The predictive and incremental validity of ADHD beyond the VRAG-R in a high-risk sample of young offenders

Abstract

The VRAG-R is a well-established actuarial risk-assessment instrument, which was originally developed for assessing violent recidivism risk in adult male offenders. Whether or not the VRAG-R can also predict violent recidivism in young offenders is unclear so far. In the emergence of juvenile offending, attention-deficit/hyperactivity disorder (ADHD) seems to be of major importance suggesting that it could be relevant for risk assessment as well. Thus, we examined the predictive accuracy of the VRAG-R in a high-risk sample of N = 106 (M = 18.3 years, SD = 1.8) young offenders and assessed the incremental predictive validity of ADHD symptomatology beyond the VRAG-R. Within a mean follow-up time of M = 13 years (SD = 1.2), n = 65 (62.5%) young offenders recidivated with a violent offense. We found large effect sizes for the prediction of violent and general recidivism and re-incarcerations using the VRAG-R sum scores. Current ADHD symptomatology added incremental predictive validity beyond the VRAG-R sum scores concerning the prediction of general recidivism but not of violent recidivism. The results supported the use of the VRAG-R for predicting violent recidivism in young offenders. Because ADHD symptomatology improves the predictive performance of the VRAG-R regarding general recidivism, we argue that addressing ADHD symptoms more intensively in the juvenile justice system is of particular importance concerning a successful long-term risk management in adolescents and young adults.

A comparison of the predictive accuracy of structured and unstructured risk assessment methods for the prediction of recidivism in individuals convicted of sexual and violent offense.

“…With regard to the results of the predictive accuracy of the different structured risk assessment approaches, different conclusions could be drawn. First, the results of the present study replicate previously published data which have shown that the test scores of the German version of the VRAG-R yielded comparable predictive validity indices as the original version (Gregório Hertz, Eher, et al, 2021, Gregório Hertz, Müller, et al, 2021). The VRAG-R was significantly predictive for (sexual) violent and general reoffenses, which can be interpreted as further evidence for its predictive validity across different countries, jurisdictions, and language areas.…”

“…The VRAG-R 4 consists of 12 predominantly static items, the total score could range from −34 to 46 and could be divided into nine risk bins (Rettenberger, Grego ´rio Hertz, & Eher, 2017;Rice et al, 2013). The German version of the VRAG-R yielded also high effect sizes for its reliability of the test scores and (predictive) validity of the test score interpretations, which were comparable to the original version (Grego ´rio Hertz, Eher, et al, 2021, Grego ´rio Hertz, Müller, et al, 2021. In the present study, the interrater reliability of the VRAG-R was calculated by analyzing the agreement of the test scores between the independent ratings made by two authors (M. Wertz and S. Schobel) in a subsample of n = 23 randomly selected assessment reports (10.0%) resulting in an excellent reliability coefficient (intraclass correlation coefficient = .934, 95% CI [.924, .949]).…”

Mental Health in Young Detainees Predicts Perpetration of and Desistance From Serious, Violent and Chronic Offending

“…Study procedures were described in detail in previous studies of our research group ( 5 , 19 – 21 ). In short, baseline assessment took place at the Ottweiler Juvenile Detention Center in Saarland, Germany, between 2001 and 2002.…”

Are mental disorders associated with recidivism in men convicted of sexual offenses?

“…In the few studies that combined risk assessment instruments and diagnoses of mental disorders, mental disorders only contributed marginally to predictive accuracy beyond standardized risk assessment instruments. Only few specific diagnoses, like an exclusive pedophilia, 24 some personality disorders, 20 symptoms of an attention deficit hyperactivity disorder (ADHD) 31 or a hypersexual disorder, 32 exhibited incremental predictive validity beyond customary risk assessment instruments. However, these studies used small samples, analyzed only specific mental disorders, or did not implement subgroup analyses.…”

“…27,29,30 In the few studies that combined risk assessment instruments and diagnoses of mental disorders, mental disorders only contributed marginally to predictive accuracy beyond standardized risk assessment instruments. Only few specific diagnoses, like an exclusive pedophilia, 24 some personality disorders, 20 symptoms of an attention deficit hyperactivity disorder (ADHD) 31 or a hypersexual…”