scholarly journals A Static-99R Validation Study on Individuals With Mental Disorders: 5 to 20 Years of Fixed Follow-Up After Sexual Offenses

2021 ◽  
Vol 12 ◽  
Author(s):  
Christian Baudin ◽  
Thomas Nilsson ◽  
Joakim Sturup ◽  
Märta Wallinius ◽  
Peter Andiné

‘The Static-99R is one of the most commonly used risk assessment instruments for individuals convicted of sexual offenses. It has been validated for use on many populations, but few studies specifically target and describe individuals with mental disorders. Additionally, research on the discriminative properties (how well the instrument separates recidivists from non-recidivists) of the instrument over longer follow-up periods is scarce. This article evaluated the validity of the Static-99R using a cohort of individuals with mental disorders convicted of sexual offenses in Sweden (N = 146) with fixed 5-year (n = 100), 10-year (n = 91), 15-year (n = 79), and 20-year (n = 36) follow-up periods. A Static-99R cut score of 6 demonstrated the highest Youden index, maximizing sensitivity (72.7%) and specificity (74.2%), with 25.8% of recidivists correctly assumed to reoffend sexually and 95.7% of non-recidivists correctly assumed not to. The Static-99R instrument demonstrated adequate discrimination (AUC = 0.79, CI 95% = 0.70–0.87, and OR = 1.45, CI 95% = 1.14–1.84, p < 0.001, 5-year fixed follow-up), with only marginal differences for 10-, 15-, and 20-year fixed follow-up (AUC = 0.73, 0.74, and 0.74 and OR = 1.31, 1.36, and 1.40, respectively). Calibration (quantifying risk and correspondence with the instrument’s norms) was acceptable (Brier = 0.088, P/E = 0.70, E/O = 1.43), with the routine sample norms displaying a decisively better fit to the study cohort compared to the high-risk/high-need sample norms. The results affirm the recommendation that, when in doubt and where there is no recent local norm group large enough available, the Static-99R routine sample found in the evaluators’ workbook should be used.

Sexual Abuse ◽  
2019 ◽  
Vol 32 (2) ◽  
pp. 203-219
Author(s):  
Leonel C. Gonçalves ◽  
Juliane Gerth ◽  
Astrid Rossegger ◽  
Thomas Noll ◽  
Jérôme Endrass

This study evaluated the validity of the Static-99 and Static-99R in assessing sexual recidivism in Switzerland, based on a sample of 142 male sex offenders. Both tools showed predictive validity, but the Static-99R had better discrimination (OR = 1.82, AUC = .81) and calibration (Brier = .078, P/E = 0.96) than the Static-99. A cut score of four on the Static-99R maximized sensitivity (92.9%) and specificity (60.2%). However, although most offenders (98.7%) with a score < 4 did not commit sexual offenses in the 5-year follow-up period, only one in five (20.3%) offenders with a score ≥ 4 actually recidivated. Furthermore, the predicted number of recidivists in the well above average risk category (Static-99R ≥ 6) was 24% higher than expected in routine samples. The results suggest that the Static-99R may be a useful screening tool to identify low-risk individuals but offenders with scores ≥ 4 should be subjected to a more thorough assessment.


Sexual Abuse ◽  
2019 ◽  
pp. 107906321988457
Author(s):  
I Ting Tsao ◽  
Chi Meng Chu

The predictive validity of risk assessment instruments for persons who have committed sexual offenses has improved tremendously in the last four decades, but the progress has been limited to Western offender populations. The aim of this study was to examine the predictive validity of Static-99R, Stable-2007, Sexual Violence Risk-20, Version 2 (SVR-20 v2), Psychopathy Checklist—Revised (PCL-R), and Level of Service/Case Management Inventory (LS/CMI) in predicting recidivism of persons convicted on sexual offenses in Singapore. Retrospective data of 134 such persons were used to code the various instruments. Receiver operating characteristic analyses revealed that combined Static-99R/Stable-2007 new standardized risk ratings, SVR-20 v2 total scores and risk ratings, PCL-R total scores, as well as LS/CMI total scores and risk ratings predicted sexual recidivism. All the aforementioned instruments’ total scores and risk ratings (if applicable) predicted any recidivism. However, risk profiles of this sample differed significantly from the normative Western samples.


2018 ◽  
Vol 5 (2) ◽  
pp. 103-118 ◽  
Author(s):  
Jacomina Gerbrandij ◽  
Barry Rosenfeld ◽  
Alicia Nijdam-Jones ◽  
Michele Galietta

2019 ◽  
Vol 131 (6) ◽  
pp. 1920-1925
Author(s):  
Daniel A. Tonetti ◽  
William J. Ares ◽  
David O. Okonkwo ◽  
Paul A. Gardner

OBJECTIVELarge interhemispheric subdural hematomas (iSDHs) causing falx syndrome are rare; therefore, a paucity of data exists regarding the outcomes of contemporary management of iSDH. There is a general consensus among neurosurgeons that large iSDHs with neurological deficits represent a particular treatment challenge with generally poor outcomes. Thus, radiological and clinical outcomes of surgical and nonsurgical management for iSDH bear further study, which is the aim of this report.METHODSA prospectively collected, single-institution trauma database was searched for patients with isolated traumatic iSDH causing falx syndrome in the period from January 2008 to January 2018. Information on demographic and radiological characteristics, serial neurological examinations, clinical and radiological outcomes, and posttreatment complications was collected and tallied. The authors subsequently dichotomized patients by management strategy to evaluate clinical outcome and 30-day survival.RESULTSTwenty-five patients (0.4% of those with intracranial injuries, 0.05% of those with trauma) with iSDH and falx syndrome represented the study cohort. The average age was 73.4 years, and most patients (23 [92%] of 25) were taking anticoagulants or antiplatelet medications. Six patients were managed nonoperatively, and 19 patients underwent craniotomy for iSDH evacuation; of the latter patients, 17 (89.5%) had improvement in or resolution of motor deficits postoperatively. There were no instances of venous infarction, reaccumulation, or infection after evacuation. In total, 9 (36%) of the 25 patients died within 30 days, including 6 (32%) of the 19 who had undergone craniotomy and 3 (50%) of the 6 who had been managed nonoperatively. Patients who died within 30 days were significantly more likely to experience in-hospital neurological deterioration prior to surgery (83% vs 15%, p = 0.0095) and to be comatose prior to surgery (100% vs 23%, p = 0.0031). The median modified Rankin Scale score of surgical patients who survived hospitalization (13 patients) was 1 at a mean follow-up of 22.1 months.CONCLUSIONSiSDHs associated with falx syndrome can be evacuated safely and effectively, and prompt surgical evacuation prior to neurological deterioration can improve outcomes. In this study, craniotomy for iSDH evacuation proved to be a low-risk strategy that was associated with generally good outcomes, though appropriately selected patients may fare well without evacuation.


2019 ◽  
Vol 65 (3) ◽  
pp. 441-446
Author(s):  
Valentina Rybkina ◽  
Tamara Azizova ◽  
Yevgeniya Grigoreva

Purpose of the study. The study is aimed to investigate skin melanoma incidence in workers occupationally exposed to radiation over a prolonged period. Materials and methods. Skin melanoma incidence was studied in a cohort of workers first employed at nuclear facility Mayak Production Association (PA) between 1948 and 1982 who had been followed up till 31.12.2013 (22,377 individuals). Mean cumulative doses from external gamma-rays over the whole follow-up period were 0.54±0.001 Sv in males and 0.44±0.002 Sv in females. Incident rates for skin melanoma were analyzed by sex, attained age, calendar period of diagnostics and radiation dose using worldwide standard and the direct standardization technique. Results. 60 skin melanoma cases (37 in males and 23 in females) were registered in the study cohort over the whole follow-up period. The standardized skin melanoma incident rate was 8.51±1.46 in males and 8.78±2.27 in females per 100000 workers revealing statistically higher rates compared to corresponding rates for general populations of the Russian Federation, Urals Federal District and Chelyabinsk region. Skin melanoma incidence was significantly increased in the period of 1994 - 2013 as compared to the period of 1974 - 1993. Skin melanoma incidence excess in females was greater than that for males. Skin melanoma incidence increment in females was mostly driven by modifications of disease occurrence risk while in males it was driven by a combined effect of age pattern modifications in the study cohort and increase of disease risk. Conclusions. Skin melanoma incidence rates in the cohort of workers occupationally exposed to ionizing radiation over a prolonged period were associated with sex and attained age workers and the calendar period of diagnostics. No significant association of skin melanoma incidence with dose from external gamma-rays was observed. A significantly increasing trend was observed for skin melanoma incidence by the end of the follow-up in both males and females.


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