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 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.

Violence risk instruments may be culturally unsafe for use with Indigenous patients

2016 ◽  
Vol 24 (6) ◽  
pp. 565-567 ◽  
Author(s):  
Stephane M Shepherd
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Forensic Assessment ◽  
Cross Cultural ◽  
Indigenous Australians ◽  
Violence Risk ◽  
Forensic Mental Health ◽  
Current Form ◽  
Health Decision Making ◽  
Health Decision

Objective: Violence risk assessment assumes a critical medico-legal role addressing offender/patient needs and informing forensic mental health decision making. Yet questions remain over the cross-cultural applicability of such measures. In their current form, violence risk instruments may not reflect the unique life and cultural experiences of Indigenous Australians rendering them culturally unsafe. Conclusions: To realize equitable forensic assessment, it is necessary to ascertain whether there are cultural differences across risk factors for violence and that risk instruments are validated as culturally appropriate. Greater cross-cultural rigour in forensic mental health risk assessment, research and practice is proposed.

scholarly journals Gender-Sensitive Violence Risk Assessment: Predictive Validity of Six Tools in Female Forensic Psychiatric Patients

2019 ◽  
Vol 46 (4) ◽  
pp. 528-549 ◽  
Author(s):  
Vivienne de Vogel ◽  
Mieke Bruggeman ◽  
Marike Lancel
Keyword(s):  
Risk Assessment ◽  
Risk Management ◽  
Predictive Validity ◽  
Predictive Accuracy ◽  
Psychiatric Patients ◽  
Violence Risk ◽  
Clinical Risk Management ◽  
Violence Risk Assessment ◽  
Forensic Psychiatric Patients ◽  
Forensic Psychiatric

Most violence risk assessment tools have been validated predominantly in males. In this multicenter study, the Historical, Clinical, Risk Management–20 (HCR-20), Historical, Clinical, Risk Management–20 Version 3 (HCR-20V3), Female Additional Manual (FAM), Short-Term Assessment of Risk and Treatability (START), Structured Assessment of Protective Factors for violence risk (SAPROF), and Psychopathy Checklist–Revised (PCL-R) were coded on file information of 78 female forensic psychiatric patients discharged between 1993 and 2012 with a mean follow-up period of 11.8 years from one of four Dutch forensic psychiatric hospitals. Notable was the high rate of mortality (17.9%) and readmission to psychiatric settings (11.5%) after discharge. Official reconviction data could be retrieved from the Ministry of Justice and Security for 71 women. Twenty-four women (33.8%) were reconvicted after discharge, including 13 for violent offenses (18.3%). Overall, predictive validity was moderate for all types of recidivism, but low for violence. The START Vulnerability scores, HCR-20V3, and FAM showed the highest predictive accuracy for all recidivism. With respect to violent recidivism, only the START Vulnerability scores and the Clinical scale of the HCR-20V3 demonstrated significant predictive accuracy.

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.

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.

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.

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