Rates of violence in patients classified as high risk by structured risk assessment instruments
TLDR
After controlling for time at risk, the rate of violence in individuals classified as high risk by SRAIs shows substantial variation and assigning predetermined probabilities to future violence risk on the basis of a structured risk assessment is not supported by the current evidence base.Abstract:
Background
Rates of violence in persons identified as high risk by structured risk assessment instruments (SRAIs) are uncertain and frequently unreported by validation studies.
Aims
To analyse the variation in rates of violence in individuals identified as high risk by SRAIs.
Method
A systematic search of databases (1995-2011) was conducted for studies on nine widely used assessment tools. Where violence rates in high-risk groups were not published, these were requested from study authors. Rate information was extracted, and binomial logistic regression was used to study heterogeneity.
Results
Information was collected on 13 045 participants in 57 samples from 47 independent studies. Annualised rates of violence in individuals classified as high risk varied both across and within instruments. Rates were elevated when population rates of violence were higher, when a structured professional judgement instrument was used and when there was a lower proportion of men in a study.
Conclusions
After controlling for time at risk, the rate of violence in individuals classified as high risk by SRAIs shows substantial variation. In the absence of information on local base rates, assigning predetermined probabilities to future violence risk on the basis of a structured risk assessment is not supported by the current evidence base. This underscores the need for caution when such risk estimates are used to influence decisions related to individual liberty and public safety.read more
Citations
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Journal ArticleDOI
International Perspectives on the practical application of violence risk assessment : a global survey of 44 countries
Jay Singh,Sarah L. Desmarais,Cristina Hurducas,Karin Arbach-Lucioni,Carolina Condemarin,Kimberlie Dean,Michael Doyle,Jorge Oscar Folino,Verónica Godoy-Cervera,Martin Grann,Robyn Mei Yee Ho,Matthew Large,Louise Hjort Nielsen,Thierry H. Pham,Maria Franscisca Rebocho,Kim A. Reeves,Martin Rettenberger,Corine de Ruiter,Katharina Seewald,Randy K. Otto +19 more
TL;DR: It is suggested that violence risk assessment is a global phenomenon, as is the use of instruments to assist in this task, and improved feedback following risk assessments and the development of risk management plans could improve the efficacy of health services.
Journal ArticleDOI
The American Psychiatric Association Practice Guidelines for the Psychiatric Evaluation of Adults
Joel J. Silverman,Marc Galanter,Maga Jackson-Triche,Douglas G. Jacobs,James W. Lomax,Michelle Riba,Lowell Tong,Katherine E. Watkins,Laura J. Fochtmann,Richard S. Rhoads,Joel Yager +10 more
TL;DR: These Practice Guidelines for the Psychiatric Evaluation of Adults mark a transition in the American Psychiatric Association’s Practice Guidelines by using a “snowball” survey methodology to identify experts on psychiatric evaluation and solicit their input on aspects of the psychiatric evaluation that they saw as likely to improve specific patient outcomes.
Journal ArticleDOI
Communicating the results of criterion referenced prediction measures: Risk categories for the Static-99R and Static-2002R sexual offender risk assessment tools
TL;DR: It is found that the new, common STATIC risk categories not only increase concordance of risk classification (from 51% to 72%)—they also allow evaluators to make the same inferences for offenders in the same category regardless of which instrument was used to assign category membership.
Journal ArticleDOI
European Psychiatric Association (EPA) guidance on forensic psychiatry: evidence based assessment and treatment of mentally disordered offenders
Birgit Völlm,Martin Clarke,Vicenç Tort Herrando,Allan Seppänen,Paweł Gosek,Janusz Heitzman,Erik Bulten +6 more
TL;DR: It is 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.
Journal ArticleDOI
Prediction of violent reoffending on release from prison: derivation and external validation of a scalable tool
Seena Fazel,Zheng Chang,Zheng Chang,Thomas R. Fanshawe,Niklas Långström,Paul Lichtenstein,Henrik Larsson,Henrik Larsson,Susan Mallett +8 more
TL;DR: A prediction model in a Swedish prison population that can assist with decision making on release by identifying those who are at low risk of future violent offending, and those at high risk of violent reoffending who might benefit from drug and alcohol treatment is developed.
References
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Journal ArticleDOI
Psychiatric Violence Risk Assessment
Journal ArticleDOI
The effect of discordance among violence and general recidivism risk estimates on predictive accuracy.
Jeremy F. Mills,Daryl G. Kroner +1 more
TL;DR: There is a distinct advantage when attempting to predict recidivism to employing measures such as the LSI-R, which includes dynamic variables and intervention-related criminogenic domains, over a measure purely of fixed characteristics,such as the GSIR; however, if there is discordance between the risk estimates, caution is exercised and more reliance on the more static historically based instrument may be indicated.
Journal ArticleDOI
Assessing Risk of Future Violence Among Forensic Psychiatric Inpatients With the Classification of Violence Risk (COVR)
TL;DR: The study provides the first independent validation of the COVR and evidence of the usefulness of theCOVR in predicting harmful behavior in forensic inpatient settings in the United Kingdom.
Journal ArticleDOI
Risk Assessment: The Value of Structured Professional Judgments
TL;DR: The structured final risk judgment had the highest predictive accuracy of violent recidivism and was superior to the HCR-20 used in an actuarial manner and at the individual item level, a higher number of the dynamic items were significantly predictive of violent Recidivism compared to static items.
Journal ArticleDOI
Comparison of Measures of Risk for Recidivism in Sexual Offenders
Jan Looman,Jeffrey Abracen +1 more
TL;DR: Overall, the Static-2002 performed best for both outcomes, although differences between measures were not significant, and the one exception to this was the RRASOR, which overall performed poorly.