Development of a brief screen for violence risk (V-RISK-10) in acute and general psychiatry: An introduction with emphasis on findings from a naturalistic test of interrater reliability

2009 ◽  
Vol 24 (6) ◽  
pp. 388-394 ◽  
Author(s):  
S. Bjørkly ◽  
P. Hartvig ◽  
F.-A. Heggen ◽  
H. Brauer ◽  
T.A. Moger
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Predictive Validity ◽  
Mental Health Professionals ◽  
Interrater Reliability ◽  
Psychiatric Treatment ◽  
Assessment Tools ◽  
Violence Risk ◽  
Short Term ◽  
Long Term Treatment

AbstractMost violence risk assessment scales were originally developed for use in forensic settings at the time of discharge or release of patients into the community after long-term treatment. However, there is a considerable need for specialized, brief and structured risk assessment tools to inform risk decisions in short-term psychiatric treatment. The present study reports on research findings from the development and implementation of the violence risk screening-10 (V-RISK-10) in two acute psychiatric settings in Norway. The 10-item screen is easy to use, time-saving and may be used for screening of violence risk during hospital stay and after discharge into the community. Prospective validation studies of the screen concerning inpatient and post-release community violence have been conducted. Although data analyses are not yet complete, preliminary findings indicate that the screen has good predictive validity. This suggests that the screen is a promising tool in short-term acute psychiatric settings. However, the importance of reliability in mental health data and tests is well recognized, and a screen with good predictive validity is not worth much if clinicians are unable to agree on the scoring of one and the same patient. In this article we report results from a naturalistic interrater reliability investigation that involved 25 mental health professionals and 73 acute psychiatric patients. V-RISK-10 scoring was accomplished by two raters for each patient. The interrater reliability value for total scores was acceptable. Variations pertaining to the individual V-RISK-10 item, patient characteristics and rater characteristics are discussed.

Factors Predicting Desistance From Reoffending: A Validation Study of the SAPROF in Sexual Offenders

2016 ◽  
Vol 62 (3) ◽  
pp. 697-716 ◽  
Author(s):  
Dahlnym Yoon ◽  
Daniel Turner ◽  
Verena Klein ◽  
Martin Rettenberger ◽  
Reinhard Eher ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Sexual Offenders ◽  
Interrater Reliability ◽  
Predictive Accuracy ◽  
Negative Relationship ◽  
Incremental Validity ◽  
Assessment Tools ◽  
Violence Risk ◽  
Limited Extent ◽  
Risk Assessment Tools

The present study aims at validating the German version of the Structured Assessment of PROtective Factors (SAPROF) for violence risk in a representative sample of incarcerated adult male sexual offenders. Sexual offenders ( n = 450) were rated retrospectively with the SAPROF using the database of the Federal Evaluation Centre for Violent and Sexual Offenders (FECVSO) in the Austrian Prison System. Interrater reliability and predictive validity of the SAPROF scores concerning desistance from recidivism were calculated. Concurrent and incremental validity were tested using the combination of the SAPROF and the Sexual Violence Risk–20 (SVR-20). Interrater reliability was moderate to excellent, and predictive accuracy for various types of recidivism was rather small to moderate. There was a clear negative relationship between the SAPROF and the SVR-20 risk factors. Whereas the SAPROF revealed itself as a significant predictor for various recidivism categories, it did not add any predictive value beyond the SVR-20. Although the SAPROF itself can predict desistance from recidivism, it seems to contribute to the risk assessment in convicted sexual offenders only to a limited extent, once customary risk assessment tools have been applied. Implications for clinical use and further studies are discussed.

scholarly journals Improving risk assessment in schizophrenia: epidemiological investigation of criminal history factors

2015 ◽  
Vol 206 (5) ◽  
pp. 424-430 ◽  
Author(s):  
Katrina Witt ◽  
Paul Lichtenstein ◽  
Seena Fazel
Keyword(s):  
Risk Assessment ◽  
Predictive Validity ◽  
Hospital Admissions ◽  
Criminal History ◽  
Assessment Tools ◽  
Violence Risk ◽  
Hazard Ratios ◽  
Violent Offence ◽  
Risk Assessment Tools ◽  
Incremental Predictive Validity

BackgroundViolence risk assessment in schizophrenia relies heavily on criminal history factors.AimsTo investigate which criminal history factors are most strongly associated with violent crime in schizophrenia.MethodA total of 13 806 individuals (8891 men and 4915 women) with two or more hospital admissions for schizophrenia were followed up for violent convictions. Multivariate hazard ratios for 15 criminal history factors included in different risk assessment tools were calculated. The incremental predictive validity of these factors was estimated using tests of discrimination, calibration and reclassification.ResultsOver a mean follow-up of 12.0 years, 17.3% of men (n=1535) and 5.7% of women (n=281) were convicted of a violent offence. Criminal history factors most strongly associated with subsequent violence for both men and women were a previous conviction for a violent offence; for assault, illegal threats and/or intimidation; and imprisonment. However, only a previous conviction for a violent offence was associated with incremental predictive validity in both genders following adjustment for young age and comorbid substance use disorder.ConclusionsClinical and actuarial approaches to assess violence risk can be improved if included risk factors are tested using multiple measures of performance.

Don't Confuse me with the Facts

1999 ◽  
Vol 26 (1) ◽  
pp. 20-43 ◽  
Author(s):  
MARK D. CUNNINGHAM ◽  
THOMAS J. REIDY
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Criminal History ◽  
Violence Risk ◽  
Illusory Correlation ◽  
Future Dangerousness ◽  
Patterns Of Behavior ◽  
Effects Of Aging

The life and death context of a capital risk assessment requires a comprehensive forensic evaluation. Mental health professionals routinely testify regarding future dangerousness in capital proceedings but too often limit assessment to DSM-IV diagnoses and criminal history without integrating empirical and actuarial data from other sources. Given the grave magnitude of a capital risk assessment both for the defendant and society, methodological and conceptual errors of this type must be avoided. This article will describe violence risk-assessment errors made by mental health professionals testifying at capital sentencing. Observed errors include inadequate reliance on base rates, failure to consider context, susceptibility to illusory correlation, failure to define severity of violence, overreliance on clinical interview, misapplication of psychological testing, exaggerated implications of antisocial personality disorder, ignoring the effects of aging, misuse of patterns of behavior, neglect of preventive measures, insufficient data, and failure to express the risk estimate in probabilistic terms.

scholarly journals The reliability and validity of the SAPROF among forensic mental health patients

2021 ◽  
Author(s):  
Sandra Oziel
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Risk Management ◽  
Protective Factors ◽  
Predictive Validity ◽  
Violence Risk ◽  
Forensic Mental Health ◽  
Institutional Misconduct ◽  
Forensic Psychologists ◽  
Mental Health Patients

Assessing and managing level of risk among forensic mental health patients is a primary role of clinical forensic psychologists. Forensic assessments are focused on risk factors and deficits, whereas patient strengths and protective factors are either partially included or overlooked altogether by forensic psychologists. As a result, less is known about protective factors in general and how they may serve to inform risk management practices. The Structured Assessment of Protective Factors for Violence Risk (SAPROF) is the first tool to exclusively rely on protective factors and was investigated for the current study. The psychometric properties of the SAPROF were examined using a sample of 50 Canadian patients found Not Criminally Responsible (NCR) at a psychiatric hospital using both file information and semi-structured interviews. Outcome variables included risk management decisions (change in privilege level and security level) and indicators of recidivism (psychiatric medication administration, institutional misconduct and disposition breaches). The study found some evidence for intrarater and interrater reliability, construct validity, predictive validity and incremental predictive validity. The SAPROF approached significance for adding incremental predictive validity to the HCR-20 V3, a measure of violence risk, for disposition breaches and institutional misconduct, and effect sizes doubled. Given that the addition of the SAPROF increased the accuracy of the violence risk assessment, there are considerable implications for informing clinical practice. Implications for risk assessment, treatment planning, intervention and risk management decisions implemented by review boards and clinical practitioners are discussed. It is recommended that the SAPROF be added as an adjunct measure to risk assessment batteries and included in hospital reports, given that it predicted several patient behaviours.

scholarly journals Violence Risk Assessment Practices in Denmark: A Multidisciplinary National Survey

2015 ◽  
Vol 21 (2) ◽  
pp. 103-110 ◽  
Author(s):  
Louise Hjort Nielsen ◽  
Sarah van Mastrigt ◽  
Randy K. Otto ◽  
Katharina Seewald ◽  
Corine de Ruiter ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Risk Management ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Assessment Practices ◽  
Violence Risk ◽  
Violence Risk Assessment ◽  
Risk Monitoring ◽  
Professional Disciplines

Abstract With a quadrupling of forensic psychiatric patients in Denmark over the past 20 years, focus on violence risk assessment practices across the country has increased. However, information is lacking regarding Danish risk assessment practice across professional disciplines and clinical settings; little is known about how violence risk assessments are conducted, which instruments are used for what purposes, and how mental health professionals rate their utility and costs. As part of a global survey exploring the application of violence risk assessment across 44 countries, the current study investigated Danish practice across several professional disciplines and settings in which forensic and high-risk mental health patients are assessed and treated. In total, 125 mental health professionals across the country completed the survey. The five instruments that respondents reported most commonly using for risk assessment, risk management planning and risk monitoring were Broset, HCR-20, the START, the PCL-R, and the PCL:SV. Whereas the HCR-20 was rated highest in usefulness for risk assessment, the START was rated most useful for risk management and risk monitoring. No significant differences in utility were observed across professional groups. Unstructured clinical judgments were reported to be faster but more expensive to conduct than using a risk assessment instrument. Implications for clinical practice are discussed.

Are Protective Factors Valid Constructs? Interrater Reliability And Construct Validity Of Proposed Protective Factors Against Sexual Reoffending

2020 ◽  
Vol 47 (11) ◽  
pp. 1448-1467
Author(s):  
Gwenda M. Willis ◽  
Sharon M. Kelley ◽  
David Thornton
Keyword(s):  
Risk Assessment ◽  
Construct Validity ◽  
Protective Factors ◽  
Interrater Reliability ◽  
Assessment Tools ◽  
Violence Risk ◽  
Sexual Offence ◽  
Sexual Recidivism ◽  
Dynamic Risk ◽  
Risk Assessment Tools

Most sexual recidivism risk assessment tools focus primarily on risk factors and deficits without consideration for strengths or protective factors which might mitigate reoffense risk. The current study is the first in a research program designed to develop and validate the Structured Assessment of PROtective Factors for violence risk—Sexual Offence version (SAPROF-SO), a measure of protective factors against sexual reoffending. The study aimed to test interrater reliability and construct validity of the SAPROF-SO with a high-risk ( n = 40) and routine ( n = 40) sample. Interrater reliability between three independent raters was generally good to excellent for the SAPROF-SO domain and Total scores across both samples and compared favorably with validated measures of dynamic risk. Moreover, the SAPROF-SO demonstrated construct validity and was moderately independent of existing measures of risk. Findings open the door for a more balanced, strengths-based, and accurate approach to recidivism risk assessment.

The predictive validity of youth violence risk assessment tools: a systematic review

2020 ◽  
Vol 26 (8) ◽  
pp. 776-796 ◽  
Author(s):  
Li Lian Koh ◽  
Andrew Day ◽  
Bianca Klettke ◽  
Michael Daffern ◽  
Chi Meng Chu
Keyword(s):  
Systematic Review ◽  
Risk Assessment ◽  
Predictive Validity ◽  
Youth Violence ◽  
Assessment Tools ◽  
Violence Risk ◽  
Violence Risk Assessment ◽  
Risk Assessment Tools

scholarly journals Risk Assessment in Juvenile and Young Adult Offenders: Predictive Validity of the SAVRY and SAPROF-YV

Assessment ◽  
2020 ◽  
pp. 107319112095974
Author(s):  
Anneke T. H. Kleeven ◽  
Michiel de Vries Robbé ◽  
Eva A. Mulder ◽  
Arne Popma
Keyword(s):  
Risk Assessment ◽  
Young Adult ◽  
Juvenile Offenders ◽  
Protective Factors ◽  
Predictive Validity ◽  
Developmental Differences ◽  
Assessment Tools ◽  
Violence Risk ◽  
Risk Assessment Tools ◽  
Dutch Sample

Most juvenile risk assessment tools heavily rely on a risk-focused approach. Less attention has been devoted to protective factors. This study examines the predictive validity of protective factors in addition to risk factors, and developmental differences in psychometric properties of juvenile risk assessment. For a national Dutch sample of 354 juvenile and young adult offenders (16-26 years) risk and protective factors were retrospectively assessed at discharge from seven juvenile justice institutions, using the Structured Assessment of Violence Risk in Youth (SAVRY) and Structured Assessment of Protective Factors for violence risk – Youth Version (SAPROF-YV). Results show moderate validity for both tools predicting general, violent, and nonviolent offending at different follow-up times. The SAPROF-YV provided incremental predictive validity over the SAVRY, and predictive validity was stronger for younger offenders. Evidently both the SAVRY and SAPROF-YV seem valid tools for the assessment of recidivism risk in juvenile and young adult offenders. Results highlight the importance of protective factors, especially in juvenile offenders, emphasizing the need for a balanced risk assessment.

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