Predictive validity and gender differences in a biopsychosocial model of violence risk assessment in acute psychiatry

Abstract

Current violence risk assessment methods seem to have reached an upper limit of accuracy. More comprehensive biopsychosocial models may improve on existing methods. Research on gender differences concerning risk factors of violence is scarce and inconclusive. In this prospective study from an acute psychiatric ward, all patients admitted from March 2012 to March 2013 were included. Predictive validity and potential gender differences in a biopsychosocial model of violence risk assessment consisting of a psychosocial checklist (Violence risk screening-10, V-RISK-10), a patient's self-report risk scale (SRS), total cholesterol (TC) and high-density lipoprotein cholesterol (HDL) were examined in an inpatient (N = 348) and a 3-months follow-up (N = 101) sample. Overall increases in explained variances and predictive values were small and non-significant compared to V-RISK-10 alone. In the inpatient sample, HDL contributed significantly to the model for men but not for women. In the follow-up sample, SRS contributed significantly for the whole sample. Results indicated that the biopsychosocial model we tested partially improved accuracy of violence risk assessments in acute psychiatry and that gender differences may exist.

How do lipids influence risk of violence, self-harm and suicidality in people with psychosis? A systematic review

“…However, there were some variations in the findings. One group of researchers ( Eriksen et al, 2018 ) did not find a link with TC but with HDL, and only for men and not for women. The same authors, while studying violence in the first 3 months after discharge, also found HDL to be inversely associated with violence in men only ( Eriksen et al, 2017 ).…”

“…A total of nine studies ( Cariou et al, 2018 ; Chakrabarti et al, 2004 ; Chen et al, 2015 ; Eriksen et al, 2017 , 2018 ; Hjell et al, 2020 ; Huang and Wu, 2000 ; Repo-Tiihonen et al, 2002 ; Turkoglu et al, 2009 ) explored the link between lipid profile and violence against others, of which six studies found a link. However, there were some variations in the findings.…”

“…Third, most of the studies had similar findings for males and females. However, low HDL was seen in two studies to be a better predictor of violence than low TC for males (Eriksen et al, 2017(Eriksen et al, , 2018. Another study found female sex and low TC levels could be used, in part, as predictors of violence in patients with schizophrenia (Chen et al, 2015).…”

Risk assessment of imminent violence in acute psychiatry: a step towards an extended model

“…This initial sample overlapped with previous studies that investigated different selections of baseline and/or outcome variables. Because of missing records in different variables, there were different selections of patients and admissions in the final samples of the respective studies (Eriksen, Bjorkly, Lockertsen, Faerden, & Roaldset, 2017;Eriksen et al, 2016;Eriksen et al, 2018;Lockertsen et al, 2017;Lockertsen et al, 2019).…”

“…Two of these studies examined the Self-report Risk Scale (SRS), of which both studies found predicted inpatient violence (Lockertsen et al, 2017;Roaldset & Bjorkly, 2010). The SRS was also included in a bio-psycho social model of violence risk assessment in acute psychiatry (Eriksen, Faerden, Lockertsen, Bjorkly, & Roaldset, 2018), but was found to be insignificant for the inpatient setting. As far as we know, to date no studies include patients' self-perceptions of risk in short-term risk assessment models.…”