The present study featured an investigation of the predictive properties of risk and change scores of two violence risk assessment and treatment planning tools—the Violence Risk Scale (VRS) and the Historical, Clinical, Risk–20, Version 2 (HCR-20)—in sample of 178 treated adult male violent offenders who attended a high-intensity violence reduction program. The cases were rated on the VRS and HCR-20 using archival information sources and followed up nearly 10 years postrelease. Associations of HCR-20 and VRS risk and change scores with postprogram institutional and community recidivism were examined. VRS and HCR-20 scores converged in conceptually meaningful ways, supporting the construct validity of the tools for violence risk. Receiver operating characteristic curve analyses demonstrated moderate- to high-predictive accuracy of VRS and HCR-20 scores for violent and general community recidivism, but weaker accuracy for postprogram institutional recidivism. Cox regression survival analyses demonstrated that positive pretreatment and posttreatment changes, as assessed via the HCR-20 and VRS, were each significantly associated with reductions in violent and general community recidivism, as well as serious institutional misconducts, after controlling for baseline pretreatment score. Implications for use of the HCR-20 and VRS for dynamic violence risk assessment and management are discussed.
Care in the field: adult anaphylaxis for paramedics
