Understanding dynamic risk factors for violence

Klepfisz, Gabrielle; Daffern, Michael; Day, Andrew

doi:10.4324/9781315266039-8

Cited by 6 publications

(12 citation statements)

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“…Pre-treatment ratings on the dynamic factors can be used to represent treatment targets and post-treatment ratings can be used to assess progress, but only if these dynamic factors not only have predictive validity but changes in these factors tap into the causal mechanism of criminal behaviour and result in changes of behaviour [62]. Causal instead of predictive models should therefore be preferred in the implementation of clinical risk management [63].…”

Section: Resultsmentioning

confidence: 99%

European Psychiatric Association (EPA) guidance on forensic psychiatry: Evidence based assessment and treatment of mentally disordered offenders

et al. 2018

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Forensic psychiatry in Europe is a specialty primarily concerned with individuals who have either offended or present a risk of doing so, and who also suffer from a psychiatric condition. These mentally disordered offenders (MDOs) are often cared for in secure psychiatric environments or prisons. In this guidance paper we first present an overview of the field of forensic psychiatry from a European perspective. We then present a review of the literature summarising the evidence on the assessment and treatment of MDOs under the following headings: The forensic psychiatrist as expert witness, risk, treatment settings for mentally disordered offenders, and what works for MDOs. We undertook a rapid review of the literature with search terms related to: forensic psychiatry, review articles, randomised controlled trials and best practice. We searched the Medline, Embase, PsycINFO, and Cochrane library databases from 2000 onwards for adult groups only. We scrutinised publications for additional relevant literature, and searched the websites of relevant professional organisations for policies, statements or guidance of interest. We present the findings of the scientific literature as well as recommendations for best practice drawing additionally from the guidance documents identified. We found that the evidence base for forensic-psychiatric practice is weak though there is some evidence to suggest that psychiatric care produces better outcomes than criminal justice detention only. Practitioners need to follow general psychiatric guidance as well as that for offenders, adapted for the complex needs of this patient group, paying particular attention to long-term detention and ethical issues.

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Section: Resultsmentioning

confidence: 99%

European Psychiatric Association (EPA) guidance on forensic psychiatry: Evidence based assessment and treatment of mentally disordered offenders

et al. 2018

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“…Even more broadly, the evidence for within-treatment change translating into real-world reduction in violent recidivism is limited and inconsistent (e.g., De Vries Robbé et al, 2015; Lewis et al, 2013; Yesberg & Polaschek, 2019). There is also debate within the field regarding what constitutes a dynamic risk factor and how it should be measured (Douglas & Skeem, 2005; Klepfisz et al, 2016); this is evidenced by the wide variability of measurement instruments used to measure change in the violence treatments included in this analysis. The field needs greater investment in violence treatment evaluations that encompass both pretreatment and post-treatment change (relative to a comparable control condition) and longer term behavioral change.…”

Section: Discussionmentioning

confidence: 99%

“…It is recommended that future evaluations adopt a top-down, theory-led approach to outcome and measure selection. One approach is to conceptualize outcomes (i.e., dynamic risk factors) in terms of broad domains that are theoretically relevant to violence and which subsume a number of more specific risk factors (Klepfisz et al, 2016). Polaschek (2006), for example, identifies four domains frequently targeted in violence reduction treatment: (a) attitudinal factors (e.g., offense-supportive attitudes and cognitive or information-processing biases); (b) impulsivity and self-regulation deficits; (c) affective dyscontrol (e.g., anger, hostility, and poor coping skills); and (d) lifestyle-related needs that also predict offending (e.g., substance abuse, antisocial peers, poor interpersonal skills, and family relationships; see also Klepfisz et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…One approach is to conceptualize outcomes (i.e., dynamic risk factors) in terms of broad domains that are theoretically relevant to violence and which subsume a number of more specific risk factors (Klepfisz et al, 2016). Polaschek (2006), for example, identifies four domains frequently targeted in violence reduction treatment: (a) attitudinal factors (e.g., offense-supportive attitudes and cognitive or information-processing biases); (b) impulsivity and self-regulation deficits; (c) affective dyscontrol (e.g., anger, hostility, and poor coping skills); and (d) lifestyle-related needs that also predict offending (e.g., substance abuse, antisocial peers, poor interpersonal skills, and family relationships; see also Klepfisz et al, 2016). The task for researchers then becomes selecting the most appropriate methods and tools for assessing these domains, with decisions ideally guided by theory, the extent to which the tools are reliable and valid for the populations with which they are used, and previous research demonstrating their sensitivity to change and association with violence.…”

Section: Discussionmentioning

confidence: 99%

“…Several dynamic risk factors have been elucidated, and some empirical support exists for the proposition that reduction in the presence and relevance of dynamic risk factors is the mechanism of change in violent individuals (e.g., Lewis et al, 2013). As such, targeting dynamic risk factors in treatment has become the fundamental strategy in contemporary violence reduction treatment programs (Daffern et al, 2017; Klepfisz et al, 2016). However, little is known about whether dynamic risk factors actually change in violence treatments, for whom change is most likely to occur, in what settings/contexts change occurs most readily, and which treatment features are most relevant to change (e.g., treatment type, duration, delivery format, content).…”

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confidence: 99%

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Are Psychological Treatments for Adults With Histories of Violent Offending Associated With Change in Dynamic Risk Factors? A Meta-Analysis of Intermediate Treatment Outcomes

Papalia

Spivak

Daffern

et al. 2020

Criminal Justice and Behavior

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This meta-analysis examined whether psychological treatments delivered to adults with histories of violent offending in correctional and forensic mental health settings were related to change in dynamic risk factors. Twenty-two controlled studies (86% comprised male samples) were identified via a comprehensive search. Treatments had a significant effect overall, with small to moderate improvements in trait anger, social problem solving, impulsivity, and general social skill. The treatment effect for antisocial cognitions was nonsignificant. There were a small number of significant moderators, which provide preliminary indications of treatment features that may promote greater change. However, small sample sizes and difficulties disentangling moderating effects preclude drawing firm conclusions. While these results are useful and promising, the field remains limited by few high-quality outcome studies, disparate outcome/measure selection, inconsistent/incomplete reporting of evaluations, and limited information about whether change in dynamic risk factors predicts reductions in recidivism. Suggestions for advancing the field are provided.

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Anger rumination and imagined violence as related to violent behavior before and after psychiatric hospitalization

et al. 2022

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Objective: Anger rumination and imagined violence, in the context of anger/aggression proclivity, are examined for their direct and conjoint associations with violent behavior by psychiatric patients. Method: A secondary analysis of data from the MacArthur Violence Risk Study was conducted with 1136 acute civil commitment patients, assessed during hospitalization and after hospital discharge. Anger/aggression proclivity was assessed with the Brief Psychiatric Rating Scale hostility subscale, anger rumination was indexed using items from the Novaco Anger Scale, and imagined violence was measured with Grisso's Schedule of Imagined Violence. Violence, prehospitalization and posthospitalization, was indexed by the MacArthur project measure.Results: Correlational analyses, mediation analyses, and moderated mediation analyses were conducted. Anger rumination significantly predicted pre-and posthospitalization violence, when controlling for age, sex, race, childhood physical abuse, and anger/aggression proclivity; and it partially mediated the relation between anger/aggression proclivity and violence.Imagined violence and anger rumination were highly interrelated. When imagined violence was added to the regression model, it was a significant predictor of prehospitalization violence; however, it did not moderate the association of anger rumination with pre-or posthospitalization violence.

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Understanding dynamic risk factors for violence

Cited by 6 publications

References 1 publication

European Psychiatric Association (EPA) guidance on forensic psychiatry: Evidence based assessment and treatment of mentally disordered offenders

European Psychiatric Association (EPA) guidance on forensic psychiatry: Evidence based assessment and treatment of mentally disordered offenders

Are Psychological Treatments for Adults With Histories of Violent Offending Associated With Change in Dynamic Risk Factors? A Meta-Analysis of Intermediate Treatment Outcomes

Anger rumination and imagined violence as related to violent behavior before and after psychiatric hospitalization

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