This prospective study investigated the predictive validity of five structured risk/forensic instruments for inpatient violence risk in a secure forensic hospital. Episodes of inpatient violence and the following instruments were each coded from hospital files: Historical Clinical Risk Management 20 – Version 3 (HCR-20V3), Psychopathy Checklist Revised (PCL-R), Short-Term Assessment of Risk and Treatability (START), Revised Violence Risk Appraisal Guide (VRAG-R), and Violence Risk Scale (VRS). The dynamic/clinical instruments (HCR-20V3, START, and VRS) predicted inpatient violence, even after controlling for the static measures. The results indicated that structured risk instruments may be applied to the assessment of inpatient violence risk.
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References
1.
ArcherR. P.Buffington-VollumJ. K.StrednyR. V.HandelR. W. (2006). A survey of psychological test use patterns among forensic psychologists. Journal of Personality Assessment, 87, 84–94. doi:10.1207/s15327752jpa8701_07
2.
BeggsS. M.GraceR. C. (2011). Treatment gains for sexual offenders against children predicts reduced recidivism: A comparative validity study. Journal of Consulting and Clinical Psychology, 79, 182–192. doi:10.1037/a0022900
3.
BontaJ.LawM.HansonK. (1998). The prediction of criminal and violent recidivism among mentally disordered offenders: A meta-analysis. Psychological Bulletin, 123, 123–142. doi:10.1037/0033-2909.123.2.123
4.
CampbellM. A.FrenchS.GendreauP. (2009). The prediction of violence in adult offenders: A meta-analytic comparison of instruments and methods of assessment. Criminal Justice and Behavior, 36, 567–590. doi:10.1177/0093854809333610
5.
ChagigiorgisH.MichelS. F.SetoM. C.LapradeK.AhmedA. G. (2013). Assessing short-term, dynamic changes in risk: The predictive validity of the Brockville Risk Checklist. International Journal of Forensic Mental Health, 12(4), 274–286. doi:10.1080/14999013.2013.857740
6.
ChuC. M.DaffernM.OgloffJ. R. P. (2013). Predicting aggression in acute inpatient psychiatric setting using BVC, DASA, and HCR-20 Clinical scale. The Journal of Forensic Psychiatry & Psychology, 24(2), 269–285. doi:10.1080/14789949.2013.773456
7.
ChuC. M.ThomasS. D. M.OgloffJ. R. P.DaffernM. (2011). The predictive validity of the Short-Term Assessment of Risk and Treatability (START) in a secure forensic hospital: Risk factors and strengths. International Journal of Forensic Mental Health, 10(4), 337–345. doi:10.1080/14999013.2011.629715
8.
CrockerA. G.NichollsT. L.SetoM. C.CharetteY.CôtéG.CauletM. (2015). The National Trajectory Project of individuals found not criminally responsible on account of mental disorder in Canada. Part 2: The people behind the label. Canadian Journal of Psychiatry, 60, 106–116.
9.
DaffernM.HowellsK.OgloffJ.LeeJ. (2005). Individual characteristics predisposing patients to aggression in a forensic psychiatric hospital. The Journal of Forensic Psychiatry & Psychology, 16, 729–746. doi:10.1080/14789940500345595
10.
de Borba TellesL. E.FolinoJ. O.TabordaJ. G. V. (2011). Incidence of violent and antisocial behavior in a forensic psychiatric population. Trends in Psychiatry and Psychotherapy, 33, 3–7.
11.
DesmaraisS. L.NichollsT. L.WilsonC. M.BrinkJ. (2012). Using dynamic risk and protective factors to predict inpatient aggression: Reliability and validity of START assessments. Psychological Assessment, 24, 685–700. doi:10.1037/a0026668
12.
DolanM.FullamR. (2007). The validity of the Violence Risk Scale Second Edition (VRS-2) in a British forensic inpatient sample. The Journal of Forensic Psychiatric & Psychology, 18(3), 381–393. doi:10.1080/14789940701489390
13.
DolanM.FullamR.LoganC.DaviesG. (2008). The Violence Risk Scale Second Edition (VRS-2) as a predictor of institutional violence in a British forensic inpatient sample. Psychiatry Research, 158, 55–65. doi:10.1016/j.psychres.2006.08.014
14.
DouglasK. S. (2014). Version 3 of the Historical‐Clinical‐Risk Management‐20 (HCR‐20V3): Relevance to violence risk assessment and management in forensic conditional release contexts. Behavioral Sciences & the Law, 32(5), 557–576. doi:10.1002/bsl.2134
15.
DouglasK. S.HartS. D.WebsterC. D.BelfrageH. (2011). Historical Clinical Risk Management (Version 3): Professional guidelines for evaluating risk of violence [Draft 2.1]. Vancouver, BC: Mental Health, Law, and Policy Institute, Simon Fraser University.
DoyleM.DolanM.McGovernJ. (2002). The validity of North American risk assessment tools in predicting in-patient violent behavior in England. Legal and Criminological Psychology, 7, 141–154. doi:10.1348/135532502760274756
18.
FazelS.SinghJ. P.DollH.GrannM. (2012). Use of risk assessment instruments to predict violence and antisocial behaviour in 73 samples involving 24,827 people: Systematic review and meta-analysis. British Medical Journal, 345, 1–12. doi:10.1136/bmj.e4692
19.
GreenD.SchneiderM.GriswoldH.BelfiB.HerreraM.DeBlasiA. (2016). A comparison of the HCR-20V3 among male and female insanity acquittees: A retrospective file study. International Journal of Forensic Mental Health, 15(1), 48–64. doi:10.1080/14999013.2015.1134726
20.
HanleyJ. A.McNeilB. J. (1982). The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology, 143, 29–36.
21.
HareR. D. (2003). The Hare Psychopathy Checklist-Revised (2nd ed.). Toronto, ON: Multi-Health Systems.
22.
HarrisG. T.RiceM. E.QuinseyV. L. (1993). Violent recidivism of mentally disordered offenders: The development of a statistical prediction instrument. Criminal Justice and Behavior, 20, 315–355. doi:10.1177/0093854893020004001
23.
HartS. D.CoxD. N.HareR. D. (1995). Manual for the screening version of the psychopathy checklist revised (PCL:SV). Toronto, ON: Multi-Health Systems.
24.
HoganN.EnnisL. (2010). Assessing risk for forensic psychiatric inpatient violence: A meta-analysis. Open Access Journal of Forensic Psychology, 2, 137–147.
25.
HoganN. R.OlverM. E. (2016). Assessing risk for aggression in forensic psychiatric inpatients: An examination of five measures. Law and Human Behavior, 40(3), 233–243. doi:10.1037/lhb0000179
26.
LinakerO. M.Busch-IversenH. (1995). Predictors of imminent violence in psychiatric inpatients. Acta Psychiatrica Scandinavica, 92, 250–254. doi:10.1111/j.1600-0447.1995.tb09578.x
NichollsT. L.BrinkJ.DesmaraisS. L.WebsterC. D.MartinM. (2006). The Short-Term Assessment of Risk and Treatability (START): A prospective validation study in a forensic psychiatric sample. Assessment, 13, 313–327. doi:10.1177/1073191106290559
29.
NichollsT. L.BrinkJ.GreavesC.LussierP.Verdun-JonesS. (2009). Forensic psychiatric inpatients and aggression: An exploration of incidence, prevalence, severity, and interventions by gender. International Journal of Law and Psychiatry, 32, 23–30. doi:10.1016/j.ijlp.2008.11.007
30.
NijmanH. L. I.MurisP.MerckelbachH. L. G. J.PalmstiernaT.WistedtB.VosA. M.van RixtelA.AllertzW. (1999). The Staff Observation Aggression Scale-Revised (SOAS-R). Aggressive Behavior, 25, 197–209. doi:10.1002/(SICI)1098-2337(1999)25:3<197::AID-AB4>3.0.CO;2-C
31.
O'SheaL. E.DickensG. L. (2014). Short-Term Assessment of Risk and Treatability (START): Systematic review and meta-analysis. Psychological Assessment, 26, 990–1002.
32.
PenneyS. R.MarshallL. A.SimpsonA. I. (2016). The assessment of dynamic risk among forensic psychiatric patients transitioning to the community. Law and Human Behavior, 40, 374–386.
33.
ProchaskaJ. O.DiClementeC. C.NorcrossJ. C. (1992). In search of how people change: Applications to the addictive behaviors. American Psychologist, 47, 1102–1114. doi:10.1037/0003-066X.47.9.1102
34.
RiceM. E.HarrisG. T.LangC. (2013). Validation of and revision of the VRAG and SORAG: The Violence Risk Appraisal Guide – Revised (VRAG-R). Assessment, 25, 951–965. doi:10.1037/a0032878
35.
SinghJ. P.DesmaraisS. L.HurducasC.Arbach-LucioniK.CondemarinC.DeanK., … & OttoR. K. (2014). International perspectives on the practical application of violence risk assessment: A global survey of 44 countries. International Journal of Forensic Mental Health, 13(3), 193–206. doi:10.1080/14999013.2014.922141
36.
StarzomskiA.WilsonK. (2015). Development of a measure to predict short-term violence in psychiatric populations: The Imminent Risk Rating Scale. Psychological Services, 12(1), 1–8. doi:10.1037/a0037281
37.
VitaccoM. J.GonsalvesV.TomonyJ.SmithB. E. R.LishnerD. A. (2012). Can standardized measures of risk predict inpatient violence? Combining static and dynamic variables to improve accuracy. Criminal Justice and Behavior, 39, 589–606. doi:10.1177/0093854812436786
38.
WebsterC. D.DouglasD.EavesD.HartD. (1997). HCR-20: Assessing risk for violence (Version 2). Vancouver, BC: Mental Health, Law, & Policy Institute, Simon Fraser University.
39.
WebsterC. D.MartinM.-L.BrinkJ. H.NichollsT. L.DesmaraisS. L. (2009). Short-Term Assessment Risk and Treatability (START). Coquitlam, BC: Forensic Psychiatric Services Commission.
40.
WilsonC. M.DesmaraisS. L.NichollsT. L.HartS. D.BrinkJ. (2013). Predictive validity of dynamic factors: Assessing violence risk in forensic psychiatric inpatients. Law and Human Behavior, 37, 377–388. doi:10.1037/lhb0000025
41.
WongS. C. P.GordonA. (1999-2003). Violence Risk Scale. Saskatoon, SK: Author.
42.
WongS. C. P.GordonA. (2006). The validity and reliability of the violence risk scale: A treatment-friendly violence risk tool. Psychology, Public Policy, and Law, 12(3), 279–309. https://doi.org/10.1037/1076-8971.12.3.279
43.
YangM.WongS. C. P.CoidJ. (2010). The efficacy of violence prediction: A meta-analytic comparison of nine risk assessment tools. Psychological Bulletin, 136(5), 740–767. doi:10.1037/a0020473
