Examining the role of static and dynamic risk factors in the prediction of inpatient violence: Variable- and person-focused analyses.

Abstract

Although the construct of psychopathy is related to community violence and recidivism in various populations, empirical evidence suggests that its association with institutional aggression is weak at best. The current study examined, via both variable-level and group-level analyses, the relationship between standard violence risk instruments, which included a measure of psychopathy, and institutional violence. Additionally, the incremental validity of dynamic risk factors also was examined. The results suggest that PCL-R was only weakly related to institutional aggression and only then when the behavioral (Factor 2) aspects of the construct were examined. The clinical and risk management scales on the HCR-20, impulsivity, anger, and psychiatric symptoms all were useful in identifying patients at risk for exhibiting institutional aggression. These data suggest that factors other than psychopathy, including dynamic risk factors, may be most useful in identifying forensic patients at higher risk for exhibiting aggression.

HCR-20 violence risk assessments as a guide for treating and managing violence risk in a forensic psychiatric setting

“…This is comparable to previous findings (Doyle, Dolan, & McGovern, 2002;Gray et al, 2003;McDermott, Edens, Quanbeck, Busse, & Scott, 2008). The predictive ability was in the poor towards moderate range only, which also may reflect good management of high-risk individuals based on in situ assessments.…”

A prospective comparison of two measures of psychopathy in the prediction of institutional misconduct

“…Our findings, along with other recent studies (e.g. McDermott, Edens, Quanbeck, Busse, & Scott, 2008), contradict claims that remorselessness, callousness, and egocentricity are valid indicators of the likelihood of subsequent violence in institutional settings. In fact, to the extent that the negative associations between PPI Coldheartedness and institutional misconduct (see Footnote 4) prove to be replicable in future investigations, our results raise the possibility that emotional detachment (at least as assessed by the PPI) may even be a protective factor against certain forms of institutional misconduct (cf.…”

The accuracy of risk assessment instruments in the prediction of impulsive versus predatory aggression

“…The addition of an extreme affective state is also critical. Previous research has indicated as such: cluster analyses revealed that patients scoring high on the PCL-R and the NAS-PI were responsible for much of the aggression exhibited in a forensic facility (McDermott et al, 2008).…”