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Risk Assessment
Abstract
In conclusion, we have attempted to illustrate how the area of risk assessment has made significant advances in the last 15
years. As the field moved from an emphasis on the prediction of violence and identification of “dangerous” persons to a risk
assessment model, application of new research approaches led to optimism that improvements in evaluation of violence potential
were possible. A substantial re-invigoration of research and clinical interest in the topic has ensued, which has resulted
in much productive research determining the evidence for many risk factors for violence, as well as innovative ways to utilize
that information to improve the risk assessment process. Our hope in making recommendations for the future is that the findings
of the science of violence risk assessment can facilitate evidenced-based practice in this area, and that the science may
be advanced through incorporation of theoretical perspectives to help understand as well as predict violence. Optimally, future
work in this area will improve not only the quality of the risk assessment enterprise, but will do so in a way that will facilitate
improved management of that risk.
... For the offender sample, one could argue that it would have been better to use more direct measures of aggression such as official records of re-arrest and reconviction. However, in criminological research, self-reports as a measure of criminal or aggressive behaviour are quite common and may be even preferred over official records (e.g., see McNiel et al., 2002). That is, official records are thought to be under-representing the actual criminal behaviour. ...
... Echter, zoals al eerder gesteld, de AVL is in verschillende onderzoeken gerelateerd aan meer directe maten van agressief gedrag (zie bijvoorbeeld Bushman, 1995;Buss & Perry, 1992;Smith & Waterman, 2004b), wat illustreert dat de AVL een goede convergente validiteit heeft en een robuuste maat van agressie is. Bovendien zijn zelfrapportagevragenlijsten in criminologisch onderzoek als maat van crimineel gedrag of agressie vrij gebruikelijk en deze onderzoeksmethode wordt soms zelfs geprefereerd boven het gebruik van officiële rapportages (zie bijvoorbeeld McNiel et al., 2002). Dat wil zeggen, bij officiële rapportages van crimineel of gewelddadig gedrag of cijfers van recidive of nieuwe arrestaties (meer directe maten van agressie) komt niet al het agressieve gedrag aan het licht. ...
Het hebben van agressieve fantasieën is zo gek nog niet. Marleen Nagtegaal onderzocht vrouwelijke en mannelijke studenten, mannelijke leden van een schietsportvereniging, mannelijke gedetineerden en deelnemers aan controlegroepen. Iedereen heeft agressieve fantasieën. Of ze ook omslaan in agressief gedrag, hangt af van wat er met de gedachten wordt gedaan: worden ze onderdrukt of wordt er bijvoorbeeld over gepraat? Nagtegaal promoveert vrijdag 29 februari 2008 aan de Erasmus Universiteit Rotterdam.
Het hebben van agressieve fantasieën an sich doet er niet zo toe, aldus Marleen Nagtegaal. Het komt immers bij iedereen voor. Het is belangrijker wat je vervolgens doet met deze gedachten. Als je afleiding zoekt voor het hebben van agressieve fantasieën of als je hierover praat, heb je minder kans agressief gedrag te vertonen. Probeer je de gedachten te onderdrukken, bestraf je jezelf of ga je over zo’n gedachte piekeren, dan is de kans groter dat je agressief gedrag gaat vertonen.
This chapter addresses the interrelated dynamics among mental health, public safety, media attention, and community sentiment, and specifically, the law’s response to (and at times impact on) this interplay of issues. For purposes of this discussion, law itself is seen as an intervention that has consequences on behaviors, attitudes, perceptions, and outcomes-positive or less so, intended or not. To ground discussion of law’s role within this context, case examples drawing on recent episodes of campus-based or campus-connected "mass killings" are featured, and reference is made to related developments in the law. Current legal mechanisms for addressing (often) community-fueled requests for action are juxtaposed with a potential alternative framing mechanism-therapeutic jurisprudence. The chapter concludes that teasing out the therapeutic and anti-therapeutic drivers and consequences of our legal mechanisms offers a more effective response to campus safety concerns and community emotions and is consistent with an evidence-based approach.
Although the evolution of psychopathy as a formal clinical disorder began more than a century ago, it is only recently that scientifically sound psychometric procedures for its assessment have become available. The result has been a sharp increase in theoretically meaningful and replicable research findings, both in applied settings and in the laboratory. The construct of psychopathy is proving to be particularly useful in the criminal justice system, where it has important implications for sentencing, diversion, placement, and treatment options and for the assessment of risk for recidivism and violence. Although the etiology of the predatory, cold-blooded nature of psychopathy remains obscure, the theories and methods of cognitive neuroscience and behavioral genetics promise to greatly increase our understanding of this disorder.
Developed a screening checklist for assessing the risk of violence at the time of psychiatric hospitalization. Checklist items and a cutoff point for low vs high risk of violence were selected based on a previous study of statistical prediction of violence. Application of the checklist to a new sample of 338 adult patients admitted to a university-based inpatient unit revealed promising results in identifying patients who later displayed aggressive behavior in the hospital, as indicated by its positive predictive value (59.0%), negative predictive value (70.6%), sensitivity (57.2%), specificity (70.0%), total predictive value (65.4%), and likelihood ratio (1.97). Results suggest the potential value of incorporating actuarial methods in the evaluation of violence risk. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
Examines whether and how psychologists can improve law and enhance the quality of its justice. A taxonomy of relationships between the 2 disciplines is presented that characterizes law and psychology research in terms of the potential for legal change. The use of psychology to effect legal change requires a bringing together of both psychological and legal paradigms. Important differences exist between the styles and methods of reasoning, proof, and justification in psychology and law. The implications of those differences for the use of psychological data in legal change efforts are developed, as are other aspects of "legalism" that may hinder or impede the effectiveness of psychologically oriented law reform. Limitations of a "factual jurisprudence" that derive from the nature of psychological data are examined. (5½ p ref) (PsycINFO Database Record (c) 2014 APA, all rights reserved)
Multivariate techniques were used to derive and validate an actuarial instrument for the prediction of violent postrelease offenses by mentally disordered offenders. The 618 subjects were a heterogeneous group of men who had been charged with serious offenses. Approximately half had been treated in a maximum security psychiatric institution and the rest had been briefly assessed prior to imprisonment. The actuarial instrument consisted of 12 variables and significantly predicted violent outcome in each of five subgroups. The instrument's practical application and its use in clinical appraisals of dangerousness are discussed.
This article describes a revised Conflict Tactics Scales (the CTS2) to measure psychological and physical attacks on a partner in a marital, cohabiting, or dating relationship; and also use of negotiation. The CTS2 has (a) additional items to enhance content validity and reliability; (b) revised wording to increase clarity and specificity; (c) better differentiation between minor and severe levels of each scale; (d) new scales to measure sexual coercion and physical injury; and (e) a new format to simplify administration and reduce response sets. Reliability ranges from .79 to .95. There is preliminary evidence of construct validity.
[This book] takes what is generally known about the prediction of violent behaviour and resolves it into a form for use by clinicians, administrators, and researchers. The main data on which the monograph is based came from criminal offenders and mentally disordered men with past violent conduct. . . . It is expected that the book may be of help to persons working in courts, mental health and criminal review boards, parole boards, and the like. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
A statistical scale to assess the probability of violence in released mental patients was developed and cross-validated. A calibration sample of 251 adult males admitted as inpatients to a community mental health center and considered potentially violent was obtained. Data collected at admission (including demographics, family background, criminal justice and mental health system contacts, past violent behavior, and current situational measures) were used to predict subsequent violent arrests or readmissions during a 1-year follow-up period with multiple regression. A statistical equation of 5 variables was derived and applied to a cross-validation sample of 265 male patients. The correlation between the scores and subsequent violence in this sample was .32. Classification using a cutoff point obtained from the calibration sample yielded 75.8% correctly classified and a false positive rate of 47.6%. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The Screening Version of the Psychopathy Checklist—Revised (PCL:SV; S. D. Hart, D. N. Cox, & R. D. Hare, 1995) was developed to complement the Psychopathy Checklist—Revised (PCL-R; R. D. Hare. 1991), and for use outside forensic settings. The PCL:SV takes less time to administer and requires less collateral information than the PCL-R. An item response theory approach was adopted to determine similarities in the structural properties of the 2 instruments and whether the PCL:SV could be regarded as a short form of the PCL-R. Eight of the 12 items in the PCL:SV were strongly parallel to their equivalent PCL-R items. Of the 4 items PCL:SV items which differed from their equivalent PCL-R items, all 4 were found to be equal or superior to their equivalent PCL-R item in terms of discrimination. The analyses confirmed previous results that the interpersonal and affective features of psychopathy have higher thresholds than do the impulsive and antisocial behavioral features; individuals have to be at a higher level of the psychopathic trait before the interpersonal and affective features become evident. The PCL:SV is an effective short form of the PCL-R. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Meteorology is often thought of as a field with highly developed techniques for forecasting rare and severe events. Risk assessment of another type of rare and severe event—violence to others—occurs in mental health law. The analogy between these 2 forms of risk assessment is explored in this article. How meteorologists go about assessing the risk of harmful weather is described. Implications from the meteorological analogy are drawn for 1 aspect of violence prediction that is routinely ignored in mental health law: the communication of risk "forecasts." (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The law is hampered in using social science research by the obsolete notion that research used to change a legal rule is "legislative fact" and research in which only the parties to a case have an interest is "adjudicative fact." In important ways, however, social research is more akin to law itself than to "fact." We suggest a paradigm in which law-changing research is "social authority," case-specific research is "social fact," and a newer hybrid combination of these two is "social framework." In each of these areas, we propose that judges treat aspects of empirical studies much as they treat legal precedents under the common law. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Structured Professional Judgement Guidelines for assessing and managing violence risk
"The Criminally Insane" is the largest scale in-depth follow-up study on mentally ill criminals yet to appear. This book challenges the assumption that inmates of maximum-security mental hospitals are extraordinarily violent and questions the necessity for maintaining maximum-security institutions which currently house some 15,000 persons in the United States. In 1971, 586 patients were released from a Pennsylvania maximum-security hospital for the criminally insane. They were not considered officially "cured," but a federal court held that their commitments had been unconstitutional. Through exhaustive examination of hospital and police records and interviews with hospital administrators and the subjects themselves, Thornberry and Jacoby assess the processes by which the patients had been retained in confinement, the impact of their release upon their communities, and their ability to adjust to the freedom of community life. The authors demonstrate that the patients did not display a significant level of violent behavior during confinement, nor did they pose a major threat to society after release. In fact, their social and psychological adjustment to community life is shown to have been comparable to that of non-criminal mental patients. Yet despite these findings the subjects had been retained in maximum-security confinement for an average of fourteen years because they were predicted to be violent and "dangerous" to society. The authors explain this inaccuracy by a process called "political prediction," in which clinicians avoid any potential risks to the community, the reputation of their hospitals, and their careers by consistently overpredicting dangerous behavior. "The Criminally Insane" will stimulate response from professionals in a wide variety of fields, including law, criminology, psychiatry, and sociology, and from anyone concerned with society's responsibility to the mentally ill offender.
Presents guidelines for ethical conduct to aid forensic psychologists when assisting courts, parties to legal proceedings, correctional and forensic mental health facilities, and legislative agencies. Among the issues that the guidelines touch on are professional responsibility, competence, relationships, confidentiality, and procedures.
This article focuses on a history of ideas-the history of the last quarter century, in which great advances have occurred in the reshaping of the concept of dangerousness while, at the same time, disappointingly little has happened to improve the abilities of frontline clinical decision-makers to make violence risk assessments. We are now operating in a fundamentally changed environment in the three core areas of research, clinical practice, and law as a result of evolving thinking and new data, shown in the following ways. (I) Risk assessment concepts and associated research models have altered the focus to probabilistic thinking and ideas of graduated interventions as opposed to the Yes-No, In-Out dichotomies formerly associated with the concept of dangerousness. (2) Likewise, it has become dear that dangerousness is a legal and not a medical concept, in which the actual clinical corollary is risk of future violent behavior. (3) The accuracy of psychiatric assessments of future violent behavior is limited, but it may increase for specific subgroups within specified time frames and locations.
'...essential reading for those confronted with the ethical and professional dilemmas involved in predicting violent behavior. Lawyers are destined to become familiar with Monahan's book, and mental health professionals will surely want to keep a step ahead.' -- Contemporary Psychology, Vol 27 No 2 '...In summary, Monahan's book is a very readable and succinct one. Often the reader finds himself saying "...well of course, what could be more obvious?" only to reflect for a minute and realize that many clinicians do not give many obvious relevant factors adequate weight in their assessments of dangerousness. Monahan's text is a very positive one which as he puts it, outlines for the clinician: "How to do it (predict violent behavior) and when to do it". Violent behavior must be viewed as the product of a dynamic interaction between an individual and situational/environmental variables.' -- Canadian Journal of Criminology, Vol 24 No 3, July 1982 'Monahan's is an important and well-documented book that deserves to be read by all concerned with the practice and politics of predicting violent behavior.' -- Contemporary Sociology, Vol 12 No 2, March 1983 'Monahan has taken a positive approach to a difficult area. He has delineated what can be done, and how, rather than wringing his hands about the problem.' -- Journal of Security Administration, Vol.9,No. 2, December 1986@Q
Background:
Owing to the fact that Finnish police have been able to solve about 95% of all homicides during recent decades and because most homicide offenders are subjected to an intensive psychiatric evaluation, it was possible to examine data on 693 of 994 homicide offenders during an 8-year period.Methods:
The prevalences of mental disorders of the homicide offenders were used to calculate odds ratios (ORs) for the statistical increase in risk associated with specific mental disorders.Results:
The results indicate that schizophrenia increases the OR of homicidal violence by about 8-fold in men and 6.5-fold in women. Antisocial personality disorder increases the OR over 10-fold in men and over 50-fold in women. Affective disorders, anxiety disorders, dysthymia, and mental retardation did not elevate the OR to any significant extent (OR <5.0).Conclusion:
Homicidal behavior in a country with a relatively low crime rate appears to have a statistical association with some specific mental disorders classified according to DSM-III-R classifications.
Studies conducted over the past three decades have consistently reported an association between mental illness and violence. We propose a sociologically inspired explanation for this association by referring to the Thomas Theorem--if situations are defined as real, they are real in their consequences. We identify a small subset of psychotic symptoms, termed "threat/ control-override" symptoms, that tend to induce violence because they influence the definitions of situations. Our data come from an epidemiological study conducted in Israel that includes a psychiatrist- administered diagnostic interview. We find an association between violent behaviors and psychiatric diagnosis that cannot be accounted for by sociodemographic variables. Threat/control-override symptoms also are strongly related to violent behaviors and explain a substantial part of the association between violence and psychiatric diagnoses. Other equally severe psychotic symptoms are not related to indicators of violence when threat/control-override symptoms are controlled. These findings support our explanation for the association between mental illness and violence, and challenge the stereotype that most people with mental illnesses are dangerous.
Psychologists, psychiatrists and other mental health professionals are frequently involved as expert witnesses in legal proceedings. However, clinical judgment and decision making, which play a role in almost all clinical evaluations, have problems and limitations. Mental health professionals who conduct forensic examinations should be aware of these problems and take steps to address them. This article details the limitations of clinical judgment and decision making, and suggests ways to minimize associated problems, thereby improving the validity and utility of forensic evaluations.
An inmate who has spent the last five years incarcerated for aggravated sexual assault comes before a parole board asking
to be considered for release. A person suffering from schizophrenia murdered his parents and was found not guilty by reason
of insanity and now, some years later, stands before a release review board. A 14-year-old girl allegedly has attacked a classmate
with a knife and a prosecutor now petitions to raise her to adult court. A police officer escorts a young man acting in a
threatening manner to a psychiatric emergency service. In each of these instances an important decision must be made that
pits the right of the individual not to be arbitrarily detained or punished against the rights of members of society to be
safe from potentially violent persons.
The abstract for this document is available on CSA Illumina.To view the Abstract, click the Abstract button above the document title.
The analytic framework of epidemiology can be used to study the relation between crime and mental disorder, distinguishing between the true rates of crime and mental disorder, that is, the rates at which crime and mental disorder actually occur, and their treated rates, that is, the rates at which the criminal justice and mental health systems respond to them. The conclusion that emerges is that rates of true and treated criminal behavior vary independently of rates of true and treated mental disorder when appropriate controls are made for such demographic factors as age, gender, and social class and for such life history factors as prior experience in the mental health and criminal justice systems. When these controls are not applied, rates of true and treated mental disorder are higher among criminals than among the general population, and rates of true and treated crime are higher among the mentally disordered than among the general population. When these controls are applied, the observed relations te...
Although advocates for the mentally ill assert that mental patients are inappropriately stigmatized as dangerous, research indicates that former mental patients have higher arrest rates than the general public. Because of the limitations of arrest-rate studies, however, alternative hypotheses have suggested that the apparent dangerousness of mental patients is a methodological artifact. We compare mental patients and never-treated community residents on several official and self-reported measures of violent/illegal conduct. Mental patients have higher rates on all measures of violent/illegal behavior, and these differences cannot be accounted for by sociodemographic and community context variables. A scale of psychotic symptoms is the only variable that accounts for differences in levels of violent/illegal behavior between patients and never-treated community residents. Although mental patients have elevated rates of violent/illegal behavior compared to nonpatients, the differences are modest and are confined to those experiencing psychotic symptoms.
Dangerousness in criminal offenders can be reliably diagnosed and effectively treated with a recidivism rate of 6.1 per cent. We define dangerousness as a potential for inflicting serious bodily harm on another.
This is a report of a ten-year study involving 592 male convict ed offenders. Most of the crimes that brought these offenders to our notice were sex offenses. Several were compounded by ex treme violence including murder, manslaughier, assault with intent to kill, and assault with a dangerous weapon. The staff's initial diagnosis indicated that 304 of these persons were not dangerous, and they were released into the community after completing their sentences. Twenty-six (8.6 per cent) subse quently committed serious assaultive (dangerous) crimes.
The courts concurred in our diagnosis of dangerous in 226 cases and committed these offenders to our special "treatment" facility for an indeterminate period of one day to life. Following treatment for an average period of forty-three months, eighty- two patients were discharged on recommendation of the clinical staff. Of these, five (6.1 per cent) subsequently committed serious assaultive crimes, including one murder.
Forty-nine of the originally committed patients were released by court order against the advice of the clinical staff. Of these, seventeen (34.7 per cent) subsequently committed serious assaul tive crimes, including two murders.
Criteria of dangerousness and guidelines for its prediction were elaborated. No tests or psychiatric examinations can depend ably predict a probability of dangerous behavior in the absence of an actual history of a seriously violent assault on another person. The potential for dangerous behavior is relative and covers a wide spectrum, from the mildly dangerous to the ex tremely dangerous. We postulate that those elements of the personality which cause dangerous behavior are common to all classes of assaultive behavior and that there is no basic difference between the man who kills to rape and the one who kills to rob. Treatment is primarily psychiatric. We consider claims for the efficacy of pharmacological and physiological measures to be unproven and even specious. Treatment involves individualiza tion and socialization: the identification and dissipation of an tisocial predatory elements of the personality and the mobiliza tion and reinforcement of socially conformative elements of the personality.
Although the evolution of psychopathy as a formal clinical disorder began more than a century ago, it is only recently that scientifically sound psychometric procedures for its assessment have become available. The result has been a sharp increase in theoretically meaningful and replicable research findings, both in applied settings and in the laboratory. The construct of psychopathy is proving to be particularly useful in the criminal justice system, where it has important implications for sentencing, diversion, placement, and treatment options and for the assessment of risk for recidivism and violence. Although the etiology of the predatory, cold-blooded nature of psychopathy remains obscure, the theories and methods of cognitive neuroscience and behavioral genetics promise to greatly increase our understanding of this disorder.
Discusses issues in laws regarding community notification of the presence of sex offenders released following incarceration. Three major problems that must be addressed are described. A number of recommendations are made that will serve to better protect the community from potentially dangerous sex offenders. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Presents the American Psychological Association's Ethics Code. The document consists of an introduction, a preamble, 6 general principles, and specific standards and rules for conduct by psychologists. Topics covered by the standards include (1) General Standards, (2) Evaluation, Assessment or Intervention, (3) Advertising and Other Public Statements, (4) Therapy, (5) Privacy and Confidentiality, (6) Teaching, Training Supervision, Research, and Publishing, (7) Forensic Activities, and (8) Resolving Ethical Issues. (0 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This chapter addresses, primarily, assessments of dangerousness concerning mentally disordered individuals possibly at risk for violence in the community. The authors first review the most prominent research published through 1997 regarding such assessments. They then survey some recent developments in the law that bear upon determining when individuals may legally be deprived of their liberty based upon assessments of dangerousness. Finally, they consider some of the factors and procedures that leading forensic clinicians, and their own experience, suggest should be a part of proper and comprehensive clinical assessments of dangerousness. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The primary focus of this book is on criminal violence of both mentally disordered and criminal inmates, whose histories of criminal violence raise serious societal concerns about the commission of future acts of violence. It is difficult for legal experts, psychologists, and policy makers to make decisions that strike the proper balance between an offender's civil liberties and community safety. Such a balance requires an accurate assessment of the likelihood that an individual offender will commit a new violent or sexual offense. On the basis of their research on mentally disordered offenders, sex offenders, fire setters, and psychopathic offenders, the authors have devised an actuarial assessment instrument, the Violence Risk Appraisal Guide. The authors argue that risk management can be improved by combining what is already known about predicting violence, clinical decision making, and program evaluation. They conclude that the results of their applied research have implications for our understanding of the etiology of violent criminal behavior. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Introduction. Human aggression and criminal violence: definitions and classifications. Aggression among animals. Neurotransmitters, hormones, and genes. Neurological, neuropsychological, and brain imaging correlates of violent behavior. Congenital and demographic factors. Developmental antecedents of violent behavior. Personality disorders and impulse control. Violence and psychoactive substance abuse. Violent behavior of persons with mental disorders outside of hospitals. Violent behavior of psychiatric inpatients. Biological treatments of violence. Summary and conclusions. Appendix: Statistical explanation of the actuarial method: Bayes decision. Index.