A Prospective Examination of the Predictive Validity of Five Structured Instruments for Inpatient Violence in a Secure Forensic Hospital

Abstract

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-20^V3), 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-20^V3, 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.