Historical and clinical items of the HCR-20 as predictors of risk within an intellectual disability population

Abstract

Purpose -The use of violence risk assessment measures within intellectual disabilities (ID) services is now the norm and a growing target for research. The purpose of this paper is to examine the clinical utility of the historical and clinical factors of the HCR-20 in predicting violence. Design/methodology/approach -The study took place within a national low secure service for adults with ID examining all completed admissions over a six-year period, (N ¼ 22). Clinical records covering the first three months of admission were examined along with historical reports and incident data recorded at three, six, nine and 12 months admission using the Modified Overt Aggression Scale (MOAS). Findings -Significant positive relationship between Historical score and total number of incidents was established. Patients with challenging behaviour less likely to have a previous history of violence, and more likely to be older at first violent incident than patients without challenging behaviour. Incidents involving patients with autism were less severe and those with no additional psychiatric diagnosis were significantly more likely to have substance misuse problems than those with a diagnosis. Originality/value -The study found the Historical section was predictive of violent incidents and whilst the study is too small to draw any firm conclusions, the significant positive relationship between the Historical Score and number of incidents for those without additional diagnosis needs to be investigated further as well as the potential positive clinical impact of using the HCR-20 in routine clinical practice.

The prevention of offending behaviour by people with intellectual disabilities: a case for specialist childhood and adolescent early intervention

“…The HCR-20 V3 assessment is based upon the evaluator assembling a sufficient information base upon which to make ratings of risk factors, and why they have led a person to be violent, which typically involves an interview with the patient being evaluated, plus a review of case files (Douglas et al, 2014). A number of studies have investigated the predictive validity of the HCR-20 in ID populations in regard to institutional aggression (Chaplin, Eyeoyibo, Wright, Xenitidis and McCarthy, 2015;Fitzgerald et al, 2013;O'Shea et al, 2015) and future reconviction (Gray et al, 2007), and reported equivalent, or higher levels of validity in the ID population as compared to the general forensic population. This measure was chosen for the study due to its inclusion of age data within the scores and qualitative evidence provided for two items: H1 -History of Problems with Violence and H2 -History of Problems with Other Antisocial Behaviour.…”

Trauma and institutional risk in a secure developmental disorder service: does the SAVRY inflate risk in adolescents exposed to ACEs?

“…This remains an important area for investigation, not least because of the absence of SPJ risk assessment tools developed for use in assessing people with developmental disorders. While there is a growing body of research to support the predictive validity of existing SPJ tools for adults with developmental disorders (Chaplin et al, 2015;Lindsay et al, 2008), research is yet to validate the use of the adolescent Structured Assessment of Violence Risk in Youth [SAVRY] (Borum et al, 2006) tool, for developmental disorder populations. Whether risk ratings on the SAVRY, which includes trauma items, are reflected in more frequent or severe displays of risk behaviours or a greater need for restrictive practices is an important area for exploration and represents a critical oversight in the literature.…”

Modèles D’intervention Médical Et Environnemental Auprès Des Personnes Manifestant Un Trouble Grave Du Comportement, Quelles Sont Les Divergences?

“…ex., mesure de la stabilité émotionnelle, évaluation du risque, opportunité de choix). Elle comprend, par exemple, un outil d'évaluation de gestion du risque des comportements sexuels abusifs chez les personnes présentant une DI hébergées en communauté (Cookman, 2012) et des outils d'évaluation des risques (Arborelius, Fors, Svensson, Sygel et Kristiansson, 2013;Chaplin, Eyeoyibo, Wright, Xenitidis et McCarthy, 2015;Pouls et Jeandarme, 2016;Taylor et Novaco, 2013). Une seule des études recensées intègre une procédure incluant un groupe contrôle (Arborelius et al, 2013).…”