients.

A qualitative analysis of suicide risk factors, preferred means, and means restriction feasibility within a homeless shelter environment

Protective Factors in Forensic Mental Health: A New Frontier

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