The Short- to Medium-Term Predictive Accuracy of Static and Dynamic Risk Assessment Measures in a Secure Forensic Hospital

Abstract

Although violence risk assessment knowledge and practice has advanced over the past few decades, it remains practically difficult to decide which measures clinicians should use to assess and make decisions about the violence potential of individuals on an ongoing basis, particularly in the short to medium term. Within this context, this study sought to compare the predictive accuracy of dynamic risk assessment measures for violence with static risk assessment measures over the short term (up to 1 month) and medium term (up to 6 months) in a forensic psychiatric inpatient setting. Results showed that dynamic measures were generally more accurate than static measures for short- to medium-term predictions of inpatient aggression. These findings highlight the necessity of using risk assessment measures that are sensitive to important clinical risk state variables to improve the short- to medium-term prediction of aggression within the forensic inpatient setting. Such knowledge can assist with the development of more accurate and efficient risk assessment procedures, including the selection of appropriate risk assessment instruments to manage and prevent the violence of offenders with mental illnesses during inpatient treatment.

Proximal Risk Factors for Short-Term Community Violence Among Adults With Mental Illnesses

“…Consistent with prior research, we found empirical support for the role of static characteristics, including age, sex, and primary diagnosis, in predicting community violence; however, alcohol use, violence, and victimization predicted subsequent violence, even after the analysis controlled for static characteristics. These findings add to the empirical evidence supporting the role of proximal factors in the assessment and management of short-term violence risk among adults with mental illnesses (15,37,38). Below, we discuss the observed effects of these proximal factors and how results may inform the administration of risk assessment instruments and formulation of interventions.…”

Exploring Gender Differences in the Utility of Strength-Based Risk Assessment Measures

“…Few studies have directly investigated the incremental validity of protective factors over risk factors, revealing mixed results, with some studies finding support for the additive value of protective factors (de Vries Robb e & de Vogel, 2010;;de Vries Robb e et al, 2011;Desmarais et al, 2012;Lodewijks et al, 2008;Lodewijks et al, 2010), while other studies did not find evidence to support incremental validity of protective factors over risk factors (Chu et al, 2011;Viljoen et al;Wilson et al, 2010). Interestingly, Lodewijks and colleagues (2010) looked at interaction effects in their study on the value of protective factors in criminal desistance.…”

“…The budding extant literature indicates that protective factors may be useful additions to risk assessments in adults (Braithwaite et al, 2010;Coupland, 2015;Chu, Thomas, Ogloff, & Daffern, 2011;de Vries Robb e et al, 2011;de Vries Robb e & de Vogel, 2010;Desmarais, Nicholls, Wilson, & Brink, 2012;Gray et al, 2011;Miller, 2006b;Nonstad et al, 2011;Viljoen et al, 2011;Wilson, Desmarais, Nicholls, & Brink, 2010) and adolescent populations (Lodewijks, de Ruiter, Doreleijers, & Borum, 2008;Rennie & Dolan, 2010). Research has shown that individuals who desisted from negative behaviours (i.e., did not commit an act of violence) displayed more protective factors and fewer risk factors than those who recidivated (Desmarais et al, 2012;Gray et al, 2011;Miller, 2006b;Nonstad et al, 2011;Viljoen et al, 2011;Wilson et al, 2010).…”

“…Thus, it may be the interaction between protective factors and risk factors that is important in the desistance process, in that more protective factors in combination with low-risk factors may be needed to stop engaging in aggression or offending behaviors. Furthermore, several studies have shown that protective factors demonstrate good predictive validity providing evidence for the utility of protective factors in risk assessment measures (Braithwaite et al, 2010;Chu et al, 2011;de Vries Robb e et al, 2011;de Vries Robb e & de Vogel, 2010;Desmarais et al, 2012;Gray et al, 2011;Lodewijks, Doreleijers, de Ruiter, & Borum, 2008;Lodewijks, de Ruiter, & Doreleijers 2010;Miller, 2006b;Nonstad et al, 2011;Rennie & Dolan, 2010;Viljoen et al, 2011;Wilson et al, 2010).…”

Smurtinio elgesio rizikos vertinimas: HCR-20 prognostinis validumas už smurtinius nusikaltimus teistų asmenų imtyje

“…Pažymėtina, kad HCR-20 validumas dažniausiai buvo tiriamas teismo psichiatrijos pacientų populiacijoje (Jung et al, 2013), tačiau pastaruoju metu tyrimai vis dažniau apima ir kitas tikslines dalyvių grupes, pavyzdžiui, bendrosios psichiatrijos pacientus, pataisos įstaigose esančius nuteistuosius ir pan. Šių tyrimų rezultatai rodo, kad HCR-20 įverčiai yra stipriai susiję su teismo psichiatrijos pacientų pakartotiniu patekimu į teismo psichiatrijos įstaigą (Dolan, Khawaja, 2004), taip pat su smurtinio elgesio pasireiškimu ateityje tiek tarp teismo psichiatrijos pacientų (Chu et al, 2011;Gray et al, 2008;O'Shea et al, 2013), tiek ir tarp pataisos įstaigose esančių nuteistųjų (de Vogel, de Ruiter, 2006;Neves et al, 2011). Be to, kai kurių autorių duomenimis (Dahle, 2006;Gray et al, 2008), HCR-20 įverčiai gerai prognozuoja bendro ir nesmurtinio nusikalstamo elgesio pasireiškimą ateityje.…”