Using the HCR-20 to Predict Aggressive Behavior among Men with Schizophrenia Living in the Community: Accuracy of Prediction, General and Forensic Settings, and Dynamic Risk Factors

Michel, Steven F.; Riaz, Muhammad; Webster, Christopher D.; Hart, Stephen D.; Levander, Sten; Müller-Isberner, Rüdiger; Tiihonen, Jari; Repo-Tiihonen, Eila; Tuninger, Eva; Hodgins, Sheilagh

doi:10.1080/14999013.2012.760182

Cited by 37 publications

(30 citation statements)

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“…They also add, “(A)lthough this has not been observed in all studies” (p. 106). Our reading of the literature leads us to conclude, contrary to Douglas et al () and Heilbrun et al (), that the accuracy of assessments of violence risk are unimproved or worsened (though rarely significantly) by the summary risk ratings compared with untempered raw scores (Belfrage et al, ; de Vogel et al, ; de Vogel, & de Ruiter, ; Desmarais, Nicholls, Wilson, & Brink, ; Douglas, Yeomans, & Boer, ; Michel et al, ; Storey et al, ; see also meta‐analyses by Guy, and O'Shea, Mitchell, Picchioni, & Dickens, ). We found one study (Douglas, Ogloff, & Hart, ) reporting that summary risk ratings improved accuracy over untempered raw totals.…”

Section: Hypothesis 1: Final Risk Ratings Are More Accurate For the Pmentioning

confidence: 69%

Progress in Violence Risk Assessment and Communication: Hypothesis versus Evidence

Harris

Rice

2015

Behavioral Sci & The Law

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We draw a distinction between hypothesis and evidence with respect to the assessment and communication of the risk of violent recidivism. We suggest that some authorities in the field have proposed quite valid and reasonable hypotheses with respect to several issues. Among these are the following: that accuracy will be improved by the adjustment or moderation of numerical scores based on clinical opinions about rare risk factors or other considerations pertaining to the applicability to the case at hand; that there is something fundamentally distinct about protective factors so that they are not merely the obverse of risk factors, such that optimal accuracy cannot be achieved without consideration of such protective factors; and that assessment of dynamic factors is required for optimal accuracy and furthermore interventions aimed at such dynamic factors can be expected to cause reductions in violence risk. We suggest here that, while these are generally reasonable hypotheses, they have been inappropriately presented to practitioners as empirically supported facts, and that practitioners' assessment and communication about violence risk run beyond that supported by the available evidence as a result. We further suggest that this represents harm, especially in impeding scientific progress. Nothing here justifies stasis or simply surrendering to authoritarian custody with somatic treatment. Theoretically motivated and clearly articulated assessment and intervention should be provided for offenders, but in a manner that moves the field more firmly from hypotheses to evidence.

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Section: Hypothesis 1: Final Risk Ratings Are More Accurate For the Pmentioning

confidence: 69%

Progress in Violence Risk Assessment and Communication: Hypothesis versus Evidence

Harris

Rice

2015

Behavioral Sci & The Law

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“…Early research showed generally that scores on the C and R items decrease over the course of forensic or civil psychiatric treatment (Belfrage & Douglas, ; Douglas & Belfrage, ). In a sample of 248 patients with schizophrenia (98 civil psychiatric and 150 forensic psychiatric patients), Michel and colleagues () reported that changes in most C and R items over two years (measured four times) were predictive of subsequent changes in violence. That is, when these items worsened, violence was more likely to occur, and vice versa.…”

Section: Hcr‐20 Versionmentioning

confidence: 99%

Version 3 of the Historical‐Clinical‐Risk Management‐20 (HCR‐20^V3): Relevance to Violence Risk Assessment and Management in Forensic Conditional Release Contexts

Douglas

2014

Behavioral Sci & The Law

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The conditional release of insanity acquittees requires decisions both about community risk level and the contextual factors that may mitigate or aggravate risk. This article discusses the potential role of the newly revised Historical-Clinical-Risk Management-20 (HCR-20, Version 3) within the conditional release context. A brief review of the structured professional judgment (SPJ) approach to violence risk assessment and management is provided. Version 2 of the HCR-20, which has been broadly adopted and evaluated, is briefly described. New features of Version 3 of the HCR-20 with particular relevance to conditional release decision-making are reviewed, including: item indicators; ratings of the relevance of risk factors to an individual's violence; risk formulation; scenario planning; and risk management planning. Version 3 of the HCR-20 includes a number of features that should assist evaluators and decision-makers to determine risk level, as well as to anticipate and specify community conditions and contexts that may mitigate or aggravate risk. Research on the HCR-20 Version 3 using approximately 800 participants across three settings (forensic psychiatric, civil psychiatric, correctional) and eight countries is reviewed.

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“…More recently, Olsson et al () have reported that the clinical (C) and risk (R) scale scores reduced, to some extent, over time in 267 patients in a forensic clinic, with female patient scores changing more than those of the men. Michel et al (), who studied a community forensic and civil psychiatric population, showed that around a third of the forensic patients showed a decrease in the C and R scale scores over five assessments. It is unknown, however, to what extent the ratings of particularly high‐risk patients reduce over time.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal HCR‐20 scores in a high‐secure psychiatric hospital

Morrissey

Beeley

Milton³

2013

Criminal Behav Ment Health

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It is unsurprising that patients in two national services (for men with intellectual disability and women) have the highest HCR-20 scores; however, the finding of relatively greater risk reduction in women needs further investigation. Although we did not find ceiling effects in this sample, the clinical value of frequently repeated HCR-20 ratings may be limited for high-risk populations where any change is likely to be slow.

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Using the HCR-20 to Predict Aggressive Behavior among Men with Schizophrenia Living in the Community: Accuracy of Prediction, General and Forensic Settings, and Dynamic Risk Factors

Cited by 37 publications

References 50 publications

Progress in Violence Risk Assessment and Communication: Hypothesis versus Evidence

Progress in Violence Risk Assessment and Communication: Hypothesis versus Evidence

Version 3 of the Historical‐Clinical‐Risk Management‐20 (HCR‐20^V3): Relevance to Violence Risk Assessment and Management in Forensic Conditional Release Contexts

Longitudinal HCR‐20 scores in a high‐secure psychiatric hospital

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Using the HCR-20 to Predict Aggressive Behavior among Men with Schizophrenia Living in the Community: Accuracy of Prediction, General and Forensic Settings, and Dynamic Risk Factors

Cited by 37 publications

References 50 publications

Progress in Violence Risk Assessment and Communication: Hypothesis versus Evidence

Progress in Violence Risk Assessment and Communication: Hypothesis versus Evidence

Version 3 of the Historical‐Clinical‐Risk Management‐20 (HCR‐20V3): Relevance to Violence Risk Assessment and Management in Forensic Conditional Release Contexts

Longitudinal HCR‐20 scores in a high‐secure psychiatric hospital

Contact Info

Product

Resources

About

Version 3 of the Historical‐Clinical‐Risk Management‐20 (HCR‐20^V3): Relevance to Violence Risk Assessment and Management in Forensic Conditional Release Contexts