Abstract
The Structured Assessment of PROtective Factors for violence risk (SAPROF) is a widely used structured professional judgment (SPJ) tool. Its indices have predictive validity regarding desistance from future violence in adult correctional/forensic psychiatric populations. Although not intended for applied use with youth, SAPROF items lend themselves to an investigation of whether their operationalizations capture only strengths or also risks. With 229 justice-involved male adolescents followed for a fixed 3-year period, promotive, risk, and mixed effects were found. Most SAPROF items exerted a mixed effect, being associated with higher
Keywords
The past decade and more has seen the development of a growing number of assessment tools that include or focus exclusively on what has been widely but imprecisely termed protective factors in forensic mental health/correctional/youth-justice practice (de Ruiter & Nicholls, 2011; Langton, 2020; Langton et al., 2022; Langton & Worling, 2015), with notable examples representing what is known as the structured professional judgment (SPJ) approach (Douglas, 2019). Among these strength-based SPJ tools, various indices from the Structured Assessment of PROtective Factors (SAPROF; de Vogel et al., 2012; i.e., its summed total score, summed scores for its rationally grouped item sets of Internal, Motivational, and External factors, and summary judgments) have been shown to predict the absence of future violence in samples from a variety of adult populations, including samples with histories of sexual offending (cf. Coupland & Olver, 2020; de Vries Robbé, de Vogel, Douglas, & Nijman, 2015; de Vries Robbé, de Vogel, Koster, & Bogaerts, 2015; de Vries Robbé et al., 2016; de Vries Robbé et al., 2021; Haines et al., 2018; Neil et al., 2020; Yoon et al., 2018).
But interest in the utility of the SAPROF with justice-involved youth has been limited, likely due in large part to the availability since 2015 of a version for use with youth, the Structured Assessment of PROtective Factors—Youth Version (SAPROF-YV; de Vries Robbé, Geers, et al., 2015). This, despite the possibility that further investigation might be illuminating, for example, in terms of identifying constructs (or at least SPJ item-specific operationalizations of constructs) that predict outcomes
Among the few studies to have investigated the predictive accuracy of the SAPROF with justice-involved youth, the findings have been mixed (cf. Klein et al., 2015, Langton et al., in press; Zeng et al., 2015; both of which involved samples of adolescents with sexual offenses). Rather than focusing on predictive accuracy, by calculating the area under the curve (AUC) of the receiver–operating characteristic (ROC; Mossman, 1994; Swets et al., 2000) or Harrell’s C (when follow-up time is unequal within the sample; Hanson, 2022; Harrell, 2015), the primary objective of the current study was to investigate the individual items of the SAPROF using the approach described by Farrington et al. (2016; see also Farrington et al., 2008; Farrington & Ttofi, 2011). Farrington et al. (2016) focused instead on exploring the
Following Farrington et al. (2016), to label a variable a risk factor, the risk
With this approach, it is possible to determine whether the main effect of a specific operationalization of a variable confers a risk effect (making an adverse outcome more likely, and indicating a unipolar operationalization of a construct), a promotive effect (making an adverse event less likely, and also indicating a unipolar operationalization), or a mixed effect (making the adverse outcome more or less likely depending on which of two poles on the variable the score falls, essentially a bipolar operationalization of a construct even if not intended as such). Yet there has been a relative neglect of the approach of Farrington and his colleagues (2008, 2016), Farrington and Ttofi (2011), in investigating purported strengths associated with the absence of new offending in recidivism-desistance prediction research with applied assessment tools. This is curious, given the aforementioned lack of consensus in the literature about what is meant by key terms, among them protective factor and strength (Langton et al., 2022). The primary objective of the current study was to undertake such an investigation of the SAPROF items. The trichotomous coding of the variables explicitly operationalized in the SAPROF and other SPJ assessment tools certainly lends itself to investigations of the sort advanced by Farrington et al. (2016).
One notable example of such work is Li et al.’s (2019) investigation of the nature of items comprising the SAPROF-YV. For an outcome of probation noncompletion (rather than new offending), Li et al. calculated two
A secondary objective of the current study was to determine whether the use of the SAPROF neglects relevant information (i.e, potential risk) when its items are combined in a mechanical manner (i.e., summed; see Sawyer, 1966, for a general discussion of types of data collection and ways of combining information in prediction methods). This would be shown if any SAPROF items coded as 0 (which ostensibly indicates that a purported strength is absent) actually confer a risk effect. That risk effect would be ignored in a simple summing of the items. More broadly, it would raise the question of what an assessor using the SPJ approach is making of items coded as 0 as they undertake the part of the assessment process that is more opaque: reaching (here, with the SAPROF), first a final protection judgment (of low, moderate, or high) and then an integrative final risk judgment (of low, moderate, or high). It would also raise the question of what an assessor using an SPJ approach is making of items coded as 0 as they identify targets for treatment and make recommendations for intervention planning.
To be clear, the developers of the SAPROF advocate use of the tool in conjunction with an SPJ risk assessment tool, the Historical, Clinical Risk–20 (HCR-20; Douglas et al., 2013) or a related tool, rather than rely on the use of the SAPROF alone. They advise both of these SPJ tools to be used to reach final judgments rather than a simple summing of item ratings (de Vogel et al., 2012, p. 27; although the developers and other research groups have reported indices for summed totals too). Rather than representing a critique, investigations, such as the current study, of SPJ items that can be shown to exert risk (or promotive) or mixed effects instead of their expected promotive (or risk) effect can inform a richer conceptualization of variables comprising these tools and their specific operationalizations of the underlying constructs. This a necessary next step before researchers can address the questions about what SPJ assessors are making of items coded as 0 when, rather than representing the absence of strength (for a tool such as the SAPROF) or the absence of risk (for a tool such as the HCR-20), the 0 for some items confers the converse effect (i.e., a risk effect for a purported strength item or a strength effect for a purported risk item).
In the present study, exploratory analyses were undertaken to determine whether the individual SAPROF items would exert promotive, risk, or mixed effects, using Farrington et al.’s (2016) rules of thumb of
Method
Procedure
Research ethics clearance was secured from the first author’s institutional affiliations and permissions obtained from the relevant Ministries. Details reported below include how the sample size was determined, all data exclusions, all manipulations, and all measures in the study. The archived case files for the sample were accessed; these contained all available assessment reports written by professionals involved in each case as well as school and police/court documentation. Almost all cases had only one comprehensive mental health-and-risk assessment report completed with the youth and all were in the community at the time of that assessment. It was the date of that report that was used as the start of the at-risk period. Only those materials on file before the beginning of the follow-up period at risk for re-offense were included in the version of each case file prepared for coding. No information about recidivism outcomes was contained in these files. In cases in which there were discrepancies between, or changes in, professionals’ opinions about risks and strengths in the materials, such discrepancies were resolved by consensus with the first and third authors, with precedence given to the final assessment report if there was more than one report before the beginning of the follow-up period.
Participants
Beginning with 617 adolescents referred for specialized services (for youth who had sexually abused others) in a major urban area in Southern Ontario from the late 1980s up to 2014, the small number of female adolescents (
For the present study, the sample was divided into two subsets using a release/at-risk date of April 2003; those at risk from the late 1980s up to April 2003 (
Of the subset of 323 male adolescents between the ages of 12 and 18.99 at risk from April 2003 onward, only those for whom the SAPROF could be coded and for whom a fixed follow-up of 3 years was available were used, resulting in an
Of these 229, 8% had one or more prior convictions for a violent (nonsexual) offense, 1% had two or more prior convictions for a sexual offense, 13% had one prior sexual offense conviction, and 86% had no prior sexual offense conviction. Just under 24% had five or more prior acts of nonviolent offending, 43% had one to five, and just under 34% had none. The mean age of this subset at the start of the follow-up period (i.e., the date the final assessment was completed or the date of release, whichever was later) was 16.03 years old (
Of the subset of 174 male adolescents between the ages of 12 and 19 at risk before April 2003, only those for whom the SAPROF could be coded and for whom a fixed follow-up of 3 years was available were used, resulting in an
Measures
SAPROF
SAPROF items were coded as per the manual (de Vogel et al., 2012), without knowledge of recidivism outcomes, and used in the logistic regression analyses (see Data Analytic Strategy, below). This was undertaken as part of a larger study of the comparative predictive validity of tools with justice-involved adolescents (Langton et al., in press). In that study, which included consideration of developmental issues, the SAPROF was included as one of the tools developed for use with adults. All items were coded for the 229 youth or 228 of them (for some items the information contained in some of the case files was insufficient to score a single item); the one exception was the Intelligence item for which information was available to score the item for 142 youth.
To check interrater reliability, intraclass correlation coefficients (ICCs) were calculated using a subset of 23 participants’ cases, coded independently by three raters (see Procedure, above). As reported in Langton et al. (in press), the ICC for the summed total for the SAPROF was .77, which falls in the range described as “excellent” by Cicchetti (1994). ICCs for the individual items fell in the ranges described as “fair” and “good” by Cicchetti, with one falling in the “excellent” range.
Outcomes
Four official sources of information were used to generate as comprehensive a measure of official recidivism as possible: The Canadian Police Information Centre records, a national database of criminal convictions provided by the Royal Canadian Mounted Police; data from the youth and adult offender tracking information systems provided by the Ontario Ministry of Community Safety and Correctional Services; and case files provided by the Ontario Ministry of Children and Youth Services. Outcomes were dichotomously coded. New offenses were coded if documented in the follow-up period as convictions in any of the first three sources or an officially confirmed new incident in the fourth source. A new violent (including sexual) offense (and the absence of) was used as the dependent variable because it is the outcome for which the SAPROF was intended to structure applied assessment work. Findings with a second outcome, any new offense (and the absence of) are also reported (data are given in Supplemental Tables 1 and 2) because an inclusive outcome of this kind is of comparative interest given its inclusion in many investigations in the recidivism-desistance prediction research with applied assessment practices.
The percentage agreement between pairs of the four sources for a new violent offense was between 81% and 88%, indicating that the outcome for as many as one in five cases was inconsistent between sources for this category of offending. The percentage agreement between pairs of the four sources for any new offenses was between 75% and 85%, indicating that the outcome for as many as one in four cases was inconsistent between sources for this category of offending. These percentage agreements confirmed the importance of using multiple sources to detect all officially recorded new offenses.
Data Analytic Strategy
For the exploratory analyses, logistic regression analyses were run using the subset of 229 (those at risk from April 2003 onward) to calculate risk
For the weighted summations (the third and fourth indices), only those items for which the risk
Results
Among the 229 adolescents at risk from April 2003 onward, 30% committed a new offense of any kind and 19% of 224 of these adolescents committed a new violent (including sexual) offense in the fixed 3-year follow-up period. The number of adolescents decreases slightly from the more inclusive outcome to the less inclusive outcome because, for some adolescents, their conviction, counted in the more inclusive any new offense category (e.g., a conviction for a Break-and-Enter), resulted in less than 3 years of time-at-risk and therefore their exclusion (because of time spent back in custody, per a custodial sentence for the Break-and-Enter) from analyses with the less inclusive new violent (including sexual) offense category.
Among the 171 adolescents at risk from April 2003 onward, 27% committed a new violent (including sexual) offense in the fixed 3-year follow-up period and 34% of 169 of these adolescents committed a new offense of any kind. The number of adolescents decreases slightly for the more inclusive outcome because discrepancies in the files for two youths who committed a new nonviolent offense made it impossible to determine whether those offenses had occurred within the fixed 3-year follow-up; so these two youths were excluded from the analyses with this outcome. But neither of these youths committed a new violent (including sexual) offense at any point in their follow-up and so were included in the analyses for that outcome.
Promotive, Risk, and Mixed Effects
A New Violent Offense
The percentage of participants with a new violent (including sexual) offense for each score on the items is given along with the promotive and risk
Percent Reoffended and Odds Ratios for SAPROF Items for a New Violent (Including Sexual) Offense Using a 3-Year Fixed Follow-Up
No youth with this score reoffended so 0.5 was added to each cell in the relevant contingency table to calculate the
A single item, Intelligence, could be described as exerting a risk effect, with a promotive
The item External Control exhibited a paradoxical risk effect, with a promotive
Five items (Secure Attachment in Childhood, Leisure Activities, Life Goals, Intimate Relationship, and Professional Care) exerted no clear effect. The remaining four items could be described as having a mixed effect (Coping, Motivation for Treatment, Attitudes Towards Authority, and Social Network). For example, Motivation for Treatment had a promotive
Any New Offense
Findings were broadly similar but not identical for this outcome. Effects were clear for 10 of the 14 items. Based on pairs of

Percentage With Any New Offense for SAPROF Items Conferring Four Types of Effect.
Predictive Accuracy of Original and Weighted Summations of SAPROF Items
The finding that some SAPROF items exerted a risk or mixed effect prompted testing of the hypothesis concerning the AUCs for the summation of SAPROF items selected and weighted according to promotive and risk
A New Violent Offense
For this outcome, the items included were weighted as follows: For the item Intelligence, 0 was recoded as −1 (indicating risk), 1 was recoded as 0, and 2 was recoded as 0 (indicating no strength). Empathy ratings were recoded as 0 = 0 (
With the subset at risk from April 2003 onward, the AUC for the
With the subset at risk before April 2003, the AUC for the
Any New Offense
The AUC for the
Post Hoc Analyses
The paradoxical risk effect for two items (Living Circumstances and External Control) prompted tests of whether youth with scores of 2 (indicating strength) on these items were at high(er) risk of re-offense than their lower scoring counterparts. The absence or presence of one or more prior charges or convictions for a sexual offense was used as the index of risk. Living Circumstances scores of those without prior charges or convictions for a sexual offense (
Discussion
Despite having been developed for use with adults, the operationalizations of constructs tapped by SAPROF items were shown to be helpful in investigating the nature of strengths with a sample of justice-involved youth using Farrington et al.’s (2016) approach and their rules of thumb for describing variables (
Effect Sizes and Comparison Groups
It is worth noting that if, instead of an
As well, some of the effects of SAPROF items would be reclassified if the promotive
The Nature of Strengths
Whether changing the
With variables intended as unidimensional operationalizations of strengths, such as those items comprising the SAPROF, it is not possible to determine if it is the absence of the strength, as operationalized, that confers the risk effect, or if the score of 0 actually captures the presence of risk in the same or a conceptually related domain, as discussed above. The same question arises with some unidimensional operationalizations of risk (i.e., does the absence of a specific risk, a score of 0 on a risk item, confer a strength effect or merely denote its absence with no effect). With bipolar operationalizations of constructs as items in other tools (e.g., Barnoski, 2004; Viljoen et al., 2014; Worling, 2017), this important question could be addressed, but that research has yet to be undertaken.
The lack of clarity here is of particular interest because, as Langton et al. (2022) have discussed, there remains in the field a lack of consensus about how strengths should be understood. Consider just three of the various ways strengths have been discussed in the literature. One is that strength is simply the absence of risk (Baird, 2009; Harris & Rice, 2015). This view cannot be investigated with SAPROF data because none of this tool’s items are operationalized as purported risk items (for which a 0, indicating the absence of that risk, could be coded). Another view is that strength should be construed as simply the extension of a continuum with risk at the opposite pole (Harris & Rice, 2015), which is a conceptualization compatible with Farrington et al.’s “mixed factors” and is consistent with findings reported by Farrington and his colleagues as well as by Li et al. (2019) and in the current study. A third is that strengths (or at least specific operationalizations of purported strength constructs) are distinct or exert an effect independent from risks (see, for example, Mowen & Boman, 2018), which could be understood as an example of Farrington et al.’s “promotive factors.” There was limited evidence for SPJ items reported in Li et al. and in the current study. With this third view, the question arises as to whether or when a strength is a unidimensional
As noted above, the SAPROF was explicitly intended to be used in applied practice in conjunction with a risk-focused SPJ tool (the HCR-20) and for assessors to reach a “final protection judgment” using the SAPROF and a “integrative final risk judgment” using the SAPROF
Indeed, the findings reported here may represent a partial explanation of why the summed total of the SAPROF External factor items failed to predict outcomes in this sample (Langton et al., in press) and in various other studies (Coupland & Olver, 2020; de Vries Robbé et al., 2016; Yoon et al., 2018). Each of the External factor items would be expected to exert a promotive effect. But in the present sample, there were notable exceptions. One of these items, Social Network, conferred a mixed effect (for a new violent offense) and a risk effect (for any new offense), evident based on its promotive and risk
Consider, the External Control, Living Circumstances, and Professional Care items might be confounded by risks because those individuals receiving higher levels of external control and professional care and subject to intensively supervised living circumstances would presumably warrant those higher levels of service based on perceived/assessed risk (which would render these items proxies for risk in analyses such as those reported here). Consistent with this, post hoc analyses with these data showed that youth with higher scores on both the External Control and the Living Circumstances items were, indeed, at higher risk (determined using a number of prior sexual offenses). The extra resources/services, reflecting increased professional involvement, tapped by those items would be provided/implemented by case-involved professionals to manage or lower perceived/assessed risk in the case (and such resources/services may well be shown to lower dynamic risk over time with a longitudinal design). Indeed, we would expect high levels of external control to reduce the likelihood of recidivism (facilitate desistance) over time in individuals at higher risk of re-offending (broadly consistent with the empirically supported Risk and Needs Principles of the Risk-Needs-Responsivity model; Andrews et al., 1990; Bonta & Andrews, 2017). But, as just noted, we would also expect that individuals at higher risk of re-offending would be subject to higher levels of external control initially. So, assessed once and at the beginning of the period that an individual is at risk (e.g., when released from custody), External Control might represent risk (as it did in the present sample, exerting a paradoxical risk effect). But it might exert a strength effect based on changes it is shown to bring about in (an index of specified) dynamic risk over time. Without further empirical investigation, however, it will be a challenge for an assessor to know how to incorporate the information provided by items such as this one in an assessment that will accurately inform intervention planning.
The results of the direct statistical comparisons of AUCs in the present study do suggest that mechanical incorporation of information about risk captured in some items’ 0 scores, demonstrated with
Limitations
The study is not without limitations. The study involved male adolescents only and was archival in nature (although coding of independent variables was undertaken without knowledge of recidivism outcomes to partially mitigate concerns over the use of archived case files). All of the adolescents had committed at least one sexual offense whether or not they also had offenses of a nonsexual nature in their criminal history; this might limit the generalizability of the findings to more general samples of justice-involved youth or to distinct offense-defined groups. For the adolescents in the subset at risk from April 2003 onward, the earliest cases received assessment services nearly 20 years ago. For the subset at risk before April 2003, that timeframe began even earlier. As such, the generalizability of these findings may be very limited. A related concern is that the materials in the archived case files would not have been written with the SAPROF items explicitly in mind although many of the constructs would be expected to have been considered by the clinical report writers. The challenges of coding/rating from archived case files is evidenced in part by the range of ICCs for items in this study, which may have lowered some of the effect sizes obtained. As well, the SAPROF was not developed for applied use with adolescents, so the implications of the findings are of conceptual and methodological significance rather than applied utility. As such, again, these findings may be shown in future work with the SAPROF to lack generalizability, whether with adults or with adolescents.
Relatedly, a focus on the SAPROF, all the items for which are unidimensional operationalizations of purported strengths (protective factors), meant it was not possible to distinguish between the effect of the absence of strength and the possible presence of risk in the same or conceptually relevant domain. It was also not possible, given the complete absence of purported risk items (risk factors) in the SAPROF, to distinguish between the effect of the absence of risk and the possible presence of strength in the same or conceptually relevant domain. We have studies underway with different tools to address some of these limitations.
What is clear is that application of Farrington et al.’s (2016) approach represents a systematic line of inquiry that prompts both an explicit consideration of what is meant by “strength” (or labels such as a promotive factor or protective factor) and grounds attempts to clarify in an empirical manner what effect a variable, given its specific operationalization, exerts on a specific outcome in a sample from a specific population. The present study used items comprising an SPJ tool designed for use with adults with a sample of justice-involved youth, which allows some preliminary inferences too about which constructs might exert an effect on reoffending among adolescents although these constructs are operationalized for use with adults (notwithstanding the importance of developmental considerations here as others have observed; see, for example, Langton et al., in press; Ralston & Epperson, 2013; Viljoen et al., 2012). The development and training in the use of SPJ tools may benefit from the research of this kind that demonstrates how their individual items can be understood to work in the assessment of risks and strengths in recidivism-desistance prediction research and in applied assessment and treatment practices.
Supplemental Material
sj-docx-1-asm-10.1177_10731911231163617 – Supplemental material for Promotive, Mixed, and Risk Effects of Individual Items Comprising the SAPROF Assessment Tool With Justice-Involved Youth
Supplemental material, sj-docx-1-asm-10.1177_10731911231163617 for Promotive, Mixed, and Risk Effects of Individual Items Comprising the SAPROF Assessment Tool With Justice-Involved Youth by Calvin M. Langton, Mackenzie Betteridge and James R. Worling in Assessment
Supplemental Material
sj-docx-2-asm-10.1177_10731911231163617 – Supplemental material for Promotive, Mixed, and Risk Effects of Individual Items Comprising the SAPROF Assessment Tool With Justice-Involved Youth
Supplemental material, sj-docx-2-asm-10.1177_10731911231163617 for Promotive, Mixed, and Risk Effects of Individual Items Comprising the SAPROF Assessment Tool With Justice-Involved Youth by Calvin M. Langton, Mackenzie Betteridge and James R. Worling in Assessment
Footnotes
Acknowledgements
The work of our research assistants, Martin Bryan, Bianca Humbert, and Amy Plomp is gratefully acknowledged as is the assistance from facility staff and ministry employees. We would also like to thank the youth and their families for their efforts.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by a grant from the Social Sciences and Humanities Research Council to the first author.
Supplemental Material
Supplemental material for this article is available online.
