Trauma and institutional risk in a secure developmental disorder service: does the SAVRY inflate risk in adolescents exposed to ACEs?

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Elanor Lucy Webb ◽  
Deborah Morris ◽  
Abbey Hamer ◽  
Jessica Davies
Keyword(s):  
Risk Assessment ◽  
Developmental Disorders ◽  
Developmental Disorder ◽  
Assessment Tools ◽  
Risk Scores ◽  
Risk Behaviours ◽  
Content Type ◽  
Assessment Scores ◽  
Institutional Risk ◽  
Risk Assessment Tools

Purpose Adverse childhood experiences (ACEs) are highly prevalent in people with developmental disorders who engage in offending behaviour. Many violence-based risk assessment tools include items pertaining to ACEs, and may inflate risk scores in trauma-exposed groups. This paper aims to explore the relationships between ACEs, risk assessment scores, incidents of risk and restrictive practices, in adolescents with developmental disorders in a forensic inpatient setting. Design/methodology/approach Secondary analysis was conducted on clinical data for 34 adolescents detained to a developmental disorder service. Data were extracted for Structured Assessment of Violence Risk in Youth (SAVRY) risk scores and risk behaviours and restrictive practices, as measures of observed risk. Findings Participants exposed to more ACEs had higher SAVRY risk scores (p < 0.001, two-tailed), with elevations specifically on the historical subscale (p < 0.001, two-tailed). Neither ACEs nor risk scores were associated with the frequency of risk behaviours. Nevertheless, participants exposed to four or more ACEs were secluded more frequently (p = 0.015, two-tailed), indicating a potential association between trauma and risk severity. Those with more complex developmental disorders experienced fewer ACEs (p = 0.02, two-tailed) and engaged in self-harm behaviours less frequently (p = 0.04, two-tailed). Research limitations/implications The inclusion of ACEs in risk assessment tools may lead to the inadvertent stigmatization of trauma-exposed individuals. Further investigation is necessary to offer clarity on the impact of early adversity on risk assessment accuracy and levels of institutional risk, and the role of developmental disorders in this relationship. Originality/value To the best of the authors’ knowledge, this study is the first to explore the relative associations between ACEs, risk assessment scores and observed institutional risk and does so in a highly marginalized population.

Are we good and are we safe? Measuring quality and assessing risk in an adult autism diagnostic service

2017 ◽  
Vol 3 (1) ◽  
pp. 15-26 ◽  
Author(s):  
Alison Jane Stansfield ◽  
Alwyn Kam ◽  
Tara Baddams ◽  
Bethany Woodrow ◽  
Emma Roberts ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Outcome Measures ◽  
Service User ◽  
Assessment Tools ◽  
Service Development ◽  
Content Type ◽  
Diagnostic Service ◽  
Wide Range ◽  
Risk Assessment Tools ◽  
Adult Autism

Purpose Leeds autism diagnostic service is an adult autism diagnostic service for people of any intellectual ability which also offers consultancy to service users/carers or professionals, as well as a wide range of autism training. The service was set up as a pilot in 2011 and a paper describing the service development was published in this journal in November 2015. The purpose of this paper is to describe the approach taken to measure the quality of the service the authors provide and accurately assess risk in adults with autism. Design/methodology/approach The process of evaluating appropriate outcome measures is described, along with considering appropriate risk assessment tools for use in the community. Over 200 people each year complete the autism diagnostic pathway, and 164 patients were invited to respond to service evaluation questionnaires in 2014. Findings To date, the most useful outcome measures for this group include a prospective service user questionnaire which enables service user opinion to influence service development. In the absence of any appropriate autism-specific risk assessment tools, the service has developed one which it is currently piloting. This has proved particularly useful in the consultancy setting Originality/value This paper is a follow-up paper looking at the day-to-day issues that the team have had to grapple with – how do you assess whether what you are doing is providing the best possible service for the people that you serve and how do you accurately assess risk in this population?

Risk assessment of online child abuse material (CAM) offenders: a review of existing tools

2018 ◽  
Vol 8 (2) ◽  
pp. 150-161 ◽  
Author(s):  
Catherine Garrington ◽  
Peter Chamberlain ◽  
Debra Rickwood ◽  
Douglas P. Boer
Keyword(s):  
Risk Assessment ◽  
Child Abuse ◽  
Sexual Offenders ◽  
Assessment Tools ◽  
Content Type ◽  
Dynamic Risk Factors ◽  
Risk Assessment Tools ◽  
Online Searches ◽  
Practical Implications ◽  
Child Abuse Material

Purpose The purpose of this paper is to summarise the available risk and assessment tools for child abuse material (CAM) offenders. Noting the rise of internet-based offences surrounding CAM, it has been proposed that there may be substantial differences between internet only (IO) offenders, contact only and mixed profile sexual offenders. Design/methodology/approach Through online searches, risk assessment tools for sexual offenders were identified. Scoring manuals were consulted for applicability to IO offenders. Findings Nine risk assessment tools for sexual offenders were included. Risk assessment tools for sexual offenders use cautionary language regarding the application of sexual offence risk assessment tools to IO offenders. An additional five tools were identified specifically addressing IO offenders. Three of these tools address risk assessment and two assess cognitions and behaviours. Research limitations/implications Limitations include the identification of static and dynamic risk factors and the application of structured professional judgement. Practical implications By drawing together existing tools and recommendations for use with the IO offender population, a gap is identified for CAM specific risk assessment tools. Originality/value Appropriate risk assessment, case planning and treatment will contribute to the appropriate management and treatment of the IO offender population.

scholarly journals An age-old issue: Evaluating the applicability of adult criminal risk assessment tools for use with youth offenders

2021 ◽  
Author(s):  
◽  
Anna Ferguson
Keyword(s):  
Risk Assessment ◽  
Cox Regression ◽  
Assessment Tools ◽  
Risk Scores ◽  
Initial Assessment ◽  
Youth Offenders ◽  
Dynamic Factors ◽  
Risk Assessment Tools ◽  
Dynamic Risk Assessment ◽  
Better Than

<p>Research has consistently recognized that youth and adults share risk factors for crime, although whether certain factors are of increased importance during adolescence is debated. The present research evaluated the extent to which two risk assessment tools could predict criminal and breach reconviction in a matched sample of youth (aged 17-19) and adult (aged 20-60) community- supervised offenders: The Dynamic Risk Assessment for Offender Re-entry (DRAOR) and the static Risk of re-Conviction X Risk of re-Imprisonment (RoC*RoI). Cox regression and AUC analyses revealed initial DRAOR scores had mixed predictive validity for both groups, while proximal risk scores showed comparably moderate to high accuracy for youth and adults. Protective scores were consistently poor predictors for adults. The proximal assessment predicted reconviction better than the initial assessment, and decreases in risk scores between assessments were associated with a reduction in the likelihood of reconviction, showing the value in monitoring risk and updating assessment. The RoC*RoI predicted criminal reconviction for adults but did not predict either reconviction outcome for youth. These findings support the use of the DRAOR for identifying which youth and adults are likely to reoffend, and suggest that dynamic factors might be more useful predictors than static for assessing and monitoring youth offenders.</p>

scholarly journals An age-old issue: Evaluating the applicability of adult criminal risk assessment tools for use with youth offenders

2021 ◽  
Author(s):  
◽  
Anna Ferguson
Keyword(s):  
Risk Assessment ◽  
Cox Regression ◽  
Assessment Tools ◽  
Risk Scores ◽  
Initial Assessment ◽  
Youth Offenders ◽  
Dynamic Factors ◽  
Risk Assessment Tools ◽  
Dynamic Risk Assessment ◽  
Better Than

<p>Research has consistently recognized that youth and adults share risk factors for crime, although whether certain factors are of increased importance during adolescence is debated. The present research evaluated the extent to which two risk assessment tools could predict criminal and breach reconviction in a matched sample of youth (aged 17-19) and adult (aged 20-60) community- supervised offenders: The Dynamic Risk Assessment for Offender Re-entry (DRAOR) and the static Risk of re-Conviction X Risk of re-Imprisonment (RoC*RoI). Cox regression and AUC analyses revealed initial DRAOR scores had mixed predictive validity for both groups, while proximal risk scores showed comparably moderate to high accuracy for youth and adults. Protective scores were consistently poor predictors for adults. The proximal assessment predicted reconviction better than the initial assessment, and decreases in risk scores between assessments were associated with a reduction in the likelihood of reconviction, showing the value in monitoring risk and updating assessment. The RoC*RoI predicted criminal reconviction for adults but did not predict either reconviction outcome for youth. These findings support the use of the DRAOR for identifying which youth and adults are likely to reoffend, and suggest that dynamic factors might be more useful predictors than static for assessing and monitoring youth offenders.</p>

scholarly journals Risk assessment tools in criminal justice and forensic psychiatry: The need for better data

2017 ◽  
Vol 42 ◽  
pp. 134-137 ◽  
Author(s):  
T. Douglas ◽  
J. Pugh ◽  
I. Singh ◽  
J. Savulescu ◽  
S. Fazel
Keyword(s):  
Risk Assessment ◽  
Criminal Justice ◽  
Forensic Psychiatry ◽  
Predictive Accuracy ◽  
Demographic Variables ◽  
Assessment Tools ◽  
Violence Risk ◽  
Violence Risk Assessment ◽  
Assessment Scores ◽  
Risk Assessment Tools

AbstractViolence risk assessment tools are increasingly used within criminal justice and forensic psychiatry, however there is little relevant, reliable and unbiased data regarding their predictive accuracy. We argue that such data are needed to (i) prevent excessive reliance on risk assessment scores, (ii) allow matching of different risk assessment tools to different contexts of application, (iii) protect against problematic forms of discrimination and stigmatisation, and (iv) ensure that contentious demographic variables are not prematurely removed from risk assessment tools.

scholarly journals Anticoagulation risk assessment for patients with non-valvular atrial fibrillation and venous thromboembolism: A clinical review

2019 ◽  
Vol 24 (2) ◽  
pp. 141-152
Author(s):  
Vincent A Pallazola ◽  
Rishi K Kapoor ◽  
Karan Kapoor ◽  
John W McEvoy ◽  
Roger S Blumenthal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Risk Assessment ◽  
Venous Thromboembolism ◽  
Anticoagulant Therapy ◽  
Bleeding Risk ◽  
Assessment Tools ◽  
Risk Scores ◽  
Increased Risk ◽  
Risk Assessment Tools

Non-valvular atrial fibrillation and venous thromboembolism anticoagulation risk assessment tools have been increasingly utilized to guide implementation and duration of anticoagulant therapy. Anticoagulation significantly reduces stroke and recurrent venous thromboembolism risk, but comes at the cost of increased risk of major and clinically relevant non-major bleeding. The decision for anticoagulation in high-risk patients is complicated by the fact that many risk factors associated with increased thromboembolic risk are simultaneously associated with increased bleeding risk. Traditional risk assessment tools rely heavily on age, sex, and presence of cardiovascular comorbidities, with newer tools additionally taking into account changes in risk factors over time and novel biomarkers to facilitate more personalized risk assessment. These tools may help counsel and inform patients about the risks and benefits of starting or continuing anticoagulant therapy and can identify patients who may benefit from more careful management. Although the ability to predict anticoagulant-associated hemorrhagic risk is modest, ischemic and bleeding risk scores have been shown to add significant value to therapeutic management decisions. Ultimately, further work is needed to optimally implement accurate and actionable risk stratification into clinical practice.

IMPACT ASSESSMENT ON STORM SURGE RISKS TO CONTAINERS CONSIDERING GLOBAL WARMING

2017 ◽  
Author(s):  
Rikito Hisamatsu ◽  
Rikito Hisamatsu ◽  
Kei Horie ◽  
Kei Horie
Keyword(s):  
Risk Assessment ◽  
Global Warming ◽  
Storm Surge ◽  
Storm Surges ◽  
Assessment Tools ◽  
Inundation Depth ◽  
Risk Assessment Tools ◽  
Risk Maps ◽  
The Impact ◽  
Vulnerability Functions

Container yards tend to be located along waterfronts that are exposed to high risk of storm surges. However, risk assessment tools such as vulnerability functions and risk maps for containers have not been sufficiently developed. In addition, damage due to storm surges is expected to increase owing to global warming. This paper aims to assess storm surge impact due to global warming for containers located at three major bays in Japan. First, we developed vulnerability functions for containers against storm surges using an engineering approach. Second, we simulated storm surges at three major bays using the SuWAT model and taking global warming into account. Finally, we developed storm surge risk maps for containers based on current and future situations using the vulnerability function and simulated inundation depth. As a result, we revealed the impact of global warming on storm surge risks for containers quantitatively.

scholarly journals The Benefits of Risk Assessment Tools for Prostate Cancer

2012 ◽  
Vol 61 (4) ◽  
pp. 662-663 ◽  
Author(s):  
Ian M. Thompson ◽  
Donna P. Ankerst
Keyword(s):  
Prostate Cancer ◽  
Risk Assessment ◽  
Assessment Tools ◽  
Risk Assessment Tools
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